Morgellons is probably a variant of delusional dermatozoa in which patients subjectively perceive the formation of threads and hyphae under the skin. Recent studies have ruled out bacterial origin and led to the classification of the disorder as a delusional disorder. Patients are treated symptomatically with antipsychotics and may also be accompanied by psychotherapy.
What is Morgellons?
Delusions of dermatozoa are characterized by delusional ideas about tiny creatures under the skin. Patients think they can feel movement under their skin. They suffer from anxiety and severe itching. The parasite infestation of their skin is an established fact for those affected. See fun-wiki for What is Hypoparathyroidism used for.
Patients do not allow doctors to correct them, although there is no clinical evidence of infestation. Karl-Axel Ekbom first described the madness in 1938. Morgellons or Morgellons disease is a variant of delusional dermatozoa. The term was first mentioned by the English physician Sir Thomas Browne in the 17th century.
In 2002, the term was particularly popular in the English-speaking world, since the mother of an affected child supported the spread by founding the so-called Morgellons Research Foundation. The delusional disorder is characterized by the illusion that hyphae or fibers are forming under the patient’s skin. So far, the cause of the disease is largely unclear. However, there are now different speculations on the pathogenesis.
Causes
The etiopathogenesis of Morgellons is speculative. Some hypotheses are based on infectious agents, such as the bacteria Agrobacterium tumefaciens or Stenotrophomonas maltophilia, the fungal apes Cryptococcus neoformans and the parasite Strongyloides stercoralis. However, since no pathogens were found in the skin samples of those affected, this explanation has probably been refuted.
In one study, fibers were actually found on the skin and in the scabs or crusts of scratches in around ten percent of the participants. Most of the fibers found consisted of cellulose, which is typically found in cotton. In addition, polyamide was found in the sense of nylon. A nail polish compound was also isolated. The study developers summarize that the fibers found probably came from the patients’ clothing.
The undamaged skin of the patients was also examined for fibers. No fibers could be found in the uninjured areas, so that the disease is almost certainly a delusion. What triggers the madness remains unclear. It is possible that a disturbance in body awareness plays a causal role and allows the patient to experience normal bodily processes particularly intensely or to assign them incorrectly.
Symptoms, Ailments & Signs
Patients with Morgellons have a persistent belief that colorful fibers and hyphae form under their skin or in subcutaneous tissue. They feel itchy and are often frightened. To get rid of the fibers, they scratch or even cut into their own skin.
For this reason, those affected show a variety of skin lesions. They often speak of inexplicable movement phenomena under their skin. Some also suffer from musculoskeletal problems or complain of gastrointestinal symptoms.
Because the patients are emotionally frightened, they suffer more or less severe performance limitations. Cognitive disorders often occur. All patients are unable to recognize their delusion as such. In the USA, a prevalence of around four cases per 100,000 inhabitants is given for the disease. The disease mainly affects women.
Diagnosis & course of disease
The diagnosis of Morgellons is usually made as part of a larger-scale diagnostics. When making the diagnosis, the doctor must carefully investigate the patient’s fears and, as part of the investigation, must rule out the presence of actual parasites or other microorganisms. A psychiatric evaluation is usually also carried out.
Complications
This disease not only leads to psychological, but also to severe physical limitations and complaints. Those affected suffer from a very unpleasant feeling and can also scratch their skin due to the delusions. It is not uncommon for inflammation or reddening to occur, and scratching can also cause scars.
For this reason, patients suffer from various lesions on the skin, which significantly reduce self-esteem and can also lead to psychological problems or inferiority complexes. There are also complaints in the stomach and intestines and not infrequently movement disorders. The quality of life of the patient is significantly reduced by this disease.
In many cases, those affected do not admit to the disease themselves, which means that early treatment is often not possible. Without treatment, irreversible damage to the skin can occur, which severely limits the patient’s aesthetics. The treatment of this disease is usually carried out without complications with the help of medication and psychological care.
This can limit most complaints. Life expectancy is usually not reduced as a result. However, the success of the treatment also depends heavily on the will of the patient.
When should you go to the doctor?
People who experience sensations just under the epidermis that are unusual should consult a doctor. Morgellons are characterized by the perception of colored threads or movements under the skin. A doctor’s visit is necessary to initiate an intensive examination and to enable a diagnosis to be made.
An itching, open sores, and a general feeling of being unwell should be presented to a doctor. If sterile wound care cannot be guaranteed, the affected person is at risk of blood poisoning and thus a potential threat to his life. A therapist is needed in the event of anxiety, behavioral problems or a feeling of lack of credibility. The clinical picture of Morgellons includes the patient’s lack of insight into the disease.
