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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Dermatology 1/2015

Exploring the association between Morgellons disease and Lyme disease: identification of Borrelia burgdorferi in Morgellons disease patients

Zeitschrift:
BMC Dermatology > Ausgabe 1/2015
Autoren:
Marianne J Middelveen, Cheryl Bandoski, Jennie Burke, Eva Sapi, Katherine R Filush, Yean Wang, Agustin Franco, Peter J Mayne, Raphael B Stricker
Wichtige Hinweise

Competing interests

MJM, PJM and RBS serve without compensation on the scientific advisory panel of the Charles E. Holman Morgellons Disease Foundation. The other authors have no competing interests to declare.

Authors’ contributions

MJM participated in the study design and coordination, performed culture, histology and immunohistochemistry experiments and drafted the manuscript. CB, JB, ES, KRF, YW and AF performed PCR tesing, in situ hybridization and DNA sequencing experiments. PJM participated in the study design and edited the manuscript. RBS participated in the study design and coordination and edited the manuscript. All authors read and approved the final manuscript.

Abstract

Background

Morgellons disease (MD) is a complex skin disorder characterized by ulcerating lesions that have protruding or embedded filaments. Many clinicians refer to this condition as delusional parasitosis or delusional infestation and consider the filaments to be introduced textile fibers. In contrast, recent studies indicate that MD is a true somatic illness associated with tickborne infection, that the filaments are keratin and collagen in composition and that they result from proliferation and activation of keratinocytes and fibroblasts in the skin. Previously, spirochetes have been detected in the dermatological specimens from four MD patients, thus providing evidence of an infectious process.

Methods & Results

Based on culture, histology, immunohistochemistry, electron microscopy and molecular testing, we present corroborating evidence of spirochetal infection in a larger group of 25 MD patients. Irrespective of Lyme serological reactivity, all patients in our study group demonstrated histological evidence of epithelial spirochetal infection. Strength of evidence based on other testing varied among patients. Spirochetes identified as Borrelia strains by polymerase chain reaction (PCR) and/or in-situ DNA hybridization were detected in 24/25 of our study patients. Skin cultures containing Borrelia spirochetes were obtained from four patients, thus demonstrating that the organisms present in dermatological specimens were viable. Spirochetes identified by PCR as Borrelia burgdorferi were cultured from blood in seven patients and from vaginal secretions in three patients, demonstrating systemic infection. Based on these observations, a clinical classification system for MD is proposed.

Conclusions

Our study using multiple detection methods confirms that MD is a true somatic illness associated with Borrelia spirochetes that cause Lyme disease. Further studies are needed to determine the optimal treatment for this spirochete-associated dermopathy.
Literatur
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