Asociación entre la infestación por el Demodex sp. y el acné vulgar grave. Estudio transversal de 168 pacientes

The Association Between Acne Vulgaris, Acne Vulgaris with Nonspecific Facial Dermatitis, and Demodex Mite Presence

Background

Demodex mites can lead to various skin disorders, from non-specific dermatitis to conditions that mimic other diseases, making it challenging to diagnose accurately. Additionally, it has been reported that Demodex mites can cause skin conditions such as perioral dermatitis, pustular folliculitis, pityriasis folliculorum, blepharitis, and rosacea. Due to conflicting studies, there is a debate regarding the link between Demodex mites and acne vulgaris. This study aims to determine the prevalence of Demodex mites on the faces of individuals with acne vulgaris, acne with nonspecific facial dermatitis, and healthy facial skin to clarify the association.

Materials and Methods

This observational case-control study involved 120 participants aged 18-37: 40 individuals with acne vulgaris only, 40 with acne and nonspecific facial dermatitis, and 40 healthy controls. The same dermatologist examined and diagnosed all participants to ensure accuracy before being grouped. The Standardized Skin Surface Biopsy (SSSB) method was used to detect Demodex mites in all three study groups. Furthermore, additional samples were collected randomly from acne lesions using the Superficial Needle Scraping (SNS) method in the two acne groups.

Results

The study found no significant difference in Demodex prevalence and high Demodex density rate between patients with only acne vulgaris and the control group (p>0.05). However, acne patients with nonspecific facial dermatitis had a higher rate of Demodex prevalence and high Demodex density rate than the only acne vulgaris and control group (p<0.05). The clinical symptoms of nonspecific facial dermatitis in acne patients strongly associated with Demodex mites are patchy red, dry, scaly skin, roughness, insect bite-like papules, and flushing.

Conclusion

Demodex prevalence and high Demodex density rate are not associated with acne vulgaris. Still, it is associated with acne and nonspecific facial dermatitis, particularly in patients with patchy redness, dry, scaly skin, roughness, insect bite-like papules, and flushing.

Type 2 Diabetes Mellitus and Demodex folliculorum Infestation: A Cross-Sectional Study in Peruvian Patients

BACKGROUND

Demodex folliculorum is a mite that causes human demodicosis, which is characterized by producing lesions on the face, and its infestation could be associated with factors that alter the immune response, including Type 2 Diabetes (T2D). This study aimed to evaluate the relationship between T2D and D. folliculorum infestation in patients attended at a hospital in Peru in 2021.

METHODS

A cross-sectional study enrolling patients who were classified according to the presence (n = 100) and absence (n = 100) of T2D was conducted. Information was obtained on age, sex, domestic animal husbandry, and symptoms and signs associated with demodicosis. Demodicosis was determined to be present when counts of D. folliculorum greater than five mites per cm² were found in superficial facial skin biopsies.

RESULTS

A frequency of demodicosis in 76 and 35 patients with and without T2D, respectively, was observed. In the multivariate analysis adjusted for confounders age, sex, and domestic animal husbandry, T2D was found to be associated with D. folliculorum infestation (PR: 2.13; 95% CI95: 1.42-3.19).

CONCLUSIONS

T2D was associated with D. folliculorum infestation. In this sense, it is important to strengthen surveillance to identify of D. folliculorum infestation in people with T2D.