An introduction to the concept of delusional parasitosis is presented. The persistent and refractory nature of the condition is emphasized. A case history is described in which a 67-year-old spinster, with classical symptoms of this condition, responded extremely favourably to simply administered pharmacotherapy. The authors allude to five similar patients also treated successfully by the same method. It is suggested that dermatologists might profitably treat this condition without recourse to psychiatric referral, which can often be counter-productive.