April 2006

Objects in lesion on child’s lip look like Kleenex fibers

Morgellons.org has, for a long time (since 2002), shown two pictures titled:

Objects emerging from lesion on child’s lip at 200x

The two photos were probably taken with a QX3 microscope, and have an image size of 512×384 pixels (standard size for QX3 and QX5 microscopes) and they exhibit the characteristic lighting of QX microscopes.

Here is one of the photos from Morgellons.org:

morgellons_drew2-200x.jpg

Here is a photo I took on a QX5 at 200x

blood-kleenex-200x-2.jpg

Notice the similarities. The size of the “structures” are almost identical. They exhibit a characteristic “flattening” in places. They have similar lengths, thickness and variety.

What are they? Kleenex tissue, stained with blood.

Here’s the same thing at 10x

blood-kleenex-10x.jpg

The only difference here is in the color, which can be accounted for by the lighting, and the amount of blood soaked into the sample. Mine just had a tiny bit of blood on it, so the fibers are not fully soaked.

So, the fibers that were found in a lesion on a child lip look exactly like Kleenex soaked in blood. Does it seem at all unlikely that if you (or your child) has some seeping lesions on their lip, then they might at some time dab them with a Kleenex, perhaps leaving a few fibers?

Morgellons.org also says the fibers “have tentatively been identified as cellulose”. What is Kleenex made from? Cellulose (refined from wood pulp).

While this does not explain the dark fibers in other photos, it’s an obvious and simple explanation for the “Objects emerging from a lesion”, and Morgellons.org should no longer be claiming that these are somehow unusual, unidentified, hyphae-like structures.

They look exactly like Kleenex fibers, soaked in blood. That’s probably what they are.

April 11, 2006 by MRF Photos Science

DermaTechRx

Is it SCABIES?

Or is it really an Unidentified Parasite?

Or a total rip-off?

The site http://www.cure-skin-parasite.com/ is preying on the fears of people who think they have something along the lines of Morgellons.

They have a ridiculously long home page – fully of testimonials like

” Doctors said I was delusional and I knew what I had.. Those things hurt and I couldn’t sleep! I had spent literally thousands of dollars on doctors & treatments that didn’t work! I can finally say, after using your products and doing everything you suggested, I am finally parasite free! ”

I’m convinced!

Unfortunately they have such a wide range of products for sale, that I don’t know what to buy. Looks like the best value is the “Human Mite and Unidentified Parasite Family Superpack”, recently reduced from $339.95 to $199.95. Sweet! What do you get?

2-8oz. Mitactin Spray
1-8oz. PuraCleen Healing Spray
1 Gallon Rejuvenating Body Wash and Skin Conditioner
1 Gallon PuraCleen Disinfectant Cleaner
1-Free 2oz.Mitactin Salve
1-Mud Pack

Okay – let’s look at their “Mitactin Spray”, normally $39.95 for 8oz (or $199.95 for a Gallon). The ingredients are listed as : “Nonionic and anionic surfactants “. A surfactant is a “wetting agent”, something that reduces the surface tension of liquids. Soap is a surfactant. Nearly all cosmetic creams contain one or more surfactant. How is this special? What does it do to the mites that any other soapy spray would not? Can’t I just make my own from water and some 2-in-1 shampoo?

Solution of nonionic and ionic surfactants is used in the pesticide industry as “Adjuvants” – an additive to make the pesticide “wetter” and to spread over the surface of plants more. Perhaps that’s where they got the idea from – pesticide without the harmful chemicals!

Next Up: The PuraClean Healing spray 8oz for $39.95 – now this actually has an active ingredient: Benzalkonium chloride. Yup, just one – and it’s the same active ingredient as is in several other products, like the ringworm cream, and the skin burn cream. What is Benzalkonium chloride? It’s “A yellow-white powder prepared in an aqueous solution and used as a detergent, fungicide, bactericide, and spermicide“. According to Wikipedia it “must not be mixed with anionic surfactants” Whoops! Better not use it with your Mitactin spray! And don’t use soap!

But benzalkonium chloride is at least known to work, such solutions are “rapidly acting anti-infective agents with a moderately long duration of action. They are active against bacteria and some viruses, fungi, and protozoa.” – nothing about mites though. Probably covering the bases.

Bactine is a benzalkonium chloride spray. About $20 for 8oz. You can get 32oz for $6. It’s sold as “Foot Rot and Ringworm Spray for cattle,horse, dogs”. Some people are allergic to benzalkonium chloride.

Moving on, what do we get in our “1 Gallon Rejuvenating Body Wash and Skin Conditioner”? The “active ingredient” is again benzalkonium chloride, but we also have “hydrooxyethyl cellulose, propylene glycol, cetyl trimethyl ammonium chloride, octoxynol – 9, methyl paraben, citric acid, fragrance. ” All these are normal inactive ingredients in cosmetic creams, except for octoxynol-9 which is a spermicide and an inhibitor of various pathogens. Huh? Sounds like an active ingredient to me. It’s actually a non-ionic surfactant, perhaps as used in other potions.

