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Morgellons disease is a multiple-symptom syndrome characterized by skin lesions; a sensation that insects are crawling on or under the skin; fibers and granules coming out of the skin; and fatigue. Morgellons has been reported in every American state, and 15 other countries. Most of the U.S. cases are in California, Texas and Florida [1]. The cause is unknown, and no diagnostic criteria have been established. Morgellons shares characteristics with various recognized conditions, including attention-deficit disorder, chronic fatigue syndrome, Lyme disease, obsessive-compulsive disorder, and delusional parasitosis, a mental illness involving false beliefs about infestation by parasites. A Nature Magazine article reported [2], quot;Most dermatologists deny the disease exists, saying the people who claim to suffer from it have either common skin illnesses or psychological disorders such as delusional parasitosis, in which people become irrationally convinced that they harbor parasites. quot; Nanette Orman, an adjunct clinical professor from Stanford University, believes it may be related to Lyme disease.[1] Researchers from the Morgellons Research Foundation, and the International Lyme and Associated Diseases Society, said [1]: quot;Morgellons disease resembles and may be confused with delusional parasitosis quot; The condition has been succesfully treated with the antipsychotic medication Pimozide, [3] which has been used to treat delusional parasitosis. No independent research has determined that Morgellons is simply delusional parasitosis. The Centers for Disease Control and Prevention (CDC) has scheduled an investigation, but postponed it six times since June, 2006. Contents [hide] 1 Morgellons Research Foundation 2 Symptoms 3 Differential diagnoses 4 Morgellons theories and research 4.1 CDC investigation 5 See also 6 References 7 External links 7.1 In the news [edit]Morgellons Research Foundation Mary Leitao of McMurray, Pennsylvania, has a Bachelor of Science degree in Biology from the University of Massachusetts at Boston[4], and has worked as a chemist. She formed the Morgellons Research Foundation (MRF) in 2002, and is its Executive Director. Leitao coined the name Morgellons (with a hard g) in 2002, while seeking treatment for her two-year-old son's rash, which doctors diagnosed as eczema. She named it after a condition in Sir Thomas Browne's 1690 monograph A Letter to a Friend, wherein he describes quot;that endemial distemper of children in Languedoc, called the morgellons, wherein they critically break out with harsh hairs on their backs. quot; [5] A 1935 paper by British doctor C.E. Kellett identifies the name morgellons with the Provençal term masclous, or quot;little flies quot;.[6]. The Foundation's website states, quot;This non-profit foundation is dedicated to finding the cause of an emerging infectious disease, which mimics scabies and lice. quot; The foundation raises public awareness of Morgellons via web and press campaigns; conducts letter writing campaigns to the U.S. Congress [7]; and conducts limited research. In February 2005, a report on a local Fox affiliate in Duval County, Florida, prompted the Duval County Health Department (DCHD) to investigate. Their report concludes: […] it was determined after extensive reviewing of these articles that Morgellons Disease is synonymous with delusional parasitosis (CDC, 1999). DCHD Epidemiology consulted a pediatric dermatologist within the health department for his professional opinion. It was concluded that this is a psychological condition that has been mentioned in literature for hundreds of years.[8] The DCHD report notes that there was a significant spike in reported cases after the news report and that quot;this is attributed to the airing of Fox News’ coverage of the illness and is not a true cluster of disease. quot;[9] In May 2006 the Morgellons Research Foundation was featured in a number of local TV news segments coordinated by the MRF's director of communications.[10] This resulted in a significant rise in the public awareness of the term Morgellons. In response, the Los Angeles County Department of Health services issued a statement that No credible medical or public health association has verified the existence or diagnosis of quot;Morgellons Disease. quot; The current description of the disease is vague and covers many conditions. Until there is a credible, national standard for the diagnosis of this condition, there is no basis for making it a reportable disease.[11] Three of the eight MRF board members, including former chairman Charles Holman, medical director Greg Smith, and treasurer Judy Smith [12], resigned in August 2006, disagreeing with Leitao over the treatment of charitable contributions to the organization. Dr. Randy Wymore, an Oklahoma State University assistant professor of pharmacology and MRF's former director of research, has also resigned and distanced himself from the organization. [edit]Symptoms According to an opinion piece published by the MRF in the American Journal of Clinical Dermatology, Morgellons symptoms include skin lesions which can be anything from minor to disfiguring in their appearance, sensations of crawling and stinging on and under the skin, and the appearance of fibers and granules coming out of the skin. In addition, quot;[a]ccording to statistics from the Morgellons Research Foundation (MRF), the majority (95%) of affected patients also report symptoms of disabling fatigue and self-described quot;brain fog quot; or problems with attention. Patients also report a high incidence (50%) of fibromyalgia, joint pain, and sleep disorders. Other symptoms include hair loss, decline in vision, neurological disorders and disintegration of teeth in the absence of cavities or gingivitis. Most patients are unable to continue working, and those who are able to continue working report that they do not function optimally. quot;[1] The authors quot;declare[d] that they have no conflicts of interest related to the contents of this article. quot; In fact, the paper was co-authored by the founder of the Morgellons Research Foundation and other MRF members involved in the treatment of patients exhibiting these symptoms. [edit]Differential diagnoses The symptoms of patients presenting with Morgellons are varied, and may match several other medical conditions. Frequently, sufferers, through a process of self-diagnosis, will say that these symptoms may then be diagnosed as