All Posts Tagged With: "Dermatologists"

Morgellons disease and delusions of parasitosis

Link: http://www.ncbi.nlm.nih.gov/pubmed/21051675

Excerpt:

Morgellons disease is a controversial and poorly defined symptom cluster of skin lesions and somatic symptoms, most notably ‘fibers’ in the skin. Because of widespread coverage in the media and on the Internet, there are an increasing number of patients presenting to dermatologists. We present three patients who believed that they had fibers in their skin. We offer a discussion of delusions of parasitosis to demonstrate similarities between these conditions. It has been suggested by a limited number of healthcare providers that an unknown infectious agent underlies this symptom complex yet no available evidence supports this assertion. Laboratory values that would be reflective of an infectious process (e.g. elevated white blood cells, sedimentation rate, C reactive protein) are routinely normal and biopsies often reflect only nonspecific findings such as acute and chronic inflammation with erosion or ulceration. Patients with Morgellons disease generally lack insight into their disease and reject the need for psychiatric help. The goal is to build trust and refrain from minimizing what the patient experiences. Attentive examination of the patient’s skin and fragments they present is necessary to rule out a true underlying pathologic process and to establish a trusting relationship. A supportive, non-confrontational approach is ideal. The patient is best treated by a team of practitioners of several specialties, including dermatologists, psychiatrists, and counselors.

Figurate Erythemas

Background: Figurate erythemas are a group of distinct conditions with different underlying causes and clinical presentations. They must be differentiated from a wide variety of dermatological entities including mycoses, urticaria, granuloma annulare, pseudolymphoma. Dermatologists need to be familiar with this set of conditions which include erythema annulare centrifugum, erythema gyratum repens, erythema marginatum, erythema migrans and necrolytic migratory erythema which are all important clues to underlying diseases. Continued