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Morgellons disease etiology and therapeutic approach: a systematic review
Katherine G Beuerlein, Esther A Balogh, Steven R Feldman1
1Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, NC Department of Dermatology, University of Southern Denmark, Odense. sfeldman@wakehealth.edu.
Abstract:
Morgellons disease is characterized by patient reports of fibers embedded in and protruding from the skin. Etiologies from infection to delusion have been endorsed, and treatment guidelines are not well-defined. The objective of this manuscript is to evaluate the existing evidence regarding the etiology and treatment of Morgellons disease in an effort to better inform clinical management. A PubMed search including key words "Morgellons," "delusional parasitosis and fibers," "delusions of parasitosis and fibers," or "delusional infestation and fibers" was completed. Original publications directly assessing etiology or treatment methods of Morgellons disease published between January, 2010 and the time of manuscript preparation were reviewed and evaluated. Sixteen articles regarding etiology were reviewed. All studies were correlative in nature with various limitations. Support for a psychiatric etiology was more widespread than support for an infectious etiology. Eleven articles regarding treatment efficacy were reviewed. Antipsychotic regimens have the most evidence of efficacy. Existing data regarding Morgellons disease suggests a psychiatric etiology and supports treatment with a low-dose antipsychotic agent once non-psychiatric causes have been excluded.
Insights
Morgellons disease, characterized by skin fibers, is best explained by a psychiatric etiology. Treatment with antipsychotic medication is supported by current evidence after excluding other causes.
Area of Science:
- Dermatology
- Psychiatry
- Infectious Diseases
Background:
- Morgellons disease presents with skin fibers, with debated infectious or psychiatric causes.
- Current treatment guidelines for Morgellons disease are not well-defined.
Purpose of the Study:
- To evaluate existing evidence on the etiology and treatment of Morgellons disease.
- To inform clinical management strategies for patients with Morgellons disease.
Main Methods:
- A comprehensive PubMed search was conducted using keywords related to Morgellons disease and delusional infestation.
- Original research articles published from January 2010 onwards, focusing on etiology and treatment, were reviewed.
Main Results:
- Sixteen articles on etiology showed correlative data, with stronger support for a psychiatric origin than an infectious one.
- Eleven articles on treatment indicated that antipsychotic regimens have the most evidence of efficacy.
Conclusions:
- Current evidence suggests Morgellons disease has a psychiatric etiology.
- Treatment with low-dose antipsychotic agents is recommended after excluding non-psychiatric causes.
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