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The Scientific Revolution
Published in Scott M. Jackson, Skin Disease and the History of Dermatology, 2023
Writing in the 1770s, Plenck (see Chapter 10) called the condition crinones and referred to the lesions as setae (Latin for bristles), noting that they sometimes resembled worms or comedones (blackheads and whiteheads). Other writers discussed the excessive swaddling of the infants as contributing to the eruption of the lesions. We know today that such swaddling can lead to “prickly heat” (miliaria). The above descriptions indicate to the present author that the spots Browne and others claimed were worms or hairs were either a form of keratosis pilaris, infantile acne (blackheads, when expressed, can have a vermiculate appearance), heat bumps (miliaria), trichostasis spinulosa, or folliculitis. The primitive microscopists of the seventeenth century may also have been looking at clothing fibers that are commonly seen under the microscope along with skin scrapings. The physicians and surgeons, influenced by both superstitions as well as valid reports of helminthic disease in a growing medical literature, could have fostered misinterpretation of the morgellons as a parasitic disease.
Psychocutaneous Disorders
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Kristen Russomanno, Vesna M. Petronic-Rosic
Morgellons disease is a condition characterized by a similar constellation of symptoms; however, it is controversial and poorly understood. Patients experience similar abnormal skin sensations, but they specifically report the emergence of small fibers protruding through the skin. Many similarities have been observed between patients affected by delusions of infestation and Morgellons disease, which is the reason that some physicians believe it may be a subset of the former rather than its distinct entity. Unlike delusions of parasitosis, the disease is not recognized by the DSM-5.
Chronic erythematous rash and lesions on trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
This is a psychiatric illness where the patient is convinced that parasites or mites are in his skin. He will complain of itching, or a crawling sensation. The skin shows multiple excoriated papules where the patient has tried to dig out the offending insect. Often he will present with a matchbox or container with bits of skin that have been scratched off as ‘proof’ of the infestation (Fig. 8.108). When examined under the microscope no creatures are found. The patient may become quite angry with you if you do not take his complaint seriously. A similar condition called Morgellons disease is associated with the delusion that fibres are trapped in the skin, and the patient attempts to pick them out resulting in the same clinical picture.
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].
Morgellons disease: experiences of an integrated multidisciplinary dermatology team to achieve positive outcomes
Published in Journal of Dermatological Treatment, 2018
Padma Mohandas, Anthony Bewley, Ruth Taylor
Morgellons disease is a condition, which is widely discussed on the internet and patients often self-diagnose before presenting to the dermatologist. The dialectic between doctors and patients with Morgellons is that the clinicians usually believe it is a variation of DI and patients perceive it to be a distinct entity. Patients often present with a list of potential causes and tests to be carried out. It is therefore, the clinician’s duty to be informed and can conduct a conversation with the patients on the merits of their requests. The course of the disease is chronic and debilitating. For a positive outcome, it is important therefore that a strong physician–patient relationship is cultivated. Patients with Morgellons can be reluctant to accept a separate referral elsewhere for psychiatric or psychological treatment, as they perceive this to be a rejection of a possible organic aetiology for their disorder. Therefore, integrating psychological care with dermatological care of this very distressing and debilitating disorder is very powerful. Our approach of addressing the physical and psychiatric aspects of Morgellons concurrently, as demonstrated in this case series, has shown that managing patients in a specialist psychodermatology setting helps improve outcomes.
Review of epidemiology, clinical presentation, diagnosis, and treatment of common primary psychiatric causes of cutaneous disease
Published in Journal of Dermatological Treatment, 2018
J. A. Krooks, A. G. Weatherall, P. J. Holland
Patients with Morgellons syndrome (MS) report fibers embedded in or projecting from the skin and with complaints of burning, stinging, and crawling sensations, which they attribute to an infection. Skin lesions from self-mutilation, chronic fatigue and/or insomnia, and mood disorders (>50%) are common findings. Patients are typically educated females in their 40s and 50s who have learned about the disease from friends or the internet (33,48,49). The Centers for Disease Control and Prevention has failed to identify an infectious or medical cause (50).