Morgellons
Encyclopedia
Morgellons is a name given in 2002 by Mary Leitao to a proposed condition characterized by a range of cutaneous (skin) symptoms including crawling, biting, and stinging sensations (formication
Formication
Formication is the medical term for a sensation that resembles that of insects crawling on the skin. It is one specific form of a set of sensations known as paresthesia, which also include the more common prickling, tingling sensation of "pins and needles"...

); finding fibers on or under the skin; and persistent skin lesions (e.g., rashes or sores). Most doctors, including dermatologists and psychiatrists, regard Morgellons as a manifestation of known medical conditions, including delusional parasitosis
Delusional parasitosis
Delusional parasitosis is a form of psychosis whose victims acquire a strong delusional belief that they are infested with parasites, whereas in reality no such parasites are present...

.

Despite the lack of evidence that Morgellons is a novel or distinct condition and the absence of any agreed set of diagnostic symptoms, the Morgellons Research Foundation and self-diagnosed Morgellons patients have successfully lobbied members of Congress and the U.S. government's Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...

 (CDC) to investigate the proposed condition. The CDC states that while it is not known at present whether the condition represents a new disease entity, or whether persons who identify themselves as having Morgellons have a common cause for their symptoms, share common risk factors, or are contagious, it has begun an epidemiological investigation of the "Unexplained Dermopathy (aka 'Morgellons')."

Mary Leitao and the MRF

In 2001, according to Mary Leitao, her then two-year-old son developed sores under his lip and began to complain of "bugs." Leitao, who graduated with a BS in Biology, and worked for five years at Boston hospitals as a lab technician before becoming a stay-at-home mother, says she examined the sores with her son's toy microscope and discovered red, blue, black, and white fibers. She states that she took her son to see at least eight different doctors who were unable to find any disease, allergy, or anything unusual about her son's described symptoms. Fred Heldrich, a Johns Hopkins
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...

 pediatrician with a reputation "for solving mystery cases," examined Leitao's son. Heldrich found nothing abnormal about the boy's skin, wrote to the referring physician that "Leitao would benefit from a psychiatric evaluation and support," and registered his worry about Leitao's "use" of her son. Psychology Today reports that Leitao last consulted an unnamed Johns Hopkins infectious disease specialist who after reviewing her son's records refused to see him, suggesting Leitao herself might suffer from "Munchausen's by proxy
Munchausen syndrome by proxy
Münchausen syndrome by proxy is a label for a pattern of behavior in which care-givers deliberately exaggerate, fabricate, and/or induce physical, psychological, behavioral, and/or mental health problems in others. Other experts classified MSbP as a mental illness...

, a psychiatric syndrome in which a parent pretends a child is sick or makes him sick to get attention from the medical system." This opinion of a potential psychological disorder, according to Leitao, was shared by several medical professionals she sought out:
Leitao says that her son developed more sores, and more fibers continued to poke out of them. She and her husband, Edward Leitao, an internist with South Allegheny Internal Medicine in Pennsylvania
Pennsylvania
The Commonwealth of Pennsylvania is a U.S. state that is located in the Northeastern and Mid-Atlantic regions of the United States. The state borders Delaware and Maryland to the south, West Virginia to the southwest, Ohio to the west, New York and Ontario, Canada, to the north, and New Jersey to...

, felt their son suffered from "something unknown." She chose the name Morgellons disease (with a hard g) from a description of an illness in the monograph A Letter to a Friend by Sir Thomas Browne
Thomas Browne
Sir Thomas Browne was an English author of varied works which reveal his wide learning in diverse fields including medicine, religion, science and the esoteric....

, in 1690, wherein Browne describes several medical conditions in his experience, including "that endemial distemper of children in Languedoc
Languedoc
Languedoc is a former province of France, now continued in the modern-day régions of Languedoc-Roussillon and Midi-Pyrénées in the south of France, and whose capital city was Toulouse, now in Midi-Pyrénées. It had an area of approximately 42,700 km² .-Geographical Extent:The traditional...

, called the morgellons, wherein they critically break out with harsh hairs on their backs." There is no suggestion that the symptoms described by Browne are linked to the alleged modern cases.

