tailieunhanh - MORGELLONS DISEASE: THE MYSTERY UNFOLDS

The Agency for Healthcare Research and Quality, part of the . Department of Health and Human Services, is the lead agency charged with supporting research designed to improve the quality of health care, reduce its costs, address patient safety and medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on health care outcomes; quality; and cost, use, and access. The David and Lucile Packard Foundation is a private family foundation that provides grants in a number of program areas, including children, families and communities, population, and conservation and science. The Health Resources and Services Administration, also part of the . Department of Health and Human Services, directs national health. | Perspective Morgellons disease the mystery unfolds Virginia R Savely and Raphael B Stricker Morgellons disease is a mysterious skin disorder that was first described over 300 years ago. The disease is characterized by fiber-like strands extruding from the skin in association with dermatologic and neuropsychiatric signs and symptoms. Although Morgellons disease has been confused with delusional parasitosis the occurrence of the disease in children the lack of pre-existing psychopathology in most patients and the presence of subcutaneous fibers on skin biopsy indicate that the disease has a somatic origin. The association with Lyme disease and the apparent response to antibiotic therapy supports the concept that Morgellons disease may be triggered by an infectious process. Recent studies suggest that infection with Agrobacterium may play a role in the disease. Further clinical and molecular research is needed to unlock the mystery of Morgellons disease. Contents Case definition Epidemiology transmission Pathophysiology Differential diagnosis association with Lyme disease Treatment Discussion Conclusions Key issues Expert commentary Five-year view Financial competing interests disclosure References Affiliations Author for correspondence International Lyme and Associated Diseases Society ILADS PO Box341461 Bethesda MD 20827-1461 USA Tel. 1 415 399 1035 Fax 1 415 399 1057 rstricker@ Keywords Agrobacterium Borrelia burgdorferi delusional parasitosis Lyme disease Morgellons Expert Rev. Dermatol. 2 5 585 591 2007 Morgellons disease is a mysterious illness characterized by nonhealing skin lesions associated with crawling or stinging sensations under the skin and the presence of fiber-like strands and granule-like objects protruding from the lesions 1 . The disease was first described in French children in 1674 by a British physician Sir Thomas Browne as follows 2 Hairs which have most amused me have not been in the face or head