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Introduction: Amongst delusional disorders, delusional parasitosis or Ekbom's syndrome is relatively infrequent. These patients report an unwavering false belief of skin infestation due to sensoperceptive hallucinations, despite the absence of any medical evidence. There are two forms of delusional parasitosis: in the primary form the delusion of parasitic infection is the only symptom present, whereas in the secondary form it occurs alongside another psychiatric disorder, such as schizophrenia, drug abuse or an organic cause. Antipsychotics are the most usen treatment. Objectives: Presentation of a case and discussion of first approach to delusional parasitosis. Methods: Presentation of a case and a small review of the scientific literature available in PubMed. Results: Caucasian, 49-year-old woman reported a not-confirmed toe nail fungic infection one year prior, progressing with the subjective sensation of spreading to the rest of the body. Consequently, she employed diverse topical and oral remedies without medical supervision. One month prior she got medical assessment in a different medical centre, being evaluated by Dermatology and Psychiatry, getting the diagnosis of delusional parasitosis despite a lack of a battery of tests. She is given treatment, with no adherence. She escalated into more aggresive compulsions of cleasing, resulting in excoriations and scaldings, with increasing difficulties to lead her life. Conclusions: We illustrate the relevance of close multidisciplinary cooperation and the use of an adequate battery of tests to rule out an organic cause. An early diagnosis is key, as a therapeutic alliance prevents the patients from isolation and the development of depression symptoms, or else, of self-harm. [ABSTRACT FROM AUTHOR]