Leitao started the Morgellons Research Foundation (MRF) in 2002 (informally) and as an official non-profit in 2004. The MRF states on its website that its purpose is to raise awareness and funding for research into the proposed condition, described by the organization as a "poorly understood illness, which can be disfiguring and disabling." Leitao stated that she initially hoped to receive information from scientists or physicians who might understand the problem, but instead, thousands of others contacted her describing their sores and fibers, as well as neurological symptoms, fatigue, muscle and joint pain, and other symptoms. The MRF claims to have received self-identified reports of Morgellons from all 50 US states and 15 other countries, including Canada, the UK, Australia, and the Netherlands, and states that they have been contacted by over 12,000 families.

Media coverage

In May 2006, a CBS news segment on Morgellons aired in Southern California. The same day the Los Angeles County Department of Health services issued a statement saying, "No credible medical or public health association has verified the existence or diagnosis of 'Morgellons Disease'," and "at this time there is no reason for individuals to panic over unsubstantiated reports of this disease." In June and July 2006 there were segments on CNN
CNN
Cable News Network is a U.S. cable news channel founded in 1980 by Ted Turner. Upon its launch, CNN was the first channel to provide 24-hour television news coverage, and the first all-news television channel in the United States...

, ABC
American Broadcasting Company
The American Broadcasting Company is an American commercial broadcasting television network. Created in 1943 from the former NBC Blue radio network, ABC is owned by The Walt Disney Company and is part of Disney-ABC Television Group. Its first broadcast on television was in 1948...

's Good Morning America
Good Morning America
Good Morning America is an American morning news and talk show that is broadcast on the ABC television network; it debuted on November 3, 1975. The weekday program airs for two hours; a third hour aired between 2007 and 2008 exclusively on ABC News Now...

, and NBC
NBC
The National Broadcasting Company is an American commercial broadcasting television network and former radio network headquartered in the GE Building in New York City's Rockefeller Center with additional major offices near Los Angeles and in Chicago...

's The Today Show. In August 2006, a segment of the ABC show Medical Mysteries was devoted to the subject. The disease was featured on ABC
American Broadcasting Company
The American Broadcasting Company is an American commercial broadcasting television network. Created in 1943 from the former NBC Blue radio network, ABC is owned by The Walt Disney Company and is part of Disney-ABC Television Group. Its first broadcast on television was in 1948...

's Nightline on January 16, 2008, and as the cover story of the January 20, 2008 issue of the Washington Post Magazine.

The first article to propose Morgellons as a new disease in a scientific journal was a review article co-authored by members of the MRF and published in 2006 by the American Journal of Clinical Dermatology. An article in the San Francisco Chronicle
San Francisco Chronicle
thumb|right|upright|The Chronicle Building following the [[1906 San Francisco earthquake|1906 earthquake]] and fireThe San Francisco Chronicle is a newspaper serving primarily the San Francisco Bay Area of the U.S. state of California, but distributed throughout Northern and Central California,...

reported, "There have been no clinical studies" (of Morgellons disease). A New Scientist
New Scientist
New Scientist is a weekly non-peer-reviewed English-language international science magazine, which since 1996 has also run a website, covering recent developments in science and technology for a general audience. Founded in 1956, it is published by Reed Business Information Ltd, a subsidiary of...

article in 2007 also covered the phenomenon noting that people are reporting similar symptoms in Europe and Australia.

In an article published in The Los Angeles Times on April 22, 2010, singer-songwriter Joni Mitchell
Joni Mitchell
Joni Mitchell, CC is a Canadian musician, singer songwriter, and painter. Mitchell began singing in small nightclubs in her native Saskatchewan and Western Canada and then busking in the streets and dives of Toronto...

 claimed to be a sufferer of the condition, stating:

Former Major League Baseball pitcher Billy Koch
Billy Koch
William Koch is a former Major League Baseball relief pitcher. He entered the majors with the Toronto Blue Jays and most recently pitched for the Florida Marlins in 2004.- Baseball career :...

 and his entire immediate family have been noted in the media to be sufferers.

CDC investigation

Following a mailing campaign coordinated by the Morgellons Research Foundation in which self-described sufferers clicked on the foundation Web site and sent thousands of form letters to members of Congress, a Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...

