Tea-tree objects identified

Over on the incredibly long biology-online thread, someone was going into great detail on his experiences with tea-tree oil. He posted a link to a photo album:

http://morgellons.shutterfly.com/action/

I’d expect a lot of fiber photos, but was surprised to find most of the photos were of things that looked like blobs of some kind of gelatinous stuff, like this:

morgellons-132.jpg
(lots more on the site, check it out).

Intrigued, I read that all he did was rub tea tree oil on his arm, and the fibers appeared. Fibers? He must include these blobs as some kind of compressed fiber.

Anyway, I got some tea tree oil and rubbed it onto my arm – smelly stuff!

Nothing seemed to be happening for a while, I notice the small hairs stuck to the skin, maybe that’s what people were seeing. Hmm, or maybe as the oil drys, the hairs pop up?

Nothing really going on, I stared at my arm, shining a flashlight, wishing I had a magnifying glass. Then suddenly I noticed a tiny little speck at the base of one hair. Whoa! I’m infected! I pinch the skin, and gently scrape it off with a sharp knife, and transfer it under the microscope, x200.

teatree-object-200x.jpg

Hey, that looks familiar – it’s a “fiber” thing. I have Morgellons!

Zoom out a little:

teatree-object-60x.jpg

It’s about 1mm long, 0.25 mm wide. Not sure where that fiber came from.

Okay, so I’m not itching. I probably don’t have Morgellons. So what is this thing?

It’s a sebum plug.

Hair on your arms is rooted in little pits called follicles. Sebaceous glands in the follicle secrete an oil substance called sebum. The follicles can become blocked (both with or without a hair growing from them). A plug of sebum forms in the follicle and can harden.

Tea tree oil dissolves the material (skin and hardened sebum) blocking the top of the follicle, and allows the sebum plug to emerge. Tea tree oil is a well-known treatment for blocked pores.

Tiny fibers could quite easily become trapped in the follicle and become part of the sebum plug. Not many of the photos actually have fibers though.

Shutterfly guy – you are collecting sebum plugs.

He also has a video of a sebum plug dissoving in some alcohol. It’s quite an energetic dissolution – titled “supernova”. Sebum is fat, alcohol dissoves fat. Fat is semi-soil and dissolving it is a naturally violent reaction due to localized changes in surface tension and density.
Here’s another sebum plug (60x)

nasal-sebum-plug-60x.jpg

You can see how people might think it was some kind of fibrous organism.

Fibers are Everywhere

Right now you are surrounded by billions of fibers.

This is perfectly natural, since fibers are everywhere. But if you think you might have a fiber disease such as Morgellons, then you need to able to distinguish normal fibers from fibers that are part of the disease.

Here’s a quick experiment. Turn your monitor off for a second and look at the screen. Covered with dust right? Look closer (get a magnifying glass if you have one), you will see the dust is mainly comprised of tiny fibers, about 1/16th of an inch long (1mm or so).

Where do they come from?

The biggest sources of fibers in the home are paper products and clothing.

Paper products are things like facial tissues, toilet tissue and paper. Paper is actually MADE from fibers. When you tear paper, the edges look like this (60x magnification):
torn-laser-printer-paper-60x.jpg

That’s just regular letter sized paper, the kind you use in your printer. Paper is actually made of millions of fibers!

Here’s the same piece of paper at 200x

torn-laser-printer-paper-200x.jpg

Those are some pretty serious fibers. Tiny though, only about 20 microns in diameter. They are visible to the naked eye if you have good eyesight.

Another common paper product is facial tissues such as Kleenex. Here’s some Kleenex at 60x:

kleenex-ultra-soft-60x.jpg

See it’s just like paper, made from millions of fibers – the fibers are just more spaced out to make it softer.

All paper products are basically the same, made entirely from cellulose fibers (extracted from wood).

What about clothes?

When you wash your clothes and dry them in the dryer, some of the fibers in the clothes come off, and that’s what makes the lint. If you look at lint under a microscope, it looks like this:

dryer-lint-fuzzball-60x.jpg

You can see it’s made from all different kinds of fibers, all different colors. Both from the clothes that were in the dryer, and other fibers the clothes might have picked up as you wore them, perhaps in contact with other clothes, or the clothes of other people you touched, or off furniture.

When paper, clothing or furniture shed fibers, the tiny fibers float around in the air and land on surfaces. Often they will land on you. If you take a fresh post-it pad and dab the sticky part over your face a few times, you will find it get quite a few fibers on it. Like this (10x):

face-postit-20-dabs-10x.jpg

Here’s a close-up (60x):

face-postit-20-dabs-60x.jpg

Not many, but I bet you did not think there were any fiber on your face, eh?

So, all these fibers flying everywhere from natural sources. If they touch something soft, they stick to it. So you tend to always find a few embedded in (and under) scabs or any mucus-like stuff you have one your body. Like this:

mucus-fibers-60x-3.jpg

Notice how the fibers here are just the same as the lint in the dryer. This indicates they are probably fibers from clothing. Paper fibers are probably there as well, just a bit harder to see.

What can we conclude?

There are lots of fibers on every surface and floating around in the air. This is not a bad thing, as the fibers are just paper or clothing fibers. The fibers will get on your skin, and get inside any damp lesion.

It’s almost impossible NOT to find fibers on your skin. Everyone has them, just most people don’t notice them, since they don’t look closely enough.

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.

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.

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.

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

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.

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