Research criticism · Dermatopathology · Morgellons
Reactive Perforating Collagenosis and Morgellons share plug and collagen observations but diverge on anatomy and symptoms. An intact, elastic-stained lesion could distinguish their tissue routes.
In reactive perforating collagenosis, damaged collagen can be pushed out through skin—and a pathologist can see that route under the microscope. Some Morgellons lesions are described as cratered or plug-centered. Middelveen has sectioned attached callus material and reported follicular casts and comedo-like masses. Those observations justify testing whether some lesions fit the RPC or acquired perforating dermatosis pattern. They do not already establish that diagnosis.