{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:03:35Z","timestamp":1790330615359,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Delusional infestation (DI) is a psychiatric disorder defined as a fixed false belief of being infested with animate or inanimate material in the absence of objective medical evidence. It presents frequently to dermatology and psychiatry and poses diagnostic and communication challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop a Delphi consensus on the definition, diagnostic work\u2010up and management of DI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Under the auspices of the European Society for Dermatology and Psychiatry (ESDaP), a core expert group drafted 22 statements based on prior survey data and the literature. International experts in DI (dermatology, psychiatry, tropical medicine) participated in two anonymous e\u2010Delphi rounds followed by a consensus meeting. Consensus was predefined as \u2265\u200975% agreement or disagreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 47 invited experts, 37 completed round 1 and 34 round 2; 23 joined the final meeting. Consensus was reached for 20\/22 statements. Agreements included: (i) defining DI as a psychiatric disorder with fixed beliefs of infestation; (ii) distinguishing primary versus secondary DI; (iii) acknowledging quality\u2010of\u2010life impairment; (iv) examining patient\u2010provided material as useful diagnostically and for rapport; (v) considering blood tests, urine toxicology and selective neuroimaging when indicated; (vi) early and concurrent management of psychiatric and cutaneous aspects; (vii) antipsychotics as first\u2010line treatment, with choice guided by evidence and patient factors; (viii) limited role for long\u2010acting depot formulations and CBT; (ix) importance of dermatology\u2013psychiatry collaboration; and (x) using adapted terminology with patients while ensuring informed consent for antipsychotic prescribing. Non\u2010consensus items concerned explicitly naming the diagnosis to patients and routine use of standardized outcome scales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This international Delphi consensus statement provides practical, expert\u2010informed recommendations for the assessment and management of DI, and is intended to inform future research and formal guideline development.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.70502","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T13:32:11Z","timestamp":1781098331000},"page":"1591-1599","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Consensus recommendations for the diagnosis and management of delusional infestation: A Delphi study"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3088-4583","authenticated-orcid":false,"given":"Patrick M. H. J.","family":"Kemperman","sequence":"first","affiliation":[{"name":"Department of Dermatology Amsterdam UMC Location AMC  Amsterdam AZ The\u00a0Netherlands"},{"name":"Department of Dermatology Dijklander Ziekenhuis Location Purmerend  Hoorn NP The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nienke C. C.","family":"Vulink","sequence":"additional","affiliation":[{"name":"Department of Psychiatry Amsterdam UMC Location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floortje E.","family":"Feikema","sequence":"additional","affiliation":[{"name":"Department of Dermatology Amsterdam UMC Location AMC  Amsterdam AZ The\u00a0Netherlands"},{"name":"Department of Internal Medicine Netherlands Cancer Institute \u2013 Antoni Van Leeuwenhoek  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1195-0290","authenticated-orcid":false,"given":"Anthony","family":"Bewley","sequence":"additional","affiliation":[{"name":"Department of Dermatology Barts Health NHS Trust  London UK"},{"name":"Queen Mary University of London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lepping","sequence":"additional","affiliation":[{"name":"Heddfan Psychiatric Unit, Wrexham Maelor Hospital Psychiatric Liaison Team  Wrexham UK"},{"name":"Centre for Mental Health and Society Bangor University  Bangor UK"},{"name":"Mysore Medical College and Research Institute  Mysuru India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0070-1945","authenticated-orcid":false,"given":"Maria\u2010Angeliki","family":"Gkini","sequence":"additional","affiliation":[{"name":"Department of Dermatology Barts Health NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6163-9164","authenticated-orcid":false,"given":"Rick","family":"Waalboer\u2010Spuij","sequence":"additional","affiliation":[{"name":"Department of Dermatology Erasmus University Medical Centre  Rotterdam Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno A.","family":"de Rie","sequence":"additional","affiliation":[{"name":"Department of Dermatology Amsterdam UMC Location AMC  Amsterdam AZ The\u00a0Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00018-09"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.14709"},{"issue":"217","key":"e_1_2_15_4_1","first-page":"58","article-title":"Delusional infestation: state of the art","volume":"96","author":"Vulink NC","year":"2016","journal-title":"Acta Derm Venereol"},{"issue":"12","key":"e_1_2_15_5_1","article-title":"Treatments for primary delusional infestation","volume":"12","author":"Assalman I","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/12034754251345785"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.20081"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2010.03782.x"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.21668"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.20485"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.002"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19831"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.06.024"},{"key":"e_1_2_15_14_1","volume-title":"Clinical Global Impressions, ECDEU Assessment Manual for Psychopharmacology, 44 revised (DHEW Publ. 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