The challenge of Morgellons disease: A patient with clinicopathologic correlation

Morgellons disease is a rare condition characterized by patient-reported multicolored fibers and other nonorganic particles or organic particles embedded in and protruding from diffuse skin ulcerations. Although the scientific community is prone to believe that Morgellons disease is a psychiatric disorder, an infectious pathogenesis associated with Borrelia burgdorferi in the setting of Lyme disease has also been proposed. The histopathology is usually considered as nonspecific. To illustrate this condition, we present the case of an adult woman with significant ulcerative skin lesions and cicatricial changes on the face, trunk, and arms. After multiple biopsies and successful microscopic visualization of the fibers, she received a diagnosis of Morgellons disease in the setting of delusional infestation. No evidence of Borrelia infection was found. Treatment with antipsychotics was initiated, but the patient was lost to follow-up, as is often the case with patients with Morgellons disease.