La sindrome di Ekbom: revisione della letteratura ed osservazioni su di un caso clinico

Introduction The Ekbom Syndrome is a rare disease characterized by the conviction of the patient to be invaded from parasitic on the skin. These cause itch and/or punctures of pin with consequent intense scratching and appearance of excoriated lesions. Purpose We describe a case where the psychotherapeutic treatment has allowed pharmacological one, removed the causes and produced the disappearance of the symptoms. Clinical Case A.G. aged 67 years, tell us, after the death of the consort by liver carcinoma, numerous “bugs” infested her head, trunk and limbs and caused itch, scratching and exoriated lesions. The patient has been submitted to the Rorschach e Machover tests, to the psychotherapy and to the administration of antidepressants and anti-psychotic. Resulted The patient presents compromised the examination of reality and goes toward a psychotic pathology (schizophrenia). Affective compulsion, scarce interests, depressed humor, extraneousness to the environment, hard social relations, cultural and intellectual poverty and polarization of the thought, are present. The interviews pointed out: a) the itch is associated to a emotional problematic nucleus b) the conversion (delirium) in somatic terms of an uneasiness psychic c) the delirium involves the whole family nucleus. The psychotherapeutic treatment has allowed the patient to accept the pharmacological one and the regression of the psychosis. Discussion The delirium, the visual hallucinatory phenomena, the itch and the skin lesions and besides the induction of the psychosis in the family and the negation of the trouble, are present in A.G. case. The itch and the scratching could be determined by emotional regressive reactions that determine a reassuring role and stabilize the emotional conflict. The content of the delirium is the evil of the consort that is connected to the bugs. The proof of the delirium are the eggs and the skin lesions. These recall the attention of the family that testify the infestation (familiar delirium). Conclusions We retain that in the described case the delirium and the tactile hallucinations are been induced by the psychic trauma. This could be considered for the appearance of the syndrome the primary determinant.