 (CDC) task force first met in June 2006. In July 2006, Dan Rutz, MPH, a communications specialist for the CDC, said, "We're not ready to concede there's a new disease, but the volume of concern has stepped up because a lot of people are writing or calling their congressmen about it." By August 2006, the task force consisted of 12 people, including two pathologists, a toxicologist, an ethicist, a mental health expert and specialists in infectious, parasitic, environmental and chronic diseases. In May 2007, KGW-TV Newschannel 8's Laural Porter asked Rutz if he had any information about the nature of the fibers. At that time Rutz said, "None. We don't know. We haven't studied them in a lab yet. There is nothing to imply there is [an infectious process], but our mind is open to everything, including that remote possibility."

In June 2007, the CDC opened a website on "Unexplained Dermopathy (aka 'Morgellons')". By November 2007, the CDC had announced an investigation process, stating that, "The primary goals of the investigation are to better describe the clinical and epidemiologic features of this condition and to generate hypotheses about possible risk factors." Kaiser Permanente
Kaiser Permanente
Kaiser Permanente is an integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield...

 in Northern California was chosen to assist with the investigation, which will begin when the scientific protocols and review board structure have been prepared and approved. Investigators will report on the geographic distribution of the illness and estimate rates of illness in affected communities. The investigation will involve skin biopsies from affected patients and characterization of foreign material such as fibers or threads obtained from patients to determine their potential source. In January 2008 it was reported that CDC was enlisting the aid of the U.S. Armed Forces Institute of Pathology and the American Academy of Dermatology "to conduct 'immediate' and 'rigorous' research."

On 4 November 2009, the CDC issued a preliminary report based on an external peer review of the project. CDC said "We recently completed the data analysis. A final report has been submitted for publication in a peer-reviewed scientific journal."

Mayo Clinic study

A study conducted of 108 patients at the Mayo Clinic
Mayo Clinic
Mayo Clinic is a not-for-profit medical practice and medical research group specializing in treating difficult patients . Patients are referred to Mayo Clinic from across the U.S. and the world, and it is known for innovative and effective treatments. Mayo Clinic is known for being at the top of...

 was published in Archives of Dermatology
Archives of Dermatology
Archives of Dermatology is a monthly professional medical journal published by the American Medical Association. Archives of Dermatology publishes original, peer-reviewed reports and discussions that address the effectiveness of diagnosis and treatment in medical and surgical dermatology,...

on May 16, 2011. The study failed to find evidence of skin infestation despite doing skin biopsies and examining specimens provided by the patients. The study, which was conducted between 2001 and 2007, concluded that the feeling of skin infestation was a delusion, delusional parasitosis
Delusional parasitosis
Delusional parasitosis is a form of psychosis whose victims acquire a strong delusional belief that they are infested with parasites, whereas in reality no such parasites are present...

.

Symptoms and diagnosis

Morgellons is not recognized as a unique disorder, so there is currently no list of symptoms or differential diagnosis
Differential diagnosis
A differential diagnosis is a systematic diagnostic method used to identify the presence of an entity where multiple alternatives are possible , and may also refer to any of the included candidate alternatives A differential diagnosis (sometimes abbreviated DDx, ddx, DD, D/Dx, or ΔΔ) is a...

 for Morgellons that is generally accepted by the medical community. Patients usually self-diagnose based on media reports and the internet.

The 2007 Atlas of Human Parasitology covers the proposed condition in its section on "Pseudoparasites and Artifacts":
The main purported symptom of Morgellons is "a fixed belief" that fibers are embedded in or extruding from the skin. The Morgellons Research Foundation claims patients have reported additional—though unsubstantiated—symptoms, including:
  • formication
    Formication
    Formication is the medical term for a sensation that resembles that of insects crawling on the skin. It is one specific form of a set of sensations known as paresthesia, which also include the more common prickling, tingling sensation of "pins and needles"...

    , the sensation of insects "moving, stinging or biting" beneath the skin
  • skin lesions, both spontaneous and self-inflicted
  • musculoskeletal effects and pain, including joints, muscles, tendons and connective tissue
  • disabling fatigue
  • cognitive and emotional effects


William T. Harvey, director of the MRF medical advisory board, claimed in 2007 that Morgellons patients exhibit laboratory findings including increased levels of inflammatory
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...

 cytokines, increased insulin
Insulin
Insulin is a hormone central to regulating carbohydrate and fat metabolism in the body. Insulin causes cells in the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in the liver and muscle....

