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Rychlik K, Sternicka J, Zabłotna M, Nowicki RJ, Bieniaszewski L, Purzycka-Bohdan D. The Prevalence of Demodex spp. Infestation in Dermatological Patients in Northern Poland. Life (Basel) 2024; 14:1196. [PMID: 39337978 PMCID: PMC11433365 DOI: 10.3390/life14091196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2024] [Revised: 09/17/2024] [Accepted: 09/19/2024] [Indexed: 09/30/2024] Open
Abstract
The presence of Demodex spp. mites on the skin is a common phenomenon in the human population. In most people, it is an asymptomatic infestation, but in some patients, it can contribute to the occurrence of diseases such as demodicosis, rosacea, or blepharitis, as well as non-specific symptoms. In this study, the results of tests assessing the presence of Demodex spp. by direct microscopic examination (DME) in 2508 patients from northern Poland with the suspicion of demodicosis were retrospectively analyzed. A total of 3684 tests were performed. Among them, only 1585 (43.02%) revealed the presence of Demodex spp., while 2099 (56.98%) were negative. It was shown that in the analyzed population of patients with clinical suspicion of demodicosis, the degree of confirmation of the presence of Demodex spp. positively correlated with the patient's age (p = 0.001) and the mite was mainly found on the edges of eyelids and on the facial skin. Additionally, in men, the presence of Demodex was more often confirmed than in women (p = 0.004). In conclusion, the proper diagnosis of demodicosis still constitutes an important clinical problem due to the non-specificity of symptoms and the low confirmation of clinical suspicions of infestation by DME, especially in lower age groups.
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Affiliation(s)
- Katarzyna Rychlik
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
- Mycology Outpatient Clinic, University Clinical Centre, 80-214 Gdańsk, Poland
| | - Julia Sternicka
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
| | - Monika Zabłotna
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
| | - Roman J Nowicki
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
- Mycology Outpatient Clinic, University Clinical Centre, 80-214 Gdańsk, Poland
| | - Leszek Bieniaszewski
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Dorota Purzycka-Bohdan
- Department of Dermatology, Venereology and Allergology, Medical University of Gdańsk, University Clinical Centre, 80-214 Gdańsk, Poland
- Clinical Physiology Unit, Medical Simulation Centre, Medical University of Gdańsk, 80-210 Gdańsk, Poland
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Aksoy H, Altıntaş Kakşi S, Gönüllü Ö, Aslan Kayıran M, Erdemir VA. Biologic therapy increases Demodex density in psoriasis patients. Int J Dermatol 2024; 63:1193-1199. [PMID: 38650106 DOI: 10.1111/ijd.17161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/29/2024] [Accepted: 03/20/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Demodex density is known to increase in various immunosuppressive conditions. The relationship between biologic therapy and Demodex density remains unknown. We aimed to investigate whether the density of Demodex mites is higher in psoriasis patients treated with biologic agents compared to treatment-naive or topically treated patients. METHODS A cross-sectional study was conducted, comparing psoriasis patients receiving biologic therapy (n = 34) with controls (n = 33). Demodex density was assessed using the standardized skin surface biopsy technique (SSSB). Statistical analysis was performed to compare the densities and prevalence of demodicosis between the two groups. RESULTS Demodex density was significantly higher in the biologic therapy group compared to the control group on the right cheek (7.29 vs. 0.12/cm2; P = 0.001), left cheek (8.15 vs. 0.24/cm2; P = 0.002), and whole face (average of all four regions: 5.50 vs. 0.80/cm2; P = 0.001). The prevalence of demodicosis was significantly higher in the biologic therapy group on the forehead (35.3% vs. 12.1%; P = 0.043), right cheek (41.2% vs. 0%; P < 0.001), and left cheek (44.1% vs. 0%; P < 0.001). The frequency of cases with demodicosis in at least one localization was higher in the biological therapy group compared to the control group (61.8% vs. 15.2%; P < 0.001). CONCLUSIONS Psoriasis patients receiving biologic therapy had a higher Demodex density and prevalence of demodicosis compared to controls. Biologics may lead to an increase in Demodex density by blocking specific cytokines, such as interleukin-17 and tumor necrosis factor-α, which play a role in immunity against Demodex. Further research is needed to explore the impact of different biological agents on Demodex density.
