LAUSR

Dear Editor, A 53-year-old man presented with an extensive necrotic ulcer with irregular borders and exposed skull bone (a, b). He had produced the wound by applying caustics and sharp objects in an attempt to exterminate a ‘virus’ that caused him pain. He claimed that much of the skin debris he had extracted from the lesion represented the organisms. Psychiatric examination established the diagnosis of self-injury secondary to delusional infestation. Control of pathological ideation was obtained with the introduction of olanzapine 10 mg per day. After 2 months, the plastic surgery team performed a scalp reconstructive surgery with micrografting technique, with an excellent result. After 1 year, he remains controlled using antipsychotics (c).