The patients often:
(1) are middle-aged to elderly women
(2) have a history of psychiatric problems
(3) may have a history of substance abuse
(4) have delusional beliefs about the illness which may overlap with delusion of parasitosis
(5) have diagnosed themselves based on what they have found on the Internet
Patients tend to have multiple skin lesions that may:
(1) have features of excoriations or traumatic ulcers
(2) contain natural or man-made fibers or filaments
Some patients:
(1) have a chronic pruritis, skin discomfort and/or “crawling” sensation
(2) may have a peripheral neuropathy or autonomic dysfunction
(3) may have a history placing the patient at risk for Lyme disease or other tick-borne infection
(4) experience moderate to severe fatigue
(5) experience a disability with reduced quality of life
(6) have no objective evidence of chronic systemic inflammatory disease (normal ESR, normal CRP, white blood cell count)