Letter to the Editor Delusional Parasitosis Following Heroin Withdrawal: A Case Report

Delusional parasitosis (DP) is a delusional disorder in which the patient has the unshakable belief of being infested by parasites. Delusional parasitosis can be classified into primary or secondary with a detectable cause. Here we describe a 21-year-old man who developed acute delusional parasitosis following withdrawal from heroin. Our experience is the first report of DP associated with opioids and demonstrates that in any young patient that presents with acute parasitosis delusion, substance screening needs to be considered to identify a possible cause. Delusional parasitosis or delusional infestation is a form of delusional disorder, somatic type (DSM-IV) in which a person has the unshakable and mistaken belief of being infested by parasites. 1 Originally described in 1984, it has been previously described to as dermatophobia, parasitophobic neurodermatitis, parasitophobia or entomorphobia. Delusional Parasitosis can be classified into a primary group without a detectable cause (so-called pure forms), or a secondary group which is associated with general organic conditions, psychiatric illnesses and drugs. 2 In reviewing the literature, delusional parasitosis reports are dominantly primary. Secondary cases of delusional parasitoses are few. Here we describe a 27 year old man that developed acute delusional parasitosis following withdrawal from heroin. CASE REPORT A 21-year-old man was hospitalized in our ward due to delusional parasitosis associated with agitation and restlessness. The patient was a known case of opioid dependency according