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Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy

BACKGROUND: Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. METHODS: A descriptiv...

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Autores principales: Pearson, Michele L., Selby, Joseph V., Katz, Kenneth A., Cantrell, Virginia, Braden, Christopher R., Parise, Monica E., Paddock, Christopher D., Lewin-Smith, Michael R., Kalasinsky, Victor F., Goldstein, Felicia C., Hightower, Allen W., Papier, Arthur, Lewis, Brian, Motipara, Sarita, Eberhard, Mark L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266263/
https://www.ncbi.nlm.nih.gov/pubmed/22295070
http://dx.doi.org/10.1371/journal.pone.0029908
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author Pearson, Michele L.
Selby, Joseph V.
Katz, Kenneth A.
Cantrell, Virginia
Braden, Christopher R.
Parise, Monica E.
Paddock, Christopher D.
Lewin-Smith, Michael R.
Kalasinsky, Victor F.
Goldstein, Felicia C.
Hightower, Allen W.
Papier, Arthur
Lewis, Brian
Motipara, Sarita
Eberhard, Mark L.
author_facet Pearson, Michele L.
Selby, Joseph V.
Katz, Kenneth A.
Cantrell, Virginia
Braden, Christopher R.
Parise, Monica E.
Paddock, Christopher D.
Lewin-Smith, Michael R.
Kalasinsky, Victor F.
Goldstein, Felicia C.
Hightower, Allen W.
Papier, Arthur
Lewis, Brian
Motipara, Sarita
Eberhard, Mark L.
author_sort Pearson, Michele L.
collection PubMed
description BACKGROUND: Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. METHODS: A descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC) during 2006–2008. A case was defined as the self-reported emergence of fibers or materials from the skin accompanied by skin lesions and/or disturbing skin sensations. We collected detailed epidemiologic data, performed clinical evaluations and geospatial analyses and analyzed materials collected from participants' skin. RESULTS: We identified 115 case-patients. The prevalence was 3.65 (95% CI = 2.98, 4.40) cases per 100,000 enrollees. There was no clustering of cases within the 13-county KPNC catchment area (p = .113). Case-patients had a median age of 52 years (range: 17–93) and were primarily female (77%) and Caucasian (77%). Multi-system complaints were common; 70% reported chronic fatigue and 54% rated their overall health as fair or poor with mean Physical Component Scores and Mental Component Scores of 36.63 (SD = 12.9) and 35.45 (SD = 12.89), respectively. Cognitive deficits were detected in 59% of case-patients and 63% had evidence of clinically significant somatic complaints; 50% had drugs detected in hair samples and 78% reported exposure to solvents. Solar elastosis was the most common histopathologic abnormality (51% of biopsies); skin lesions were most consistent with arthropod bites or chronic excoriations. No parasites or mycobacteria were detected. Most materials collected from participants' skin were composed of cellulose, likely of cotton origin. CONCLUSIONS: This unexplained dermopathy was rare among this population of Northern California residents, but associated with significantly reduced health-related quality of life. No common underlying medical condition or infectious source was identified, similar to more commonly recognized conditions such as delusional infestation.
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spelling pubmed-32662632012-01-31 Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy Pearson, Michele L. Selby, Joseph V. Katz, Kenneth A. Cantrell, Virginia Braden, Christopher R. Parise, Monica E. Paddock, Christopher D. Lewin-Smith, Michael R. Kalasinsky, Victor F. Goldstein, Felicia C. Hightower, Allen W. Papier, Arthur Lewis, Brian Motipara, Sarita Eberhard, Mark L. PLoS One Research Article BACKGROUND: Morgellons is a poorly characterized constellation of symptoms, with the primary manifestations involving the skin. We conducted an investigation of this unexplained dermopathy to characterize the clinical and epidemiologic features and explore potential etiologies. METHODS: A descriptive study was conducted among persons at least 13 years of age and enrolled in Kaiser Permanente Northern California (KPNC) during 2006–2008. A case was defined as the self-reported emergence of fibers or materials from the skin accompanied by skin lesions and/or disturbing skin sensations. We collected detailed epidemiologic data, performed clinical evaluations and geospatial analyses and analyzed materials collected from participants' skin. RESULTS: We identified 115 case-patients. The prevalence was 3.65 (95% CI = 2.98, 4.40) cases per 100,000 enrollees. There was no clustering of cases within the 13-county KPNC catchment area (p = .113). Case-patients had a median age of 52 years (range: 17–93) and were primarily female (77%) and Caucasian (77%). Multi-system complaints were common; 70% reported chronic fatigue and 54% rated their overall health as fair or poor with mean Physical Component Scores and Mental Component Scores of 36.63 (SD = 12.9) and 35.45 (SD = 12.89), respectively. Cognitive deficits were detected in 59% of case-patients and 63% had evidence of clinically significant somatic complaints; 50% had drugs detected in hair samples and 78% reported exposure to solvents. Solar elastosis was the most common histopathologic abnormality (51% of biopsies); skin lesions were most consistent with arthropod bites or chronic excoriations. No parasites or mycobacteria were detected. Most materials collected from participants' skin were composed of cellulose, likely of cotton origin. CONCLUSIONS: This unexplained dermopathy was rare among this population of Northern California residents, but associated with significantly reduced health-related quality of life. No common underlying medical condition or infectious source was identified, similar to more commonly recognized conditions such as delusional infestation. Public Library of Science 2012-01-25 /pmc/articles/PMC3266263/ /pubmed/22295070 http://dx.doi.org/10.1371/journal.pone.0029908 Text en This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. https://creativecommons.org/publicdomain/zero/1.0/ This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose.
spellingShingle Research Article
Pearson, Michele L.
Selby, Joseph V.
Katz, Kenneth A.
Cantrell, Virginia
Braden, Christopher R.
Parise, Monica E.
Paddock, Christopher D.
Lewin-Smith, Michael R.
Kalasinsky, Victor F.
Goldstein, Felicia C.
Hightower, Allen W.
Papier, Arthur
Lewis, Brian
Motipara, Sarita
Eberhard, Mark L.
Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy
title Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy
title_full Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy
title_fullStr Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy
title_full_unstemmed Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy
title_short Clinical, Epidemiologic, Histopathologic and Molecular Features of an Unexplained Dermopathy
title_sort clinical, epidemiologic, histopathologic and molecular features of an unexplained dermopathy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266263/
https://www.ncbi.nlm.nih.gov/pubmed/22295070
http://dx.doi.org/10.1371/journal.pone.0029908
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