Elirium of Skin Infestation: Epidemiological and Clinical Profile of 73 Patients

Abstract

Background This was a descriptive and prospective study that focused on 73 cases of delirium of skin infestation (DSI) from January 1st to December 31st, 2018, in the dermatology department of the Bamako Dermatology Hospital (HDB). Aim The aim of this work was to describe the epidemiological and clinical profile of delusions of infestation (Ekbom syndrome), to deepen our knowledge of the disease in order to improve its overall management. Methods We carried out a descriptive cross-sectional study of cases of identity document (ID) seen in dermatological consultation in the HDB dermatology department between January 1st and December 31st, 2018. Now, this department is the largest dermatological reference center in the country. In our study, we have included any patient with delirium of parasitic infestation (defined as an unshakeable conviction that small vermin, insects, lice, maggots, proliferate in the skin and sometimes in the body without biological proof). Results Delirium of skin infestation constituted 0.3% of consultations in the service. The average age was 52-years with extremes ranging from 12 to 85-years. They were 45 female (62%) and 28 male (45%). The age group (25-64) was the most represented. Out-ofschool patients represented 65% of the sample. Among them, 6 cases (8%) were known in psychiatry. The agents incriminated by the patients were mainly ants, earthworms and cicadas. The specimen sign was found in 89% of cases. Insomnia was the most frequent associated sign, at 75%. The types of lesion complications observed in our patients were mainly lichenification, ulceration and excoriation. Seventy-two percent (72%) of patients have refused referral to the mental health service. The profile of Ekbom syndrome was the one of the adult women, described in the previous work. Conclusion Delirium of skin infestation is generally considered as rare disease, increasingly observed during our dermatology consultations. Its frequency is probably underestimated.