A 68-year-old male with a history of hypertension and chronic kidney disease on hemodialysis for five years.
A year ago he perceived that small insects were displaced by his body, which he could barely see and which caused him pruritus.
The patient was evaluated repeatedly by different physicians (general practitioners, internists and nephrologists) without being able to demonstrate the presence of malformations.
She was also referred to a dermatologist who did not show any lesions on physical examination.
In addition, the EPSD, Graham test and acarotest were negative.
As he did not find an explanation for his symptoms, which he considered to be caused by "parasites", he asked to be evaluated by a parasytologist specialist.
Physical examination revealed only excoriations in forearms and thighs attributable to the recording.
The new parasitological study and five previous studies were negative.
Finally, the patient was suggested to be evaluated with a psychiatrist, which deviated her anger and the phrase: "I am not aware and know nothing about bi-chain".
