A Mysterious Morgellons Disease

Morgellons, also called Morgellons disease or Morgellons syndrome is a popular and controversial condition in which unusual thread-like fibers appear under the skin. The patient may feel like something is crawling, biting, or stinging all over. Experts note that the signs and symptoms of Morgellons disease are very similar to those of a mental illness involving false beliefs about infestation by parasites (delusional parasitosis). Your doctor may call it an "unexplained dermopathy," which means a skin condition that occurs without a known reason. Other medical professionals have dubbed the condition "fiber disease."

Who Gets Morgellons?

In the past, few doctors had heard of Morgellons. But in response to scattered reports, the CDC worked together with several other health care agencies to investigate this condition. Most reports came from California, Texas, and Florida, although patients have been seen in all 50 states.

The CDC study found that Morgellons is most likely to affect middle-aged white women.

Many of the patients in the CDC study showed signs of being obsessively concerned about health problems in general. This is called somatic concerns.

About half of the people in the study had other health problems, including depression and drug abuse.

Causes

There is no known cause for Morgellons disease. 

Symptoms

Unpleasant skin sensations are the main complaint. People with Morgellons may also complain of:

• Feeling like bugs are crawling all over the skin.
• Burning or stinging sensations under the skin.
• Intense itching.
• Skin sores that appear suddenly and heal slowly.
• Sores that leave very red (hyperpigmented) scars.
• Some patients report thread-like fibers stuck in the skin.

People with Morgellons sometimes complain of other symptoms which may include:

• Difficulty paying attention and concentrating
• Extreme fatigue
• Hair loss
• Joint and muscle pain
• Nervous system problems
• Tooth loss
• Sleep problems
• Short-term memory loss

How to cope with the signs and symptoms

The signs and symptoms linked to Morgellons disease can be distressing. Even though health professionals may disagree about the nature of the condition, you deserve compassionate treatment. To manage your signs and symptoms:

• Establish a caring health care team. Find a doctor who acknowledges your concerns and does a thorough examination.
• Be patient. Your doctor will likely look for known conditions that point to evidence-based treatments before considering a diagnosis of Morgellons disease.
• Keep an open mind. Consider various causes for your signs and symptoms, and follow your doctor's recommendations for treatment — which may include long-term mental health therapy.
• Seek treatment for other conditions. Get treatment for anxiety, depression or any other condition that affects your thinking, moods or behavior.

Treatment

There is no known cure for Morgellons. Treating any medical or psychiatric problems that occur at the same time as Morgellons may help ease Morgellons symptoms in some patients.

Delusional parasitosis

Many dermatologists treat Morgellons as delusional parasitosis. After a thorough medical examination to rule out known organic causes for the symptoms, delusional parasitosis patients are typically prescribed one of several typical antipsychotic drugs. In the past, pimozide was the drug of choice; in addition to antipsychotic activity, it also has antipruritic activity, meaning it inhibits the sensation of itching. However, pimozide requires frequent electrocardiographic monitoring. Currently, atypical antipsychotics such as olanzapine or risperidone are used as first line treatment. Antipsychotics are effective at treating delusional parasitosis at doses as low as one-fifth to one-tenth the dose typically prescribed for schizophrenia. It is common for patients who believe they have Morgellons to reject a physician's diagnosis of delusional parasitosis. It has been suggested that the term Morgellons should be adopted by dermatologists to enhance their rapport with their patients, allowing them to overcome this resistance.

Infectious Disease

People who say they have Morgellons frequently reject the diagnosis of delusional parasitosis, "report that their symptoms are not taken seriously", and refuse psychotropic medicine. Individuals have claimed positive results from antibiotic treatment. Dermatologists say that these positive effects of antibiotic use for some patients are likely the result of a placebo effect or anti-inflammatory actions of the drugs. They advise against prescribing antibiotics, which may reinforce the patients' delusions instead of addressing what these doctors consider the core problem: delusional parasitosis. In addition, long-term antibiotic use can have serious side effects.

Prognosis

This condition is not currently recognized as a distinct clinical disorder with established diagnostic criteria that are generally accepted by the medical community and many dermatologists consider the condition to be synonymous with delusional parasitosis (DP). To date, most of what is known about the condition is based on isolated case reports or anecdotal accounts. A range of potential infectious (e.g., Lyme disease, parasitic) and non-infectious causes has been postulated, but the etiology of this condition remains unknown and there have been no proven effective medical therapies.