, and antibodies to three bacterial pathogens, but did not provide evidence for these claims. Many Morgellons patients have symptoms that are also consistent with chronic fatigue syndrome
Chronic fatigue syndrome
Chronic fatigue syndrome is the most common name used to designate a significantly debilitating medical disorder or group of disorders generally defined by persistent fatigue accompanied by other specific symptoms for a minimum of six months, not due to ongoing exertion, not substantially...

, depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...

, obsessive–compulsive disorder, and attention deficit disorder. Rhonda Casey, chief of pediatrics at OSU Medical Center
Oklahoma State University Medical Center
Oklahoma State University Medical Center is a health institution located in Tulsa, Oklahoma. OSU Medical Center was known as Tulsa Regional Medical Center prior to the hospital's rebranding on November 2, 2006...

, while working with the OSU-CHS for the Investigation of Morgellons Disease, stated that her Morgellons patients looked ill with neurological symptoms, which included confusion, difficulty walking and controlling their feet (foot drop
Foot drop
Foot drop is the dropping of the forefoot due to weakness, damage to the peroneal nerve or paralysis of the muscles in the anterior portion of the lower leg. It is usually a symptom of a greater problem, not a disease in itself. It is characterized by the inability or difficulty in moving the ankle...

), and a sagging mouth when speaking. The OSU-CHS has issued a list of symptoms similar to that of the MRF.

Delusional parasitosis and other neuropsychological disorders

Most dermatologists, psychiatrists, and other medical professionals view Morgellons as a new name for a well established condition, delusional parasitosis
Delusional parasitosis
Delusional parasitosis is a form of psychosis whose victims acquire a strong delusional belief that they are infested with parasites, whereas in reality no such parasites are present...

, also known as "delusions of parasitosis" (DP or DOP) and Ekbom's Syndrome: Morgellons is "a pattern of dermatologic symptoms very similar, if not identical, to those of delusions of parasitosis," and "the vast majority" (elsewhere, 95%) of Morgellons patients are diagnosed with delusional parasitosis or another psychosomatic illness. This explanation is, however, "unpopular among individuals identifying themselves as having Morgellons disease."

In delusional parasitosis, patients hold a delusional belief that they are infested with parasites. They may experience formication
Formication
Formication is the medical term for a sensation that resembles that of insects crawling on the skin. It is one specific form of a set of sensations known as paresthesia, which also include the more common prickling, tingling sensation of "pins and needles"...

, a sensation similar to that of insects crawling on or under the skin. Individuals suffering from this condition may develop elaborate rituals of inspection and cleansing to locate and remove "parasites" and fibers, resulting in a form of self-mutilation; they injure themselves in attempts to be rid of the "parasites" by picking at the skin, causing lesion
Lesion
A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...

s, and then pick at the lesions, preventing them from healing. Patients with delusional parasitosis often present at the doctor's office with what MDs term the "matchbox sign
Matchbox sign
Matchbox sign is a psychiatric symptom. Patients with delusional parasitosis often present at the doctor's office with what MDs term the "matchbox sign", a medical sign characterized by the patient making collections of fibers and other foreign objects supposedly retrieved from the skin...

" -- a medical sign
Medical sign
A medical sign is an objective indication of some medical fact or characteristic that may be detected by a physician during a physical examination of a patient....

 characterized by the patient making collections of fibers and other foreign objects supposedly retrieved from the skin -- and, because of "unshakeable delusional ideation", strongly reject diagnoses that do not involve parasites. A significant minority of DP cases occur in groups of two, three, or more individuals in close proximity, even families, known by the French terms folie à deux
Folie à deux
-Further reading:*Halgin, R. & Whitbourne, S. Abnormal Psychology: Clinical Perspectives on Psychological Disorders. McGraw-Hill. ISBN 0072817216...

, folie à trois, and folie à famille. Delusional parasitosis, with symptoms that have "extraordinary similarities" to Morgellons, has been described in the medical literature for over 75 years. Dr. Noah Craft, a dermatologist at the Harbor-UCLA Medical Center, Torrance, CA
Torrance, California
Torrance is a city incorporated in 1921 and located in the South Bay region of Los Angeles County, California, United States. Torrance has of shore-front beaches on the Pacific Ocean, quieter and less well-known by tourists than others on the Santa Monica Bay, such as those of neighboring...

, has seen a handful of Morgellons patients and biopsied their skin lesions, but found only normal skin and inflammation, as one would find in a bump that has been picked at.

