Page 31 - JCBP-3-2

Journal of Clinical and
Basic Psychosomatics Morgellons: Delusion or disease

including pathological painful ulcerations, prurigo associated with schizophrenia, bipolar affective disorder,
nodularis, and secondary infections, may be observed and obsessive-compulsive disorder. 17,22 These psychological
(Figure 2). 15,18 disturbances can arise anytime during the course of the
Patients with Morgellons may exhibit associated systemic disease, particularly in the later periods.
symptoms, including neurological (e.g., headaches, fatigue, 4.2. Objective findings in clinical studies
short-term memory deficits, and emotional lability),
cardiovascular (e.g., irregular heart rates, tachycardia, and Several studies have aimed to clarify the objective
intolerance to changes in blood pressure), respiratory (e.g., symptoms of Morgellons. Recently, most authors have
coughing and shortness of breath), and musculoskeletal realized that the disease is debilitating and centered around
(e.g., diffuse musculoskeletal pain, fibromyalgia, and the symptom of finding fibers in the skin, which can
chronic fatigue syndrome) symptoms. 20 cause secondary symptoms such as itching and picking.
Reportedly, the histological analysis of filaments presented
In addition, patients with Morgellons may present by the patients is not textile fibers but biofilaments of
with several psychological symptoms, including mood human cellular origin; 20,23,24 the filaments comprise
disturbances, delusions, paranoia, cognitive impairments, collagen and keratin, hypothesizing that they may be the
and suicide attempts. In addition, Morgellons is product of cutaneous filament overproduction in response
21
to a spirochetal infection, 25,26 namely Borrelia burgdorferi
(causative organism of Lyme disease). 20,24

However, recent studies investigating the association
between B. burgdorferi and Morgellons through laboratory
assessments have yielded conflicting results. Four
studies have yielded no evidence linking Morgellons
to B. burgdorferi or any other infectious agents. 27-30
However, some authors believe that Morgellons is caused
by B. burgdorferi. 31,32 Internal and external validation
of such findings cannot be generalized and may not be
reproducible. Moreover, CDC studies have reported that
there is no common underlying medical condition or
infectious organism in patients with Morgellons. 1
Recognizing the interplay between Morgellons disease
and the associated clinical outcomes is crucial. The severity
Figure 1. Secondary rash highlights embedded fibers (shown with an of symptoms reported in patients cannot be understated.
arrow) linked to Morgellons. Image created using BioRender.com.
The diverse somatic and psychiatric comorbidities and
the challenge of establishing a consensus on causality
ultimately impact the affected individuals’ quality of life.
The Dermatology Life Quality Index assesses a patient’s
quality of life. However, studies assessing the Dermatology
Life Quality Index within a Morgellons-affected population
are limited. Future studies are required to navigate a
bottoms-up approach by assessing and evaluating the
experiences of affected individuals, understanding how the
disease affects their quality of life, and what clinicians can
do to relieve their symptomology.
5. Delusion versus disease

Herein, we aim to examine the theories regarding
Morgellons in the current literature. We will explore the
delusional hypothesis, neurological hypotheses, infectious
agent hypothesis, and the impact of certain drugs, in
Figure 2. Ulcerated erosions on a patient’s back similar to those with addition to the multifactorial approach in managing
Morgellons. Image created using BioRender.com. Morgellons. A substantial portion of the literature equates

Volume 3 Issue 2 (2025) 25 doi: 10.36922/jcbp.4735