In response to this column:
http://www.straightdope.com/columns/000623.html
For some photos of my delusions, including a video, and text questioning the way this diagnosis is currently applied, please see my website: www.dpref.com
Entomologists at the University of Georgia have suggested my delusions may be (caused by) a flagellate protozoa.
So, are the doctors treating this, now that they’ve identified a possibly real problem?
A few are trying, but they don’t really know what it is yet. There are lots of flagellate protozoa, and even this much has not been confirmed clinically yet. We have a long ways to go, but I remain hopeful that we will get there. Thanks for asking.
Welcome to the Straight Dope Message boards, Ever Hopeful, glad to have you with us.
Just to clarify, please note that the first words of Cecil’s column is:
Cecil did not say – or imply – that all infestations are delusional. Hee was talking about people who THINK they are covered with bugs, although no one else can see them. Hence, delusional. That’s very different from your situation.
Wow, Ever Hopeful, those are amazing pictures. Highly disturbing.
Understood. But the docs will not look at my skin because they jump to the delusional conclusion without testing, etc. It’s a stupid idea and never been clinically estabished anyway.
I can certainly imagine your intense frustration. But why is it a “stupid idea”? Do you believe that there is **no such thing ** as delusional parasitosis? Are you suggesting that all cocaine addicts with “coke bugs” genuinely infected or infested (as you may well be)? That seems to be an assumption on your part which is just as broad as the MD’s assumption that you are delusional. (BTW – I do get it that the fact that some people’s perceptions of parasites respond to psychopharmaceuticals prescribed by doctors does not prove conclusively that the bugs were imaginary in the first place; it just proves that psychopharmaceuticals alter perceptions.)
I genuinely wish you the very best in getting competent and effective help for your wretched dilemma. Given the vast and bizarre variety of parasites that people and animals have been known to harbor, I see no reason why your problem couldn’t be zoological rather than psychological.
I’m confused as to what the term ‘delusion’ means in this context; your website carries some interesting pictures of dead skin flakes, hair follicles, fluff and other things that may or may not be actual parasites (but it certainly isn’t the case that they are all parasites).
Are you saying that you believe you have some kind of microbial infection that makes it feel like you have parasites, which actually turn out to be the things you have photographed, or are you saying that you actually believe that all those items depicted are parasites? (in which case, are you referring to them ironically as ‘delusions’)
Sorry for the double post, but I just re-read Cecil’s column, and I couldn’t help noticing the following (bolding added):
The first hand accounts Cecil quotes vary widely in terms of credibility, and this one seems like one of the more unlikely ones (I though at least one of the other ones was very believable); however, what Cecil refers to as the “matchbox sign” of delusional parasitosis seems to me to place the patient in a double bind. Let’s face it – wouldn’t a person who was GENUINELY infested with a mysterious bug **also ** attempt to get a sample of it? I probably would.
(reading more) Now I’m starting to itch. Oh, my! It’s a part of the Tropical Diseases Webring! Some people are scared of ghosts but I prefer being scared of real things so I won’t click “Next.” I ever tell you about the parasitologist who finally got to go to Africa and who made it as far as the lab where he was to work but had them turn the car around and go back to the airport because he knew what critters live there?
Could this also be caused by an infection leading to paranoia? Here’s what I mean: My parents’ cat brought in a rat last year that died. The rat mites attacked my mom and she got some nasty bites (apparently, they’re more attracted to females than to males). The house was thoroughly cleaned and the carpet in her studio (where the rat had been) was replaced with Pergo. However, she now thinks every piece of lint of flake of wax from her pastels is another bug. She’s angry at my dad for not believing her. Is this a case where a real, but cleared-up, infestation has led to this? (She is also keeping “catches” in Ziploc bags and so forth.)
Ever Hopeful, I appreciate your ironic style and you seem very intelligent. I hope others who suffer from your condition appreciate the effort you have put into trying to find an explanation. It is hard to imagine how miserable and frustrated you must be, particularly at how much time and effort you have to expend to create an open-minded look at such a complicated and mysterious concept. Reality Bites or Delusion Bites, eh? I hope you have a clear answer and treatment very soon.
Something like that. One of Cecil’s links, the National Unidentified Skin Parasite Association, says, “USPI has been known to frequently follow a lice and/or scabies outbreak. In those cases, after the original infestation (i.e., lice/scabies) has been successfully treated, the unidentified parasite “takes over” the infestation and fails to respond to usual pesticide treatments. The person then becomes infested with this organism, without any successful treatments available.”
