Ekbom's syndrome or delusional parasitosis (DP), is an “uncommon psychiatric syndrome” characterized by the presence of delusion of infestation.

The syndrome may be seen in association wiht a number of neuropsychiatric conditions, including bipolar disorder, paranoia,schizophrenia, dementia, depression as well as abuse of drugs, such as cocaine or amphetamines. Previously, DP was often considered to be a monosymptomatic hypochondraical psychosis. Delusions of parasitosis has also been reported in association with a number of medical conditions that are characterized by itching.

To review the literature through a case report.

A 52 year-old female, unmarried who lives alone, was admitted for parasitosis delusions that had started in the last two months. She complained of vermins crawling through her skin, mainly on her face and scalp. The illness began with pricking and itching sensations on her head. She used to put the “little animals” in a piece of paper to prove their existence. Risperodone was started up to 3 mg per day. She had a progressive clinical improvement and in one week was discharged.

In conclusion, rather than a unique illness, DP is a neuropsychiatric syndrome that can follow primary psychotic and depressive disorders, dementia or other organic diseases. The typical patient is an elderly woman who is unmarried or living along.

There have been no double-blind studies confirming that atypical antipsychotics are more effective than pimozide in the treatment of DP. Further trials are warranted to study the true efficacy of atypical antipsychotics in the treatment of DP.