<p>Sir,</p> <p>Fetishism, a paraphilic sexual disorder, is characterized by recurrent intense sexual urges and sexually arousing fantasies, involving specific objects over a period of at least 6 months. <sup> <xref ref-type="bibr" rid="ref1">1</xref> </sup></p> <p>The psychopathology of the fetishism is disputed. Dysfunction of the temporal lobe and its subcortical connections is currently a subject of extensive investigation. <sup> <xref ref-type="bibr" rid="ref2">2</xref> </sup>Fetishism almost always occurs in males. <sup> <xref ref-type="bibr" rid="ref3">3</xref> </sup>We present a case of female foot fetishism in a 3.5-year-old male child with problem of getting excited to see a female leg or stockings and trying to touch them by his mouth and genitalia since he was 3. His reactions included tachypnea, tachycardia, flushing, dilated pupils, and penile erection. He had no history of physical or mental disorders with any signs of child abuse in his examinations in spite of the apparent signs of neglect and low attention given by his parents. He was diagnosed with fetishism related to female leg, foot, and stocking which is a rare condition in early childhood. Risperidone tablet 0.5 mg/day orally was prescribed. The patient was followed-up to his 7 <sup>th</sup>year and his symptoms diminished from the age of 6 and a 1/2. This suggested the efficacy of the treatment; however, the compliance with respect to taking his medicine was not acceptable.</p> <p>A brief Internet search showed that it is not actually a very rare behavior in the children; however, most mothers find fetishism "cute" rather than neurotic. As was described in this case, early treatment can be helpful in treating childhood fetishism. <sup> <xref ref-type="bibr" rid="ref4">4</xref> </sup>Childhood foot fetishist is introduced from a developmental, psychodynamic point of view. Pre-Oedipal fixation is suggested for this condition. The patient focuses on a unit matter like women′s wearing; therefore, autism can be a comorbidity or be considered as a differential diagnosis. In a report by Dozier et al., <sup> <xref ref-type="bibr" rid="ref5">5</xref> </sup>a 36-year-old man who diagnosed with autism, engaged in bizarre sexual behavior in the presence of women wearing sandals. Therefore, there should be an effort to inform parents about this disorder and encourage them to visit a psychiatrist. It is necessary to train the parents about the identity of disorder that child is not guilty or crime and punishment is forbidden.</p> </sec> </body> <back> <ref-list> <ref id="ref1"> <label>1</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>American Psychiatric</surname> <given-names>Association</given-names> </name> </person-group> <article-title>Diagnostic and Statistical Manual of Mental Disorders</article-title> <source>th ed</source> <year>4 th</year> <volume></volume> <fpage></fpage> <comment>Diagnostic and Statistical Manual of Mental Disorders 4 th ed Washington, DC: American Psychiatric Association; 2000;1:535</comment> </nlm-citation> </ref> <ref id="ref2"> <label>2</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Epstein</surname> <given-names>AW</given-names> </name> </person-group> <article-title>Fetishism: A study of its psychopathology with particular reference to a proposed disorder in brain mechanisms as an etiological factor</article-title> <source>J Nerv Ment Dis</source> <year>1960</year> <volume>130</volume> <fpage>107</fpage> <lpage>19</lpage> </nlm-citation> </ref> <ref id="ref3"> <label>3</label> <nlm-citation citation-type="book"> <person-group person-group-type="author"> <name> <surname>Kaplan</surname> <given-names>HI</given-names> </name> <name> <surname>Sadock</surname> <given-names>BJ</given-names> </name> </person-group> <article-title>Synopsis of Psychiatry: Behavioral Sciences, Clinical Psychiatry</article-title> <source></source> <publisher-loc>Lippincott Williams and Wilkins</publisher-loc> <publisher-name>Baltimore Maryland</publisher-name> <year>2003</year> <volume></volume> <fpage>718</fpage> <lpage>29</lpage> </nlm-citation> </ref> <ref id="ref4"> <label>4</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Coskun</surname> <given-names>M</given-names> </name> <name> <surname>Mukaddes</surname> <given-names>NM</given-names> </name> </person-group> <article-title>Mirtazapine treatment in a subject with autistic disorder and fetishism</article-title> <source>J Child Adolesc Psychopharmacol</source> <year>2008</year> <volume>18</volume> <fpage>206</fpage> <lpage>9</lpage> </nlm-citation> </ref> <ref id="ref5"> <label>5</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Dozier</surname> <given-names>CL</given-names> </name> <name> <surname>Iwata</surname> <given-names>BA</given-names> </name> <name> <surname>Worsdell</surname> <given-names>AS</given-names> </name> </person-group> <article-title>Assessment and treatment of foot-shoe fetish displayed by a man with autism</article-title> <source>J Appl Behav Anal</source> <year>2011</year> <volume>44</volume> <fpage>133</fpage> <lpage>7</lpage> </nlm-citation> </ref> <ref id="ref6"> <label>6</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"></person-group> <article-title></article-title> <source></source> <year></year> <volume></volume> <fpage></fpage> </nlm-citation> </ref> </ref-list> </back> </article>

JRMS

J Res Med Sci

Journal of Research in Medical Sciences

1735-1995 1735-7136

Medknow Publications Pvt Ltd

India

JRMS-18-170

23914223

Letter to Editor

Female foot fetishism disorder in childhood

Zarei

Mina

Bidaki

Reza

Department of Medicine, Tehran University of Medical Sciences, Tehran, Iran Department of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

