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Morgellons disease: a narrative review.

Jana Dib El Jalbout¹, Heba Sati², Perla Ghalloub²

¹Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, Lebanon.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology

|February 6, 2024

Summary

Morgellons disease, a persistent delusion of skin infestation, presents diagnostic and treatment challenges due to limited research. Understanding its brain pathologies and clinical features is crucial for patient care.

Keywords:

Clinical manifestations Delusional infestation Etiology Morgellons Morgellons disease Treatment

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Area of Science:

Neurology
Dermatology
Psychiatry

Background:

Morgellons disease (MD) is a poorly understood condition characterized by the delusion of skin infestation.
Limited research and conflicting findings pose challenges for diagnosis and treatment.
It is often classified as delusional infestation (DI) but sometimes linked to spirochetal infections like Lyme disease.

Purpose of the Study:

To review the existing literature on Morgellons disease.
To summarize its history, epidemiology, pathophysiology, neurobiology, clinical presentation, diagnosis, and treatment.
To highlight the need for better understanding and management strategies.

Main Methods:

Comprehensive literature review using PubMed, Embase, and Scopus.
Articles screened by independent reviewers based on inclusion/exclusion criteria.
No date limitations applied due to scarce literature.

Main Results:

Neuroimaging reveals abnormalities in the fronto-striato-thalamo-parietal network and itch pathways, common in DI.
The "match box sign" (patients collecting skin fibers) is a notable clinical feature.
Diagnosis is by exclusion, requiring ruling out secondary causes.

Conclusions:

Morgellons disease is underdiagnosed due to lack of established pathophysiology and treatment guidelines.
Awareness of the condition and its underlying pathogenesis is essential for clinicians.
Effective detection, diagnosis, and treatment are vital due to the significant impact on patients' quality of life.