Then: “1 Gallon PuraCleen Disinfectant Cleaner” ($69.95) – Purified water, cetyl trimethyl ammonium chloride, fragrance, color. and an active ingredient: Benzalkonium chloride. Just like the other things we got in the pack.

A note on “cetyl trimethyl ammonium chloride” aka Cetyltrimethylammonium chloride aka CTAC, aka cetrimonium chloride (and lots of other names) It’s a cationic surfacant. Calling it CTAC is a bit obscurantist, as it’s better known as Cetrimonium chloride. It’s generally used in conditioners.

If you really want some of the magic ingredient, Benzalkonium chloride, it’s generic Zephiran, you can get it extra strength at Trask Research – where they make 1:750 aqueous solution. One gallon for $99.95. More expensive? but wait – for dermatology applications up to “oozing and open infections”, you can use a 1:5000 solution. So that makes about 6.5 gallons, or just $15 per gallon! Yay! And a gallon is $640 worth of PuraClean Healing spray!

Finally the feebies – Micatin Salve is like Micatin spray, but as a salve, exact same ingredients. The “Mud Pack” contains “Diatomacious Earth, Rosemary Oil, Tea Tree Oil, & Antimicrobial formulas” and is “Manufactured in our FDA approved lab”

What does the FDA Recommend for lice?
http://www.fda.gov/cder/drug/infopage/lindane/lindaneQA.htm#14
Scabies:
Crotamiton cream and lotion 10% (Eurax) – Rx
Permethrin cream 5%, (Acticin, Elimite) – Rx
Permethrin cream rinse 1% (Nix) – OTC
Head and pubic lice:
Malathion lotion 0.5% (Ovide) – Rx
Pyrethrum extract 0.33% with piperonyl butoxide shampoo (Rid) – OTC
Permethrin cream rinse 1% (Nix) – OTC

Hmm, DermaTech has none of the above.

April 9, 2006 by Quackery Science

How do fibers get under the skin?

Fibers in Morgellons people are often described as being “under the skin”, or “in the skin”. They are also described as “coming out of the skin” when various liquids are applied.

However, the “under the skin” usually seems to refer to being “from a lesion”, or “under a scab”. Scabs form over several days, and it’s quite possible the fibers might simply become mixed in with the normal lesion seepage, and become encased in the scab.

The skin’s integrity has been compromised – there is a hole in it, so any kind of contaminant can get in it.

Likely sources of fibers:
– clothes
– tissues
– bedding
– pets
– airborne fibers from any number of sources

Another thing that might be mistaken for a fiber is a “vellus hair”. This is a tiny hair, less than 30 microns in diameter, found all over the body, but almost invisible to the naked eye.

If some fibers are vellus hairs, then they are already in the skin. Ingrown hairs are possible explanation.

What about the application of liquid causing the fibers to come out?
– for fibers that are nearly invisible, getting them wet can change the refractive index, causing them to be more visible.
– coating fibers or hairs with a liquid increases their effective diameter, making them more noticeable.
– application of liquid can cause “goose-bumps”, causing hairs (including vellus hairs) to stand on end, and become more noticeable. The bump in the skin may be interpreted as the fiber “pushing” itself out of the skin.
– wet skin will attract airborne fibers, which will then stick to the skin.
– applying the liquid will cause some hairs to stick to the skin, as the liquid dries they will gradually pop up, making it look like they are coming out of the skin.
– some liquids may make hairs and fibers actually less noticeable (depending on both the liquid and the fiber). Again, as the liquid dries, the hairs will become noticeable.
– some liquids contain salts. As they dry, they deposit the salts on the surface of vellus hairs, leading to increased visibility.

April 9, 2006 by Science

An early exchange

Back in July 2002, Mary Leitao posted a request for help on the medhelp.org buletin board, and entered into a brief discussion with Dr Rockoff (a dermatologist). Dr Rockoff was very polite. After a few back and forth exchanges the thread devolved into a “me too!” state.

Dr Rockoff’s responses are very reasonable, and should be a model for similar exchanges.

http://www.medhelp.org/perl6/dermatology/messages/31706a.html

April 9, 2006 by Medical Professional MRF Science

Atopic Dermatitis, Scabies, et al.

Patients claiming to have Morgellons frequently present symptoms of Atopic Dermatitis (which is coded 691.80, amusingly I saw someone claim this was the insurance code for morgellons – that’s probably what the doctor told them so they would get their prescription filled).

http://www.niams.nih.gov/hi/topics/dermatitis/

and

http://www.aafp.org/afp/990915ap/1191.html

Atopic Dermatitis symptoms are:
– Itching
– Rashes
– scratching
– Inflammation

How does Morgellons differ from Atopic Dermatitis?

And how does it differ from scabies – it seems with all these known diseases out there that cover the symptoms, why invent new diseases? Scabies actually is caused by a mite that burrows into the skin.

April 9, 2006 by Science

Hypha? Hair?