Address for correspondence:Mina Zarei, Department of Medicine, Tehran University of Medical Sciences, #32, Abbaspour St. Sharif Minacity 1497943551 Tehran, Iran mina.zarei64@gmail.com

February 2013

18 2 170 170

2013

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

<p>Sir,</p> <p>Fetishism, a paraphilic sexual disorder, is characterized by recurrent intense sexual urges and sexually arousing fantasies, involving specific objects over a period of at least 6 months. <sup> <xref ref-type="bibr" rid="ref1">1</xref> </sup></p> <p>The psychopathology of the fetishism is disputed. Dysfunction of the temporal lobe and its subcortical connections is currently a subject of extensive investigation. <sup> <xref ref-type="bibr" rid="ref2">2</xref> </sup>Fetishism almost always occurs in males. <sup> <xref ref-type="bibr" rid="ref3">3</xref> </sup>We present a case of female foot fetishism in a 3.5-year-old male child with problem of getting excited to see a female leg or stockings and trying to touch them by his mouth and genitalia since he was 3. His reactions included tachypnea, tachycardia, flushing, dilated pupils, and penile erection. He had no history of physical or mental disorders with any signs of child abuse in his examinations in spite of the apparent signs of neglect and low attention given by his parents. He was diagnosed with fetishism related to female leg, foot, and stocking which is a rare condition in early childhood. Risperidone tablet 0.5 mg/day orally was prescribed. The patient was followed-up to his 7 <sup>th</sup>year and his symptoms diminished from the age of 6 and a 1/2. This suggested the efficacy of the treatment; however, the compliance with respect to taking his medicine was not acceptable.</p> <p>A brief Internet search showed that it is not actually a very rare behavior in the children; however, most mothers find fetishism "cute" rather than neurotic. As was described in this case, early treatment can be helpful in treating childhood fetishism. <sup> <xref ref-type="bibr" rid="ref4">4</xref> </sup>Childhood foot fetishist is introduced from a developmental, psychodynamic point of view. Pre-Oedipal fixation is suggested for this condition. The patient focuses on a unit matter like women′s wearing; therefore, autism can be a comorbidity or be considered as a differential diagnosis. In a report by Dozier et al., <sup> <xref ref-type="bibr" rid="ref5">5</xref> </sup>a 36-year-old man who diagnosed with autism, engaged in bizarre sexual behavior in the presence of women wearing sandals. Therefore, there should be an effort to inform parents about this disorder and encourage them to visit a psychiatrist. It is necessary to train the parents about the identity of disorder that child is not guilty or crime and punishment is forbidden.</p> </sec> </body> <back> <ref-list> <ref id="ref1"> <label>1</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>American Psychiatric</surname> <given-names>Association</given-names> </name> </person-group> <article-title>Diagnostic and Statistical Manual of Mental Disorders</article-title> <source>th ed</source> <year>4 th</year> <volume></volume> <fpage></fpage> <comment>Diagnostic and Statistical Manual of Mental Disorders 4 th ed Washington, DC: American Psychiatric Association; 2000;1:535</comment> </nlm-citation> </ref> <ref id="ref2"> <label>2</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Epstein</surname> <given-names>AW</given-names> </name> </person-group> <article-title>Fetishism: A study of its psychopathology with particular reference to a proposed disorder in brain mechanisms as an etiological factor</article-title> <source>J Nerv Ment Dis</source> <year>1960</year> <volume>130</volume> <fpage>107</fpage> <lpage>19</lpage> </nlm-citation> </ref> <ref id="ref3"> <label>3</label> <nlm-citation citation-type="book"> <person-group person-group-type="author"> <name> <surname>Kaplan</surname> <given-names>HI</given-names> </name> <name> <surname>Sadock</surname> <given-names>BJ</given-names> </name> </person-group> <article-title>Synopsis of Psychiatry: Behavioral Sciences, Clinical Psychiatry</article-title> <source></source> <publisher-loc>Lippincott Williams and Wilkins</publisher-loc> <publisher-name>Baltimore Maryland</publisher-name> <year>2003</year> <volume></volume> <fpage>718</fpage> <lpage>29</lpage> </nlm-citation> </ref> <ref id="ref4"> <label>4</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Coskun</surname> <given-names>M</given-names> </name> <name> <surname>Mukaddes</surname> <given-names>NM</given-names> </name> </person-group> <article-title>Mirtazapine treatment in a subject with autistic disorder and fetishism</article-title> <source>J Child Adolesc Psychopharmacol</source> <year>2008</year> <volume>18</volume> <fpage>206</fpage> <lpage>9</lpage> </nlm-citation> </ref> <ref id="ref5"> <label>5</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"> <name> <surname>Dozier</surname> <given-names>CL</given-names> </name> <name> <surname>Iwata</surname> <given-names>BA</given-names> </name> <name> <surname>Worsdell</surname> <given-names>AS</given-names> </name> </person-group> <article-title>Assessment and treatment of foot-shoe fetish displayed by a man with autism</article-title> <source>J Appl Behav Anal</source> <year>2011</year> <volume>44</volume> <fpage>133</fpage> <lpage>7</lpage> </nlm-citation> </ref> <ref id="ref6"> <label>6</label> <nlm-citation citation-type="journal"> <person-group person-group-type="author"></person-group> <article-title></article-title> <source></source> <year></year> <volume></volume> <fpage></fpage> </nlm-citation> </ref> </ref-list> </back> </article>