Review of literature and clinical practice experience for the therapeutic management of Morgellons disease.

Morgellons disease (MD) is a rare and contentious health condition characterized by dermatological symptoms including slow-healing skin lesions 'attributed' to fibres emerging from or under the skin. Patients also report sensations of crawling, biting and infestation with inanimate objects. This review examines the aetiology, patient characteristics, epidemiology, historical context, correlation with Lyme disease, role of internet, impact on quality of life and treatment approaches for MD. Despite ongoing debate, MD is not officially recognized in medical classifications, with differing views on its aetiology. Some link MD to Lyme disease, while others view it as a variant of delusional infestation. The literature suggests both psychiatric and environmental factors may contribute. The manuscript explores the association with substance abuse, psychiatric comorbidities, infectious agents and the role of internet communities in shaping perceptions. MD's impact on quality of life is significant, yet often overlooked. Treatment approaches are varied due to limited evidence, with low-dose antipsychotics being considered effective, but patient beliefs may influence adherence. A patient-centred, multidisciplinary approach is emphasized, considering both the physical and psychological dimensions of MD. Addressing the controversies surrounding MD while focusing on patient well-being remains a critical challenge for healthcare professionals.

[Urticaria multiforme: difficult to distinguish from other skin conditions]. / Urticaria multiforme.

BACKGROUND: Urticaria multiforme is a rare clinical variant of urticaria that occurs specifically in children. CASE DESCRIPTION: A boy aged 11 months was presented at the Emergency Department with acute onset of itching urticarial skin weals and acral oedema. This picture is consistent with the diagnosis of urticaria multiforme. CONCLUSION: The diagnosis of urticaria multiforme can be made on the basis of the clinical picture. Treatment is symptomatic and in most cases this condition resolves spontaneously within two weeks. It is often confused with erythema exsudativum multiforme, urticarial vasculitis, a serum sickness-like reaction or acute haemorrhagic oedema of infancy (AHOI syndrome). As each of these clinical presentations involves specific treatment and prognosis, it is important to be able to distinguish between them.

100 years of Wood's lamp revised.

The Wood's lamp is a diagnostic tool in dermatology. Unfortunately, this useful tool is often overlooked in the busy and hectic outdoor dermatology clinic. To emphasize its value in modern dermatology, we present an updated review of the principles and applications and shed new light on its proper place in our practice.

[Diagnostic image (323). An infant with a tumour on a finger]. / Diagnose in beeld (323). Een zuigeling met een tumor aan een vinger.

A 7-month-old girl was presented with a tumour on the lateral side of the terminal phalanx of the right digitus IV, which displayed the histopathological characteristics ofa digital fibroma.