Jan 31, 2012
The debate surrounding an inexplicable skin disease, coined “Morgellons” in 2002, may finally provide patients and practitioners with some answers. The CDC’s anticipated study was published on January 25 in the Public Library of Science journal, PLoS One, and concluded that patients did not demonstrate a common underlying condition or infection.
The study was launched in 2008 after a growing number of inquiries from both patients and doctors spurred the CDC into action. By piloting a representative and extensive research study, CDC investigators hoped to identify possible risk factors, and to empirically describe the clinical signs and symptoms of the condition.
The study identified 115 patients enrolled in Kaiser Permanente Northern California (KPNC) between 2006 and 2008. All case-patients noted solid materials excreting from their skin. These were described as fibers, threads, specks, dots, fuzzballs, or granules. Additionally, 99 percent reported a disturbing skin symptom, such as: pruritus (itching), formication (a tactile hallucination; the sensation of insects crawling over one’s skin), as well as stinging, biting, or pins and needles. Last, 90 percent of patients displayed a skin lesion that took the form of a rash, wound, ulcer, or nodule. The most commonly described non-cutaneous symptoms included temporary and chronic fatigue, muscle aches, and joint and back pain.
Skin biopsies suggest that the solid materials collected from the patients’ lesions and skin are likely residual cotton fibers from clothing or bandages. Further, the majority of lesions were attributed to sun damage, although 40 percent were due to chronic irritation and scratching, and 16 percent were caused by bug bites or drug allergies.
Psychiatric evaluations assessed cognitive deficits, psychiatric co-morbidity, and functional impairment and disability of the case-patients. Nearly 60 percent showed evidence of a cognitive impairment, 63 percent had clinically significant somatic complaints, and 50 percent had a history of drug use. Researchers believe it may be possible that formication is a side effect of drug use or drug withdrawal. Other possible diagnoses include: neurotic excoriations (repetitive scratching or rubbing, causing skin lesions. Neurotic excoriation is understood as a physical manifestation of an emotional disturbance), atopic dermatitis (a chronic disorder involving itching and rashes), or brachioradial pruritus (a condition involving intense itching in the upper extremities).
The data confirms that there is no clinical or epidemiological pattern that would suggest an infectious parasite or bacteria as the causative agent. Furthermore, Pearson et al., the authors of this study, clarify that the findings do not present this unexplained dermopathy as a new disease, such as Morgellons, nor that it is exclusively a delusional infestation, as has been generally accepted by the medical community.
The information garnered from this study will be useful for healthcare practitioners caring for patients with symptoms similar to those observed by the CDC. The information suggests that practitioners should determine possible co-morbidity and tailor their treatment approach accordingly.
A slug, a myriapod, and some cockroaches walk into a bar….
An estimated 604-795 million people in the world are infected with whipworm (Trichuris trichiura).