The original regimen involved patient isolation, enforced bed rest, diary writing, manual labor, and lectures on the importance of self-acceptance and positive endeavor. Since the 1930s, the treatment has been modified to include out-patient and group treatments. This modified version is known as neo-Morita therapy. Medications have also gained acceptance as a treatment option for taijin kyofusho. Other treatments include systematic desensitization, which includes slowly exposing one self to the fear, and learning relaxation skills, to extinguish fear and anxiety. Milnacipran, a serotonin–norepinephrine reuptake inhibitor (SNRI), is currently used in the treatment of taijin kyofusho and has been shown to be efficacious for the related social anxiety disorder. The primary aspect of treating this disorder is getting patients to focus their attention on their body parts and sensations. Prevalence
Typically, this disease is presaged by a childhood history of social inhibition and shyness. It is possible that it could result from a humiliating traumatic experience, or it could emerge from a lifelong onset of the illness that only comes to the surface after time.Clinical data indicates that more males have the condition than females, despite the fact that females scored higher on a social phobia scale than men, and report higher scores on proclivity towards feelings of embarrassment. This differs from Western society where the prevalence of females with social phobias is to some extent greater than that of males. The lifetime prevalence of the disorder falls anywhere between 3% and 13% with changes in severity occurring throughout ones lifetime.
Complement fixation allows for a measure of severity of cases by quantifying the antibody level, and is thus useful for monitoring treatment response. It is however only sensitive for 85% of cases, and cross-reacts with H. capsulatum. Differential diagnosis
The disease can appear similar to tuberculosis, leukaemia, and lymphoma

Treatment
Both P. brasiliensis and P. lutzii are in-vitro susceptible to most antifungal agents, unlike other systemic fungal infections. Mild and moderate forms are treated with itraconazole for 9 to 18 months, as this has been shown to be more effective, has a shorter treatment duration and is more tolerated. Acidic beverages have been shown to reduce absorption of itraconazole. Co-trimoxazole is a second line agent, and is preferred for those with brain involvement, and during pregnancy. For severe cases, intravenous treatment with amphotericin B is indicated, for an average of 2 to 4 weeks.Prednisolone prescribed at the same time may reduce inflammation during treatment. Patients should be treated until stabilisation of symptoms, and increase in body weight. Advice in regards to nutritional support, as well as smoking and alcohol intake should be provided. Adrenal insufficiency, if found, is treated with corticosteroids. Clinical criteria for cure includes the absence or healing of lesions, stabilisation of body weight, negative as well as negative autoantibody tests. There is insufficient data to support the benefits of above drugs to treat the disease. Epidemiology
Paracoccidioidomycosis is endemic in rural areas of Latin America, from southern Mexico to Argentina, and is also found in Brazil, Colombia, Venezuela, Ecuador and Paraguay.