Page 28 - JCBP-3-2

Journal of Clinical and

Basic Psychosomatics

REVIEW ARTICLE
An in-depth critical analysis of

Morgellons: Delusion or disease?

1†
2†
Bisam-Ul Haq * , Kashaf I. Zaidi * , Yasmin Nikookam 3 , Mahnoor Irfan 4 ,
and Shehryar Khan 5
1 Department of Dermatology, Churchill Hospital, Oxford University Hospitals, United Kingdom
2 Bart’s and The London School of Medicine and Dentistry, United Kingdom
3 Department of Oncology, Guy’s and St Thomas’ Hospital, United Kingdom
4 St. George’s, University of London, United Kingdom
5 InPatient Psychiatry, Pilgrim Hospital, Lincolnshire Partnership NHS Foundation Trust, United
Kingdom

Abstract

Morgellons is a poorly understood entity and is characterized by cutaneous findings
such as fibers emerging from the skin, which can cause secondary symptoms such
as formication and itching. Morgellons is an understudied area with conflicting
results; this imposes challenges to clinicians while navigating consultations
† These authors contributed equally and understanding, diagnosing, and treating Morgellons. This literature review
to this work. summarizes the available data on the etiology, epidemiology, clinical presentation,
*Correspondent authors: treatment, and social media influence within Morgellons. Medical Subject Headings
Bisam-Ul Haq terms were used to systematically search PubMed, Medline, and EMBASE, and two
(buh20@cantab.ac.uk)
Kashaf I. Zaidi independent reviewers screened the selected articles, revealing that Morgellons is
(ha19238@qmul.ac.uk) poorly understood among the scientific community, with a population prevalence
of 3.65/100,000. The etiology of Morgellons is controversial, and opinions among
Citation: Haq B, Zaidi KI,
Nikookam Y, Irfan M, Khan S. psychiatrists and dermatologists are conflicting. Some studies propose a biological
An in-depth critical analysis of origin linked to Lyme disease, whereas others view Morgellons as a delusional
Morgellons: Delusion or disease? disorder without an underlying pathology. The conflicting views can be attributed
J Clin Basic Psychosom.
2025;3(2):22-34. to the lack of robust research with no consensus on an established pathophysiology,
doi: 10.36922/jcbp.4735 disease classification, or treatment guidelines. Herein, the majority of literature views
Received: September 2, 2024 Morgellons as a delusional disorder, wherein an underlying pathology triggers the
delusional experience. However, further studies are required to accurately classify the
Revised: November 4, 2024 disease and direct patients to the right specialists to ensure effective treatment and
Accepted: December 10, 2024 development of treatment guidelines. Nevertheless, a holistic treatment approach,
Published online: February 3, integrating psychosomatic and dermatological modalities, is lacking.
2025
Copyright: © 2025 Author(s). Keywords: Morgellons disease; Delusional infestation; Delusional disorder
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Introduction
provided the original work is
properly cited. Morgellons is a poorly understood condition that is sometimes characterized as a type
Publisher’s Note: AccScience of delusional infestation (DI), which predominantly believes that one’s skin is infested
Publishing remains neutral with by foreign pathogens. It usually manifests as non-healing lesions that are frequently
1
regard to jurisdictional claims in
published maps and institutional ulcerated and superficially infected. Patients often present samples of fibers, hairs, or
affiliations. other materials to their physician, claiming that they have extruded them from their

Volume 3 Issue 2 (2025) 22 doi: 10.36922/jcbp.4735