Morgellons disease is usually discussed as a disease of fibers. Under the microscope, however, the more difficult questions concern the skin producing, surrounding, or containing those structures. Published reports describe altered epidermal architecture, abnormal hairs and filaments, comedo-like masses, and thickened follicular casts. None of this proves why Morgellons patients experience stinging, pressure, crawling, or the persistent sensation that something must be removed from the skin. It does raise a question that dermatology has barely studied: what was present at the site before the patient began manipulating it?
