Morgellons Disease: The Spread of a Mass Psychogenic Illness via the Internet and Its Implications in Hand Surgery

Abstract

Somatic manifestations of mental illness sometimes occur in patients presenting to hand specialists. These conversion disorders can also occur in groups, a phenomenon known as “mass psychogenic illness.” The increasing penetrance of the Internet and social media in modern society has greatly facilitated the interaction of patients with others with similar disorders. One example relevant to hand surgery is “Morgellons disease,” a disorder popularized in 2002 and characterized by a firm belief in foreign material extruding from the skin, leading to nonhealing, self-inflicted ulcerations and excoriations. A series of 4 patients collected through an informal survey of hand surgeons regarding experience with Morgellons disease is reviewed and discussed. All patients in the series presented with a chief complaint of foreign material extruding from the hand. In 1 case, the complaint was made by a young patient’s mother. In none of the patients were foreign bodies identified, although 2 patients demonstrated significant ulcerations and scars from self-excoriation. Three patients had a somatic condition affecting the hand or upper extremity, 1 directly related to self-excoriation and 2 unrelated. Treatments, workups, and ultimate outcomes varied among patients. Patients presenting with Morgellons disease often undergo multiple unnecessary tests and are at risk of inappropriate procedures. It is therefore important that providers have a compassionate understanding of the involved psychology. Herein, we offer an approach to the recognition of and treatment strategies for these patients.

Review of literature and clinical practice experience for the therapeutic management of Morgellons disease

“…In some medical literature, MD has been referred to as an 'internet-transmitted disease'. 26,27 This terminology is used to describe the phenomenon of online communities where patients can share their experiences and seek advice from peers. While these communities can provide valuable support to individuals with MD, there is a growing concern regarding the trend towards self-diagnosis and the use of unproven alternative therapies that are recommended in these forums.…”

“…In some medical literature, MD has been referred to as an ‘internet‐transmitted disease’ 26,27 . This terminology is used to describe the phenomenon of online communities where patients can share their experiences and seek advice from peers.…”

Morgellons: Uma Investigação Crítica Da Síndrome E Sua Relação Com a Saúde Dermatológica E Mental

“…Na doença de Morgellons, uma característica marcante é a firme convicção do indivíduo quanto à validade de seu próprio diagnóstico, possuindo grande resistência em acreditar e aceitar as explicações alternativas. Em alguns casos, os pacientes com essa condição chegam a procurar cirurgiões em busca de intervenções para tentar eliminar a infestação que sentem na pele (NUNZIATO et al, 2021).…”

“…Nunziato et al, (2021), a doença de Morgellons ilustra uma questão de como a mente e o corpo podem estar ligados por uma conexão, onde o psicológico tende a se manifestar, pelo menos em parte, como sintomas físicos. O estresse e a histeria coletiva também desempenham um papel significativo no surgimento destes sintomas.…”