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Parasitophobia. This relates to a morbid fear of being infested with parasites. Sufferers of this condition may also be deluded, believing themselves already infested, and may bring in various pieces of thread, lint, scrapings and debris of all sorts believing them to be the ‘parasites’. The deluded victim often has hallucinations, insisting that he can see and feel the parasites within his skin. Patients with this disorder require psychiatric help, as they frequently ‘need’ the symptom to remain, in other areas of their functioning life, sane.

Dermatitis artefacts. This is a skin disorder which is self-inflicted. Furthermore the patient denies having produced the lesion with his own hands. Chemicals, heat, or other physical and mechanical means may be used to inflict the disorder, and the lesions are therefore of singularly curious patterning, generally not conforming to known disorders and usually in an easily accessible area. A fairly decisive diagnostic indication is the disappearance of the lesion under an occlusive dressing.

Generally speaking two types of patient perpetrate this type of disorder: the hysterical individual, with a rather apathetic appearance, who converts intense anxiety into this symptom; and the malingering individual, who produces the lesion to attain some gain or to explain a lack of success. These patients require definite help, and should certainly not be confronted or accused of self-infliction. Psychiatric referral is very wise.

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