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It is not Delusions of Parasitosis

Morgellonsitchyrash.com serves to create a directory of all Morgellons conversation and news on the internet. We urge you to do your own research to acquire a sense of what your condition could be. Morgellons is real, but there are varying views on how it is caused and what the symptoms really are. The following article is not a claim that has been researched or is being endorsed by this website.

Author: Noah S Scheinfeld

Delusions of parasitosis manifest in the patient’s firm belief that he or she has pruritus due to an infestation with insects. Patients may present with clothing lint, pieces of skin, or other debris contained in plastic wrap, on adhesive tape, or in matchboxes. They typically state that these contain the parasites; however, these collections have no insects or parasites. This presentation is called the matchbox sign, or what the authors term the “Saran-wrap sign.”

The patients have no obvious cognitive impairment, and abnormal organic factors are absent. True infestations and primary systemic diseases that cause pruritus are not involved. Primary skin lesions are not present. Physical examination may reveal no lesions, but only linear erosions with crusts, prurigo nodularis, and/or ulcers.

The classification of delusions of parasitosis is complicated. It is considered primarily a monosymptomatic hypochondriacal psychosis and has been associated with schizophrenia, obsessional states, bipolar disorder, depression, and anxiety disorders. Delusions of parasitosis occur primarily in white middle-aged or older women, although the condition has been reported in all age groups and in men.

Savely et al[1] introduced the term Morgellon disease to describe a condition characterized by fibers attached to the skin. The entity appears to be little more than a new designation for delusions of parasitosis. Koblenzer[2] and Waddell and Burke[3] have discussed the utility of the term, with Murase et al[4] finding the term useful for building a therapeutic alliance with patients with delusions of parasitosis. The Centers for Disease Control and Prevention is currently investigating Morgellon disease.[5]

William Harvey[6] of the Morgellons Research Foundation Medical Advisory Board states the following:

“All patients with Morgellons carry elevated laboratory proinflammatory markers, elevated insulin levels, and verifiable serologic evidence of 3 bacterial pathogens. They also show easily found physical markers such as peripheral neuropathy, delayed capillary refill, abnormal Romberg’s sign, decreased body temperature, and tachycardia. Most importantly they will improve, and most recover on antibiotics directed at the above pathogens.”

The author of this article has not found reliable data to back up William Harvey’s claims, but they are included here to comprehensively address this issue.

Walling and Swick[7] suggest abandoning 3 the diagnostic terms trichotillomania, delusions of parasitosis, and neurotic excoriation, which they believe have become barriers to treatment. Instead, they suggest using the alternative patient-centered nomenclature of neuromechanical alopecia, pseudoparasitic dysesthesia, and (simply) excoriation.

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