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CDC deflates public health threat of mysterious skin condition

Patients with the unexplained skin condition commonly referred to as Morgellons experience real symptoms that often lead to a diminished quality of life, say the authors of a recent Centers for Disease Control and Prevention study.

The condition is characterized by unexplained lesions that contain fibers, threads or other foreign materials accompanied by sensations of crawling, biting and stinging, the CDC says.

Although the health problem is not recognized as a distinct clinical disorder with diagnostic criteria, the study authors recommend that physicians keep an open mind when they see such patients and not dismiss the individual's medical concerns as untrue.

The study encourages physicians to fully examine these patients and create a treatment plan that addresses co-existing medical conditions.

"It is unfair to dismiss [these patients'] complaints as invalid, and that has happened," said Daniel Rutz, MPH, a CDC public health communications specialist who worked on the study, published in the Jan. 25 issue of PLoS ONE. "We're hoping the [new] data will cast some light on the fact that this is for real."

The CDC launched its study in 2008 after an increase in inquiries to the agency about Morgellons. Enrolled in the CDC study were 109 people 18 and older who had symptoms of the skin problem and received care at Kaiser Permanente Northern California between July 2006 and June 2008.

Seventy participants completed a survey on their medical history, alcohol and illicit drug use and potential environmental exposures. Clinical evaluations, which included a physical exam and neuro-psychological tests, were administered to 41 of the 109 participants. Biopsies were taken, and experts collected and analyzed fibers that were found on the patients' skin. Not a public health threat

Researchers determined that the condition affects fewer than four in 100,000 people seeking medical care and is not infectious.

Most of the materials collected from the skin were fibers from cloth. Others were skin fragments that became entrapped in participants' puss crust or scabs, the study showed.

Participants had a wide range of skin lesion types, which suggests the condition cannot be explained by a single disorder, the study authors said. They did not identify an environmental cause for the condition, but found that 78% of participants reported they or a household member were exposed to solvents, such as paint thinner, while participating in hobbies.

Nearly 60% of people had some cognitive impairment, and 63% had clinically significant somatic complaints. Half of the participants tested positive for drug use (prescription and illicit substances), and many had a history of psychiatric problems.

Rutz cautioned physicians from thinking that all patients with the health issue have a psychiatric problem or are taking drugs. "For some people, this might be part of the problem, and it is worth following up with clinically," he said.

The study shows the skin condition is not a significant public health problem "but it is significant to the people who have it," Rutz said.

The full and original article can be found at: http://www.ama-assn.org/amednews/2012/01/30/hlsb0203.htm

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