Monosymptomatic hypochondriacal syndromes in dermatology.

Monosymptomatic hypochondriasis (MH) is a term applied to the manifestation of a single prominent belief that one is diseased in some particular way despite evidence to the contrary. Although MH may assume a variety of clinical forms, three consistently described syndromes are found in the literature: (1) delusions of parasitosis (the belief that one is infested with vermin), (2) delusions of dysmorphosis (the belief that one is physically misshapen and unattractive), and (3) delusions of bromosis (the belief that one emits an offensive body odor). These syndromes may be the clinical expression of a number of underlying pathologic conditions, including psychiatric disorders, structural brain disease, metabolic and endocrine disease, and toxic states. Treatment of MH is based on the biopsychosocial evaluation of the patient and on addressing the multiple etiologic factors often found in these patients.