http://psy.psychiatryonline.org/cgi/content/full/39/6/491

Excerpts from case reports:

• a 39-year-old white woman who presented to dermatology clinic complaining of “white strands” on her face that “feel like they are moving — like hair being pulled through the skin.” She brought several Ziploc (plastic) bags filled with samples, which microscopy revealed to be fibrous strands and epithelial cells. Physical examination demonstrated multiple hyper pigmented patches and a healing erythematous lesion on her right cheek. Otherwise, her skin was clear.
•  a 69-year-old man stated that 3 to 4 months prior to his dermatology evaluation, he began to observe “little tubes” protruding from his skin. These tubes were stated to be extremely pruritic, causing him to scratch. When he did scratch, he believed that this incited a process in which three-cornered crystals would sprout legs and jump out of the tubes. After “exciting” the tubes, the crystals would leave “slag” (a byproduct of “welding”) behind. He also complained that physicians would not look at him and that they thought he was “going crazy”.

     Both of those patients appeared to have DOP. However, their beliefs were NOT unshakable. The female patient was cooperative and responded favorably to treatment for anxiety, and the male improved after his underlying physical condition was explained to him as having resulted in the development of  his skin symptoms.  I hope they continued doing well, and I wonder if they’ve heard of “morgellons disease”.

    Sadly, in the next case, the woman did have an unshakable belief. Even with attempted treatment efforts, she was lost to follow-up, ending with her doctor receiving a call from her pet’s concerned veterinarian.

• a 32-year-old woman who presented to dermatology clinic reporting a 3-month history of “bugs” infecting her fingers, lips, scalp, ears, nose, face, and genitals. She believed she had been infected by her husband, as she observed him frequently scratching his scalp. However, she stated her husband feels that “it [her condition] is all in her head.” She noticed others scratching while around her and believed that they became infested by her presence. Multiple samples of the “bugs” were brought in plastic bag

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