Terrifying, painful, exhausting. When I have spoken with people who identify as having Morgellons disease, these are the words I hear. Most researchers and medical professionals consider Morgellons Disease (MD) to be synonymous with Delusory Parasitosis (DP), a false, unshakable belief that insects are living in or on your skin or inside your body. Yet, several small, concerted groups work to express it as a distinct medical condition.
MD was first described in academic literature in 2005, when an unidentified number of patients described itching, crawlingsensations, lesions, and the eruption of red and blue fibers and “granules” from their skin. Most had Lyme disease, and MD was thought to be significantly related to that (Savely & Leitao, 2005). Recently, agrobacterium was indicted as the new culprit, when two self-identified MD patients with scleroderma were found to have increased amounts of cellulose-protein complex in their connective tissue (Savely & Stricker, 2007, Harvey et al, 2009). A multi-systemic medical framework for MD with immunodeficiency problems has been described (Harvey et al, 2009).
The majority of physicians and researchers consider MD to be synonymous with DP (Murase, Woo & Koo, 2006), with the difference that it is not believed to be parasites, but about the fibers and granules (Robles et al, 2008). In response, proponents of MD as amedical condition herald it as different from DP, citing a “lack of pre-existing psychopathology” (Savely & Stricker, 2007). Yet, a study by Harvey et al (2009) found 25 self-diagnosed MD participants all had previous diagnoses of DP, and 23 had other previous diagnoses, including bipolar disorder, attention-deficit disorder, and obsessive-compulsive disorder, the symptoms of which coincided with the onset of their MD symptoms. These psychological diagnoses have many somatic connections, and their medications commonly have side effects of itching, crawling, and tingling sensations (Hinkle, 2000), indicating that a psychological composition of MD is very likely.
Some will disagree with a psychological conceptualization of MD, and firmly believe that this is a distinct medical condition. In fact, a DP diagnosis is not always accurate, such as with cutaneous myiasis, where fly larvae inhabits the skin of a person (Barros et al, 2010). Medical and scientific knowledge, and identification of new pathogens, diseases, and treatments, continually occur.
The burden of proof is on the advocates for MD to be a distinct medical condition. In my opinion, mental health should be recognized as the possible, if not probable foundation of MD. Fibers and granules of dirt and debris are everywhere. Increased cellulose-protein complex in two patients who also have scleroderma is still distant from being definitive. Harvey’s study found many vague health anomalies, yet the autoimmune problems sound like what one would expect from intense stress (Khansari et al, 1990). What would be more stressful than the real or perceived experience of an infestation of the most personal and offensive kind, the body?
Dr. Harvey recommends that we be open and skeptical, and I agree. The CDC is in the data-analysis stage of an investigation of MD through Kaiser in Northern California. As a scientist and as a person who is aware of the suffering of people with these experiences, I look forward to the results.
Sarah Bione-Dunn is a doctoral candidate in clinical psychology at Alliant International University. She expects her degree in June, 2010.
de Barros N, D’Avila MS, de Pace Bauab S, Issa FK, Freitas FJ, Kim SJ, Chala LF, & Cerri GG (2001). Cutaneous myiasis of the breast: mammographic and us features-report of five cases. Radiology, 218 (2), 517-20 PMID: 11161171
Harvey WT, Bransfield RC, Mercer DE, Wright AJ, Ricchi RM, & Leitao MM (2009). Morgellons disease, illuminating an undefined illness: a case series. Journal of medical case reports, 3 PMID: 19830222
Hinkle, N. (2000). Delusory Parasitosis. American Entomologist, 46 (1), 17-25
Khansari, D., Murgo, A., & Faith, R. (1990). Effects of stress on the immune system Immunology Today, 11, 170-175 DOI: 10.1016/0167-5699(90)90069-L
Murase JE, Wu JJ, & Koo J (2006). Morgellons disease: a rapport-enhancing term for delusions of parasitosis. Journal of the American Academy of Dermatology, 55 (5), 913-4 PMID: 17052509
Robles DT, Romm S, Combs H, Olson J, & Kirby P (2008). Delusional disorders in dermatology: a brief review. Dermatology online journal, 14 (6) PMID: 18713583
Savely G, & Leitao MM (2005). Skin lesions and crawling sensations: disease or delusion? Advance for nurse practitioners, 13 (5), 16-7 PMID: 15898309
Savely VR, Leitao MM, & Stricker RB (2006). The mystery of Morgellons disease: infection or delusion? American journal of clinical dermatology, 7 (1), 1-5 PMID: 16489838
Savely, V., & Stricker, R. (2007). Morgellons disease: the mystery unfolds Expert Review of Dermatology, 2 (5), 585-591 DOI: 10.1586/174698126.96.36.1995