The 10th Annual Medical-Scientific Conference on Morgellons Disease, organized by the Charles E. Holman Morgellons Disease Foundation, was held in Austin, TX, in April 2017. The meeting featured scientists reporting their findings of bacterial species (particularly Borrelia) in Morgellons lesions,1 clinicians describing the disease and their experiences treating it (with antibiotics, functional medicine, and low-dose antigen treatment), and a parasitologist debunking the landmark Centers for Disease Control and Prevention study that found no infection in Morgellons patients.2
What is Morgellons disease? I had the impression, as I think most dermatologists do, that Morgellons disease is another name for delusions of parasitosis. The people attending this conference think otherwise. They have a dermopathy that appears to them to be caused, at least in part, by chronic Lyme disease that causes fibers to form in their skin, that is associated with crawling sensations, that is resistant to standard treatments, and that is completely misunderstood by the mainstream medical community.
Are people with Morgellons disease delusional? I have patients who clearly have delusions of parasitosis. Perhaps these patients do not have Morgellons, though the Morgellons advocates may hypothesize that my delusional patients may be delusional due to the chronic effects of having crawling sensations in their skin or to direct central effects of chronic Lyme disease on the brain.
At least some of the people I met at the conference were very thoughtful and dedicated to developing a better understanding of the condition with which they are suffering. They have sensations and lesions, do not know for sure what is causing the symptoms, and find the scientists reporting Lyme/Borrelia to be very convincing. Are these patients delusional or simply being misled by less than high quality science? For many of the people I met at the meeting, I think the latter seems to fit; others, some of whom had been treated with antecedent stimulants, seemed to fall on a wide spectrum that extended to frank delusions.
One strong theme permeated the conference: patients were angry with physicians for discounting their problem and labeling them as delusional without a thorough search for an organic cause for their symptoms. Some patients, clearly, have delusions and need immediate psychiatric care (perhaps from us if they will not consider referral). But I am not sure we are doing a great service if we assume that everyone who thinks they have Morgellons disease is delusional. Is there ever an organic cause for crawling sensations? Hopefully, I am not delusional for thinking there could be.
In next month’s column, I will share more experiences and impressions from this conference.
Steven R. Feldman, MD, PhD
Chief Medical Editor
Dr Feldman is with the Center for Dermatology Research and the Departments of Dermatology, Pathology, and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC.
References
1. Middelveen MJ, Bandoski C, Burke J, et al. Exploring the association between Morgellons disease and Lyme disease: identification of Borrelia burgdorferi in Morgellons disease patients. BMC Dermatol. 2015;15:1-14.
2. Pearson ML, Selby JV, Katz KA, et al; Unexplained Dermopathy Study Team. Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy. PLoS One. 2012;7(1):e29908.
The 10th Annual Medical-Scientific Conference on Morgellons Disease, organized by the Charles E. Holman Morgellons Disease Foundation, was held in Austin, TX, in April 2017. The meeting featured scientists reporting their findings of bacterial species (particularly Borrelia) in Morgellons lesions,1 clinicians describing the disease and their experiences treating it (with antibiotics, functional medicine, and low-dose antigen treatment), and a parasitologist debunking the landmark Centers for Disease Control and Prevention study that found no infection in Morgellons patients.2
What is Morgellons disease? I had the impression, as I think most dermatologists do, that Morgellons disease is another name for delusions of parasitosis. The people attending this conference think otherwise. They have a dermopathy that appears to them to be caused, at least in part, by chronic Lyme disease that causes fibers to form in their skin, that is associated with crawling sensations, that is resistant to standard treatments, and that is completely misunderstood by the mainstream medical community.
Are people with Morgellons disease delusional? I have patients who clearly have delusions of parasitosis. Perhaps these patients do not have Morgellons, though the Morgellons advocates may hypothesize that my delusional patients may be delusional due to the chronic effects of having crawling sensations in their skin or to direct central effects of chronic Lyme disease on the brain.
