Research Article| Volume 40, ISSUE 6, P686-690, November 2022

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The challenge of Morgellons disease: A patient with clinicopathologic correlation


      Morgellons disease is a rare condition characterized by patient-reported multicolored fibers and other nonorganic particles or organic particles embedded in and protruding from diffuse skin ulcerations. Although the scientific community is prone to believe that Morgellons disease is a psychiatric disorder, an infectious pathogenesis associated with Borrelia burgdorferi in the setting of Lyme disease has also been proposed. The histopathology is usually considered as nonspecific. To illustrate this condition, we present the case of an adult woman with significant ulcerative skin lesions and cicatricial changes on the face, trunk, and arms. After multiple biopsies and successful microscopic visualization of the fibers, she received a diagnosis of Morgellons disease in the setting of delusional infestation. No evidence of Borrelia infection was found. Treatment with antipsychotics was initiated, but the patient was lost to follow-up, as is often the case with patients with Morgellons disease.
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        • Hylwa SA
        • Ronkainen SD.
        Delusional infestation versus Morgellons disease.
        Clin Dermatol. 2018; 36: 714-718
        • Yu DA
        • Ohn J
        • Kim KH.
        Morgellons disease: a manifestation of psychiatric disorder.
        Ann Dermatol. 2018; 30: 362-363
        • Middelveen MJ
        • Haggblad JS
        • Lewis J
        • et al.
        Dermatological and genital manifestations of Lyme disease including Morgellons disease.
        Clin Cosmet Investig Dermatol. 2021; 14: 425-436
        • Kellett CE.
        Sir Thomas Browne and the disease called Morgellons.
        Ann Med Hist. 1935; 7: 467-479
        • Savely G
        • Leitao MM.
        Skin lesions and crawling sensation: disease or delusion?.
        Adv Nurse Pract. 2005; 13: 16-17
        • Savely VR
        • Leitao MM
        • Stricker RB.
        The mystery of Morgellons disease: infection or delusion?.
        Am J Clin Dermatol. 2006; 7: 1-5
        • Savely VR
        • Stricker RB.
        Morgellons disease: the mystery unfolds.
        Expert Rev Dermatol. 2007; 2: 585-591
        • Middelveen MJ
        • Stricker RB.
        Filament formation associated with spirochetal infection: a comparative approach to Morgellons disease.
        Clin Cosmet Investig Dermatol. 2011; 4: 167-177
        • Pearson ML
        • Selby JV
        • Katz KA
        • et al.
        Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy.
        PLoS One. 2012; 7: e29908
        • Middelveen MJ
        • Rasmussen EH
        • Kahn DG
        • et al.
        Morgellons disease: a chemical and light microscopic study.
        J Clin Exp Dermatol Res. 2012; 3: 140
        • Middelveen MJ
        • Martinez RM
        • Fesler MC
        • et al.
        Classification and staging of Morgellons disease: lessons from syphilis.
        Clin Cosmet Investig Dermatol. 2020; 13: 145-164
        • Zhang JF
        • Gopalakrishnan K
        • Molloy D.
        Treatment of Morgellons disease with doxycycline.
        Clin Case Rep. 2021; 9: e05148
        • Ma J
        • Roelofs KA
        • Badilla J.
        Morgellons disease leading to corneal perforation and enucleation.
        Can J Ophthalmol. 2019; 54: e285-e288
        • Diaz-Perez JA
        • Desai KR
        • Li YM
        • et al.
        Delusional infestation complicated by gangrene and osteomyelitis requiring finger amputation.
        JAAD Case Rep. 2021; 2: 6-9
        • Driscoll MS
        • Rothe MJ
        • Grant-Kels JM
        • et al.
        Delusional parasitosis: a dermatologic, psychiatric and pharmacologic approach.
        J Am Acad Dermatol. 1993; 29: 1023-1033
        • Gupta MA
        • Vujcic B
        • Pur DR
        • et al.
        Use of antipsychotic drugs in dermatology.
        Clin Dermatol. 2018; 36: 765-773