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I tawt I taw an erythema migrans....
Joined: Aug 2007 Gender: Female Posts: 2,766 Karma: 25
Demystifying Morgellons...? « Thread Started on Jul 10, 2008, 1:33pm »
A More Rational Look at “Morgellons”
The term “Morgellons” is not new to the medical community, although its use might refer to a few different interpretations. Numerous patients claim they suffer from some kind of dermatological parasite. Certain Lyme disease advocates insist it is a co-infection. Numerous dermatologists claim it is nothing more than delusional parasitosis. The Centers for Disease Control (CDC) recently announced its formal investigation into the phenomenon. The suggested evidence is disturbing, no matter how one looks at it, although the collective data does nothing to point to any one single agent or disease. The questions still remain: What is this skin condition that allegedly is afflicting so many people? Is there a biological agent responsible, or might there be a simpler explanation?
Morgellons patients complain of small bumps or lesions on the skin, from which “fibers” or “specks” of various colors (usually white, black, red, or blue) protrude. Patients claim the fibers cause itching and pain, and also often complain of related “crawling” or “biting” sensations on the skin. While the chances of “Morgellons” actually being the result of an unknown parasite are pretty slim, it is always possible that patients who believe they have Morgellons are legitimately suffering from one or more of numerous diseases or disorders. It is very possible that hereditary, bacterial, and psychological factors are involved. It is my hypothesis that manifestations caused by keratosis pilaris and similar examples of keratinized skin, combined with various common strains of dermatitis-causing staphlylococcus and/or certain specific neurological and mental conditions, are the main causes to Morgellons-related dermatological complaints.
The literature that exists on Morgellons is varied, ranging from mere speculation to documented data and covering a vast spectrum of viewpoints. If one attempts to search the Internet for information on Morgellons, for instance, the results are disturbingly mixed. The Morgellons Research Institute suggests that Morgellons is a disease that deserves its own distinction from other skin conditions and causes, in addition to various skin manifestations, symptoms that others might identify as Chronic Fatigue Syndrome (CFS) and/or Fibromyalgia Syndrome (FMS). The watchdog site, Morgellons Watch, on the other hand, advertises a very different view:
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I believe that much of the recent media coverage of Morgellons has been inaccurate and sensationalist. This is misleading sick people into thinking they may have a terrible disease, when the evidence does not indicate that such a disease actually exists. People have very real physical symptoms, but those symptoms have many possible causes, which have very real treatments.
Misdirecting people into a wild goose chase, after a disease for which there is no evidence, is harmful to their health.
The site offers numerous explanations to references, pictures, and claims made across the Web, citing the Morgellons Research Institute and others it its attempt to debunk the “evidence” provided. For example, here is a picture of an alleged fiber growing from a child’s lip, as well as a Morgellons Watch recreation of that image using tissue paper. A deeper examination of the site effectively covers just about all Morgellons claims one can find Online, claiming the enigmatic fibers to be nothing more than skin, cotton, silicon, and other materials that patients could have picked up from various benign, external sources. So does that mean that there is no basis to the disease, whatsoever? Not necessarily.
When one considers the superficial and visual descriptions of reported Morgellons lesions, similarities between these lesions and certain keratonizing skin disorders begin to become evident. Crowe and Escobar describe in their eMedicine article on keratosis pilaris:
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History
* The patient may report groups of keratotic papules, which feel rough and prickly. The patient may describe them as persistent, rough goose bumps. They are not painful or significantly pruritic in most patients.
* About half of all affected patients notice a worsening of symptoms in the winter months.
* These lesions tend to improve after a few years.
Physical
* Keratosis pilaris alba is the more common variant and is characterized by small gray-white papules with a negligible inflammatory component.
* Keratosis pilaris rubra has a significant inflammatory component, and thus patients present with small erythematous papules. More widespread areas of skin are involved. This variation is most conspicuous during the winter months.
* Observe for small, horny, follicular papules with (ie, rubra) or without (ie, alba) surrounding erythema.
* Most commonly, lesions occur on the posterolateral upper arms and anterior thighs. Less commonly, lesions involve the face, buttocks, and trunk.
* In involved areas, lesions are extensive, monomorphic, and very evenly spaced.
* A fine hair may pierce the papules, or hair may be found coiled up within the keratin plug.
* The keratin plug cannot be expressed with pressure.
