A 32-year-old man presented to our clinic with a chief complaint of “bugs flying out of my skin and swarming around my head.” In the early summer for the past 2 years he believed he had seen insects emerging from his skin, which left pruritic lesions. He was quite distraught and reported fleeing public places because of embarrassment. No lesions were present at the time of examination, but the patient provided a glass slidewith a specimen he obtained from his skin (Figure). He stated that his 27-year-old girlfriend had the same symptoms and had recently seen another dermatologist who sent her “bugs” taped to a glass slide for entomological identification.
Martin J, Richmond A, Davis BM, Krejci-Manwaring J. Thysanoptera Dermatitis Presenting as Folie à deux. Arch Dermatol. 2012;148(7):864–865. doi:10.1001/archdermatol.2012.305
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