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Morgellons disease: experiences of an integrated multidisciplinary dermatology team to achieve positive outcomes
Padma Mohandas1,2, Anthony Bewley2, Ruth Taylor2
1a Department of Dermatology , The Royal Derby Hospital , Derby , England.
Background:
In recent years, there has been a reported increase in affliction of the skin with small fibres or other particles. The condition has been referred to as Morgellons disease. Patients present with stinging, burning or crawling sensations of the skin, with perceived extrusion of inanimate material alongside fatigue and other systemic symptoms. Sufferers often experience significant morbidity and reduction in quality of life.
Objectives:
We aimed to explore the various clinical presentations, management strategies and outcomes employed to treat this condition in our patients.
Methods:
We conducted a retrospective case notes review of 35 patients referred to our multidisciplinary psycho-dermatology clinic at the Royal London Hospital between January 2004 and January 2017.
Results:
The majority of patients were women (25) 71.4%, with a mean age of 54.6 years (26-80 years). Most (26) 74.2% were living alone. The average duration of illness prior to presentation was 3.8 years (4 months-20 years). Many patients had perceived precipitating factors (54.2%) and often self-diagnosed (28.5%). Psychiatric co-morbidities included 42.8% with depressive symptoms and 25.7% with anxiety. Substance misuse was elicited in five patients (14%). Management of patients included both the treatment of skin disease and psychosocial co-morbidities. Out of the 35 patients who attended (14) 40% cleared or showed significant improvement. Sixteen (45.7%) patients were stable and under review. One patient declined treatment and three did not attend review. One patient died from disease unrelated to her skin condition.
Conclusions:
Morgellons disease is a condition, which is widely discussed on the internet and patients often self-diagnose. The course of the disease can be chronic and debilitating. For a positive outcome, it is important that a strong physican-patient relationship is cultivated. As demonstrated in this case series, managing patients holistically in an integrated multidisciplinary dermatology setting helps achieve positive outcomes.
Insights
Morgellons disease, a chronic skin condition, often presents with self-diagnosis and requires holistic management. Integrated multidisciplinary care significantly improves patient outcomes.
Area of Science:
- Dermatology
- Psychiatry
- Public Health
Background:
- Morgellons disease is characterized by skin sensations and perceived extrusion of fibers.
- Patients report significant distress, morbidity, and reduced quality of life.
Purpose of the Study:
- To investigate clinical presentations, management strategies, and outcomes for Morgellons disease.
- To explore the effectiveness of a multidisciplinary psycho-dermatology approach.
Main Methods:
- Retrospective case notes review of 35 patients.
- Data collected from a multidisciplinary psycho-dermatology clinic (January 2004 - January 2017).
Main Results:
- Majority of patients were women (71.4%), with a mean age of 54.6 years.
- Average illness duration was 3.8 years; many patients self-diagnosed.
- Psychiatric comorbidities were common (42.8% depressive symptoms, 25.7% anxiety).
- 40% of patients cleared or improved significantly with holistic management.
- 45.7% of patients were stable under review.
Conclusions:
- Morgellons disease is a chronic, debilitating condition often self-diagnosed via the internet.
- A strong physician-patient relationship is crucial for positive outcomes.
- Holistic management in an integrated multidisciplinary dermatology setting leads to better results.
