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Mystery of Morgellons Disease - Infection or Delusion?

by Virginia R. Savely, Mary M. Leitao, and Raphael B. Stricker
in American Journal of Clinical Dermatology, 2006

Quote:Morgellons disease is a mysterious skin disorder that ws first described more than 200 years ago. The disease is characterized by fiber-like strands extruding from the skin in conjunction with various dermatologic and neuropsychiatric symptoms.
[...]

The perforating dermatoses are a group of skin diseases characterized by elimination of elastic or collagen fibers from the upper dermis through the skin. There are five members of this group: Kyrle's disease, perforating folliculitis, reactive perforating collagenosis, elastosis, perforans serpiginosa, and acquired perforating dermatosis. The perforating dermatoses are associated with hereditary diseases including Ehlers-Danlos syndrome, osteogenesis imprefecta, Downs syndrome and Wilson disease. They may also be seen in patients with brittle diabetes mellitus or dialysis-dependent renal failure. These dermatoses are distinct from Morgellons because the protruding fibres are made up of elastic or collagenous tissue that is easily identified by histopathology. In adition, Morgellons patients generally do not have the rare hereditary conditions or severe metabolic abnormalities associated with the perforating dermatoses. Conversely, systemic infection and neuropshychiatric symptoms have not been associated with these dermatoses, and they do not respond to antibacterial therapy.

Many patients with Morgellons disease have positive Western blots for Borrelia burgdorferi, the causative agent of the Lyme disease. It appears that there may be a connection between the two diseases with one infection possibly predisposing the individual to a second infectious agent. Whether all patients with Morgellons disease also have Lyme borreliosis remains to be seen.

The first author now has more than 80 ptients in her practice who fit he criteria for Morgellons disease. The patients have come from all over the US, and the consistency of their stories is impressive. All but one of these patients have tested positive for Lyme borreliosis. When these patients are treated with antibacterials for their Lyme disease, remission of Morgellons symptoms is seen in most. This observation distinguishes Morgellons from the dermatologic conditions described above.
[...]
A colleague informed Ms. Savely that the Morgellons Research Foundation had described a disease matching the symptoms that she had observed in her patients. She contacted the foundation and was informed that her state, Texas, was second only to California in thenumber of reports of this bizarre disease, which was being called Morgellons disease.
[...]
The US states of California, Texas, and Florida appear to have the highest number of reports of Morgellons disease, with primary clusters noted in Los Angeles and San Francisco, California, an din Houston, Dallas, and Austin, Texas. California accounts for 26% of cases in the US. All 50 US states and 15 nations, including Canada, the UK, Australia and the Netherlands, have reported cases of Morgelllons disease. The total number of registrations ont he Morgellons Research Foundation website is presently at 2200, which is believed to be a fration of the actual number of cases.

The two main occupational groups reporting symptoms of Morgellons disease are nurses and teachers. Nurses outnumber teachers 3:1, but both occupational groups represent a significant precentage of patients with this disease. It is unclear what the risk factors of these two occupational groups might be, but the possibility of casual transmission of infectious agents has been entertained.

There is some evidence to suggest that skin lesions and fibers may not be readily appparent in all individuals with this disease, as family members of patients often report similar systemic disease symptoms without skin symptoms. Whether the disease is transmissible by human contact remains unclear. Although most people with Morgellons disease are fearful of infecting family members, families in which all members are affected often have suspected simultaneous exposure to an inciting agent. Contact with the soil or waste products also appears to be associated witht he disease.

Patients have reported symptoms of this disease in their pets. The majority of reports involve dogs, but cats appear to be increasingly affected. There have also been recent reports of horses with skin leasions fitting the description of Morgellons lesions. Several horse owners have observed fibers associated with the skin lesions on their animals by using lighted 30x hand-held microscopes.

Skin biopsies of patients with Morgellons disease typical reveal nonspecific pathology or an inflammatory process with no observable pathogens. Several biopsies have shown fibrous material projecting from an inflamed epidermal tissue. There is some speculation that the fibrous (and other) material associated with skin lesions may be linked to the biofilm of a bacteria, Stenotrophomonas maltophila, and this possibility requires further histopathologic investigation. In general, pathologists look for signs of known diseases and, thus, may miss clues of Morgellons disease in biopsies.

There is preliminary information that Morgellons fibers are made of cellulose, but this information has been neither formally evaluated or confirmed.


Attachments File comment: Mystery of Morgellons Disease - Infection or Delusion?
by Virginia R. Savely, Mary M. Leitao, and Raphael B. Stricker
in American Journal of Clinical Dermatology, 2006
alt BIO-MORG-Mystery of Morgellons Disease-AJCDermatology.pdf [414.45 KiB]
Downloaded 12 times

Source: http://www.nwolibrary.com/library/viewtopic.php?p=173#p173

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