Bilateral Nipple Itching at the Age of 4 Years: A Case of Conversion Disorder

Redwana Hossain, Wasima Rahman, MMA Shalahuddin Qusar, Sanjida Tanjin Khan, S M Yasir Arafat

Abstract


Clinical presentation of conversion disorder varies with multiple factors such as culture, education, personality traits of the subjects. It was aimed to report a case of conversion disorder presented with bilateral nipple itching which starts at the age of 4 years. Master M, a 6 years old Muslim girl of lower socioeconomic status, with good intelligence hailing from rural area admitted with the complaints of episodic intense itching of both nipples & areola for last 2 years. The itching involves both areola & nipple which was initially mild in intensity, lasts for 5 to 10 minutes without any specific aggravating factor and relieved by scratching by herself or her mother. The itching episodes were noticed only in the home setting and with presence of her mother. The girl was consulted with general physician, dermatologist, pediatrician; extensive investigations were done with negative outcome and subsequently referred to psychiatry. She was diagnosed as a case of conversion disorder, stressor (parental discord) was identified and managed properly. She was discharged on the 10th day of admission and 3 months follow up revealed full remission with regularized usual activity of the child.  Conversion disorder may start from very early age and with atypical symptom profile. Clinicians need to keep the differential in their list in order to avoid exhausting investigations.

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Keywords


Conversion Disorder; Nipple Itching; Children; Psychiatry; Bangladesh

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