Some cases of delusional parasitosis have organic causes other than those associated with neurological/psychological conditions of unknown etiology. For example, formication, the sensation that bugs are crawling under one's skin, can be caused by allergies, diabetic neuropathy
Diabetic neuropathy
Diabetic neuropathies are neuropathic disorders that are associated with diabetes mellitus. These conditions are thought to result from diabetic microvascular injury involving small blood vessels that supply nerves in addition to macrovascular conditions that can culminate in diabetic neuropathy...

, menopause
Menopause
Menopause is a term used to describe the permanent cessation of the primary functions of the human ovaries: the ripening and release of ova and the release of hormones that cause both the creation of the uterine lining and the subsequent shedding of the uterine lining...

, skin cancer
Skin cancer
Skin neoplasms are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises...

, demodex mites, stimulant drug abuse or herpes zoster
Herpes zoster
Herpes zoster , commonly known as shingles and also known as zona, is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe...

. Both dementia and mental retardation have been reported in association with DP. Symptoms associated with delusional parasitosis, including urticaria
Urticaria
Urticaria is a kind of skin rash notable for pale red, raised, itchy bumps. Hives is frequently caused by allergic reactions; however, there are many non-allergic causes...

 (hives), paresthesia
Paresthesia
Paresthesia , spelled "paraesthesia" in British English, is a sensation of tingling, burning, pricking, or numbness of a person's skin with no apparent long-term physical effect. It is more generally known as the feeling of "pins and needles" or of a limb "falling asleep"...

 (unexplained tingling sensations in the skin), and pruritus
Itch
Itch is a sensation that causes the desire or reflex to scratch. Itch has resisted many attempts to classify it as any one type of sensory experience. Modern science has shown that itch has many similarities to pain, and while both are unpleasant sensory experiences, their behavioral response...

 are common side-effects of many prescription drugs or drug abuse. The sensations are real, but the attribution of the sensations to unknown parasites and the collection of fibers is part of the delusion.

The MRF's William Harvey has written that non-healing "Morgellons lesions" have been found on infants' bodies in locations that the infants cannot themselves reach to scratch.

Some cases of Morgellons have been diagnosed as "cutaneous dysaesthesia".

Role of the Internet

Morgellons patients usually self-diagnose on the Internet
Internet
The Internet is a global system of interconnected computer networks that use the standard Internet protocol suite to serve billions of users worldwide...

 and find support and confirmation in on-line communities of people with similar illness beliefs. In 2006, Waddell and Burke reported the influence of the Internet on their self-diagnosed Morgellons patients: "physicians are becoming more and more challenged by the many persons who attempt self-diagnosis on-line. In many cases, these attempts are well-intentioned, yet wrong, and a patient's belief in some of these oftentimes unscientific sites online may preclude their trust in the evidence-based approaches and treatment recommendations of their physician." Dermatologist Caroline Koblenzer specifically faults the MRF website for misleading patients: "Clearly, as more and more of our patients discover this site (MRF), there will be an ever greater waste of valuable time and resources on fruitless research into fibers, fluffs, irrelevant bacteria, and innocuous worms and insects." Vila-Rodriguez and MacEwan said in the American Journal of Psychiatry
American Journal of Psychiatry
The American Journal of Psychiatry is a monthly peer-reviewed medical journal covering all aspects of psychiatry and the official journal of the American Psychiatric Association. The first volume was issued in 1844, at which time it was known as the American Journal of Insanity...

that the Internet is important in spreading and supporting "bizarre" disease beliefs, because "a belief is not considered delusional if it is accepted by other members of an individual’s culture or subculture."

The LA Times, in an article on Morgellons, notes that "(t)he recent upsurge in symptoms can be traced directly to the Internet, following the naming of the disease by Mary Leitao, a Pennsylvania mother." Robert Bartholomew, a sociologist who has studied the Morgellons phenomenon, states that the "World Wide Web has become the incubator for mass delusion and it (Morgellons) seems to be a socially transmitted disease over the Internet." According to this hypothesis, patients with delusions of parasitosis and other psychological disorders become convinced they have "Morgellons" after reading internet accounts of others with similar symptoms. A 2005 Popular Mechanics article stated that Morgellons symptoms are well-known and characterized in the context of other disorders, and that "widespread reports of the strange fibers date back" only a few years to when the MRF first described them on the Internet.

