‘Morgellons’ is the popular name for a skin condition that, from scientific evidence, appears similar to delusional parasitosis, i.e. a very strong delusional belief that parasites are crawling under the skin. But just because it’s a delusion doesn’t mean people are making it up, or that it an be cured simply by telling the patient that it’s psychological.
The symptoms are real enough: skin lesions, a feeling of stinging, biting, or pins and needles, and frequently also fatigue, difficulty in concentrating, short-term memory loss and depressed mood. But perhaps the most characteristic feature is the appearance of fibres – often blue or red – or other solid material under the skin.
It’s relatively new, first ‘identified’ in 2001 by Mary Leitao, whose two-year-old son complained of ‘bugs’ and developed sores with curiously coloured fibres. Disappointed with the lack of medical recognition, she named the condition ‘Morgellons’ after a mention in A Letter to a Friend by Sir Thomas Brown, published in 1690.
Since then, the number of patients reporting similar symptoms – mostly in the United States – grew rapidly, despite lack of formal recognition in the medical community. The level of attention led the US Centers for Disease Control and Prevention (CDC) to conduct a study into what they called ‘unexplained dermopathy’.
The results of this study were published in January 2012, and they reinforced the similarity to delusional parasitosis (Pearson ML, Selby JV, Katz KA, Cantrell V, Braden CR, et al. 2012, “Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy”, PLoS ONE, vol. 7, no. 1, e29908, doi:10.1371/journal.pone.0029908).
The mystery fibres, analysed with light and scanning electron microscopes, X-ray and infrared spectroscopy, turned out to largely be cellulose, consistent with the idea that they came from clothing or bandages – some even with evidence of dyes.
Skin lesions showed evidence of being caused either by scratching or bites (by insects or other arthropods, not humans). And interestingly, those with sores on their backs usually had an unaffected dumbell-shaped area – just where they wouldn’t be able to reach.
There was no sign of any infection by parasites or bacteria, other than those normally found on skin, and there was no consistent evidence of environmental factors through analysis of geographical locations or habits (apart from a finding that most patients had been near some sort of solvent, but the researchers had no comparison with normal prevalence in the community.
What they did find was a high rate of psychiatric conditions, including somatisation (feeling physically ill due to anxiety) and depression, and of illicit drug use. These may not be surprising, given that psychological effects are included in the usual description of Morgellons, and although some drugs can cause delusional parasitosis, it’s not clear here whether that could have happened or whether patients may have used drugs to alleviate their symptoms.
Overall, the researchers couldn’t identify a cause. Based on what they did find, they suggested doctors treat either the individual symptoms, or use treatments recommended for delusional parasitosis (and treatment with anti-psychotic drugs has been tried – see Reid E & Lio PA 2010, “Successful treatment of Morgellons disease with pimozide therapy”, Archives of Dermatology, vol. 146, no. 10, pp. 1191-1193. doi:10.1001/archdermatol.2010.276).
Of course, not everyone agrees with this finding. The spread of Morgellons seems to have been due as much to the Internet as anything else – computer viruses aren’t the only diseases you can catch online.
But remember that even healthy people can have itching induced by visual stimuli. For those experiencing an actual delusion, the symptoms are very real and very painful – the hope is that with this thorough study they can be directed to realistic treatments, rather than the conspiracies so easily found online.
(This story aired on 29 November 2012 – you can listen to the podcast.)