Mohandas Padma, Bewley Anthony, Taylor Ruth
a Department of Dermatology , The Royal Derby Hospital , Derby , England.
b Department of Dermatology , The Royal London Hospital , London , England.
J Dermatolog Treat. 2018 Mar;29(2):208-213. doi: 10.1080/09546634.2017.1349868. Epub 2017 Jul 14.
In recent years, there has been a reported increase in affliction of the skin with small fibres or other particles. The condition has been referred to as Morgellons disease. Patients present with stinging, burning or crawling sensations of the skin, with perceived extrusion of inanimate material alongside fatigue and other systemic symptoms. Sufferers often experience significant morbidity and reduction in quality of life.
We aimed to explore the various clinical presentations, management strategies and outcomes employed to treat this condition in our patients.
We conducted a retrospective case notes review of 35 patients referred to our multidisciplinary psycho-dermatology clinic at the Royal London Hospital between January 2004 and January 2017.
The majority of patients were women (25) 71.4%, with a mean age of 54.6 years (26-80 years). Most (26) 74.2% were living alone. The average duration of illness prior to presentation was 3.8 years (4 months-20 years). Many patients had perceived precipitating factors (54.2%) and often self-diagnosed (28.5%). Psychiatric co-morbidities included 42.8% with depressive symptoms and 25.7% with anxiety. Substance misuse was elicited in five patients (14%). Management of patients included both the treatment of skin disease and psychosocial co-morbidities. Out of the 35 patients who attended (14) 40% cleared or showed significant improvement. Sixteen (45.7%) patients were stable and under review. One patient declined treatment and three did not attend review. One patient died from disease unrelated to her skin condition.
Morgellons disease is a condition, which is widely discussed on the internet and patients often self-diagnose. The course of the disease can be chronic and debilitating. For a positive outcome, it is important that a strong physican-patient relationship is cultivated. As demonstrated in this case series, managing patients holistically in an integrated multidisciplinary dermatology setting helps achieve positive outcomes.
近年来，有报道称皮肤受小纤维或其他颗粒影响的情况有所增加。这种病症被称为莫吉隆斯症。患者表现为皮肤有刺痛、灼痛或爬行感，感觉有无生命的物质排出，同时伴有疲劳和其他全身症状。患者常出现严重的发病率并导致生活质量下降。
我们旨在探讨在我们的患者中治疗这种病症所采用的各种临床表现、管理策略和结果。
我们对2004年1月至2017年1月间转诊至伦敦皇家医院多学科心理皮肤科诊所的35例患者进行了回顾性病例记录审查。
大多数患者为女性（25例，占71.4%），平均年龄54.6岁（26 - 80岁）。大多数（26例，占74.2%）独自生活。就诊前的平均患病时长为3.8年（4个月至20年）。许多患者察觉到诱发因素（54.2%），且常自我诊断（28.5%）。精神共病包括42.8%有抑郁症状，25.7%有焦虑症状。5例患者（14%）存在药物滥用情况。对患者的管理包括皮肤病治疗和心理社会共病治疗。在就诊的35例患者中，14例（40%）病情缓解或有显著改善。16例（45.7%）患者病情稳定并在接受复查。1例患者拒绝治疗，3例未接受复查。1例患者死于与皮肤状况无关的疾病。
莫吉隆斯症是一种在互联网上被广泛讨论的病症，患者常自我诊断。该疾病病程可能是慢性且使人衰弱的。为取得积极的治疗效果，培养牢固的医患关系很重要。如本病例系列所示，在综合多学科皮肤科环境中对患者进行全面管理有助于取得积极的治疗效果。