The Dallas Observer writes that Morgellons may be spread via the Internet and mass media, and "(i)f this is the case, then Morgellons is one in a long line of weird diseases that have swept through populations, only to disappear without a trace once public concern subsides." The article draws parallels to several mass media-spread mass delusions. An article in the journal Psychosomatics in 2009 similarly asserts that Morgellons is an Internet meme
Meme
A meme is "an idea, behaviour or style that spreads from person to person within a culture."A meme acts as a unit for carrying cultural ideas, symbols or practices, which can be transmitted from one mind to another through writing, speech, gestures, rituals or other imitable phenomena...

.

In 2008 the Washington Post Magazine reported that Internet discussions about Morgellons include many conspiracy theories
Conspiracy theory
A conspiracy theory explains an event as being the result of an alleged plot by a covert group or organization or, more broadly, the idea that important political, social or economic events are the products of secret plots that are largely unknown to the general public.-Usage:The term "conspiracy...

 about the cause, including biological warfare
Biological warfare
Biological warfare is the use of biological toxins or infectious agents such as bacteria, viruses, and fungi with intent to kill or incapacitate humans, animals or plants as an act of war...

, nanotechnology
Nanotechnology
Nanotechnology is the study of manipulating matter on an atomic and molecular scale. Generally, nanotechnology deals with developing materials, devices, or other structures possessing at least one dimension sized from 1 to 100 nanometres...

, chemtrails and extraterrestrial life
Extraterrestrial life
Extraterrestrial life is defined as life that does not originate from Earth...

.

Known skin conditions

Some cases of self-diagnosed Morgellons disease are actually other recognized skin disorders, including allergic dermatitis, contact dermatitis
Contact dermatitis
Contact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants . Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight....

, and infestation with the parasite scabies
Scabies
Scabies , known colloquially as the seven-year itch, is a contagious skin infection that occurs among humans and other animals. It is caused by a tiny and usually not directly visible parasite, the mite Sarcoptes scabiei, which burrows under the host's skin, causing intense allergic itching...

. There are also case reports of patients submitting self-dissected superficial nerves.

Hypotheses about the fibers

Randy Wymore, a former research director of the MRF and presently director of the Oklahoma State University Center for Health Sciences' Center for the Investigation of Morgellons Disease, claims that Morgellons patients have submitted masses of dark fibers visible at 60x magnification under the unbroken skin, while unaffected individuals do not. Wymore sent samples of fibers, none of which collected by biopsy, to the Police Crime Lab in Tulsa, Oklahoma
Tulsa, Oklahoma
Tulsa is the second-largest city in the state of Oklahoma and 46th-largest city in the United States. With a population of 391,906 as of the 2010 census, it is the principal municipality of the Tulsa Metropolitan Area, a region with 937,478 residents in the MSA and 988,454 in the CSA. Tulsa's...

, for analysis. A forensic scientist at the Tulsa Police Crime Lab in Oklahoma searched the FBI's national database, but the Morgellons sample did not match any known fiber in the database. Lab director Mark Boese said the fibers were "consistent with something that the body may be producing," adding, "These fibers cannot be manmade and do not come from a plant. This could be a byproduct of a biological organism."

Rhonda Casey, chief of pediatrics at Oklahoma State University Hospital and part of the MRF research team at OSU, claimed that she has examined many patients' skin via a dermatoscope and performed biopsies on both lesions and apparently healthy skin, and that "she saw fibers embedded in both places. The white ones, she says, are hard to see. A dermatologist who either didn't look at all, or didn't use a dermatoscope, might not see them under the skin."

Dermatologists say many fibers are from clothing embedded in self-imposed sores and the fibers patients bring in bags are textile in nature. The fibers may also be peripheral nerve endings.

Bacterial hypothesis

Three members of the Morgellons Research Foundation, including Raphael Stricker, Director and former President of the International Lyme and Associated Diseases Society (ILADS), and Ginger Savely, also an ILADS member, authored an article about Morgellons published by the American Journal of Clinical Dermatology in early 2006. The authors wrote that "Morgellons disease may be linked to an undefined infectious process," and reported that many patients with Morgellons disease have positive Western blot
Western blot
The western blot is a widely used analytical technique used to detect specific proteins in the given sample of tissue homogenate or extract. It uses gel electrophoresis to separate native proteins by 3-D structure or denatured proteins by the length of the polypeptide...

s for Borrelia burgdorferi
Borrelia burgdorferi
Borrelia burgdorferi is a species of Gram negative bacteria of the spirochete class of the genus Borrelia. B. burgdorferi is predominant in North America, but also exists in Europe, and is the agent of Lyme disease....

