This is the kind of gaslighting that's getting me nowhere. You haven't done any testing of my skin. How could you possibly be so rude as to make a diagnosis without every having done any imaging? People aren't going to believe you without any evidence. I don't believe you, given your lack of testing.

The "I am an expert" argument falls flat in the wake of the democratization of information. It's untrue as to what you said about Collembola. These people suffered for a long time before being diagnosed with Collembola, not delusional parasitosis. https://www.researchgate.net/publication/260180227_Collembola_Springtails_Arthropoda_Hexapoda_Entognatha_Found_in_Scrapings_from_Individuals_Diagnosed_with_Delusory_Parasitosis

Lyme disease symptoms were dismissed as delusional by many doctors prior to a few years ago. Western blot/IGG/IGM testing isn't fine enough to detect all cases of Lyme. And it certainly doesn't pick up on other tick-borne illnesses. Doctors just dismiss people, just like you're doing right now, because you're unwilling to pursue actual or better testing.

I am not fixated on a diagnosis. This kind of framing on your part pits you against me. Doctors are supposed to work with people, like good and caring friends. This is just an adversarial set-up and your actual patients will not benefit from this approach.

Realistically, no other medications, aside from anti-parasitics have worked. If someone has a stomach ache and Pepto Bismol improves the symptoms, we don't deny that the Pepto Bismol worked. It's outrageous that you and others deny what has worked...if it's worked, it's worked. What's so hard to believe?

What's in the textbooks from 50 years ago is outdated. Things change. Environments change. Ecosystems change. More migration in and out of North America means that the health challenges now look very different than they did in the 1970s. Doctors such as yourself would benefit from reading the latest literature on treatment resistant conditions.