Morgellons disease (MD) is a rare dermatopathy characterized by nonspecific symptoms and the production of multicolored fibers and granular tissue from diffuse skin ulcerations which are described as being either pruritic or painful.The etiology of MD is currently unknown; previous studies have suggested both psychiatric and infectious causes, with increasing interest over the previous decade in elaborating a possible pathogenesis for the disease secondary to infection by Borrelia species. We report a middle-aged Caucasian female who developed symptoms of MD in the days following exposure to a tick bite after spending an afternoon hiking through a wooded area. She was subsequently treated with a course of Doxycycline and found on two-week follow-up to have complete remission of her symptoms. This case report further supports the theory for an infectious etiology of MD and encourages future studies into its pathophysiology.

Peer intervention aroundproblem drinking anddrug use is an understudied, but increasingly imponant, area in occupationallindustrial programming. Consistent supervision isnotavailable inmanywork settings. At the same time, peer mechanisms are primary work principles and structures in some occupations. This study explores procedures for evaluating and implementing a peer intervention program.The NMU Peer Committee Project T he National Maritime Union (NMU) Peer Committee Project was administered by the author of thisstudy, who is also director of the Personal Service Unit (PSU) of the NMU Pension and Welfare Plan, over an eight-month period beginning in mid-February, 1985. Participants were active merchant seamen and members of the union, whom the PSU serves.The core programmatic theme of Employee Assistance has been supervisory intervention around documented, impaired job performance, with the use of worker-based disciplinary mechanisms as a motivator to seek help. It is a model which reflects a top-down design based on the most traditional and accepted notions of how work organizations operate. However, theNMU project aimed at exploring the use of and carefully reported on the implementation of a model, in large measure, poles apart from the original notion. It was a worker-based peer intervention and networking strategy, which was more horizontal than vertical, more participatory than supervisory, and more bottom-up than top-down in design. The central purpose of this project was to tell the story of the implementation of this model, with an eye toward its viability and the replication of the implementation strategy again at the NMU or elsewhere.The project activity had two distinct but connected phases. First, from the program's cases, thirty active seamen were selected who had used the program consistently, had made referrals to it, were recognized by others as trusted helpers and/or had upgraded themselves in the industry. Attention was paid