Morgellons in dermatology

@article{Harth2010MorgellonsID,
  title={Morgellons in dermatology},
  author={Wolfgang Harth and Barbara Hermes and Roland Wolfgang Freudenmann},
  journal={JDDG: Journal der Deutschen Dermatologischen Gesellschaft},
  year={2010},
  volume={8}
}
Delusional parasitosis (DP) is the most frequent delusional disorder in dermatology. In DP there is a fixed belief of a usually skin‐related invasion or infestation by a number of alleged infectious species (usually parasites and bacteria), whose identity has varied over the decades. Since 2002 worldwide an increasing number of patients have complained of unverifiable fibers and filaments in or on the skin, associated with numerous nonspecific complaints (arthralgias, altered cognitive function… 
Morgellons Disease and Delusions of Parasitosis
TLDR
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.
History of Morgellons disease: from delusion to definition
TLDR
Investigations intoorgellons disease have determined that the cutaneous filaments are not implanted textile fibers, but are composed of the cellular proteins keratin and collagen and result from overproduction of these filaments in response to spirochetal infection.
A Case Report of Morgellons Disease
TLDR
This case represents a cutaneous pathology in relation to the delusional spectrum of Ekbom’s syndrome and Delusional Infestation and in this once in a life time encounter with a Morgellons disease patient, the classic “physician Odyssey” was prevented.
Delusions of Parasitosis: An Update
TLDR
For many patients with delusional parasitosis, a sense of a lack of understanding leads to isolation and the development of depression symptoms, which is why it is crucial to earn the trust of such patients while taking care of them.
Delusional infestations: clinical presentation, diagnosis and treatment
  • M. Heller, Jillian W. Wong, J. Murase
  • Medicine, Psychology
    International journal of dermatology
  • 2013
TLDR
An overview of delusional infestations including its clinical presentation, diagnosis, and treatment is provided including strategies on how to establish a strong therapeutic alliance with DI patients are discussed.
Reframing delusional infestation: perspectives on unresolved puzzles
TLDR
This review aims to discuss the following topics that currently confuse understandings of DI: the relationship of real/sham “infestation” with DI/MD; behavior alterations, such as self-inflicted trauma; neuroimaging abnormality and disturbance in neurotransmitter systems; and impaired insight in patients with this disease.
Variable Clinical Presentations of Secondary Delusional Infestation: An Experience of Six Cases from a Psychodermatology Clinic
TLDR
It seems that both psychiatrists and dermatologists can face diagnostic and therapeutic challenges of this complex disease in clinical settings, particularly if there are unusual clinical features of DI.
Dermatozoenwahn: Psychologische Aspekte für die dermatologische Praxis
TLDR
Some advices for a successful management of delusional parasitosis despite the different discipline of the illness are given.
Morgellons Disease: The Spread of a Mass Psychogenic Illness via the Internet and Its Implications in Hand Surgery
TLDR
An approach to the recognition of and treatment strategies for patients presenting with Morgellons disease is offered, a disorder popularized in 2002 and characterized by a firm belief in foreign material extruding from the skin, leading to nonhealing, self-inflicted ulcerations and excoriations.
History of Morgellons disease: the same name for different psychodermatologic diseases?
TLDR
This paper intends to critically review the main ideas and controversies, since its first description of Morgellons disease, which has been a controversial topic in the history of psychodermatology.
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References

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TLDR
It is concluded that delusion of parasitosis usually represents a solitary phenomenon of primary psychosis, which can largely be regarded as a monosymptomatic hypochondriac disorder and success with neuroleptic drugs depends on a confidential interrelation between patient and physician.
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TLDR
“meeting the patient halfway” and creating a therapeutic alliance when providing dermatologic treatment by taking their cutaneous symptoms seriously enough to provide both topical ointments as well as antipsychotic medications, which can be therapeutic in these patients.
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TLDR
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TLDR
Course of DP is not so unfavorable as commonly thought; in about half the patients a full remission was described during the observation period or at catamnesis, and short preclinical courses may indicate better outcome.
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TLDR
Delusional parasitosis is an uncommon disorder that presents particular challenges to the dermatologist and close collaboration of dermatologists and psychiatrists is recommended.
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TLDR
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TLDR
Diagnosis requires at least 1 month's duration of the delusion; impact on functioning that is consistent with the delusion or its ramifications; generally normal appearance and behavior; and the exclusion of schizophrenia, mood disorder, substance-induced toxicity, and medical disease.
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TLDR
A comprehensive literature review on the pathogenesis of DP and its classification is delivered and possible future therapies in DP, e.
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