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Diagnosis of the affection is ordinarily easy. The patients, in recounting their histories, soon make it plain that the disease of which they complain exists only in their imaginations. Hypochondria with obsession is manifest. The accounts of the beginning of the trouble, the subjective symptoms complained of, the absence of every cutaneous lesion of parasitic origin, are the facts which indicate a profound alteration in the intellectual faculties. Dangerous hallucinations may complicate the disease. Parasitophobias may be primary or secondary—i.e., they may occur with or without preceding invasion by parasites. In the latter case it is a true stigma of mental degeneration. The affection being psychic, it is to that element to which treatment should be directed. Suggestion may be tried, but the best plan is to convince the patients of a cure by treatment calculated to calm the general nervous system and pruritus.
J Cutan Genito-Urin Dis.
Perrin L. Parasitophobic Neurodermites. Arch Dermatol. 1996;132(7):764. doi:10.1001/archderm.1996.03890310046006