Justified & Ancient
- Jan 22, 2016
yeah but...Well, not so fast. The dermatological conclusion was not widely accepted. The consensus was that it is still a psychiatric issue although that doesn't preclude some cases of dermopathy.
Dermatol Online J
2021 Aug 15;27(8). doi: 10.5070/D327854682.
Morgellons disease etiology and therapeutic approach: a systematic review
Support for a psychiatric etiology was more widespread than support for an infectious etiology. Eleven articles regarding treatment efficacy were reviewed. Antipsychotic regimens have the most evidence of efficacy. Existing data regarding Morgellons disease suggests a psychiatric etiology and supports treatment with a low-dose antipsychotic agent once non-psychiatric causes have been excluded.
Every one of those symptoms (apart from the fibre presentation) are also symptoms of menopause.Morgellons disease: A review of a mysterious psychodermatologic disorder
Elizabeth Strada, BS, Creighton University School of Medicine; Jenna
Sitenga, BS, Creighton University School of Medicine; Anthony Strada,
BS, Creighton University School of Medicine; Greg Aird, BS, Creighton University
Data synthesis: Most patients were middle-age women from the United States presenting with $1 patch or erosion located anywhere on the body. Most cases reported associated symptoms of pain, itching, bleeding, fiber presentation within the lesion, formication, extreme fatigue, weakness and impaired memory and attention.
AB194 J AM ACAD DERMATOL SEPTEMBER 2018
This is a great common-sensical surmise. For people who have had the tick-borne disease, the little fibers are karetin-based and are grown under and inside of the skin, leading to pain and itching. The people who do not have these probably have some sort of psychological problem.The fibres are probably from clothing that sticks to the slightly-weeping wounds.
I have this problem myself with a small wound on my foot. I have to use tweezers to remove the fibres that have come off my sock.
I can imagine no bigger diagnostic problem than the one you describe: a real but rare disease that has a lot of symptoms in common with common psychosomatic disorders. Even well intentioned doctors will struggle to make sense of it.This is a great common-sensical surmise. For people who have had the tick-borne disease, the little fibers are karetin-based and are grown under and inside of the skin, leading to pain and itching. The people who do not have these probably have some sort of psychological problem.
If I recall correctly, very young children (under 2 years of age) children have had these fibers. How terrible for a young child who can't understand what is happening. This is part of the evidence for me that this is not just a psychological illness, but a physical one with documented and testable causes. The people whose blood tests show they have not had the tick-borne disease also do not have the karetin fibers in the skin.
I think of this situation in terms of a Venn diagram of overlapping circles. The bigger circle contains the psychological sufferers; the smaller circle contains the tick-born illness sufferers. Since in the US, most people who experience itching and sensations of movement under their skin have psych problems, the medical response is that ALL of these symptoms are psychological. Compounding the medical misdiagnosis is that the tick-based illness seems to be new for the US, and so there is no good source for information about this. Physicians, like most people, go for the easiest, most likely cause. A new, rare disease with symptoms coinciding with symptoms of an established disease is unlikely to get the attention it deserves.
My personal experience causes me to empathize with the real sufferers (! Alert to both TMI and Rant below!):
I have endured great pain frequently over most of my adult life with a medical condition which doctors refused to recognize because their tests indicated everything was OK. (But other types of tests which are not recognized by medical insurance indicated a clear problem.) Also, it falls between two different medical specialties, so it was nobody's baby. 100% of all my doctors until I was in my 50s gently told me that I needed psychological counseling. This condition caused pain and other effects such that I was sometimes in the hospital for days. In 2010, it landed me in the critical care unit after emergency surgery for multiple stomach ulcers that had ruptured and caused peritonitis. Four years ago, the US AMA recognized this was a real disease, and so getting the medicine I needed became much easier. Until then, I had to search for independent physicians who would prescribe off-label for me. I told them what to prescribe based on my symptoms and my hypothesis of what was going on. The drug and the dose are what I came up with myself after I got out of the hospital in 2010 and decided I needed to take matters into my own hands. What I dealt with on my own for all those decades is now considered a "life-threatening" situation requiring immediate, emergency medical attention. No shit, Sherlock.
My experience is very like the Morgellens sufferers' experience. A real, rare, "new" disease; some symptoms in common with people who have psychological problems.
I can imagine no bigger diagnostic problem than the one you describe: a real but rare disease that has a lot of symptoms in common with common psychosomatic disorders. Even well intentioned doctors will struggle to make sense of it.
Note: I'm interested in the Lyme and Morgellons connection, but there is also evidence that "long Lyme disease", with lingering weird after effects might be psychosomatic. So it's a big muddle.
Note: I am totally convinced that psychosomatic disorders should be taken seriously, but I think that "yet another MRI scan" is not always the best solution.
Good questions. I am not a doctor or weird-things-ticks-carry expert, but: I vaguely remember reading that this was a relatively new disease, arising in Texas and perhaps northern Mexico. All diseases have not been around for thousands of years, at least crossing the species line to humans.Another thought that arises. Morgellons from what I've read here and elsewhere seems to be exclusively an affluent first-world issue. Has anyone reported this in under-developed nations? Societies more prone to parasite infestations (poor or no infrastructure, lower expectations of and access to hygiene as we understand it, more active parasites and diseases). It should be cropping up as often in sub-Saharan Africa as it does in California? Is it something in the psyche of people whose basic needs for shelter, cleanliness, adequate nutrition, et c, are all taken care of, people who then have leisure? (Or it could be an environmental thing, living in the developed and industrialised First World?)
Get it. We're so focused on what we can see - the fleas and ticks - that we don't wonder on what might be hitching a ride on them, that we can't see.Ticks carry multiple diseases in the parasites they carry. Ticks are the vectors, but they are not the infectious agents themselves.
Or the relative closeness of industrial processes in a developed country? A western industrial society might also be Ground Zero for environmental pollutants.If the disease is confined to a particular area/continent, could it simply be that the parasites or their carriers are only native to that area? Nothing to do with its relative prosperity.
Or the fact that only those in developed countries tend to have a relationship with pets that is physically close? I kiss my dog a lot - do those in underdeveloped countries have that almost over-developed sense of sentimentality for animals that we, in the West, do?Or the relative closeness of industrial processes in a developed country? A western industrial society might also be Ground Zero for environmental pollutants.
Depends on the country. In some countries they'll sleep with the dogs on the bed for mutual warmth, in other countries they'll drive them away with stones or eat them. Not something it's easy to generalise on.Or the fact that only those in developed countries tend to have a relationship with pets that is physically close? I kiss my dog a lot - do those in underdeveloped countries have that almost over-developed sense of sentimentality for animals that we, in the West, do?