As with a vast majority of the total studies done on Morgellons, Lyme Disease is a key clue to the disorder.
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Clin Cosmet Investig Dermatol. 2011; 4: 167–177.
Published online 2011 November 14. doi: 10.2147/CCID.S26183
PMCID: PMC3257881
Filament formation associated with spirochetal infection: a comparative approach to Morgellons disease
This article has been cited by other articles in PMC.
Abstract
Bovine
digital dermatitis is an emerging infectious disease that causes
lameness, decreased milk production, and weight loss in livestock.
Proliferative stages of bovine digital dermatitis demonstrate keratin
filament formation in skin above the hooves in affected animals. The
multifactorial etiology of digital dermatitis is not well understood,
but spirochetes and other coinfecting microorganisms have been
implicated in the pathogenesis of this veterinary illness. Morgellons
disease is an emerging human dermopathy characterized by the presence of
filamentous fibers of undetermined composition, both in lesions and
subdermally. While the etiology of Morgellons disease is unknown, there
is serological and clinical evidence linking this phenomenon to Lyme
borreliosis and coinfecting tick-borne agents. Although the microscopy
of Morgellons filaments has been described in the medical literature,
the structure and pathogenesis of these fibers is poorly understood. In
contrast, most microscopy of digital dermatitis has focused on
associated pathogens and histology rather than the morphology of
late-stage filamentous fibers. Clinical, laboratory, and microscopic
characteristics of these two diseases are compared.
Keywords: Digital dermatitis, Morgellons disease, Lyme disease, Borrelia burgdorferi, spirochetes
Introduction
First
described in 1974, bovine digital dermatitis (BDD), also known as
papillomatous digital dermatitis, is an emerging infectious disease that
causes lameness, decreased milk production, and weight loss in cattle.1,2
Since 1993, BDD has spread rapidly throughout the US, Europe, and
Australia, becoming a significant cause of morbidity in dairy
operations.3–5
The disease causes dermatitis and papillomatous lesions of the skin
bordering the coronary band in the hooves of livestock, primarily cattle
(Figure 1).3–5
Bovine
digital dermatitis. Note painful ulcerating lesion above the
interdigital cleft of the hoof with multiple grayish fibers (top) and
closer view of fibers (bottom). Photographs courtesy of GEA Farm
Technologies, reprinted with permission.
Histologically, the lesions resemble those of yaws, which suggests spirochetal involvement,5,6 and cattle with BDD are reported to be serologically reactive to Borrelia burgdoferi antigens.7,8
Consistent detection of spirochetes in the lower dermal layers adds
further weight to the etiological involvement of these bacterial agents.9–16 Proliferative or late-stage lesions demonstrate hyperkeratosis and proliferation of keratin filaments4 as well as elongated keratinocytes.17
The proliferation of keratin filaments that may reach several
centimeters in length has led to the disease receiving descriptive
common names, such as “hairy heel warts” (Figure 1).18
Morgellons disease is an emerging human dermatological disorder that parallels BDD in many aspects (Tables 1 and and2).2).
In addition to a spirochetal association, Morgellons disease is
characterized by dermatological lesions associated with filament
formation (Figure 2). Symptoms such as fatigue, neurological disorders, and joint pain suggest systemic involvement as well as dermopathy.19–22
Peripheral neuropathy, delayed capillary refill, abnormal Romberg’s
sign, decreased body temperature, tachycardia, elevated proinflammatory
markers, and elevated insulin levels are reported to be objective
clinical evidence of the disease.23
Morgellons
disease. Note painful ulcerating lesions on hand (top) and subcutaneous
white and blue fibers (bottom, 60× magnification). Photographs courtesy
of the Charles E Holman Foundation, reprinted with permission.