Lee Chai Sue
Department of Dermatology, University of California Davis School of Medicine, and Sacramento VA Medical Center, Sacramento, California 95816, USA.
Dermatol Ther. 2008 Jan-Feb;21(1):2-7. doi: 10.1111/j.1529-8019.2008.00163.x.
Delusions of parasitosis is a rare psychiatric disorder in which the patient has a fixed, false belief that he or she is infested by parasites. Even though it is a psychiatric disorder, these patients usually present to a dermatologist because they are convinced that they have a dermatologic problem. Patients with delusions of parasitosis generally reject psychiatric referral. The traditional treatment of choice for delusions of parasitosis is the antipsychotic medication pimozide (Orap, Gate Pharmaceuticals, Philadelphia, PA). The use of pimozide has been limited by its adverse effects, most notably extrapyramidal adverse effects. There is now an emerging role for atypical antipsychotics with a safer adverse effect profile in the treatment of delusions of parasitosis. However, the most challenging aspect of managing these patients may be the challenge of establishing rapport in the face of unshakable delusional ideation.
寄生虫妄想症是一种罕见的精神疾病，患者坚信自己被寄生虫感染，这种信念顽固且错误。尽管它属于精神疾病，但这些患者通常会去看皮肤科医生，因为他们坚信自己患有皮肤病。患有寄生虫妄想症的患者一般拒绝转诊至精神科。寄生虫妄想症传统的首选治疗药物是抗精神病药匹莫齐特（奥rap，盖特制药公司，宾夕法尼亚州费城）。匹莫齐特的使用因不良反应而受到限制，最显著的是锥体外系不良反应。目前，具有更安全不良反应谱的非典型抗精神病药在治疗寄生虫妄想症方面正发挥着越来越重要的作用。然而，管理这些患者最具挑战性的方面可能是在面对坚不可摧的妄想观念时建立融洽关系的挑战。
