Volume 22 Number 2, Part I February 1990
confirmed as delusions of parasitosis be given a trial course of pimozide. If the delusions remain and are still interfering with the patient's life, then referral to a psychiatrist is appropriate. The duration of treatment required has been disputed. Munro lO initially believed that pimozide did not effect a cure but only a remission. However, Lenskov and Baadsgaard6 found that a large proportion of patients with delusion of parasitosis could discontinue the medication after 3 to 5 months of treatment. REFERENCES 1. Lyell A. Delusions of parasitosis. Br J Dermatol 1983; 108:485-99. 2. Munro A. Monosymptomatic hypochondriacal psychosis manifesting as delusions of parasitosis. Arch Dermatol 1978;114:940-3. 3. Reilly TM, Jopling WH, Beard A W. Successful treatment with pimozide of delusional parasitosis. Br J Dermatol 1978;98:457-9. 4. Hamann K, Avnstorp C. Delusions of infestation treated by pimozidc: a double-blind crossover clinical study. Acta Derm Venereol (Stockh) 1982;62:55-58. 5. Duke E. Clinical experience with pimozide: emphasis on its usc in postherpetic neuralgia. J Am Acad Dermatol 1983; 8:845-50. 6. Lindskov R, BaadsgaardO. Delusions of infestation treated with pimozidc, a follow-up study. Acta Derm Venereol 1985;65:267-70. 7. Hamann K. Onychotillomania treated with pimozide. Acta Derm Venereol 1982;62:364. 8. Physicians' desk reference. 42nd ed. Oradell, N.J.: Medical Economics Company, 1988. 9. Gould W, Gragg T. Delusions of parasitosis. Arch Dermatol 1976; 112: 1745-8. 10. Munro A. Monosymptomatic hypochondriacal psychosis. Br J Hosp Med 1980;24:34-8.
Acquired secondary syphilis in a child Sandra K. Echols, BS, David L. Shupp, MD, and Arnold L. Schroeter, MD Dayton, Ohio Recent statistics released by the Centers for Disease Control indicate that the incidence of both primary and secondary syphilis in men and women has been steadily increasing during the past 2 years. In 1987, the nationwide rate of 14.6 syphilis cases per 100,000 people was the highest since 1950 and the largest increase within a single year since 1960. This also represents a 25% increase over the 1986 incidence.! As more adull~ are infected, so the likelihood of children contracting syphilis increases. From the Departmentof Dermatology, Wright Slate Univcrsity School of Medicinc. . Reprint requests: David L. Shupp, MD. Wright Slate Univcrsity, Dcpartment of Dermatology, School of Medicine, Dayton, OH 45401.
16/4/13900
Brief communications 313 Case report. A 4-year-old girl had a "rash," hair loss, cough, and sore throat. When examined, the patient had a low-grade fever and a few enlarged cervical lymph nodes. There were scattered white patches on the buccal, palatal, and gingival mucosa and erythematous, denuded areas of the tongue. Patchy areas of alopecia were noted that gave the child's hair a "motheaten" appearance. Numerous hyperpigmented macules with peripheral scales were present on the palms and soles. Results of a genital examination were normal without any signs of trauma but a I X 1.5 em, hypopigmented, moist verrucous plaque was noted in the perianal area. A scraping examined under a darkfield microscope demonstrated multiple spirochetes. A VDRL test was positive at a dilution of ] :64. The fluorescent treponemal antibody absorption (}
confirmed as delusions of parasitosis be given a trial course of pimozide. If the delusions remain and are still interfering with the patient's life, then referral to a psychiatrist is appropriate. The duration of treatment required has been disputed. Munro lO initially believed that pimozide did not effect a cure but only a remission. However, Lenskov and Baadsgaard6 found that a large proportion of patients with delusion of parasitosis could discontinue the medication after 3 to 5 months of treatment. REFERENCES 1. Lyell A. Delusions of parasitosis. Br J Dermatol 1983; 108:485-99. 2. Munro A. Monosymptomatic hypochondriacal psychosis manifesting as delusions of parasitosis. Arch Dermatol 1978;114:940-3. 3. Reilly TM, Jopling WH, Beard A W. Successful treatment with pimozide of delusional parasitosis. Br J Dermatol 1978;98:457-9. 4. Hamann K, Avnstorp C. Delusions of infestation treated by pimozidc: a double-blind crossover clinical study. Acta Derm Venereol (Stockh) 1982;62:55-58. 5. Duke E. Clinical experience with pimozide: emphasis on its usc in postherpetic neuralgia. J Am Acad Dermatol 1983; 8:845-50. 6. Lindskov R, BaadsgaardO. Delusions of infestation treated with pimozidc, a follow-up study. Acta Derm Venereol 1985;65:267-70. 7. Hamann K. Onychotillomania treated with pimozide. Acta Derm Venereol 1982;62:364. 8. Physicians' desk reference. 42nd ed. Oradell, N.J.: Medical Economics Company, 1988. 9. Gould W, Gragg T. Delusions of parasitosis. Arch Dermatol 1976; 112: 1745-8. 10. Munro A. Monosymptomatic hypochondriacal psychosis. Br J Hosp Med 1980;24:34-8.
Acquired secondary syphilis in a child Sandra K. Echols, BS, David L. Shupp, MD, and Arnold L. Schroeter, MD Dayton, Ohio Recent statistics released by the Centers for Disease Control indicate that the incidence of both primary and secondary syphilis in men and women has been steadily increasing during the past 2 years. In 1987, the nationwide rate of 14.6 syphilis cases per 100,000 people was the highest since 1950 and the largest increase within a single year since 1960. This also represents a 25% increase over the 1986 incidence.! As more adull~ are infected, so the likelihood of children contracting syphilis increases. From the Departmentof Dermatology, Wright Slate Univcrsity School of Medicinc. . Reprint requests: David L. Shupp, MD. Wright Slate Univcrsity, Dcpartment of Dermatology, School of Medicine, Dayton, OH 45401.
16/4/13900
Brief communications 313 Case report. A 4-year-old girl had a "rash," hair loss, cough, and sore throat. When examined, the patient had a low-grade fever and a few enlarged cervical lymph nodes. There were scattered white patches on the buccal, palatal, and gingival mucosa and erythematous, denuded areas of the tongue. Patchy areas of alopecia were noted that gave the child's hair a "motheaten" appearance. Numerous hyperpigmented macules with peripheral scales were present on the palms and soles. Results of a genital examination were normal without any signs of trauma but a I X 1.5 em, hypopigmented, moist verrucous plaque was noted in the perianal area. A scraping examined under a darkfield microscope demonstrated multiple spirochetes. A VDRL test was positive at a dilution of ] :64. The fluorescent treponemal antibody absorption (}
