Patients may report persistent skin sensations such as crawling, stinging, or movement beneath the skin. These Morgellons symptoms may also include concern that fibers or material are emerging from the body. Such experiences can be distressing and may interfere with daily functioning.

The term Morgellons is frequently used by patients to describe this symptom pattern.

This article describes how Morgellons symptoms and delusional parasitosis commonly present in clinical settings, without assuming etiology or therapeutic approach.

Morgellons Symptoms as a Patient-Used Term

Morgellons is not recognized as a distinct, universally accepted medical diagnosis. In the medical literature, the term is used inconsistently and is best understood as a patient-used descriptor rather than a defined disease entity.

In clinical settings, Morgellons symptoms are often discussed alongside delusional parasitosis, also referred to as delusional infestation. Before diagnostic conclusions are reached, careful medical and neurologic assessment is essential to ensure that other contributing conditions are not overlooked.

Brief History of Morgellons Symptoms

The term Morgellons was originally described in the 17th century by the English physician Thomas Browne. At that time, it was not clearly defined and does not correspond to a modern diagnostic entity.

The term re-emerged in the early 2000s through patient advocacy and online communities to describe unexplained skin sensations and related concerns. Subsequent public health and academic investigations did not identify a consistent infectious cause or distinct pathologic features.

As a result, Morgellons is not recognized today as a separate medical diagnosis. Symptoms described under this label are evaluated using established dermatologic, neurologic, and psychiatric frameworks.

Delusional Parasitosis in Clinical Context

Delusional parasitosis is classified as a somatic type of delusional disorder and is described in both dermatology and psychiatry literature. The condition is historically associated with Karl Axel Ekbom, who characterized this clinical presentation.

Clinically, delusional parasitosis involves persistent physical sensations accompanied by a fixed belief that these sensations are caused by infestation. The defining feature is the persistence of the belief despite repeated evaluations that do not demonstrate organisms.

Common Clinical Features of Morgellons Symptoms

Patients describing Morgellons symptoms or delusional parasitosis often report a similar clinical pattern, including:

1. Sensations of crawling, biting, stinging, or movement (formication)

2. Repetitive scratching or skin picking

3. Secondary skin changes related to manipulation

4. Concern about fibers, lint, flakes, or debris emerging from the skin

Some individuals bring samples to medical visits, a behavior sometimes referred to as the matchbox sign. Concern may persist even when diagnostic testing does not identify an infestation.

These Morgellons symptoms are documented across a range of clinical presentations and warrant careful, neutral documentation.

Medical and Neurologic Considerations

A variety of medical and neurologic conditions can produce sensory symptoms similar to those described above, including:

1. Peripheral or small-fiber neuropathy

2. Vitamin B12 deficiency

3. Hormonal changes (e.g., menopause)

4. Medication effects or substance exposure

Infectious, inflammatory, or post-infectious conditions with neurologic involvement—including Lyme disease—may also be considered among many possible contributors. Other neurologic or systemic illnesses can present in similar ways.

For related neurologic context, see:
Autonomic dysfunction, small fiber neuropathy and Lyme disease

Because of this overlap, clinical presentation alone does not establish diagnosis.

Clinical Observation From Practice

In clinical practice, some patients initially described as having Morgellons symptoms or delusional parasitosis are later found to have contributing medical or neurologic conditions, including tick-borne illness.

In selected cases, changes in symptoms and associated beliefs have been observed alongside treatment of identified medical contributors. These observations are individualized and clinical and do not establish causation.

They underscore the importance of comprehensive assessment when patients present with complex sensory complaints.

Clinical Summary

Morgellons is best understood as a patient-used term describing a constellation of symptoms. Delusional parasitosis provides an established diagnostic framework when a fixed belief of infestation is present after exclusion of medical causes.

Describing the clinical presentation with care and neutrality supports appropriate evaluation, patient communication, and therapeutic alliance.

When to Seek Medical Evaluation

Comprehensive medical and neurologic assessment is appropriate when symptoms include:

1. Persistent skin sensations not explained by dermatologic examination

2. Sensory symptoms accompanied by fatigue, cognitive changes, or joint pain

3. New neurologic symptoms such as numbness, tingling, or weakness

4. Symptoms following tick exposure or outdoor activity

5. Symptoms that interfere with daily functioning

Clinical Takeaway

Patients reporting persistent sensory symptoms deserve comprehensive medical and neurologic evaluation before diagnostic conclusions are reached.

For clinicians: Maintaining a therapeutic alliance while conducting a careful differential diagnosis is essential. Dismissing concerns without assessment risks overlooking treatable medical contributors.

For patients: These symptoms warrant medical evaluation, even when early explanations are uncertain or incomplete.

Frequently Asked Questions

Is Morgellons a recognized medical diagnosis?
No. Morgellons is best understood as a patient-used term rather than a formally recognized disease entity.

Are Morgellons symptoms imagined?
The sensations are experienced by patients. Clinical evaluation focuses on how these symptoms are interpreted and assessed within established medical frameworks.

What is the difference between Morgellons symptoms and delusional parasitosis?
Morgellons refers to a symptom description used by patients. Delusional parasitosis is a psychiatric diagnosis characterized by a fixed belief of infestation after medical causes are excluded.

Should medical causes be ruled out first?
Yes. Careful medical and neurologic assessment is essential before diagnostic conclusions are made.

Can Lyme disease cause similar sensory symptoms?
Lyme disease and other neurologic or inflammatory conditions may produce sensory symptoms that overlap with those described as Morgellons and should be considered among many possibilities.

References

1. Can J Infect Dis Med Microbiol. Laupland, Louis Valiquette. Delusional Infestation  2016
2. Psychopathology. Trabert W.  Epidemiology of delusional parasitosis. 1995;28(4):238–246.
3. Clinical, Cosmetic and Investigational Dermatology Middelveen MJ, et al. History of Morgellons disease: from delusion to definition. . 2013;6:1–21.

Related reading

1. Dr. Daniel Cameron: Lyme Science Blog. Unique presentation of Lyme disease skin rash
2. Dr. Daniel Cameron: Lyme Science Blog. Hair loss in Lyme disease – the last straw?