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Affiliation(s)
- Hasan Aksoy
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Sümeyye Altıntaş Kakşi
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Öykü Gönüllü
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Vefa A Erdemir
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
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Parra-Cares J, Meza-Romero R, Ibáñez S, Canales M, Concha M, Navarrete-Dechent C, Abarzúa-Araya Á. Dermoscopy as a clinical tool for the diagnosis of demodicosis: a retrospective intrapatient case-control study. Arch Dermatol Res 2024; 316:509. [PMID: 39126525 DOI: 10.1007/s00403-024-03252-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 06/03/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024]
Abstract
Dermoscopy has been used for the non-invasive diagnosis of demodicosis. Several studies have evaluated the usefulness of this tool in the diagnosis, however, there are differences in the gold standard (SSSB or KOH test) and criteria of positivity used between studies. Added to this, is the lack of controls and objective quantification of the usefulness of dermoscopic signs in clinically observable and relevant ranges. To validate the usefulness of dermoscopy for the diagnosis of demodicosis by calculating the performance indicators for the different dermoscopic signs. Retrospective intrapatient case-control study, which included adults with suspicion of demodicosis. Dermoscopic photographs and scraping of healthy and lesional skin were obtained. Samples were analyzed microscopically by trained personnel. Photographs were evaluated by determining the presence of Demodex tails (DT), dilated follicular openings (DFO) and dilated blood vessels (DBV) in pre-defined ranges. 64 patients were included (total = 256 samples); the presence of demodex on skin scraping was seen in 69%. Under dermoscopy, the presence of DT in range 11-20/field had a positive likelihood ratio (LR) of 12.10 (95%CI 6.52-22.45) and negative LR 0.32 (95%CI 0.23-0.45). Combined and dichotomized performance for at least one positive sign under dermoscopy (DT > 10/field, DFO > 10/field or DBV > 50% of the field): positive LR 7.14 (95%CI 4.80-10.62) and negative LR 0.11 (95%CI 0.06-0.22). The presence of DT, DFO or DBV has a high correlation with a positive mite test, so the diagnosis of demodicosis could be made only through dermoscopy.
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Affiliation(s)
- Julio Parra-Cares
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, 4686 Vicuña Mackenna Avenue, Macul, Santiago de Chile, Chile
| | - Rodrigo Meza-Romero
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, 4686 Vicuña Mackenna Avenue, Macul, Santiago de Chile, Chile
| | - Samuel Ibáñez
- School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marilena Canales
- Microbiology Laboratory, San Joaquín Medical Center, UC-Christus Health Network, Santiago de Chile, Chile
| | - Mónica Concha
- Microbiology Laboratory, San Joaquín Medical Center, UC-Christus Health Network, Santiago de Chile, Chile
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, 4686 Vicuña Mackenna Avenue, Macul, Santiago de Chile, Chile
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Álvaro Abarzúa-Araya
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, 4686 Vicuña Mackenna Avenue, Macul, Santiago de Chile, Chile.
- Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
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Caputo V, Calò D, Rongioletti F. Unilateral demodicidosis of the nipple/areola complex mimicking nevoid hyperkeratosis. JAAD Case Rep 2024; 49:62-64. [PMID: 38883167 PMCID: PMC11176602 DOI: 10.1016/j.jdcr.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Affiliation(s)
- Valentina Caputo
- Department of Surgical Pathology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Donata Calò
- Department of Multispecialist Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Franco Rongioletti
- Division of Clinical Dermatology, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Milano, Italy
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Chioveanu FG, Niculet E, Torlac C, Busila C, Tatu AL. Beyond the Surface: Understanding Demodex and Its Link to Blepharitis and Facial Dermatoses. Clin Ophthalmol 2024; 18:1801-1810. [PMID: 38948346 PMCID: PMC11213710 DOI: 10.2147/opth.s440199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/29/2024] [Indexed: 07/02/2024] Open
Abstract
Demodex represents the most frequent ectoparasite found in humans. Although Demodex mites are considered commensals of human pilosebaceous units, an abnormally high mite density can cause several ocular and cutaneous symptoms and signs, sometimes to a severe degree. Both Demodex spp. (folliculorum and brevis) play a significant part in eye pathology and facial dermatoses. These mites have been related to blepharitis, ocular rosacea, meibomian gland dysfunction and various skin diseases, including rosacea, demodicosis and seborrheic dermatitis. Understanding the importance of Demodex in both eye and skin conditions is crucial for accurate diagnosis and appropriate management strategies, which may involve targeted treatments to control the mite population and reduce associated symptoms.
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Affiliation(s)
- Flavia Giorgiana Chioveanu
- Hexamed” Ophthalmology Clinic, Braila, Romania
- Biomedical Doctoral School, “Dunarea de Jos” University, Galati, Romania
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, Galaţi, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, “Dunarea de Jos” University, Galaţi, Romania
| | - Cristina Torlac
- Biomedical Doctoral School, “Dunarea de Jos” University, Galati, Romania
- Individual Medical Office - Dentistry, Galati, Romania
| | - Camelia Busila
- Dunarea de Jos University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania
- Sf. Ioan Emergency Clinical Paediatric Hospital, Galati, Romania
| | - Alin Laurentiu Tatu
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, “Dunarea de Jos” University, Galaţi, Romania
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University, Galaţi, Romania
- Dermatology Department, “Sf. Cuvioasa Parascheva” Clinical Hospital of Infectious Diseases, Galaţi, Romania
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Ozdemir Cetinkaya P, Özkesici Kurt B, Altunay IK, Aksu Cerman A. Which factors influence Demodex mite density in standardized superficial skin biopsy in patients with rosacea? A prospective cross-sectional analysis. Arch Dermatol Res 2024; 316:231. [PMID: 38787449 DOI: 10.1007/s00403-024-03049-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/08/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Abstract
Rosacea is a chronic cutaneous disease that manifests with facial erythema, telangiectasia, papules and pustules on the central face. Although the pathogenesis is not well established, rosacea appears to have a close relationship with Demodex mites. The aim of the study was to elucidate the factors influencing Demodex mite density by standardized superficial skin biopsy (SSSB) in patients with rosacea. This prospective, cross-sectional study included 200 patients with rosacea. Clinical characteristics of the patients were recorded and SSSB was used to measure Demodex density (Dd). If Dd was < 5 D/cm2 in the first SSSB, SSSB was repeated 4 more times to avoid false negative results. Of 200 patients, 152 (76%) were females and 48 (24%) males with a mean age of 43.47 ± 11.87 years. Ninety-nine patients (49.5%) had erythematotelangiectatic (ETR) and 101 patients (50.5%) had papulopustular (PPR) subtype of rosacea. Among 200 patients, the ratio of cumulative positive results of the consecutive SSSBs were as follows: 1st SSSB = 125 (62.5%), 2nd SSSB = 155 (77.5%), 3rd SSSB = 170 (85%), 4th SSSB = 173 (86.5%) and 5th SSSB = 174 (87%). The ratio of detecting Demodex infestation in the first SSSB was significantly lower in patients with PPR (55/101, 54.5%) than in patients with ETR (70/99, 70.7%). Median total Demodex mite density and D. folliculorum density were significantly higher in the ETR group than in the PPR group. There was a statistically significant relationship between density of Demodex tails in dermoscopy and positive/negative results of Demodex infestation in SSSB. As a conclusion, Demodex mite density by SSSB was influenced by various factors such as subtypes of rosacea, types of Demodex species, and dermoscopic findings.
