We report a case of 64-year-old female patient who has had factitious skin lesions for 20 years. She complained formification sense and severe itching on her face. These symptoms were improved with squeezing and bleeding. There were scuare shaped ulcerated nodule on the right cheek and white depressed scar on the left cheek. She was treated with wet dressing and occlussive dressing, and skin lesions were nearly cleared within 3 weeks, but new lesion appeared. Pimozide 2mg #1 p.o were given under the diagnosis of delusion of parasitosis from June, 1984. Her symptoms were improved without recurrence till now. Treatment with pimozide in monosymptomatic hypochondriacal syndrome is discussed.
Bandages ; Cheek ; Cicatrix ; Delusions ; Dermatitis* ; Diagnosis ; Female ; Hemorrhage ; Humans ; Middle Aged ; Pimozide* ; Pruritus ; Recurrence ; Skin ; Ulcer

Delusions of parasitosis is a type of monosymptomatic hypochondrial psychosis and is defined as the fixed belief that one is infested with living organisms, in t.he abscence of any objective evidence that such infestation exists. A 43 year-old woman had a 2-month history of generalized pruritus and skin ulceration on the buttock representing dermatitis artefacta. She also complained of seeing small black insects crawling on her whole body skin, especially on the pubic area without evidence of cutaneous invasion by the parasites. She had no evidence of other medical diseases. She was treated with oral pimozide, starting with 1mg/day to 3mg/day. In two weeks, clinical symptoms and false belief that she is infested with parasites subsided.
Adult ; Buttocks ; Delusions* ; Dermatitis ; Female ; Humans ; Insects ; Parasites ; Pimozide* ; Pruritus ; Psychotic Disorders ; Skin ; Skin Ulcer

The aim of this study was to investigate the role of Ca2+-channel blockers in norepinephrine (NE) release from rat hippocampus. Slices and synaptosomes were incubated with [3H]-NE and the releases of the labelled products were evoked by 25 mM KCl stimulation. Nifedipine, diltiazem, nicardipine, flunarizine and pimozide did not affect the evoked and basal release of NE in the slice. But, diltiazem, nicardipine and flunarizine decreased the evoked NE release with a dose-related manner without any change of the basal release from synaptosomes. Also, a large dose of pimozide produced modest decrement of NE release. omega-conotoxin (CTx) GVIA decreased the evoked NE release in a dose-dependent manner without changing the basal release. And omega-CTxMVIIC decreased the evoked NE release in the synaoptosomes without any effect in the slice, but the effect of decrement was far less than that of omega-CTxGVIA. In interaction experiments with omega-CTxGVIA, omega-CTxMVIIC slightly potentiated the effect of omega-CTxGVIA on NE release in the slice and synaptosomal preparations. These results suggest that the NE release in the rat hippocampus is mediated mainly by N-type Ca2+-channels, and that other types such as L-, T- and/or P/Q-type Ca2+-channels could also be participate in this process.
Animals ; Diltiazem ; Flunarizine ; Hippocampus ; Nicardipine ; Nifedipine ; Norepinephrine* ; omega-Conotoxins ; Pimozide ; Rats* ; Synaptosomes*

Tics are brief, rapid and repetitive movement and sounds that are either simple or complex in presentation. Tics can be preceded by a premonitory urge (sensation) that decreases after tic is completed. The fourth edition of Diagnostic Statistical Manual of Mental Disorder (DSM- IV) includes diagnoses for Tourettes disorder, chronic motor or vocal tic disorder, transient tic disorder and tic disorder not otherwise specified (Table 1) according to the duration of tic symptoms and degree of complexity. The purposes of treatment of tic disorders must be set up based on the comprehensive evaluation of developmental profiles, strength, weakness, family situation, and school adaptation status. The family education must be included early in treatment process and psychosocial treatment including the cognitive behavioral therapy will be needed to develop and maintain the self-efficacy in controlling the tic symptoms. The most effective and efficient method for the reduction of tic symptoms, however, are drug treatment. The pharmacotherapy is usually one component of treatment for chronic tic disorder and Tourettes disorder. The gold standard for tic reduction is the dopaminergic receptor blocking agent (or antipsychotic agent, neuroleptics). The primary drugs are haloperidol, pimozide, and risperidone. Among theses, risperidone will be the primary choice because of its low side effect profiles, esp, neurologic side effects. In the near future, the studies on the efficacy of the olanzapine, quetiapine and ziprasidone will be more reported. As second line drugs, clionidine, guanfacine, nicotine related drugs can be considered.
Cognitive Therapy ; Diagnosis* ; Drug Therapy ; Education ; Guanfacine ; Haloperidol ; Humans ; Mental Disorders ; Nicotine ; Pimozide ; Risperidone ; Tic Disorders* ; Tics ; Tourette Syndrome

BACKGROUND: Delusions of parasitosis (DOP) is a psychiatric disorder in which patients have a fixed, false belief that they are infested by parasites. Management of patients with DOP presents a challenge to dermatologists, because such patients usually refuse to see a psychiatrist. OBJECTIVE: The aim of this study was to investigate the clinical manifestations and responses to treatment in DOP patients. METHODS: Between January 2010 and December 2012, the medical records of 32 DOP patients were reviewed to obtain data on clinical presentation, family history, accompanied psychiatric disorders, and treatments. RESULTS: The male-to-female ratio was 1:4.3. Twenty-two patients (68.8%) had symptoms for over 6 months. Seven patients (21.9%) had apparent skin lesions. Eighteen patients (56.3%) had a positive specimen sign. Three patients had depression, 4 had insomnia, and 2 had other delusional disorders. Eight patients (25%) reported that their family members were also experiencing itching. Six patients underwent skin biopsies, the results of which were consistent with chronic dermatitis. With pimozide treatment, 6 patients (18.8%) achieved complete remission, 17 (53.1%) showed a partial response, and 9 (28.1%) showed no response. CONCLUSION: Because DOP patients depend on dermatologists for treatment, it is crucial for dermatologists to be prepared for the proper management of this condition. This study expands our understanding of the disease and suggests the optimal methods of treatment. Further studies on socioeconomic data and selection of effective antipsychotics are needed.
Antipsychotic Agents ; Biopsy ; Delusions* ; Depression ; Dermatitis ; Dermatology* ; Humans ; Medical Records ; Parasites ; Pimozide ; Pruritus ; Psychiatry ; Retrospective Studies* ; Schizophrenia, Paranoid ; Skin ; Sleep Initiation and Maintenance Disorders