XXXX . A dermatologist's guide to diagnosis and treatment.

@entity1 @entity1766 @entity3933 @entity943 @entity146 @entity910 @entity299 @entity1370 @entity2146 @entity5662 @entity272 @entity8143 @entity221 @entity1090
@entity8143 is a rare @entity146 in which the @entity1 has a fixed, false belief that he or she is infested by parasites. Even though it is a @entity146 , these @entity1 usually present to a dermatologist because they are convinced that they have a dermatological problem. @entity1 with @entity8143 generally reject psychiatric referral. The diagnosis of @entity8143 can often be made on the basis of the history alone, but it is important to make sure that the @entity1 does not have a @entity272 , and the delusion is not secondary to another mental or @entity221 . The current treatment of choice is the antipsychotic medication @entity1766 . The principal difficulty in management is convincing @entity1 to take the drug. This results from the obvious discrepancy between the @entity1 ' belief system and the clinician's understanding of the situation. The most common adverse effects of @entity1766 are extrapyramidal symptoms such as stiffness and, less frequently, a special inner sense of restlessness called @entity2146 . Effective treatment of such extrapyramidal reactions includes @entity5662 1 to 2 mg up to 4 times daily as needed, or @entity3933 25 mg 3 times daily as needed. @entity1766 can have @entity1370 effects at high dosages. Traditionally, it has been recommended to check pretreatment and post-treatment electrocardiograms even for @entity1 who have no history or @entity299 or @entity943 . However, a more recent publication questions the need for this if the @entity1 takes < 10 mg/day, is not elderly, and has no history of @entity943 . Effective dosages of @entity1766 for @entity8143 have ranged from 1 to 10 mg/day. The lowest effective dosage of @entity1766 should be used for the shortest possible duration to minimize the risk of @entity910 developing in these @entity1 . Significant improvements in quality of life have been achieved with successful treatment with @entity1766 . Atypical antipsychotics such as @entity1090 with a much safer adverse effect profile may prove to be effective for the treatment of @entity8143 in the future.
