Abstract
IntroductionThis review of 25 consecutive patients with Morgellons disease (MD) was undertaken for two primary and extremely fundamental reasons. For semantic accuracy, there is only one "proven" MD patient: the child first given that label. The remainder of inclusive individuals adopted the label based on related descriptions from 1544 through 1884, an internet description quoted from Sir Thomas Browne (1674), or was given the label by practitioners using similar sources. Until now, there has been no formal characterization of MD from detailed examination of all body systems. Our second purpose was to differentiate MD from Delusions of Parasitosis (DP), another "informal" label that fit most of our MD patients. How we defined and how we treated these patients depended literally on factual data that would determine outcome. How they were labeled in one sense was irrelevant, except for the confusing conflict rampant in the medical community, possibly significantly skewing treatment outcomes.Case presentationClinical information was collected from 25 of 30 consecutive self-defined patients with Morgellons disease consisting of laboratory data, medical history and physical examination findings. Abnormalities were quantified and grouped by system, then compared and summarized, but the numbers were too small for more complex mathematical analysis. The quantification of physical and laboratory abnormalities allowed at least the creation of a practical clinical boundary, separating probable Morgellons from non-Morgellons patients. All the 25 patients studied meet the most commonly used DP definitions.ConclusionsThese data suggest Morgellons disease can be characterized as a physical human illness with an often-related delusional component in adults. All medical histories support that behavioral aberrancies onset only after physical symptoms. The identified abnormalities include both immune deficiency and chronic inflammatory markers that correlate strongly with immune cytokine excess. The review of 251 current NLM DP references leads us to the possibility that Morgellons disease and DP are grossly truncated labels of the same illness but with the reversal of the cause-effect order. Further, the patients' data suggest that both illnesses have an infectious origin.
Highlights
This review of 25 consecutive patients with Morgellons disease (MD) was undertaken for two primary and extremely fundamental reasons
The remainder of inclusive individuals adopted the label based on related descriptions from 1544 through 1884, an internet description quoted from Sir Thomas Browne (1674), or was given the label by practitioners using similar sources
There has been no formal characterization of MD from detailed examination of all body systems
Summary
The term “Morgellons disease” first publicly appeared on the Internet in 2002. The “index” case was the first modern case to which that label was appended: a sick child whose physical signs and symptoms were collectively unrecognized as an entity at local and regional medical facilities. Medical records indicated that the dermal symptoms and signs preceded or occurred simultaneously with the onset of emotional signs, with an emotionally “normal” time in each patient’s life prior to Morgellons disease. Illness onset appears with moderately rapid transition (weeks) from healthy to unhealthy, including “emotional discomfort” These gravid Morgellons females had an extraordinarily high miscarriage rate. Itching of unbroken skin appeared to precede all other skin symptoms; 4) Unidentified objects (called “filaments” or “granules”) “extrude” uncomfortably from unbroken skin or skin lesions; 5) Painful ulcer-like concave, circular skin lesions with distinct border; 6) Excoriations adjacentto but separate from ulcerations were common; 7) Dermal symptoms were the central focus of discomfort for most patients. This is intended as a simplistic tool for clinical use
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