The matchbox sign, also referred to as the Ziploc bag sign or the specimen sign, is a psychiatric medical sign in which a patient arrives at a doctor's office with items extracted from the skin; these items are intended to serve as proof of a parasitic infestation, and are typically stored in a small container such as a matchbox. [1] [2] 50–80% of patients with delusional parasitosis present with this sign. [3]
People with delusional parasitosis can damage their skin by attempting to remove imaginary parasites. These items may include scabs and skin particles, dust and dirt, and plant or animal fibers, and may be accompanied by photographs. [4] Laboratory analysis fails to find proof of parasitic infestation. [1]
The matchbox was described by Lyell (1983) as the most common container used to present specimens to the physician. [5]
Shelomi (2013) published a study of what he called scientific misconduct when a 2004 article in the Journal of the New York Entomological Society included what he says is photo manipulation of a matchbox specimen to support the claim that individuals with delusional parasitosis are infested with collembola. [6]
Delusional parasitosis (DP), also called delusional infestation, is a mental health condition where a person falsely believes that that their body is infested with living or nonliving agents. Common examples of such agents include parasites, insects, or bacteria. This is a delusion due to the belief persisting despite evidence that no infestation is present. People with this condition may have skin symptoms such as the urge to pick at one's skin (excoriation) or a sensation resembling insects crawling on or under the skin (formication).Morgellons disease is a related constellation of symptoms. This self-diagnosed condition is considered a form of a type of delusional parasitosis. People with Morgellons falsely believe harmful fibers are coming out of their skin and causing wounds.
Rosacea is a long-term skin condition that typically affects the face. It results in redness, pimples, swelling, and small and superficial dilated blood vessels. Often, the nose, cheeks, forehead, and chin are most involved. A red, enlarged nose may occur in severe disease, a condition known as rhinophyma.
Strongyloidiasis is a human parasitic disease caused by the nematode called Strongyloides stercoralis, or sometimes the closely related S. fülleborni. These helminths belong to a group of nematodes called roundworms. These intestinal worms can cause a number of symptoms in people, principally skin symptoms, abdominal pain, diarrhea and weight loss, but also many other specific and vague symptoms in disseminated disease, and severe life-threatening conditions through hyperinfection. In some people, particularly those who require corticosteroids or other immunosuppressive medication, Strongyloides can cause a hyperinfection syndrome that can lead to death if untreated. The diagnosis is made by blood and stool tests. The medication ivermectin is widely used to treat strongyloidiasis.
Formication is the sensation resembling that of small insects crawling on the skin, in the absence of actual insects. It is one specific form of a set of sensations known as paresthesias, which also include the more common prickling, tingling sensation known as pins and needles. Formication is a well-documented symptom which has numerous possible causes. The word is derived from formica, the Latin word for ant.
Tazarotene, sold under the brand name Tazorac, among others, is a third-generation prescription topical retinoid. It is primarily used for the treatment of plaque psoriasis and acne. Tazarotene is also used as a therapeutic for photoaged and photodamaged skin. It is a member of the acetylenic class of retinoids.
Livedo reticularis is a common skin finding consisting of a mottled reticulated vascular pattern that appears as a lace-like purplish discoloration of the skin. The discoloration is caused by reduction in blood flow (ischemia) through the arterioles that supply the cutaneous capillaries, resulting in deoxygenated blood showing as blue discoloration (cyanosis). This can be a secondary effect of a condition that increases a person's risk of forming blood clots (thrombosis), including a wide array of pathological and nonpathological conditions. Examples include hyperlipidemia, microvascular hematological or anemia states, nutritional deficiencies, hyper- and autoimmune diseases, and drugs/toxins.
The Leser–Trélat sign is the explosive onset of multiple seborrheic keratoses, often with an inflammatory base. This can be a sign of internal malignancy as part of a paraneoplastic syndrome. In addition to the development of new lesions, preexisting ones frequently increase in size and become symptomatic.