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Affiliation(s)
- Pinar Ozdemir Cetinkaya
- Dermatology and Venereology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
| | - Birgül Özkesici Kurt
- Dermatology and Venereology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ilknur Kivanc Altunay
- Dermatology and Venereology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Asli Aksu Cerman
- Dermatology and Venereology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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7
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Tokiwa T, Ueda K, Watanabe N, Chou S, Ozaki K. A new species of Demodex (Acari: Demodecidae) from the skin of golden-handed tamarins, Saguinus midas (Primates: Cebidae). Int J Parasitol Parasites Wildl 2024; 23:100920. [PMID: 38487812 PMCID: PMC10937822 DOI: 10.1016/j.ijppaw.2024.100920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 03/17/2024]
Abstract
Two captive-bred golden-handed tamarins, Saguinus midas L., 1758 (Primates: Cebidae), kept in households in Japan, presented with psoriasis-like plaques on their faces, along with scale, alopecia, and itching. Histopathological examination revealed numerous Demodex mites in the hair follicles, and the clinical symptoms in both cases improved after treatment with fluralaner. Based on the morphological and genetic characteristics of the mites collected from tamarins, we describe a new species of Demodex. This new species is the fifth valid Demodex species recorded from primates.
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Affiliation(s)
- Toshihiro Tokiwa
- Laboratory of Veterinary Parasitology, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo, Japan
| | - Kengo Ueda
- Vogel Animal Hospital, 5-1-1 Kotoku-cho, Nada, Kobe, Hyogo, Japan
- Laboratory of Pathology, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, Japan
| | - Nagi Watanabe
- Laboratory of Veterinary Parasitology, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo, Japan
| | - Shyun Chou
- Laboratory of Veterinary Parasitology, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo, Japan
| | - Kiyokazu Ozaki
- Laboratory of Pathology, Setsunan University, 45-1 Nagaotoge-cho, Hirakata, Osaka, Japan
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8
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Aksoy H, Aslan Kayıran M, Dede Y, Altıntaş Kakşi S, Erdemir VA. The effect of phototherapy on Demodex density: a case-control study. Int J Dermatol 2024; 63:201-206. [PMID: 38234255 DOI: 10.1111/ijd.17002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/18/2023] [Accepted: 12/15/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Human Demodex mites, Demodex folliculorum and Demodex brevis, are microorganisms that reside in the pilosebaceous units, usually without causing symptoms. Phototherapy has been linked to demodicosis in previous studies. We aimed to determine whether there was an increase in the frequency of demodicosis and Demodex density after 20 phototherapy sessions. METHODS A case-control study was conducted with 32 participants who received narrowband ultraviolet B or ultraviolet A-1 therapy for various dermatological indications. Standardized skin surface biopsies were performed before and after phototherapy to assess Demodex density. The presence of Demodex-related skin conditions was assessed before phototherapy. A statistical analysis was performed to compare the Demodex densities and prevalence of demodicosis between the baseline and 20th session of phototherapy. RESULTS No significant change was observed in Demodex density after 20 sessions of phototherapy. The average Demodex density before treatment was 2.75 ± 4.48 (/cm2 ), and after treatment, it was 2.85 ± 4.81 (/cm2 ), indicating no significant difference (P = 0.879). The percentage of patients with demodicosis in at least one region of the face was 28.1% (9/32) before treatment, and after treatment, it was 31.3% (10/32), with no significant difference (P = 1.00). CONCLUSIONS Our findings contradict previous studies that suggested an increased Demodex density and demodicosis prevalence after phototherapy. The data from previous studies are open to debate due to their selected samples, designs, and interpretations regarding the phototherapy-immunosuppression-Demodex relationship. Larger-scale longitudinal studies conducted on a homogeneous sample are warranted to better understand the relationship between phototherapy and demodicosis.
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Affiliation(s)
- Hasan Aksoy
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Yeşim Dede
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Sümeyye Altıntaş Kakşi
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
| | - Vefa A Erdemir
- Department of Dermatology, Istanbul Medeniyet University Prof. Dr. Suleyman Yalcin City Hospital, İstanbul, Turkey
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Paichitrojjana A, Chalermchai T. The Association Between Acne Vulgaris, Acne Vulgaris with Nonspecific Facial Dermatitis, and Demodex Mite Presence. Clin Cosmet Investig Dermatol 2024; 17:137-146. [PMID: 38283791 PMCID: PMC10813226 DOI: 10.2147/ccid.s450540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/18/2024] [Indexed: 01/30/2024]
Abstract
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.