, the causative agent of Lyme disease
Lyme disease
Lyme disease, or Lyme borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi sensu stricto is the main cause of Lyme disease in the United States, whereas Borrelia afzelii and Borrelia garinii cause most...

, and treatment with anti-bacterials appropriate for Lyme disease leads to remission of Morgellons symptoms in most patients; however, no methodology or clinical data are provided in support of any of these claims. Harvey, another member of ILADS, has also stated there is serological
Serology
Serology is the scientific study of blood serum and other bodily fluids. In practice, the term usually refers to the diagnostic identification of antibodies in the serum...

 evidence of bacterial pathogens in Morgellons patients, but did not provide any such evidence. Stricker, along with Citovsky, MRF board member from the State University of New York at Stony Brook
State University of New York at Stony Brook
The State University of New York at Stony Brook, also known as Stony Brook University, is a public research university located in Stony Brook, New York, on the North Shore of Long Island, about east of Manhattan....

, claimed that Morgellons skin fibers could come from Agrobacterium
Agrobacterium
Agrobacterium is a genus of Gram-negative bacteria established by H. J. Conn that uses horizontal gene transfer to cause tumors in plants. Agrobacterium tumefaciens is the most commonly studied species in this genus...

, a plant-infecting organism known to induce cellulose fibers at infected sites within plant tissues. Agrobacterium is already known to be responsible for opportunistic infection
Opportunistic infection
An opportunistic infection is an infection caused by pathogens, particularly opportunistic pathogens—those that take advantage of certain situations—such as bacterial, viral, fungal or protozoan infections that usually do not cause disease in a healthy host, one with a healthy immune system...

s in humans with weakened immune system
Immune system
An immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own...

s, but has not been shown to be a primary pathogen in otherwise healthy individuals.

Environmental toxins

Richard Fagerlund, an entomologist who has a column titled "Ask the Bugman" in the San Francisco Chronicle
San Francisco Chronicle
thumb|right|upright|The Chronicle Building following the [[1906 San Francisco earthquake|1906 earthquake]] and fireThe San Francisco Chronicle is a newspaper serving primarily the San Francisco Bay Area of the U.S. state of California, but distributed throughout Northern and Central California,...

and Albuquerque Journal
Albuquerque Journal
-History:Its earliest predecessor, the Albuquerque Daily Journal, was first published on October 14, 1880. The newspaper is owned by the Journal Publishing Company, a family-owned business headed by president/publisher T.H. Lang; it is operated by the Albuquerque Publishing Company...

, stated that he takes Morgellons disease seriously, and he receives letters from people with Morgellons symptoms daily. Twenty years ago, he got three to four letters like this a year. He believes the condition is reaching epidemic proportions and speculates only a small percentage of cases are delusional parasitosis, while the rest may be caused by something else, such as pollutants, especially pesticide
Pesticide
Pesticides are substances or mixture of substances intended for preventing, destroying, repelling or mitigating any pest.A pesticide may be a chemical unicycle, biological agent , antimicrobial, disinfectant or device used against any pest...

s.

Treatment for 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
Typical antipsychotic
Typical antipsychotics are a class of antipsychotic drugs first developed in the 1950s and used to treat psychosis...

 drugs. In the past, pimozide
Pimozide
Pimozide is an antipsychotic drug of the diphenylbutylpiperidine class. It was discovered at Janssen Pharmaceutica in 1963. It has a high potency compared to chlorpromazine . On a weight basis it is even more potent than haloperidol. It also has special neurologic indications for Tourette syndrome...

 was the drug of choice; in addition to antipsychotic activity, it also has antipruritic
Antipruritic
Antipruritics, also known as anti-itch drugs, are medications that inhibit the itching that is often associated with sunburns, allergic reactions, eczema, psoriasis, chickenpox, fungal infections, insect bites and stings like those from mosquitoes, fleas, and mites, and contact dermatitis and...

 activity, meaning it inhibits the sensation of itching. However, pimozide requires frequent electrocardiographic monitoring. Currently, atypical antipsychotic
Atypical antipsychotic
The atypical antipsychotics are a group of antipsychotic tranquilizing drugs used to treat psychiatric conditions. Some atypical antipsychotics are FDA approved for use in the treatment of schizophrenia...

s such as olanzapine
Olanzapine
Olanzapine is an atypical antipsychotic, approved by the FDA for the treatment of schizophrenia and bipolar disorder...

 or risperidone
Risperidone
Risperidone is a second generation or atypical antipsychotic, sold under the trade name . It is used to treat schizophrenia , schizoaffective disorder, the mixed and manic states associated with bipolar disorder, and irritability in people with autism...