Morphea is a form of scleroderma that mainly involves isolated patches of hardened skin on the face, hands, and feet, or anywhere else on the body, usually with no internal organ involvement. However, in Deep Morphea inflammation and sclerosis can be found in the deep dermis, panniculus, fascia, superficial muscle and bone.
Dermatoses of pregnancy are the inflammatory skin diseases that are specific to women while they are pregnant. While some use the term 'polymorphic eruption of pregnancy' to cover these, this term is a synonym used in the UK for Pruritic urticarial papules and plaques of pregnancy, which is the commonest of these skin conditions.
Muir–Torre syndrome is a rare hereditary, autosomal dominant cancer syndrome that is thought to be a subtype of HNPCC. Individuals are prone to develop cancers of the colon, genitourinary tract, and skin lesions, such as keratoacanthomas and sebaceous tumors. The genes affected are MLH1, MSH2, and more recently, MSH6, and are involved in DNA mismatch repair.
Grover's disease (GD) is a polymorphic, pruritic, papulovesicular dermatosis characterized histologically by acantholysis with or without dyskeratosis. Once confirmed, most cases of Grover's disease last six to twelve months, which is why it was originally called "transient". However it may last much longer. Nevertheless, it is not to be confused with relapsing linear acantholytic dermatosis.
Florid cutaneous papillomatosis (FCP) is an obligate paraneoplastic syndrome.
Cutaneous amoebiasis, refers to a form of amoebiasis that presents primarily in the skin. It can be caused by Acanthamoeba or Entamoeba histolytica. When associated with Acanthamoeba, it is also known as "cutaneous acanthamoebiasis". Balamuthia mandrillaris can also cause cutaneous amoebiasis, but can prove fatal if the amoeba enters the bloodstream It is characterized by ulcers. Diagnosis of amebiasis cutis calls for high degree of clinical suspicion. This needs to be backed with demonstration of trophozoites from lesions. Unless an early diagnosis can be made such patients can develop significant morbidity.
Frontal fibrosing alopecia is the frontotemporal hairline recession and eyebrow loss in postmenopausal women that is associated with perifollicular erythema, especially along the hairline. It is considered to be a clinical variant of lichen planopilaris.
Morgellons is the informal name of a self-diagnosed, scientifically unsubstantiated skin condition in which individuals have sores that they believe contain fibrous material. Morgellons is not well understood, but the general medical consensus is that it is a form of delusional parasitosis, on the psychiatric spectrum. The sores are typically the result of compulsive scratching, and the fibers, when analysed, are consistently found to have originated from cotton and other textiles.
The American Board of Dermatology (ABD), located in Newton, Massachusetts, United States, certifies physicians in dermatology, dermatopathology, and pediatric dermatology. Board-certified physicians are known as diplomates. Since its inception in 1932, the ABD has certified over 15,000 physicians. The ABD was one of the original four sponsoring organizations of the American Board of Medical Specialties (ABMS). Dermatologists possess expertise in all aspects of healthy and diseased skin through basic scientific research and clinical care. In addition to the wide range of medical diseases, dermatologists have practices devoted to skin surgery, care of children with skin disease, immunologic diseases of the skin and pathology of the skin. Dermatologists play an important role in the maintenance of the general public health in educating people about sun avoidance, sun protection and the signs of skin cancer.
The International Lyme and Associated Diseases Society is a non-profit advocacy group which advocates for greater acceptance of the controversial and unrecognized diagnosis "chronic Lyme disease". ILADS was formed by advocates for the recognition of "chronic Lyme disease" including physicians, patients and laboratory personnel, and has published alternative treatment guidelines and diagnostic criteria due to the disagreement with mainstream consensus medical views on Lyme disease.
A variety of health effects can result from tattooing. Because it requires breaking the skin barrier, tattooing carries inherent health risks, including infection and allergic reactions. Modern tattooists reduce such risks by following universal precautions, working with single-use disposable needles, and sterilising equipment after each use. Many jurisdictions require tattooists to undergo periodic bloodborne pathogen training, such as is provided through the Red Cross and the U.S. Occupational Safety and Health Administration.
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