Practical Management of Delusional Infestation (DI)

This chapter discusses the practical management of delusional infestation (DI) patients in the dermatology clinic. DI as a psychodermatological disorder is defined and reviewed. The diagnosis of DI is reviewed along with the characteristics of primary and secondary causes of DI. Key laboratory tests in the diagnosis of DI are summarized. A hypothesis for the etiology of primary DI is briefly mentioned. The importance of building a rapport is stressed along with tips on how to optimize rapport during these often difficult patient encounters. The pharmacotherapy of DI is examined including effective medications, dosing regimens, and expected possible side effects. Specifically, the side effect of tardive dyskinesia with antipsychotic medication is highlighted along with new therapeutic options.