A common phone call, message or sample involves a client who feels "bugs" are crawling on or burrowing into their skin, or that unexplained skin irritation is caused by insects they can not see or feel.  A microscopic examination of their sample specimens yields dust, lint, scabs, skin and other debris but never a mystery bug that would account for the symptoms described.  When the situation advances to an unshakable belief that insects are involved it is called delusory parasitosis or delusions of parasitosis (formerly also called illusory parasitosis).
 
A recent news release from the Mayo Clinic reports the same conclusion we have had for years.  No mystery bugs can be found that infest the skin of people with unexplained skin irritations.  "Researchers tested the skin of more than 100 patients convinced that bugs, worms or germs had invaded their skin. In all but one case, the skin tests turned up no sign of possible infestation."  The one exception was a pubic louse.  
 
The erroneous belief that bugs are present leads to over-application and misapplication of insecticides and several other issues.  Biting pests are few, well-known and mostly visible to the naked eye.  See our website for information.