Morgellons: Difference between revisions

Morgellons or Morgellons disease is a controversial name for an alleged polysymptomatic syndrome characterized by the patient's presentation of intense itching, skin lesions and the patient's claim of finding unusual structures, fibers or objects in or on the skin as well as a wide range of other chronic symptoms. These symptoms are occasionally accompanied by the belief in infestation by some unknown arthropod or parasite. The term Morgellons is not in accepted use by the medical community and the syndrome is widely held by the medical community to be a presentation of delusional parasitosis. There is no agreed-upon physical cause, etiology, diagnostic criteria or proven treatment. Pressure from patients convinced they have Morgellons resulted in June 2006 in a statement from the federal Centers for Disease Control and Prevention that it had begun organizing a committee for the purpose of investigating the ailment to determine whether it exists.

Origin of name

The name Morgellons was coined in 2002 by Mary Leitao of McMurray, PA, while investigating her son's unexplained rash. She named the condition Morgellons (with a hard g), after a condition from the monograph A Letter to a Friend by Sir Thomas Browne, in 1690, wherein he describes several medical conditions in his experience, including that endemial distemper of children in Languedoc, called the morgellons, wherein they critically break out with harsh hairs on their backs. A 1935 paper by British doctor C.E. Kellett identifies the name morgellons with the Provençal term masclous, or "little flies". It is doubtful that the 17th century disease has anything to do with modern day Morgellons, however the similarities were such that Leitao elected to use the name as a consistent label when addressing politicians, physicians and health departments.

Morgellons Research Foundation

The naming of the condition in 2002 coincided with the creation of the Morgellons Research Foundation by Leitao, who has a degree in biology and has worked as a chemist and electron microscope operator. The Morgellons Research Foundation web site states: "This non-profit foundation is dedicated to finding the cause of an emerging infectious disease, which mimics scabies and lice." The foundation attempts to raise public awareness of Morgellons via web and press campaigns. They conduct limited research into the cause of the symptoms. They also conduct letter writing campaigns to the US Congress, urging that Morgellons be taken seriously.

In May 2006 the Morgellons Research Foundation was featured in a number of local TV news segments coordinated by the MRF's director of communications. This resulted in a significant rise in the public awareness of the term Morgellons. In February 2005, a similar report on a local Fox affiliate in Duval County, FL, prompted the Duval County Health Department (DCHD) to investigate. Their report concludes:

[…] it was determined after extensive reviewing of these articles that Morgellons Disease is synonymous with delusional parasitosis (CDC, 1999).

DCHD Epidemiology consulted a pediatric dermatologist within the health department for his professional opinion. It was concluded that this is a psychological condition that has been mentioned in literature for hundreds of years.

The DCHD report notes that there was a significant spike in reported cases after the news report, but note: "this is attributed to the airing of Fox News’ coverage of the illness and is not a true cluster of disease"

In response to the May 2006 local TV coverage, the Los Angeles County Department of Health services issued a statement:

No credible medical or public health association has verified the existence or diagnosis of "Morgellons Disease." The current description of the disease is vague and covers many conditions. Until there is a credible, national standard for the diagnosis of this condition, there is no basis for making it a reportable disease.

Symptoms

The symptoms are frequently characterized as rashes or non-healing skin lesions associated with unusual structures that look like granules and filaments, and in particular a burning or itching sensation as if small parasites are crawling on or under the skin.

When treated as a fungal infection with topical medications, the symptoms return within days and further use of the antifungal drug is ineffective.

Some sufferers have tested positive for Lyme disease (borreliosis).

Some sufferers complain of seeing insects flying in and out of their skin, while others say they have filaments or fibers growing out of their skin. Some of these fibers are microscopic, while others are so large that they can be seen growing with the naked eye. The fibers range in color, some being white, blue, black or red, and are often dismissed by doctors as lint. It is also noted that widespread reports of skin fibers only date back to the time they were described at a Morgellons website.

Many of the symptoms are shared, but no one symptom is shared by all individuals. The Morgellons Research Foundation states that the "troubling sensations and accompanying physical structures" are the most consistent symptoms.

Diagnosis

The symptoms of patients presenting with Morgellons are varied, and match several other medical conditions. Frequently these symptoms are diagnosed as any of a number of conditions including:

• Scabies - an infestation of the mite Sarcoptes scabei.
• Lice - an infestation of parasitic insects.
• Atopic Dermatitis or Eczema - a common skin condition with various causes including stress.
• Neurodermatitis - Eczema or other skin condition exacerbated by scratching
• Tinea - A fungal infection of the skin or hair.
• Folliculitis - An infection of the hair follicles.
• Cellulitis - A skin infection.
• Seborrhea - A condition due to over-active sebaceous glands
• Impetigo - A rash caused by bacterial infection
• Drug side effects - from use, overuse, or withdrawal.

