Unusual Findings in Morgellons Disease and Delusions of Parasitosis

We are presenting four new cases of delusions of parasitosis, two of which also had features of Morgellons disease. This illustrates the difficulties in therapy of these patients having almost universal refusal to accept the psychiatric component. Two of the patients responded to treatment while two did not. Of the two responders one was lost to follow up. The recommended treatments of pimozide, lexapro, and risperdone are examined. These rare diseases continue to be a challenge to the dermatologic community.