Morgellons Disease: Truth & Belief.

Dear Editor:

Morgellons disease (MD) is characterized by crawling skin sensations, associated with itchy rashes, stinging sores, fiber-like filaments, severe fatigue, concentrating difficulty and memory loss1. This rare syndrome classically affects middle-aged white women, and the scientific community is prone to support that it is the manifestation of psychiatric disturbances (Ekbom, Wittmaack-Ekbom, Munchausen, Munchausen by proxy)12. Recently, we have observed a 49-year-old Caucasian woman affected by typical MD symptoms. In particular, the patient referred an increase in the viscosity of her tear film and saliva, together with the elimination from epidermal spots of small spherical granules and/or narrow long wires, grayish in color, placed on her hands and arms (Fig. 1). We have investigated the chemico-elemental composition of these filaments, extracted from the skin lesions, with a field emission gun-environmental electron scanning microscope, equipped with an X-ray microprobe. Some wires appeared to be keratinic organic hairs of humans or pets, while others plastic inorganic fibers. Our analyses showed that the wires were the same found in the homely indoor air and inside the washing machine filter, previously collected during a site inspection. This finding could be explained only through a self-introduction under the epidermis of the wires by the patient1. For this reason, we have read with great interest the accurate paper of Ohn et al.3 concerning with MD. In the etiopathogenetic considerations, the authors report the various theories in this regard, such as a form of delusional parasitosis or a variant of Lyme's disease, caused by Borrelia burgdorferi3. However, Pearson et al.4 have reported that no infective agent has been isolated in a cohort study of 115 patients conducted in Northern California. Moreover, Harvey and colleagues have examined 25 self-defined patients with MD, and they have noted physical illness associated with a delusional component5. In their paper, Ohn et al.3 conclude that further investigations into MD are still needed, and large population studies are required for establishing appropriate treatment methods. Actually, the histopathological examination, reported by the authors, showed only mild lymphocytic infiltration, and failed to reveal evidence of any microorganism; moreover, the polymerase chain reaction for B. burgdorferi resulted negative on patient's serum, exactly as ascertained in our above mentioned case1, all elements in favor of MD psychogenesis.

Fig. 1

Photo of the grayish wires under the epidermis of the patient (by courtesy of Prof. A.M. Gatti).