If a specific complaint is not identified, the doctor could diagnose a medically unexplained physical symptoms (MUPS) syndrome, such as fibromyalgia or chronic fatigue syndrome. Diagnosis of MUPS is seldom a satisfactory situation for the patient, as many patients feel this implies it is "all in their head", and this can lead to an adversarial doctor-patient relationship.

Very few doctors will offer a diagnosis of Morgellons. Sufferers generally self-diagnose after conventional treatments for the original diagnosis seem not to be working. At this point the patient is sometimes diagnosed with delusional parasitosis.

Delusional parasitosis

Presentations of Morgellons are frequently diagnosed as delusional parasitosis. The symptoms of delusional parasitosis are very similar to those presented by a Morgellons sufferer who rejects conventional diagnosis of their symptoms, or who presents a belief in the existence of an organism that cannot be observed except by the patient. There is no agreed upon differential diagnosis since Morgellons is not an accepted medical condition.

In her article Delusory Parasitosis, Nancy C. Hinkle outlines thirteen indications of delusional parasitosis, many of which are shared by patients claiming to have Morgellons. These indications include:

• The presentation of physical evidence such as skin scrapings and debris
• Obsessive cleaning and use of disinfectants and insecticides
• Rejection of the possibility of psychological or other explanations
• Emotional trauma, desperation, social isolation
• Having seen numerous physicians, to no avail

Not all patients claim to have delusions of parasitosis, since many do not believe a parasite is responsible, and instead describe the cause as some other unknown pathogen such as a bacteria or virus. The belief that fibers are emerging from their skin is still present in these patients. This belief is generally regarded by doctors as either delusional or a result of simply mistaking fibers from clothing (lint) as fibers emerging the body. One doctor, declining to be named for a news article, indicated that he treats patients simply by placing a cast over the affected area of skin, protecting it from the patient's scratching, which results in healing in a matter of weeks.

Morgellons theories and research

No clinical studies have been done into Morgellons. Only one paper mentioning Morgellons has been published in a medical journal; the paper was co-authored by the founder of the Morgellons Research Foundation and other MRF members.

Dr. William Harvey of Houston, Texas champions the disease as real, probably related to Lyme disease, and claims success in treating it with antibiotics.

Dr. George Schwartz of Santa Fe, New Mexico believes the cause may be the bacterium Stenotrophomonas maltophilia, and has claimed success in treating patients with antibiotics that target this waterborne bacterium. In his booklet "Lisa's Disease, A Fiber Disease", he describes four stages to this condition. Stage four places body organs in jeopardy. Schwartz also treated patients with anti-worm medication and diatomaceous earth.

Randy S. Wymore, Ph.D., of the Oklahoma State University Center for Health Sciences in Tulsa, OK is the current Director of Research at the Morgellons Research Foundation (since spring of 2005). Wymore is examining the fibers, scabs and other samples from Morgellons patients. To date, Wymore's preliminary research has no conclusive results.

Wymore believes that in 2006 formal studies with Morgellons patients will begin. The Morgellons Research Foundation has recently published a Case Definition for physicians. One of Wymore's goals is to identify concrete diagnostic criteria.

See also

• Medically Unexplained Physical Symptoms

Notable people claiming to have Morgellons

• Billy Koch

External links

• Morgellons Research Foundation
• Gallery of images taken by a Morgellons disease sufferer (Ever Hopeful's Delusions)

Many Vivid Photos, MorgellonsUSA.com http://www.morgellonsusa.com

• Lymebusters' Morgellon's message board. Large community base of self-described Morgellon's sufferers, topics include discussion of symptoms, of treatments, and of a possible link between Morgellon's and Lyme disease.
• 2006 Silent Epidemic via (broken link) Video, detailing hypothesis as to origins of Morgellon's syndrome.
• "The mystery of Morgellons disease: infection or delusion?" (PubMed)
• Morgellons Watch Skeptical analysis and debunking of Morgellons.

• In the news
  • "Mystery disease", CBS News, 05 May 2006.
  • "Doctors puzzled over bizarre infection surfacing in South Texas", My San Antonio, 15 May 2006.
  • "Parasitic Infection Flummoxes Victims and Doctors, Slashdot, 19 May 2006.
  • "Frightening Skin Disease Invades L.A., CBS News, 20 May 2006.