The “horny follicular papules” can present as sheaths around a growing hair and can give off the appearance of thin, white fibers protruding from the skin. As an adult who has had keratosis pilaris on and off since childhood, I can attest that the condition can have a clear parasitic appearance to it. The keratinized skin grows fiber-thin, and it can grow surprisingly long and tactile.
The cause to keratosis pilaris is unknown, but there is a good possibility that it is pathogenic and/or autoimmune in nature. My reasoning is simple, although it may also be flawed: I had constant follicular papules as a child, all of them presenting on my thighs and upper arms. This is a common phenomenon, occurring in as many as 80% of children (Crowe and Escobar, Alai et al). As in at least half of all cases of keratosis pilaris (Alai et al), mine appeared to abate when I reached adulthood. Interesting enough, however, it returned once again after I contracted Lyme disease. The follicular papules are constant, to this day, as are a number of other lingering symptoms, including other dermatological phenomena that includes petechia, multiple discoid lesions and facial patches similar to the lupus “butterfly” rash. While there is no evidence to connect Lyme disease with keratosis pilaris the timetable experienced in most patients, suggesting that the immune system may play a role in the dermatological disorder, combined with the high number of Lyme patients who complain of “Morgellons” symptomology, does suggest that immunological changes resulting from Lyme and other diseases may contribute to outbreaks of follicular papules.
The bacterial skin flora of patients with atopic dermatitis is different from that in healthy people. In addition, such patients more often suffer from microbial infections such as impetigo, folliculitis, and furunculosis. The microbial flora of AD patients shows striking differences in term of the presence of Staph. aureus. The relative rarity (2%-25%) of colonization by Staph. aureus on normal skin sites is in sharp contrast to the high carriage rate found in patients with ADES ranging from 76% on unaffected areas and up to 100% on acute, weeping lesions. As the colonization correlates significantly with the severity of ADES, anti-staphylococcal treatment measurements are widely used.
If we consider the numerous ways different individuals react to different pathogens, with some of the most common bacteria capable of causing atypical, sometimes serious, manifestations, we might also consider variables such as individual bacterial skin flora and its role in other various, seemingly unusual symptoms. For example, might people with “Morgellons” have or lack certain common flora that inhibit or promote excessive collagen formation? Might that, in turn, also provide an easier host for other, more opportunistic, infections such a staph?
The final elements that likely play a role in the identification of Morgellons, as adverse as patients might be to the idea, are neurological and mental illness. Lyme disease patients offer an ideal model for this particular part of the thesis. According to sources such as the Morgellons Research Institute, there does exist a connection, albeit an anecdotal one, between Lyme disease and Morgellons. Just as important, whereas not all Morgellons patients claim also to have Lyme disease, many do suffer from numerous similar neurological symptoms, such as fatigue and “brain fog.” Lyme disease can cause numerous neurological manifestations, including physical sensations of crawling skin, pinches, and burns (UMM). Lyme disease is also capable of producing significant mental illness in some individuals (Fallon et al), which might prime some patients to misinterpret neurological manifestations, in combination with visual dermatological issues, as being caused by parasites. It is also very likely that some of these patients are exacerbating the severity of their lesions, by picking at them in their attempts to remove said perceived parasites. This conclusion becomes clearer when one compares certain Morgellons photos with those of self-induced lesions found on long-term methamphetamine users (Morgellons Research Foundation, CBS, MAPP-SD, Craig Police Online). It is my stance that the various manifestations that can come with Lyme disease, certain neurological conditions, or in some cases even dermatitis itself, combined with the above mentioned other possible factors, could easily lead to delusions of parasite infestation.
I learned something. I didn't know this skin thing even had a name.
I pop 'em, and I know I shouldn't. The ones on the backs of my arms...the little white dry ones...they don't bother me. They DO bug me on my legs because of shaving. Its the red or swollen ones I get on my forearms on the soft inner part or on my torso that I end of popping cause those will itch. Sometimes they are white and have fluid inside or the plug, other times they are red with the plug in them. You can ALWAYS yank out a hair. Then I look like I have been injuring myself. I end up putting a little neosporin on it after. BUT I never thought it was a parasite. I just always thought I had problems with ingrown hairs. And a bad habit of popping said ingrown hairs.
Always there is a plug of puss or dry skin inside (which now I know is keratin thanks to you) and an ingrown hair all curled up. I always thought it was little ingrown vellous hairs that got infected.
I did find a cream, though LE, that seems to really help. Its expensive, though.
True Blue Spa by bath and body works Self Meditating body butter with rice bran oil and green tea. Its like 15 bucks a jar but it is very nice for the dry bumps on the backs of the arms and the thighs.
