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MRCPsych Paper A1 Mock Examination 2: Answers
Published in Melvyn WB Zhang, Cyrus SH Ho, Roger Ho, Ian H Treasaden, Basant K Puri, Get Through, 2016
Melvyn WB Zhang, Cyrus SH Ho, Roger CM Ho, Ian H Treasaden, Basant K Puri
Explanation: This woman suffers from delusions of parasitosis or Ekbom’s syndrome, which is the belief that one is infested with parasites that live on or under the skin. The primary symptom is a cutaneous pruritus. This itch causes continuous picking of the skin to extract the suspected parasites. Patients often present with foreign objects or debris from their skin in small containers. This is called the ‘matchbox sign’.
Choosing the appropriate pharmacotherapy for Morgellons disease: an expert perspective
Published in Expert Opinion on Pharmacotherapy, 2022
Esther A. Balogh, Katherine G. Beuerlein, Steven R. Feldman
Morgellons disease (MD) is a cutaneous condition with a controversial etiology in which affected patients report embedding of fibers, strands, hairs, or other inanimate materials in the skin. Clinically, this condition presents as multiple nonhealing lesions that can be ulcerated and superficially infected; affected patients claim the lesions appear spontaneously. Classically, lesions often spare the hard-to-reach areas such as the mid-back, and patients often bring in a collection of specimens which they claim to have removed from their skin (so-called ‘matchbox sign’).[1,2] The typical patient with MD is a middle-aged Caucasian woman: 77% of MD patients studied in an extensive descriptive study by the Centers for Disease Control (CDC) were female and Caucasian and had a median age of 52 years [2].
Historical and clinical considerations on Ekbom’s syndrome
Published in International Review of Psychiatry, 2020
Laura Orsolini, Alessia Gentilotti, Matteo Giordani, Umberto Volpe
Moreover, the patient may present with the supposed ‘organisms’ wrapped in a paper or transported in boxes (known as ‘matchbox sign’) which is considered pathognomonic of the condition (Bhatia et al., 2000). Nowadays, matchboxes have been replaced as specimen containers by plastic bags or universal containers (Freudenmann et al., 2012), as patients are usual to offer ‘evidence’ of their infestation in photographs and videos, often self-recorded on their personal phones, tablets, laptop or sometimes using a dermoscopy (Bhushan et al., 2015; Garcia-Mingo et al., 2019; Ladizinski & Elpern, 2013). About half of the patients may present with the ‘specimen sign’ (i.e. they may bring specimens, including skin particles, hair samples, as proof of infestation; Kuhn et al., 2017), although its presence is frequent but not mandatory in patients with a primary delusional infestation (Freudenmann et al., 2012).