I do believe in secondary DOP, i.e., DOP caused by underlying phsyical or mental conditions, including drug abuse, diabetes, schizophrenia, dementia, and a long list of other conditions. My statement is that Primary DOP–without any precipitating organic or emotional cause–has never been clinically demonstrated to exist. Also, one of the main psychopharmaceuticals used to treat DOP has a powerful anti-itch property! I’d like to see a double-blind study that compared the effect of the psychopharms to anti-parasitics. At the moment, however, derms diagnose people with DOP in less than 10 minutes and without any testing. I know of a few patients who went to psychologists after seeing the derms and were told there was nothing wrong with them mentally; it had to be a physical condition. But researchers are few and far between and, in the meantime, this illness is not in the books and so it doesn’t exist in the medical world. DOP, however, is in the books (described in 1937–all later studies ultimately trace back to that single description). You really ought to read my piece on the website on the science and concept of DOP.
I am not a parasitologist and do not know which objects are parasites and which are not. I believe that most of the photos depict something related to a parasitic infection. Some may be other things, i.e., pollen, etc. However, I have seen some of those objects clearly demonstrate motility and they are far too large to be bacteria or viruses. Which leaves parasites. Several of the fibers clearly show the typical flagellate protozoan appearance, down to the little flagella, and people with more expertise than me have said that my video looks to them like a flagellate protozoan. Other objects look very much like ova and/or oocytes. And others are simply baffling. I don’t think there are any hair follicles among them. Are you a parasitologist?
Thanks for the clarification. Yes, I shall refer back to your site. Again, best of luck to you.
As a pathologist and microbiologist who has studied parasitology and has occasion to apply this knowledge in my work:
I have to say I agree that the objects photographed on Ever Hopeful’s website look like no parasites in existence.
They look like amorphous glop, vegetable matter or in one case, possibly a portion of the leg of some small insect.
These sorts of photos can be found in another type of setting - among adherents of colon and gallbladder “cleanses”. These enthusiasts are convinced that they are eliminating stones and various harmful foreign substances, and produce photos to “prove” it. Analyses by trained observers have identified such objects as fecal material and mucus. The people who are obsessive about recovering such material from their excrement do not believe it.
Ever Hopeful has my sympathy, and I don’t doubt he/she is experiencing discomforting symptoms. But if a thorough physical exam and routine tests haven’t found a parasite, it’s time to look at some other type of (non anti-parasitic) treatment.
My what leaps you have made. It’s amazing how you can look at those images taken on a toy microscope and know so much about me and my illness–more than the study group that has spent a month analyzing them. Also amazing that you know what every parasite in existence looks like when there are over 50,000 (by the best estimate), most of which are unidentified. I believe, from your name, you are probably a botanist. But you would have made a good dermatologist.
Not sure who you are agreeing with here. The several parasitologists who looked at my sandal thing all thought it looked like an aquatic invertebrate, but one with which they were not familiar. You might look at some lamprey images on the web to see something extremely similar.
No, not a parasitologist, just an interested party with a microscope, who has examined bits and pieces of his own body.
Lets talk about some of your photographs though (and referring to the cross-sectional skin diagram here); - the ones on this page, purporting to be burrows - they just look like a piece of epidermis that has come away with some of the cells that line the hair shaft, or perhaps a buildup of hardened sebum.
The things on the grains of sand page can’t possibly be flagellate protozoans (or you wouldn’t be describing them as grains of sand) - they just look like the little hardened lumps of sebaceous gunk that come out of expired hair follicles or ‘spent’ pimples - these often have a little colourless hair embedded in them.
The fibers page? - some of these pictures show dyed, man-made fibres - these are shed all the time by clothing and soft furningshings and easily adhere to parts of the human body (that’s why they are so beloved of forensic investigators) - unless you live in a fibre-free environment, there are a wealth of disappointingly mundane explanations for these.
The video clip just shows a few blobby things and fibres, apparently being jostled around by vibration and air currents (I can tell there’s vibration involved because the whole frame jumps at times) but I’m curious as to how you captured these things you say are flagellate protozoans; we’re talking about single-celled organisms invisibly small to the naked eye - not something you can pick out of your hair with your fingers - even at 200x magnification, they’re still going to appear as smallish dots.
None of this is to say that you don’t have parasites, I’m just stuggling in vain to see anything resembling them on your site. The sandal thing is interesting, but that’s an entirely different class of phenomenon - even if you did find a flatworm on your shoe, it doesn’t mean the dandruff you’re picking out of your scalp is alive.