That's good to know. I have had limited success with benedryl gel, but they usually don't get so unsightly that I feel the need to do too much more. Every once in a while I'll get an outbreak that is really bad, and it usually corresponds with waiting too long to shave my legs and getting too close of a shave.
Although rationally I have always known that the patches are benign (they're always symmetrical; if it's on one hip, it's on the other without fail), when I was a kid sometimes I would let the plugs and horns mess with my mind (those plugs could easily be interpreted as bug eggs, and the horns as miniature fungal growths or "fibers"). A doctor told me that it was a "common bacterial infection," and that was the end to my questions ... until I started reading about this "Morgellons" condition.... Ever eager to separate myself from the hysterics, I felt compelled to come up with some REAL answers.
I try not to mess with my breakouts ... but I do sometimes obsessively pull the "fibers" off when there are a lot of them. I need to borrow my neighbor's camera sometime when there are some big ones poking out; I'd love to prove to a "Morgie" or two that what they have, at least on their skin, is benign (because I feel pretty sure about this), but my camera is a piece of crap that loses focus when I try to take a close-up. The best photos I have right now show the horns as tiny white blobs....
Oh, I'm sure it is benign, too. I have had this my whole life. But even when it was at its worst one winter a few years ago and my arm was all torn up from it (BECAUSE I WAS ITCHY, and I scratched it up, not some strange flesh-eating parasite), I never thought it was anything at all except the way my skin is, combination, often dry though oily in some places, and genetically predisposed to ingrown hair.
Is this really what they call morgellons??
Maybe if they would just let the sores heal and quit picking...
Sometimes I have to remind myself to do that. I will pick if i itch or if it annoied me. and sometimes without thinking. Then I tell myself to 'quit it and let it heal'...slap on a little antibiotic ointment and keep it real moisturized so that I am not tempted to yank off the scab.
I truly do believe that keratosis pilaris is one of the main "causes" of Morgellons ... and I think that less people would have such visibly disturbing cases if they would just leave the lesions to heal.
And I think one of the big factors, here, is LLMDs are trying to do the job of dermatologists, as well, missing this simple diagnosis ... because, well, Stricker and Savely are not dermatologists....
Again, we have a pharmacologist trying to play at dermatologist ... who proves (IMHO) very unprofessional and even a bit crazy in his rantings:
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Amateur debunkers carry no weight in academia and have no relevance in the discussion of Morgellons Disease in the scientific and medical community. Since the clinicians (both D.O. and M.D.) and scientists at the conference I mentioned above did not debunk a formal presentation on the topic of Morgellons Disease, why would an amateur think that they could? An amateurish debunking approach is often nothing more than a type argumentative arrogance. A person, or persons, manages to attract an audience that will participate in the argument and it gives the debunker a sense of power. What goes on at debunking sites is most definitely NOT scientific debate and critical inquiry. Critical scientific debate occurs at conferences (regional, national or international), during seminars and during the editorial review when scientific manuscripts are submitter. If an amateur debunker (unless the debunker is paid for the debunking services, in which case she/he would be a professional debunker) feels that they can compete in the professional scientific arena, let them submit an abstract to a conference or a manuscript to a scientific journal (a legitimate, peerreviewed scientific journal). The results would be laughable; probably not to the debunker, but the reality of the world is that none of the mainstream journals that are peerreviewed would publish such a manuscript. The internet is a wonderful forum for discussions of all sorts and a place where information can be obtained on just about any subject imaginable. If a person, or group of people, wish to spend time deconstructing the words, comments and images of others, or to try to debunk what they view as unreal, then that is certainly their option in life. I personally do not find that it would be very personally satisfying. In my mind, such efforts are, at the very least, a waste of valuable time and at the worst, hurtful. What good can come of it? If the Morgellons community TRULY was delusional, then a debunking site would not convince them not to be delusional. Truly delusional behavior is a psychological condition; one cannot "cure" a delusion by simply arguing against the delusion on an internet site. The delusional person will not simply read the words and in near-miraculous form say, "Oh my, I really am delusional. Now that I know this I can give up my delusion. Thank you for pointing out the obvious and curing me." Since that will not happen, then what good can come from the debunking site? It is difficult to use the word "good" when the main accomplishment of such a site is to cause consternation and further emotional pain to an already suffering population. The reason is that, while the professional medical and scientific community will pay no attention to a debunking website, the same cannot be said for the friends and family of the Morgellons sufferer.
I don't think I'm going to give this guy much weight....
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