Post by LymeEnigma on Jul 10, 2008 13:33:51 GMT -8
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:
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:
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.
Enter bacteria such as Staphlylococcus aureus, which can cause painful, weeping lesions. According to the study Staphylococcus Aureus As A Causative Agent Of Atopic Dermatitis/ Eczema Syndrome (ADES) And Its Theraputic Implications:
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.
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:
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.
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:
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 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.
Enter bacteria such as Staphlylococcus aureus, which can cause painful, weeping lesions. According to the study Staphylococcus Aureus As A Causative Agent Of Atopic Dermatitis/ Eczema Syndrome (ADES) And Its Theraputic Implications:
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.
