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Journal of Clinical and
Basic Psychosomatics Morgellons: Delusion or disease

10. Controversies and future directions complexities and lack of clarity regarding Morgellons, a
multidisciplinary approach is important for ensuring that
An analysis of relevant studies highlights several gaps clinical inputs from all specialists are considered. Until the
and potential directions for future studies. At present, pathology of Morgellons is further studied, it is better to
Morgellons lacks a specific ICD code, resulting in the maintain a full psychodermatology view for managing this
absence of clear diagnostic criteria (Diagnosis and condition. By segmenting the Morgellons manifestations
differential diagnosis), which can result in misdiagnosis into a dermatologic or psychiatric issue, we cannot provide
and misidentification and prevent us from conducting holistic care, especially because both systems are involved
large-scale population-based cohort studies. Recruiting in patients with Morgellons. Although this condition needs
patients for a study is a major challenge considering the to be categorized as a “delusion” or “disease” to advocate
condition is rare; this makes it even vital to differentiate for improved studies and a definition for Morgellons, the
Morgellons from other psychodermatological conditions condition should not be treated as one or the other. Patients
or factitious disorders to enroll patients in studies. 1,75 with Morgellons respond to different treatments and describe
Further studies on genetic predispositions, varying symptoms, indicating considerable variations in
neuroimaging studies, or novel treatment options can Morgellons. Thus, a combined approach is required. In the
improve our current understanding of Morgellons. There future, Morgellons may fall into one category. However, at
is a lack of emphasis on the quality of life of individuals present, it should be treated using a psychodermatology
with Morgellons. Administering questionnaires such as approach, as exemplified by the Royal London Hospital.
the Dermatology Life Quality Index is crucial for assessing
the impact of Morgellons on the patient when they initially Acknowledgments
present to the dermatologist’s clinic. 1,75 None.
The most critical areas that require further studies are
the pathophysiology, detailed toxicology, wound healing Funding
in patients with chronic Morgellons, and underlying None.
neuropsychiatric mechanisms. Prioritizing these areas
may help understand the condition. Conflict of interest
Appropriate study types should be used for ensuring The authors declare they have no competing interests.
robust studies on Morgellons. Furthermore, a national
Morgellons registry should be created to enable a database Author contributions
for research and foster temporal regression. Due to Conceptualization: All authors
the rarity of the disease, these data should be globally Writing – original draft: All authors
accessible for international collaboration; this would Writing – review & editing: All authors
aid in reaching a consensus regarding a clear definition,
diagnostic criteria, and subsequent treatment evaluation Ethics approval and consent to participate
of Morgellons. Furthermore, the development of cohort Not applicable.
studies would enable the identification of risk factors and
epidemiological analysis. Consent for publication

11. Conclusion Not applicable.
The current literature does not support a direct causative Availability of data
link between Morgellons and Lyme disease or any other Not applicable.
pathological disease processes. Furthermore, the method
of diagnosing Lyme disease was not valid, and the patient References
selection in the CDC study potentially introduced a
selection bias. Even though there was limited evidence 1. Pearson ML, Selby JV, Katz KA, et al. Clinical, epidemiologic,
during this literature review, a causal association with histopathologic and molecular features of an unexplained
dermopathy. PLoS One. 2012;7(1):e29908.
pathological diseases cannot be excluded. Thus, further
case-controlled studies with larger samples are required. doi: 10.1371/journal.pone.0029908
Morgellons is a debilitating illness that requires a patient- 2. Mohandas P, Bewley A, Taylor R. Morgellons disease:
centered management approach and further studies Experiences of an integrated multidisciplinary dermatology
on its genetics, pathogenesis, and treatment. Given the team to achieve positive outcomes. J Dermatolog Treat.

Volume 3 Issue 2 (2025) 31 doi: 10.36922/jcbp.4735