Consider the photos here:
http://www.morgellons.org/symptoms.html


* “These structures can be described as fiber-like or filamentous”
* “The unknown fibers associated with skin lesions can be described as coenocytic (aseptate), smooth-walled, branching, filamentous objects. The fibers have been analyzed by FTIR (Fourier Transform Infrared Spectroscopy) and have tentatively been identified as cellulose.”
* “The fibers are clearly hyphae-like structures, and yet, do not fall within the description of known hyphae or pseudohyphae”

So can the items in the photos be described as “coenocytic” or “hyphae-like”? The two photos are titled “Objects emerging from lesion on child’s lip at 200X”. Now given this “200X”, how long does that make the “objects”? We can’t really say, as the images themselves could be scaled to any size. But approximately, the “fibers” on my screen are 40mm long, and 2mm thick. This makes them 0.2mm long, and 0.01mm thick. (200 microns by 10 microns, where 1 micron=0.001mm). This puts them approximately in the same scale as hyphae (the living, growing parts of fungi, tiny tubes filled with cytoplasm and nuclie).

On an old page at morgellons.org, that is still up, but seemingly not linked to, it says:
“The fibers are clearly hyphae-like structures, and yet, due their immense size (150 microns wide), they do not fall within the description of known hyphae or pseudohyphae. “
Huh? Even if measuring off 1:1 the screen, then at 200x magnification, 150 microns would appear as 30mm wide (about an inch). Plainly the objects are not 150, and are more like 15 microns thick. Either that or the photos are labled incorrectly. However, the SEM photos clearly show “fibers” that are about 15 microns.

Hypha can be both septate and aseptate (Coenocytic). Septate hyphae are divided by cross section segments called septa. Aseptate hyphae are not. Detrmining if a structure is septate or aseptate is difficult with the images provided, as the most of the structures are out of focus. The clearest structure (in the first image) actually shows some evidence of being septate, rather than aseptate. The picture appears to have been taken with reflective light (from above), and a better determination could be made with transmissive light (from below). Additionally, the specimen should be mounted on a slide and stained to enhance contrast.

Additional stained images are given here:
http://www.morgellons.org/images.html

However, this photo does not resemble the first photos at all, clearly they are different structures, much longer, and smoother.

Then we have some SEM (Scanning Electron Microscope) photos. These photos reveal surface features.

Here we have a scale, showing the object is about 15 microns thick. Human hair is generally described as “60-100 microns in diameter”, which would seem to eliminate that as a candidate. However, that is the diameter of full grown head hair (a “terminal” hair). Finer new grown body hair will emerge with an initial diameter that is much smaller, children are covered in “vellus” hair, which has a diameter of under 30 microns.

Going back to the first photo, since the “structures” here are from a lesion on the lip of a child”, and the lesions clearly extend beyond the actual lip surface, then is it not reasonably to think they might be vellus hairs, coated in some viscous liquid (blood, puss or sebum)?

In this photo of the site from which the specimen was obtained:

You can clearly see what look like vellus hair in the lower portions of the image

April 9, 2006 by MRF Photos Science

Use of words

Morgellons proponents sometimes use technical language in describing their findings. I feel this clouds the meaning somewhat.

consider:

http://www.morgellons.org/symptoms.html
“The unknown fibers associated with skin lesions can be described as coenocytic (aseptate), smooth-walled, branching, filamentous objects. The fibers have been analyzed by FTIR (Fourier Transform Infrared Spectroscopy) and have tentatively been identified as cellulose.”

What does this mean?

coenocytic – I like how this is “explained” as being “aseptate”, as if this will somehow help the reader understand. Of course, you can look these words up, on the internet.

Coenocytic basically means cells with multiple nuclei. Aseptate can mean the same thing, but more literally means lacking the cell walls (septate) between nuclei. This type of cellular growth is typical of the threads of many fungi and some algae. See:
http://www.botany.hawaii.edu/faculty/wong/BOT135/Lect03_b.htm

“Smooth walled” seems a little odd, as the example photos at the top of the “symptoms” page do not look smooth walled at all. The next set of photos show some very thin black fibers, that appear at first glance to be smooth walled (but you can’t really tell), which surround a much thicker white fuzzy object. Where did “smooth walled” come from?

“FTIR” is your standard chemical spectography thing. You measure the absoption of various wavelengths of light, and that gives you graphs you can compare against known substances to see if it matches. A tentative identification as “cellulose” is not surprising. Cellulose is the most abundant form of living biomass on the planet. Cotton, for example, is composed largely of cellulose (91% cellulose, 8% water, 1% other).
http://www.tis-gdv.de/tis_e/ware/fasern/baumwoll/baumwoll.htm. Other cellulose fibers are linen, ramie, rayon, tencel and lyocell all of which are almost purely cellulose. Paper and paper tissues are also largely comprised of cellulose fibers.

April 9, 2006 by MRF Science

The Evidence Indicates:

1. The fibers are environmental and unrelated to any illness
2. Morgellons is not a distinct disease
3. People who think they have "Morgellons" probably have a mixed variety of physical and/or mental illnesses.

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