The Internet has revolutionized modern medicine. Physicians have unlimited access to the latest achievements of modern medical knowledge and can consult difficult cases with specialists from all over the world. However, not only doctors are searching for some medical information. Increasingly, patients try to diagnose themselves using web sites and they form discussion groups associating people with similar ailments. This phenomenon reached its peak when Morgellons Research Foundation was established.

It is impossible to find Morgellons among diseases contained in ICD-10. Why? The reason is very simple: since 2002, when this syndrome was described for the first time in the Internet by a mother of 2-year-old boy who complained about unbearable itching and bugs under his skin[1], there is no consensus among health professionals whether it is a new skin disease, a psychiatric disorder or maybe a manifestation of other clinical afflictions.

On the basis of available medical literature I am going to present briefly the main points of view about this mysterious disease.

The main symptoms of Morgellons are skin lesions, in which patients observe structures similar to fibers or threads; crawling, biting, sores and rashes. It usually coexists with chronic fatigue, mental confusion and memory disorders.[2][3] Causes of this disorder are still not known. Internet users have their own theories which remind of a scenario of s-f movies; they consider Morgellons disease to be the result of using GMF[4], pesticides[5] or men-made nanotechnology[6]. Physicians are far away from these unbelievable explanations and most of them reckon that Morgellons is another manifestation of delusional parasitosis. Similarities between these two disorders are undeniable: patients suspect that some foreign bodies or worms live under their skin, they try to extract them from their bodies, using nails. They also visit many specialists such as dermatologists or GPs, but refuse to consult psychiatrists.[7] What is very characteristic of both conditions is matchbox sign (collecting proofs of infestation such as fibers or worms)[8].

Of course, not all of the health professionals share the opinion about the psychiatric cause, cites the examples of Semmelweiss or gastric ulcers[9]. What is more, CDC is conducting an investigation which aims to reveal the Morgellons potential risk factors.

Because the researches evidence is still insufficient, the data about laboratory values are inconsistent. Some studies did not reveal any abnormalities[10], while others revealed abnormal RBC level, anemia, high monocyte count, NK irregularities, elevation of serum calcium and so on. However, test groups were too small to put any proposals on this basis.

There is also no common opinion about the treatment. Some specialists described positive effects of aggressive, long-term antibiotic therapy (as in chronic Lyme patients)[11], others successfully use antipsychotic medication. We have to remember that Morgellons affects not only skin, and, whatever is the cause, patients really suffer. Therefore therapy should be conducted by a multidisciplinary group which consists of dermatologist, psychologist and physician. Meeting patient half way is the best way of medical approach. Excluding the organic causes of skin lesions and using soothing ointments during psychiatric treatment may be a chance to rebuilt patient’s trust to the doctor.[12]

At present there are above 13 thousand of people suffering from Morgellons disease. Due to Internet lobby and mass-media popularity, epidemic of Morgellons spreads very fast. Every day someone discovers mysterious fiber on their skin and after self-diagnosis joins the huge Morgellons community, which presses the government to lead an investigation into possible contagious causes of the disease. Despite that, physicians are still skeptical and treat it rather as a psychiatric disorder.

There are few facts about Morgellons disease. However, analyzing the Morgellons phenomena, there are many questions – not only connected with the clinical aspects,  but also of ethical nature. In the world of widespread Internet we should ask ourselves: where is the borderline of self-diagnosing? And what is the reason why increasing number of people put more trust in the web than in the opinion of  medic?

[1] Oliver Freudenreich, M.D., Nicholas Kontos, M.D., Constantin Tranulis, M.D., and Corinne Cather, Ph.D. Morgellons Disease, or Antipsychotic-Responsive Delusional Parasitosis, in an HIV Patient: Beliefs in The Age of the Internet, http://psy.psychiatryonline.org/cgi/content/full/51/6/453, (19.02.2011)

[2] http://www.morgellons.org/symptoms.html

[3] http://www.cdc.gov/unexplaineddermopathy/

[4] http://www.freerepublic.com/focus/f-chat/1710422/posts

[5] http://morgellons2.wordpress.com/2010/03/30/bio-pesticides-the-cause-of-morgellons-disease/

[6] http://loveforlife.com.au/node/7097

[7] Robert E. Accordino, Danielle Engler, Iona H. Ginsburg, John Koo Morgellons disease?, http://onlinelibrary.wiley.com/doi/10.1111/j.1529-8019.2008.00164.x/pdf

[8] Roland W. Freudenmann, Markus Kolle, Carlos Schonfeldt-  Lecuona, Sebastian Dieckmann, Wolfgang Harth, Peter Lepping,  Delusional Parasitosis and the matchbox sign revisited: the internationale perspective, http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-0909&html=1

[9] Virginia Savely, Delusions may not always be delusions (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6WB7-50KFCY8-4&_user=544889&_coverDate=08%2F31%2F2010&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000027840&_version=1&_urlVersion=0&_userid=544889&md5=c6ffc8450b7c04619855350ed8f2baab&searchtype=a

[10] Robles DT, Olson JM, Combs H, Romm S, Kirby P. Morgellons disease and delusions of parasitosis, http://www.ncbi.nlm.nih.gov/pubmed/21110523

[11] Mary  Paquette, Morgellons: Disease or delusions?, http://onlinelibrary.wiley.com/doi/10.1111/j.1744-6163.2007.00113.x/pdf

[12] Robert E. Accordino, Ibidem

Author: Patrycja Marciniak