Therefore, relatives or people from the close social environment of the person concerned who have the trust of the person concerned and should initiate a doctor’s visit. If delusions occur, there is an impairment in coping with daily life, a general malaise or emotional stress, medical help is required.
If the affected person appears confused, shows an unusual appearance or if there are mobility problems, a doctor’s visit is necessary. Impaired digestion, pain in the stomach or intestines and a feeling of illness should be presented to a doctor. Dizziness, trouble sleeping, weight changes, diarrhea or constipation are other signs of a health problem that needs to be investigated.
Treatment & Therapy
Since the cause of Morgellons is unclear, there are currently no causal treatment options. The delusional illness can only be treated symptomatically. Drug-based conservative approaches with antipsychotics are widespread. Improvements in delusions have been brought about primarily with pimozide, risperidone, and aripiprazole.
Since these substances have led to an improvement in symptoms, the classification of the disorder as delusional is almost certainly correct. Psychotherapeutic care is indicated. For the causal treatment of Morgellons, the psychological cause for the onset of the delusions would first have to be identified in order to be able to be resolved using talk therapy.
If the hypothesis of a disturbed body feeling in the sense of an over-sensitization to one’s own body processes is correct, a reassignment of the perceived stimuli under the skin could lead to a causal healing of the symptoms. This reassignment would open up a different perspective for the patient and could lead to the perceived stimuli no longer being perceived as frightening.
As soon as this is no longer the case, the patients no longer focus as much on the detection of the stimuli themselves and the delusions recede bit by bit. This type of therapy would be a much gentler variant than the symptomatic administration of antipsychotics. Even without detecting the psychological cause, a positive re-evaluation of the delusions could bring about a subjective improvement.
Outlook & Forecast
Morgellons syndrome can be treated with medication. Because the symptoms can vary greatly, the prognosis is rather negative. In any case, patients must consult a specialist and be treated closely. Prescribed antipsychotics can cause undesirable side effects and interactions. Muscle and movement disorders, pregnancy damage and psychological complaints such as depression or listlessness are typical. The side effects and Morgellons disease itself reduce the well-being of the patient. Serious mental illnesses can occur, which often persist beyond any recovery. Morgellons tend to reduce life expectancy as well.
The complaints of the gastrointestinal tract, the skin and the musculoskeletal system cause various complications in the long term, such as cancer, circulatory disorders or optical changes. Morgellons primarily affects women, who develop symptoms over a long period of time. Prompt treatment of the rare condition improves the prognosis. However, serious side effects can never be completely ruled out. The overall prognosis is therefore relatively poor. Patients usually have to be treated throughout their lives and suffer from physical and mental problems, which often result in further health problems.
Prevention
The primary cause for the emergence of Morgellons is so far in the dark. For this reason, the delusional disorder is difficult to prevent until now. Efforts to stabilize one’s own psyche can be understood in the broadest sense as an unspecific preventive measure.
Aftercare
In most cases, the person affected with Morgellons has very few and limited follow-up measures available, so that the person concerned should consult a doctor very early on in order to prevent the occurrence of further complications and symptoms. It cannot heal on its own, so the person affected with this disease always has to rely on medical examination and treatment.
In many cases, those affected depend on the help and support of their own family and friends. In many cases, they must also inform the patient about the complaints and symptoms of Morgellons and also initiate treatment. In serious cases, treatment in a closed clinic may be necessary.
Those affected themselves are usually dependent on taking various medications with Morgellons. Regular intake and the prescribed dosage must always be observed in order to alleviate and limit the symptoms. Regular check-ups with a psychologist are also very important for Morgellons. As a rule, this disease does not reduce the life expectancy of the affected person.
You can do that yourself
Since it is not yet known how Morgellons develops, there is no way to treat the trigger. In any case, the patient needs psychotherapeutic treatment. This can be supported, for example, by attending a self-help group. Specialist clinics for delusional mental illnesses can provide the person concerned with further information about the illness and thus help them to accept the symptoms in the long term.
Even as part of therapy, the delusions can often only be reduced slowly or not at all. The most important self-help measure is to accept the illness and to develop appropriate coping strategies. Despite illness, an active and healthy lifestyle with sufficient exercise, an appropriate diet and the avoidance of stress should be maintained. Otherwise, as a result of misperception and withdrawal from social life, other psychological problems can develop, which in turn are accompanied by serious complications.
The person concerned needs support from friends and relatives in order to be able to cope with everyday tasks. In the best case, the person concerned is cared for or monitored around the clock so that a rapid response can be made in an emergency. In addition, medical examinations should be arranged to determine any physical triggers.