At least some of the people I met at the conference were very thoughtful and dedicated to developing a better understanding of the condition with which they are suffering. They have sensations and lesions, do not know for sure what is causing the symptoms, and find the scientists reporting Lyme/Borrelia to be very convincing. Are these patients delusional or simply being misled by less than high quality science? For many of the people I met at the meeting, I think the latter seems to fit; others, some of whom had been treated with antecedent stimulants, seemed to fall on a wide spectrum that extended to frank delusions.
One strong theme permeated the conference: patients were angry with physicians for discounting their problem and labeling them as delusional without a thorough search for an organic cause for their symptoms. Some patients, clearly, have delusions and need immediate psychiatric care (perhaps from us if they will not consider referral). But I am not sure we are doing a great service if we assume that everyone who thinks they have Morgellons disease is delusional. Is there ever an organic cause for crawling sensations? Hopefully, I am not delusional for thinking there could be.
In next month’s column, I will share more experiences and impressions from this conference.
Steven R. Feldman, MD, PhD
Chief Medical Editor
Dr Feldman is with the Center for Dermatology Research and the Departments of Dermatology, Pathology, and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC.
References
1. Middelveen MJ, Bandoski C, Burke J, et al. Exploring the association between Morgellons disease and Lyme disease: identification of Borrelia burgdorferi in Morgellons disease patients. BMC Dermatol. 2015;15:1-14.
2. Pearson ML, Selby JV, Katz KA, et al; Unexplained Dermopathy Study Team. Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy. PLoS One. 2012;7(1):e29908.
The 10th Annual Medical-Scientific Conference on Morgellons Disease, organized by the Charles E. Holman Morgellons Disease Foundation, was held in Austin, TX, in April 2017. The meeting featured scientists reporting their findings of bacterial species (particularly Borrelia) in Morgellons lesions,1 clinicians describing the disease and their experiences treating it (with antibiotics, functional medicine, and low-dose antigen treatment), and a parasitologist debunking the landmark Centers for Disease Control and Prevention study that found no infection in Morgellons patients.2
What is Morgellons disease? I had the impression, as I think most dermatologists do, that Morgellons disease is another name for delusions of parasitosis. The people attending this conference think otherwise. They have a dermopathy that appears to them to be caused, at least in part, by chronic Lyme disease that causes fibers to form in their skin, that is associated with crawling sensations, that is resistant to standard treatments, and that is completely misunderstood by the mainstream medical community.
Are people with Morgellons disease delusional? I have patients who clearly have delusions of parasitosis. Perhaps these patients do not have Morgellons, though the Morgellons advocates may hypothesize that my delusional patients may be delusional due to the chronic effects of having crawling sensations in their skin or to direct central effects of chronic Lyme disease on the brain.
At least some of the people I met at the conference were very thoughtful and dedicated to developing a better understanding of the condition with which they are suffering. They have sensations and lesions, do not know for sure what is causing the symptoms, and find the scientists reporting Lyme/Borrelia to be very convincing. Are these patients delusional or simply being misled by less than high quality science? For many of the people I met at the meeting, I think the latter seems to fit; others, some of whom had been treated with antecedent stimulants, seemed to fall on a wide spectrum that extended to frank delusions.
One strong theme permeated the conference: patients were angry with physicians for discounting their problem and labeling them as delusional without a thorough search for an organic cause for their symptoms. Some patients, clearly, have delusions and need immediate psychiatric care (perhaps from us if they will not consider referral). But I am not sure we are doing a great service if we assume that everyone who thinks they have Morgellons disease is delusional. Is there ever an organic cause for crawling sensations? Hopefully, I am not delusional for thinking there could be.
In next month’s column, I will share more experiences and impressions from this conference.
Steven R. Feldman, MD, PhD
Chief Medical Editor
Dr Feldman is with the Center for Dermatology Research and the Departments of Dermatology, Pathology, and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC.
References
1. Middelveen MJ, Bandoski C, Burke J, et al. Exploring the association between Morgellons disease and Lyme disease: identification of Borrelia burgdorferi in Morgellons disease patients. BMC Dermatol. 2015;15:1-14.
2. Pearson ML, Selby JV, Katz KA, et al; Unexplained Dermopathy Study Team. Clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy. PLoS One. 2012;7(1):e29908.
