Formication

Abstract: Cocaine affects the cutaneous system and other organ systems. Cocaine use is associated with vasculitides, infectious complications, and numerous dermatologic conditions. It has been associated with formication (ie, tactile hallucinations of insects crawling underneath the skin), which leads to delusions of parasitosis and other psychosis-related dermatologic disorders. When a patient presents to a dermatology clinic with chronic skin lesions, a vague medical history, negative findings from previous evaluations, labile affect, and delusional behavior, drug screening should be performed to identify possible cocaine use.

Abstract: A 15 year old boy was evaluated in the psychiatric emergency room for the acute onset of "confusion,"insomnia, headache, and shaking of one week's duration. Two days later hallucinations, formication and a movement disorder emerged characterized by action tremor, myoclonus, chorea and ataxia. Further history revealed inhalation of gasoline for its euphoric effects. Plasma lead levels were in the toxic range. Chelation therapy reversed the clinical symptoms. Behavioral changes and a movement disorder in the context of gasoline inhalation are highly suggestive of organic lead encephalopathy. Recognition of this syndrome is important as chelation therapy is effective. Language: en

Abstract: Vulvodynia is a frequently used medical term that literally means "vulvar pain". Therefore, vulvodynia is a symptom, not a disease. The term itself indicates a variety of unpleasant chronic vulvar sensations, including burning, rawness, soreness, irritation, sensitivity, and formication. This may or may not include dyspareunia. Primary vulvodynia occurs when these sensory disturbances occur in the absence of observable dermatologic disease or vulvovaginal infection. There are several causes for this, including neuropathy, referred pain, and pelvic floor muscle dysfunction. For the purist, it is the patient in whom there is no observable reason for vulvar pain who represents the true case of vulvodynia. However, vulvodynia can also occur secondarily as a symptom of vulvar skin disease. Restricting the present paper to patients without objective signs leaves out all the important conditions which come into the differential diagnosis of vulvar pain which should be ruled out first. The first step in managing vulvodynia is making an accurate diagnosis of its cause. The present review summarizes the diagnosis and management of the chronic dermatologic diseases which may cause primary and secondary vulvodynia. The etiology of primary vulvodynia is much more poorly understood than secondary vulvodynia, and treatment of some aspects remains controversial.

Abstract: Case Report: Peritoneal exposure to mercury has been rarely reported and long-term consequences of this type of exposure have not been documented. We report the clinical course of a patient who has survived almost eight years with a massive intraperitoneal load of mercury. She has suffered formication, pruritis, fatigue, irritiability, insomnia, alopecia, dizziness, a gait disturbance, loss of balance and multiple falls, abdominal pain, choking, and headaches. Two courses of chelation with dimercaptosuccinic acid using the standard protocol were undertaken, resulting in increased daily excretion, but without demonstrable objective or subjective benefit or lasting effect. She had multiple medical problems before the mercury intoxication, which complicates the attribution of all her problems to mercury intoxication. It is of particular interest that the patient survived and did not suffer any marked cognitive deterioration. She died in 2002 shortly after being diagnosed with lung cancer and declaring that s...