 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
Rapport
Rapport is a term used to describe, in common terms, the relationship of two or more people who are in sync or on the same wavelength because they feel similar and/or relate well to each other....

 with their patients, allowing them to overcome this resistance.

Treatment for 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. Hypothesizing that Morgellons is the result of an infectious process, some medical practitioners associated with the MRF recommend the use of antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...

s, antifungal
Antifungal
* Antifungal medication, a medication used to treat fungal infection s such as athlete's foot , ringworm, candidiasis, etc.* Antifungal protein, a protein family* an adjective referring to a fungicide compound...

s, antiparasitic medications, herbal supplements, and light therapy. Randy Wymore, a former MRF director, has claimed on his website that some Morgellons patients who test positive for Lyme disease obtain symptom relief using aggressive, long-term antibiotic treatment similar to what is used by some doctors to treat "chronic" Lyme disease, another proposed but medically disputed condition. Virginia Savely, a nurse with the MRF and member of the International Lyme and Associated Diseases Society (ILADS), claims to have similar unpublished results. The antibiotic treatment is not curative, because when it is discontinued, the symptoms return. 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.

Self-treatment

Persons with Morgellons symptoms may turn to alternative remedies described on web sites and discussion groups. Some treatments are dangerous, however, and have included the use of bleach, veterinary medicines intended for deworming horses, and industrial insecticides.

See also

  • Cascade effect
    Cascade effect
    A Cascade Effect is an unforeseen chain of events due to an act affecting a system. If there is a possibility that the cascade effect will have a negative impact on the system, it is possible to analyze the effects with a consequence/impact analysis...

  • Conspiracy theory
    Conspiracy theory
    A conspiracy theory explains an event as being the result of an alleged plot by a covert group or organization or, more broadly, the idea that important political, social or economic events are the products of secret plots that are largely unknown to the general public.-Usage:The term "conspiracy...

  • Delusional parasitosis
    Delusional parasitosis
    Delusional parasitosis is a form of psychosis whose victims acquire a strong delusional belief that they are infested with parasites, whereas in reality no such parasites are present...

  • Disease mongering
    Disease mongering
    ]Disease mongering is a pejorative term for the practice of widening the diagnostic boundaries of illnesses, and promoting public awareness of such, in order to expand the markets for those who sell and deliver treatments, which may include pharmaceutical companies, physicians, and other...

  • Iatrogenesis
    Iatrogenesis
    Iatrogenesis, or an iatrogenic artifact is an inadvertent adverse effect or complication resulting from medical treatment or advice, including that of psychologists, therapists, pharmacists, nurses, physicians and dentists...

  • Medicalization
    Medicalization
    Medicalization is the process by which human conditions and problems come to be defined and treated as medical conditions and problems, and thus come under the authority of doctors and other health professionals to study, diagnose, prevent or treat...

  • Munchausen syndrome
    Munchausen syndrome
    Münchausen syndrome is a psychiatric factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention or sympathy to themselves. It is also sometimes known as hospital addiction syndrome or hospital hopper syndrome...

  • Psychosis
    Psychosis
    Psychosis means abnormal condition of the mind, and is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality"...

  • Quaternary prevention
    Quaternary prevention
    The quaternary prevention, concept coined by the Belgian general practitioner , are the action taken to identify patient at risk of overmedicalisation, to protect him from new medical invasion, and to suggest to him interventions, which are ethically acceptable...

  • Somatoform disorder
    Somatoform disorder
    In psychology, a somatoform disorder is a mental disorder characterized by physical symptoms that suggest physical illness or injury - symptoms that cannot be explained fully by a general medical condition, direct effect of a substance, or attributable to another mental disorder . The symptoms that...


External links

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