any of a number of conditions including: Nematodes - helminth or worm infestation, cause of biting and squirming sensation, moving from place to place in the body. Scabies - an infestation of the mite Sarcoptes scabei. Lice - an infestation of parasitic insects. Atopic Dermatitis or Eczema - a common skin condition with various causes including stress. Contact dermatitis, an allergic rash. Neurodermatitis - Eczema or other skin condition exacerbated by scratching Tinea - A fungal infection of the skin or hair. Folliculitis - An infection of the hair follicles. Cellulitis - A skin infection. Seborrhea - A condition due to over-active sebaceous glands Impetigo - A rash caused by bacterial infection Compulsive skin picking - Obsessive picking at ones own skin. Drug side effects - from use, overuse, or withdrawal. Delusional parasitosis - a tactile hallucination of insects, snakes, or other vermin crawling over the skin If a specific complaint is not identified, the doctor could diagnose a medically unexplained physical symptoms (MUPS) syndrome, such as fibromyalgia or chronic fatigue syndrome. Delusional parasitosis is one of the most common differential diagnoses that is used for these patients, and it is the primary source of controversy. The symptoms of delusional parasitosis are very similar to those presented by a Morgellons sufferer who rejects conventional diagnosis of their symptoms, or who presents a belief in the existence of an organism that cannot be observed except by the patient. There is no agreed-upon differential diagnosis since Morgellons is not an accepted medical condition. In her article Delusory Parasitosis, Nancy C. Hinkle[13] outlines thirteen indications attributed to delusional parasitosis, many of which are shared by patients claiming to have Morgellons. These indications include: The presentation of physical evidence such as skin scrapings and debris Obsessive cleaning and use of disinfectants and insecticides Rejection of the possibility of psychological or other explanations Emotional trauma, desperation, social isolation Having seen numerous physicians, to no avail The belief that fibers are emerging from their skin is still present in these patients. This belief is generally regarded by doctors as either delusional or a result of simply mistaking fibers from clothing (lint) as fibers emerging from the body.[14] One doctor, declining to be named for a news article, indicated that he treats patients simply by placing a cast over the affected area of skin, protecting it from the patient's scratching, which results in healing in a matter of weeks.[15] This lends weight to the theory that perceived skin abnormalities interpreted as the manifestation of Morgellons are a side-effect of habitual scratching. Patients who suffer from delusional parasitosis and who also believe they have Morgellons will often move from doctor to doctor in search of one who will offer them the diagnosis they are seeking. As a result, some doctors have adopted the use of the term quot;Morgellons disease quot; as quot;a rapport-enhancing term for delusions of parasitosis quot;[16] [edit]Morgellons theories and research No formal clinical studies have yet been published on the cause of Morgellons, though one study has demonstrated that patients can be cured using Pimozide, reinforcing the contention that the condition is probably synonymous with delusional parasitosis, which is treated with the same drug.[3]. Stephen Stone, president of the American Academy of Dermatology, has stated: quot;There really is no scientific basis at this point to believe that this is real quot;[2]. Only one paper treating Morgellons as a disease has been published in a medical journal; the paper was co-authored by the founder of the Morgellons Research Foundation and other MRF-supported researchers.[1] The Morgellons Research Foundation has published its own Case Definition for physicians, and MRF-supported researchers at Oklahoma State University and the State University of New York at Albany are undertaking ongoing clinical research into Morgellons. The Pittsburgh Post-Gazette, reporting on Ms. Leitao's plight, noted that Dr. Randy Wymore, Oklahoma State University assistant professor of pharmacology and physiology, and former MRF director, recruited two Oklahoma State faculty physicians who tweezed fibers from beneath the skin of some Morgellons patients. The samples were sent to the Tulsa Police Department’s forensic laboratory. The police checked the samples against carpet and clothing fibers and other materials, and conducted chemical analyses and other tests, and found no matches against any fiber in their databases. However, the fibers taken from the Morgellons patients matched each other.[17] There are apparently no published records of the composition of the fibers from this case or other Morgellons cases. George Schwartz of Santa Fe, New Mexico initially believed the cause may be the bacterium Stenotrophomonas maltophilia, and has claimed success in treating patients with antibiotics that target this waterborne bacterium.[15] He now believes it is a parasitic infection. In his booklet quot;Lisa's Disease, A Fiber Disease quot;, he describes four stages to this condition. Stage four places body organs in jeopardy. Schwartz also treated patients with anti-worm medication and diatomaceous earth.[18]. He says it is quot;a modern day plague which silently grows within the host and after weeks may explode into cavernous, thread- bearing skin lesions, and can extrude eggs and larvae quot; and is quot;a highly contagious, world-wide epidemic which will soon reach a critical mass quot;. He has developed a treatment plan for the early stages[19]. In August, 2006 he published a new book describing this disease and treatment plans.[20] Currently he is barred from practicing medicine, due to a narcotics violation[2]. [edit]CDC investigation The Centers for Disease Control and Prevention are launching a study of Morgellons disease:[21] quot;We're going into this with an open mind, quot; said Dan Rutz, spokesman for the CDC Morgellons task force that first met in June 2006. quot;The 12-person CDC task force includes two pathologists, a toxicologist, an ethicist, a mental health expert and specialists in infectious, parasitic, environmental and chronic disease. Among other tasks, the group is developing a case definition of Morgellons. quot;[22] [edit]See also Medically unexplained physical symptoms
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