Antipsychotic Treatment for a Patient with Ekbom's Syndrome

目的：Ekbom's症候群是一種妄想疾患，妄想身體被微生物侵入。目前關於病因學、臨床表徵及病程研究仍有限。我們報告一追蹤兩年的病例，反覆因此症造成皮膚潰爛並進行多次植皮手術。病例報告：一位59歲男性最近5年感覺手腕有寄生蟲並試圖用針挖出，結果造成反覆皮膚潰爛及植皮。透過抗精神病藥物治療，寄生蟲妄想逐漸消失，傷口亦癒合良好。兩年追綜期間，因患者自行停藥，曾兩次住院清創及植皮。結論：此病例具有多重病因、慢性化病程、多次復發及反覆植皮。治療上對抗精神病藥有良好效果，持續治療是預防復發的關鍵因素。

關鍵字

Ekbom's症候群；寄生蟲妄想；皮膚潰爛；抗精神病藥物

並列摘要

Objective: Ekbom's syndrome is defined as a false belief of infestation by living organisms such as insects or parasites. The etiology, treatment and clinical outcome of this disease are not well known. We report a case of delusional parasitosis in a patient who received multiple skin grafts due to skin ulcers which developed after repetitive self-injury. Case Report: The patient reported feeling irritation due to parasitic infestation in the deep skin in the recent 5 years. Gradually, he reported that these organisms had invaded the dorsum of both wrists. He reported attempts to scratch these parasites out, and had developed skin erosive ulcers, and received repetitive skin grafts. On treatment with atypical antipsychotics, the delusions ceased gradually. During the following two years, the delusional symptoms and episodes of self-injury resulting in skin erosion recurred when he discontinued taking antipsychotic medication. Conclusion: Ekbom's syndrome is a complex disease with diverse manifestations and a chronic course. Antipsychotics are effective in the treatment of associated delusions and perceptual disturbances. Long-term medication and psychiatric intervention are needed to prevent relapse of the disease.

並列關鍵字

Ekbom's syndrome ； delusional parasitosis ； skin ulcer ； self-injury ； antipsychotics

參考文獻

Botschev C,Muller N(1991).Opiate receptor antagonists for delusions of parasitosis.Biol Psychiatry.30,530-531.

Google Scholar

de Leon J,Antelo RE,Simpson G(1992).Delusion of parasitosis or chronic tactile hallucinosis: hypothesis about their brain physiopathology.Compr Psychiatry.33,25-33.