Morgellons disease: no infectious cause was found

There is no scientific evidence that Morgellons disease is an infectious illness, a study published this week in the journal PLoS One has shown.

The half-million-dollar study performed by the Centers for Disease Control and Prevention was started because of the increasing reports of the symptoms and the intense public interest.

“We saw a growing number of people complaining about these unusual symptoms, and as a public health agency we felt the need to see what was going on. It was important to rule out an infectious cause because a lot of people were concerned about transmission,” said CDC spokesman Daniel Rutz.

The CDC “was receiving inquiries from a variety of sources, including the public, about this condition. It was clear that these people were suffering from something; the question was what might it be,” said Mark Eberhard, director of CDC’s Division of Parasitic Diseases.

In 2002 Mary Leitao, a stay-at-home-mom, has given the name Morgellons to a syndrome that includes skin symptoms (crawling, biting, and stinging sensations, formication) and signs such as finding fibers on or under the skin; and persistent skin lesions (rashes, sores). Generally,  physicians include Morgellons in a group of medical conditions called delusional parasitosis, and the disease is hardly considered an official diagnose. Similar conditions are called Ekbom’s syndrome or delusional infestation.

Around 3.2 million people, over 13 years old, at Kaiser Permanente Northern California (KPNC) were included in the study from 2006 to 2008. The scientists searched among the records of dermatology, psychiatry, infectious diseases, pediatric, and primary care clinic visits.

Among them, 115 patients (3.65%) had skin lesions or the feeling that “something is crawling on top of or under the skin,” they also reported fibers or other solid material coming through their skin.

They were predominantly medium age, white women (45-64 years). The majority of them (70%) reported the material emerging from their skin as fibers, and the rest described “specks, granules, dots, worms, sand, eggs, fuzz balls and larvae.”

The most frequent histopathologic abnormality (51% of biopsies) was solar elastosis. Actinic, or solar elastosis is caused by photoaging (excessive sun exposure), and consists in an accumulation of abnormal elastin in the skin and in the  eye.

The materials collected from intact skin were composed of superficial skin, cotton fibers, nylon, polyester, nail polish remains. Skin lesions appeared only in the body areas where the person could reach. Arthropods (insects, spiders) bites and rubbing or scratching seemed to cause them (chronic excoriations).

“These sores appear often to be the result of people picking at themselves, as they would if they had a chronic irritation that couldn’t be resolved any other way,” said Daniel Rutz.

No parasites or mycobacteria were detected in the skin or blood samples taken from Morgellons disease sufferers.

“We were able to answer conclusively that they were not living entities,” said Mark Eberhard.

“They’re not alive. They’re pieces of cotton and other elements of clothing; common debris,” said Daniel Rutz, regarding the rumors that the fibers are insects, or even alien microchips.

Among the Morgellons disease sufferers there were a lot with other health problems. Chronic fatigue was reported in 70% of cases and 54% said their overall health was fair or poor. They had an excessive preoccupation with their health, or high levels of “somatic concerns“, one-third had a neuropsychiatric condition. The hair sample testing of half of the patients showed evidence of illicit drug use and 78% reported exposure to solvents. In the general population the percentage of illicit drug use is 8.9, according to a national survey conducted by the Substance Abuse and Mental Health Services Administration. The high usage in Morgellons disease cases may be caused by the attempts to alleviate the symptoms, said Mark Eberhard.

Although Morgellons disease is rare, this unexplained dermopathy causes a negative impact on quality of life. More research has to be done to clarify  the etiology and to find a treatment.

Nerve damage might transmit the itch sensation, according to Dr. Anne Louise Oaklander, neurologist at Massachusetts General Hospital in Boston.

“This causes them to fire without appropriate cause, and it’s natural that people interpret this as a sensation of insects crawling on the skin… I think it’s wonderful that the syndrome is receiving careful and thoughtful research attention, which has been scarce in the past. And I hope other physicians and researchers are encouraged to take these symptoms seriously, as they’re very disabling,” Dr. Oaklander said.

“This is something that needs to be treated. It’s really important to discuss that there might be other ways to approach the disease. Until we can find an exact cause or a cure, it’s important that we try to improve their suffering,” said Jason Reichenberg, director of dermatology at the University of Texas Southwestern-Austin. He leads a session on Morgellons disease at a dermatology organization meeting in San Diego.

Morgellons disease pictures (video):