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Affiliation(s)
- Anon Paichitrojjana
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
| | - Thep Chalermchai
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
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10
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Żychowska M, Tognetti L, Rubegni P, Cinotti E. Pigmented Demodex Folliculorum: A Novel Dermoscopic Finding in Brown Facial Macules. Dermatol Pract Concept 2024; 14:dpc.1401a44. [PMID: 38364427 PMCID: PMC10868774 DOI: 10.5826/dpc.1401a44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 02/18/2024] Open
Affiliation(s)
- Magdalena Żychowska
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
| | - Linda Tognetti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Pietro Rubegni
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
| | - Elisa Cinotti
- Dermatology Unit, Department of Medical, Surgical and Neurosciences, University of Siena, Siena, Italy
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11
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Huang WL, Huang CM, Chu CY, Hu FR. Comorbidity of Ocular and Facial Demodicosis. Am J Ophthalmol 2024; 257:201-211. [PMID: 37739203 DOI: 10.1016/j.ajo.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
PURPOSE To determine the association between ocular and facial demodicosis, and the effect of facial treatment on ocular demodicosis. DESIGN Prospective clinical cohort study. METHODS Ocular demodicosis outpatients from a tertiary medical center were enrolled from April to December 2020. The diagnosis was based on epilation of 4 eyelashes from each upper eyelid. High ocular Demodex load (ODL) was defined as ≥8 mites per eye. Facial infestation was assessed by direct microscopic examination, with facial Demodex overgrowth (FDO) defined as a density >5 mites/cm2. All patients were prescribed 3 months of ocular treatment, and FDO patients received dermatologic treatment. RESULTS Eighty-nine patients were enrolled. Among those that completed the treatment course, 39 presented high ODL. Lower cylindrical sleeve counts were found in low ODL patients (low ODL vs high ODL: 8 vs 14, P = .009). FDO was less prevalent in this group (49% vs 77%, P = .012). The Ocular Surface Disease Index score decreased in patients without FDO (20.0 ± 17.1 to 14.0 ± 16.6, P = .027) after 3 months of topical tea tree oil treatment. Topical ivermectin treatment on the facial skin provided a higher ocular Demodex eradication rate in FDO patients (76% vs 16%, P < .001). CONCLUSION Concurrence of ocular and facial demodicosis is common, especially in cases of severe ocular demodicosis. Although ocular treatment alone is effective for patients with ocular demodicosis only, cotreatment with topical ivermectin on the facial skin enhances ocular Demodex eradication in patients with comorbid facial Demodex overgrowth.
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Affiliation(s)
- Wei-Lun Huang
- From the Department of Ophthalmology, National Taiwan University Hospital Hsinchu Branch (W.-L.H.), Hsinchu, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University (W.-L.H.), Taipei, Taiwan
| | - Chang-Ming Huang
- Department of Dermatology, National Taiwan University Hospital, College of Medicine, National Taiwan University (C.-M.H., C.-Y.C.), Taipei, Taiwan
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital, College of Medicine, National Taiwan University (C.-M.H., C.-Y.C.), Taipei, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University (F.-R.H.), Taipei, Taiwan.
