A 59-year-old woman was admitted to a dermatological ward because she was convinced that there were multiple purulent skin lesions on her back that had spread to her internal organs. She maintained that these symptoms first appeared 7 years previously, following her admission to hospital after a mosquito bite. The patient complained of numerous disorders during the previous years for which she had received treatment from various specialists (e.g., endocrinologists, gastroenterologists, gynecologists, urologists) without seeing any improvement. A general physical examination and laboratory tests did not reveal any abnormalities. Dermatological examinations did not demonstrate any significant skin lesions besides a small scar on her back, which formed as a consequence of intensive self-scratching. While being attended to on the dermatological ward, she was also examined by a psychiatrist, who reported that her "orientation to time, place and person, and also memory and cognition is intact". The patient was communicative, sometimes even chatty, when describing the course of her disease. She reported many family problems (she was separated from her alcoholic h4usband but was still living in the same house as him because of financial difficulties). She had hallucinations of a "double back" tingling sensation, caused, so she claimed, by viruses