Morgellons mind games

‘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.

Two examples of Morgellons skin lesions on patients in the CDC study, with close-ups showing the characteristic blue fibres (click to embiggen)
Examples of Morgellons skin lesions. B and D are close-ups of the sores in A and C respectively. You can see the characteristic blue fibres in each of these (photos by CDC, via PLoS ONE)

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.)

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5 thoughts on “Morgellons mind games

    1. You’re quite right: it was a treatise called A Letter to a Friend, written in 1656 but published posthumously in 1690. Thanks for pointing that out, I’ve corrected the text.

  1. No. NO NO NO NO. You see, I personally seem to be afflicted by this strange “condition,” which comes in waves, usually hitting at times of high stress/ lack of sleep. But, and I want to make this absolutely clear, don’t believe that I have parasites, or nanobots, or aliens crawling around under my skin…. These fibers are generally white and wavy, very fine, often stretchy, can be quite long, often congregate around sores, or else (personally) my lips, nostrils, fingers and hands… Sometimes they are red or blue or black. I have seen green and pink…. They typically match the color that I am wearing that day, or the day before, though not always. Their appearance is often preceded by an itch. I attribute the itch simply to the fibers being buffeted about (they are always very fine) by the air (or skin, clothes, whatever makes it move) around me, which tickles; I will then see if I can’t pluck the fiber off my skin, or rub it… sometimes scratching will dislodge it, other times (when my skin is very dry) the fiber will be slightly embedded, and I will dig for it, which will often cause it to only embed itself further, which might explain why some people will create and sustain (through picking) lesions… These fibers come from my environment. As I say, if I am wearing a green sweater, then I will often find green threads around my knuckles… I find this issue to be a nuisance, but I don’t feel that my case warrants any help or intervention. Its just annoying.
    I would like to submit, however, that it doesn’t make it any less fascinating. Why are some people much more prone to attract all the fine fibers floating in the air around them? What causes it? I’m surprised people don’t talk more about static electricity, because that is my best guess.
    Anyways. It doesn’t seem to be deadly, or indicative of some underlying fatal ailment. It is not always occurring, only sometimes. Therefore, I don’t obsess. And i don’t buy into the conspiracy theories. However, this issue is quite real. These people are not imagining the fibers. Any psychosis displayed has nothing to do with the fibers themselves, though the fibers probably work quickly to induce psychotic episodes in those who are susceptible. It just hasn’t been identified.

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