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threadlike fibers of varying colors in lesions and

intact skin; and thick, tough, translucent fibers

that are highly resistant to extraction.

When commercial laboratories examine wound

biopsies of MD patients, the fibers are usually

mislabeled as textile in origin. However, when

matched to 100,000 organic and inorganic sub-

stances in an FBI database, the fibers were unique

and incomparable. Thus far, only individuals

claiming to have MD have been observed to have

these unknown fibers in their skin. (Research

scientist Randy Wymore, PhD, and colleagues

presented these findings at the 14th International

Molecular Medicine Tri-Conference in San

Francisco in 2007.)

The distinguishing characteristic of MD is the

presence of microscopic subcutaneous fibers,

which can be visualized with lighted mag-

nification. If a person complains of MD-like

symptoms, the practitioner should examine theskin thoroughly before initiating a psychiatric

referral, because the diagnosis of a delusional

disorder should not be made lightly.

The CDC began investigating MD in January

2008, but for now the diseases cause and cure

remain a mystery. Whether or not MD proves

to be a distinct entity, its victims deserve to

be taken seriously and treated with respect.

Primary-care clinicians can make a difference

to these patients through validation, reassur-

ance, and a commitment to help.

www.clinicaladvisor.com 109

superficial exam, doctors assumed the patients

were delusional. A recent explosion in the

diagnosis of DOP raises suspicion that these

unfortunate people may actually have had a

real, unrecognized disease all along ( J Am

Acad Dermatol. 2007;56:705-706).

In 2002, Mary Leitao, a Pennsylvania mother,

noticed unusual fiber-containing lesions on

the body of her 2year-old son. Unable to

find a diagnosis, Ms. Leitao began to call the

ailment Morgellons disease(MD) after discov-

ering a similary named condition resembling

her sons in a 17th-century medical text by Sir

Thomas Browne. Since Ms. Leitao started the

nonprofit Morgellons Research Foundation in

2003, more than 14,000 families have registered

(www.morgellons.org).

I recently completed a descriptive study of 122

patients who had a positive in-office examina-

tion for microscopic, subcutaneous fibers. Thetop 10 symptoms specific to the patients skin

condition and experienced by more than 70%

of the sample were: crawling sensations under

the skin; spontaneously appearing, slow-healing

lesions; hyperpigmented scars when lesions

heal; intense itching; seed-like objects coming

out of the lesions; black specks coming out of

the lesions; a sensation of something trying

to poke through the skin from the inside out;

fuzz balls on intact skin (balls of fine fuzz that

are usually only visible microscopically); fine,

The CDCbegan to

investigateMorgellonsin 2008, but

for now thecause and

cure remaina mystery.

Ginger Savely, MEd, MSN, DNP, RN, FNP, is an expert in Morgellons disease as well as

Lyme disease and other tick-borne illnesses (www.gingersavely.com).

Delusions of parasitosis (DOP) is a psychiatric disorder in which patients mistakenly believe they

have a skin infestation. As Koo and Lee reported in theAmerican Journal of Clinical Dermatology

(2001;2[5]:285-290), DOP is actually very rare, and oddly, individuals diagnosed with it have

no history of mental illness. In fact, patients seem cognitively intact in every way while adamant

that something inside of them is causing itching and other disturbing sensations (Dermatol Clin.

1996;14[3]:429-438). Some of the earliest patients exhibiting these symptoms expressed beliefthat their symptoms were due to a parasite. Because a known parasite could not be identified on