Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy

Abstract

BackgroundMorgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies.MethodsA descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC) during 2006–2008. A case was defined as the self-reported emergence of fibers or materials from the skin accompanied by skin lesions and/or disturbing skin sensations. We collected detailed epidemiologic data, performed clinical evaluations and geospatial analyses and analyzed materials collected from participants' skin.ResultsWe identified 115 case-patients. The prevalence was 3.65 (95% CI = 2.98, 4.40) cases per 100,000 enrollees. There was no clustering of cases within the 13-county KPNC catchment area (p = .113). Case-patients had a median age of 52 years (range: 17–93) and were primarily female (77%) and Caucasian (77%). Multi-system complaints were common; 70% reported chronic fatigue and 54% rated their overall health as fair or poor with mean Physical Component Scores and Mental Component Scores of 36.63 (SD = 12.9) and 35.45 (SD = 12.89), respectively. Cognitive deficits were detected in 59% of case-patients and 63% had evidence of clinically significant somatic complaints; 50% had drugs detected in hair samples and 78% reported exposure to solvents. Solar elastosis was the most common histopathologic abnormality (51% of biopsies); skin lesions were most consistent with arthropod bites or chronic excoriations. No parasites or mycobacteria were detected. Most materials collected from participants' skin were composed of cellulose, likely of cotton origin.ConclusionsThis unexplained dermopathy was rare among this population of Northern California residents, but associated with significantly reduced health-related quality of life. No common underlying medical condition or infectious source was identified, similar to more commonly recognized conditions such as delusional infestation.

Diagnosis and treatment management procedure in a case with delusional parasitosis

“…Tipik olarak hastalar, derideki varsandıkları patojeni ortadan kaldırmak için kendilerine zarar verecek şekilde tırnak, cilt soyucu, cımbız gibi gereçlerle ciltte yara, erozyonlara yol açabilirler. [9][10][11][12] Hastamız böceklerle vücudunun istila olduğunu düşünen klasik bir olguydu; görsel varsanısı nedeniyle evinde pestisit kullanmıştı ve kaşıma, tırnakları ile kazı-ma yoluyla cildinde yaralara neden olmuştu.…”

Morgellons: a novel dermatological perspective as the multisystem infective disease borreliosis

“…Note that the single fiber strands on the side of the twisted cotton thread are closer in size to that of the MD fiber depicted here. The fact that the CDC study only used a dermoscope in the search for filaments may explain why only cotton fibers were found in that study, and so the opportunity to find the smaller filaments found in MD was missed 9 .…”

“…In 2012 Pearson et al published a long awaited Centre of Disease Control (CDC) sponsored study on the possible causes of MD 9 . The key findings of this study of only 115 patients were: median age 52, 77% female, 77% Caucasian, 70% chronic fatigue symptoms, 54% reported poor state of health, 59% were found to have cognitive defects on testing, 63% had somatic complaints, 50% had detectable drugs in hair analysis and 78% reported exposure to solvents.…”

Advances in and hope for the treatment of parasitosis

“…This condition, also called Morgellon's disease, has defied easy identification of the causative organisms. Even the Center for Disease Control's efforts to identify the cause have not yet found the specific infectious agent or agents that cause this debilitating condition (1).…”