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<p>Morgellons disease (MD) is a controversial condition intersecting dermatology, psychiatry, infectious diseases, and neurology. Patients report cutaneous sensations of crawling or stinging, often associated with fibers emerging from their skin. The etiology remains debated, with hypotheses ranging from delusional infestation (DI) to infectious or neurobiological origins, complicating diagnosis and treatment. To review MD literature for standardized diagnostic criteria, outcome measures, and randomized controlled trials (RCTs). A systematic search of PubMed, Scopus, Embase, and Web of Science was performed using relevant keywords. After removing duplicates and screening abstracts, 167 studies remained for full-text review. No RCTs evaluating MD treatments were found. One double-blind crossover trial addressed DI, a condition often conflated with MD. Neuroimaging findings of DI suggest possible brain alterations, but no standardized biomarker framework exists for MD. The absence of standardized definitions and clinical endpoints prevents the implementation of high-quality trials. A three-phased approach is suggested to address this: (1) formation of a multidisciplinary Expert Group to develop standardized diagnostic guidelines (2) Multicenter observational studies to refine patient stratification and biomarker identification and (3) well-structured RCTs to evaluate therapeutic interventions. Taking these implementations would ultimately improve patient care by guiding future treatment strategies.</p>

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Morgellons disease: a review on current evidence and the need for consensus, standardized criteria, and future randomized controlled trials

  • 期刊论文

  • 发表日期：

    2025年6月24日

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  • Hossein Akbarialiabad,
  • Sadaf Salehi,
  • Dédée F. Murrell,
  • Mohammad Jafferany

摘要

Morgellons disease (MD) is a controversial condition intersecting dermatology, psychiatry, infectious diseases, and neurology. Patients report cutaneous sensations of crawling or stinging, often associated with fibers emerging from their skin. The etiology remains debated, with hypotheses ranging from delusional infestation (DI) to infectious or neurobiological origins, complicating diagnosis and treatment. To review MD literature for standardized diagnostic criteria, outcome measures, and randomized controlled trials (RCTs). A systematic search of PubMed, Scopus, Embase, and Web of Science was performed using relevant keywords. After removing duplicates and screening abstracts, 167 studies remained for full-text review. No RCTs evaluating MD treatments were found. One double-blind crossover trial addressed DI, a condition often conflated with MD. Neuroimaging findings of DI suggest possible brain alterations, but no standardized biomarker framework exists for MD. The absence of standardized definitions and clinical endpoints prevents the implementation of high-quality trials. A three-phased approach is suggested to address this: (1) formation of a multidisciplinary Expert Group to develop standardized diagnostic guidelines (2) Multicenter observational studies to refine patient stratification and biomarker identification and (3) well-structured RCTs to evaluate therapeutic interventions. Taking these implementations would ultimately improve patient care by guiding future treatment strategies.