Morgellons disease (MD) is a dermopathy characterized by multicolored filaments 
that lie under, are embedded in, or project from skin. Although MD was initially 
considered to be a delusional disorder, recent studies have demonstrated that 
the dermopathy is associated with tickborne infection, that the filaments are 
composed of keratin and collagen, and that they result from proliferation of 
keratinocytes and fibroblasts in epithelial tissue. Culture, histopathological 
and molecular evidence of spirochetal infection associated with MD has been 
presented in several published studies using a variety of techniques. 
Spirochetes genetically identified as Borrelia burgdorferi sensu stricto 
predominate as the infective agent in most of the Morgellons skin specimens 
studied so far. Other species of Borrelia including Borrelia garinii, Borrelia 
miyamotoi, and Borrelia hermsii have also been detected in skin specimens taken 
from MD patients. The optimal treatment for MD remains to be determined.