Morgellons Disease: Delusional Parasitosis
It was the first time I had seen the patient but my eyes were immediately drawn to her arms. Small, ulcerated, singular patches dotted her forearm and upper arms. I went through the history taking asking questions about her previous medical history and I was struck by her rather emotionless responses. But then again, English wasn’t her primary language and sometimes people answer with brief responses, embarrased by their language skills.
When I asked about her skin, she responded that she had Morgellons disease. I hadn’t heard of this and asked her to write it out so that I could learn more about it. As it turns out, Morgellons disease is otherwise known as “delusional parasitosis” (DP) a rare psychological disorder in which individuals have the mistaken but unshakeable belief that they are infected by bugs, parasites or other living organisms that infest their body. I asked her what she knew about the disorder and she shrugged her shoulders. Frankly, I wasn’t sure how to proceed – did she know it was a delusional disorder? If not, how would she react to the explanation? And if she did know, how did she feel about it? Did she think that we were delusional because we couldn’t see these bugs? I proceeded cautiously.
She was not forthcoming when I asked what she knew about her disease or who told her she had Morgellons but I gradually pieced together that she was aware that it was a delusional disorder. I took my cues from her responses and didn’t question her further.
Delusional parasitosis is also known as Ekbom’s syndrome, psychogenic parasitosis, delusional infestation, or cocaine bugs. The symptoms were first described by Sir Thomas Browne in 1674. It is a psychiatric disorder that affects patients of all ages and socioeconomic background. Patients often see multiple practitioners complaining of sensations of stinging, biting, crawling or itchiness, receiving repeated courses of skin treatments which of course, do not clear up the problem. Sometimes, patients are convinced they have caught some disease from their pets and seek treatment for their animals. Oftentimes, they have repeated exterminations of their houses.
Viewed as a psychiatric disorder, there is a growing movement by non-medical people that the disease is caused by some unknown parasite or bacteria. This understanding is viewed skeptically by many in the medical profession. The CDC has launched an epidemiologic investigation into this with the Kaiser foundation in California. Careful not to be offensive to anyone, the CDC instead calls this an “unexplained dermopathy”. Some websites offer cures and treatments for this disorder but nothing has been proven to effectively treat this disorder. Certain antipsychotics appear to be effective.