[Delusional Parasitosis associated with diabetes mellitus treated in outpatient care during COVID-19 pandemic - case report].

Abstract

The presenile dermatozoic delusion, subsequently referred to as Ekbom's syndrome and delusional parasitosis is a rare chronic condition, having an undetermined etiology and rising challenging treatment approaches. The diagnosis of delusional parasitosis can be presumed on the basis of the clinical history, but it is important to thoroughly assess the existence of an underlying systemic disorder or unrecognized skin disorder. A skin examination must be performed to rule out an infestation or a skin disorder. We present a 63-year-old diabetic woman with a high level of resilience towards the psychiatric treatment for whom we successfully offered outpatient psychiatric and dermatological assistance during the pandemic COVID-19. The trigger for a successful treatment scheme in outpatient care in a case of delusional parasitosis was the close and trustful relationship between the patient and the doctor. Different pharmacological treatments were approached and adjusted according to the patient adherence and the objective result (quetiapine XR, duloxetine, risperidone, olanzapine, and lamotrigine along with chronic disease treatment and wound management). Having a mutual agreed objective criteria for the treatment outcome, and creating a throughout examination scheme with frequent medical checks, increased the patient adherence to the treatment.