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12
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Sulik M, Antoszczak M, Huczyński A, Steverding D. Antiparasitic activity of ivermectin: Four decades of research into a "wonder drug". Eur J Med Chem 2023; 261:115838. [PMID: 37793327 DOI: 10.1016/j.ejmech.2023.115838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/17/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023]
Abstract
Parasitic diseases still pose a serious threat to human and animal health, particularly for millions of people and their livelihoods in low-income countries. Therefore, research into the development of effective antiparasitic drugs remains a priority. Ivermectin, a sixteen-membered macrocyclic lactone, exhibits a broad spectrum of antiparasitic activities, which, combined with its low toxicity, has allowed the drug to be widely used in the treatment of parasitic diseases affecting humans and animals. In addition to its licensed use against river blindness and strongyloidiasis in humans, and against roundworm and arthropod infestations in animals, ivermectin is also used "off-label" to treat many other worm-related parasitic diseases, particularly in domestic animals. In addition, several experimental studies indicate that ivermectin displays also potent activity against viruses, bacteria, protozoans, trematodes, and insects. This review article summarizes the last 40 years of research on the antiparasitic effects of ivermectin, and the use of the drug in the treatment of parasitic diseases in humans and animals.
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Affiliation(s)
- Michał Sulik
- Department of Medical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61‒614, Poznań, Poland
| | - Michał Antoszczak
- Department of Medical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61‒614, Poznań, Poland
| | - Adam Huczyński
- Department of Medical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Uniwersytetu Poznańskiego 8, 61‒614, Poznań, Poland.
| | - Dietmar Steverding
- Bob Champion Research & Education Building, Norwich Medical School, University of East Anglia, Norwich, UK
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13
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Paichitrojjana A, Paichitrojjana A. Case Series of Demodicosis in Acne Vulgaris Patients. Clin Cosmet Investig Dermatol 2023; 16:3363-3368. [PMID: 38021431 PMCID: PMC10664713 DOI: 10.2147/ccid.s441581] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
An abnormal density of Demodex mites can trigger many skin disorders known as demodicosis. Clinical manifestations of demodicosis may resemble other skin diseases and can coexist with other skin disorders, resulting in underdiagnosis and a more challenging diagnosis. Here, we report three cases of demodicosis in acne vulgaris patients. These case series have discussed their clinical features along with optimal strategies for diagnosis and treatment.
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Affiliation(s)
- Anon Paichitrojjana
- School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, Thailand
| | - Anand Paichitrojjana
- Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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14
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DEMİRBAŞ A, BAYRAMGÜRLER D, YAŞAR EK, ADAK M, DEMİR Cİ. Relationship between surgical rhinoplasty and Demodex infestation: a case-control study. Turk J Med Sci 2023; 53:1738-1743. [PMID: 38813499 PMCID: PMC10760571 DOI: 10.55730/1300-0144.5743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 12/12/2023] [Accepted: 11/11/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim Human Demodex mites are parasites that live in the pilosebaceous unit and can cause demodicosis. While demodicosis may occur as a primary skin disease, it may also result from immunosuppression and topical or systemic immunosuppressive therapies. Surgical rhinoplasty is one of the most commonly performed cosmetic procedures, and it is the cause of a variety of cutaneous complications, particularly acne, as it affects the skin's adnexal structures. Thus, this study aimed to investigate whether the cutaneous changes in surgical rhinoplasty patients render them vulnerable to Demodex infestation. Materials and methods Individuals who had undergone rhinoplasty (patients) and age- and sex-matched healthy volunteers (controls) were included in this prospective case-control study. To determine the Demodex density, samples were collected from the malar and nasal regions of both the patients and controls using the standard superficial skin biopsy method. Results A total of 50 rhinoplasty patients and 50 healthy controls were enrolled in the study. The Demodex density on the nose was significantly higher in the rhinoplasty patients (p = 0.0001). Furthermore, the frequency of xerosis and pustules was significantly higher in the rhinoplasty patients compared to the control group (p = 0.046 and p = 0.001, respectively). Conclusion Surgical rhinoplasty may be a risk factor for demodicosis, and patients will recover faster after surgery with proper diagnosis and treatment.
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Affiliation(s)
- Abdullah DEMİRBAŞ
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli,
Turkiye
| | - Dilek BAYRAMGÜRLER
- Department of Dermatology, Faculty of Medicine, Kocaeli University, Kocaeli,
Turkiye
| | - Emrah Kağan YAŞAR
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Kocaeli University, Kocaeli,
Turkiye
| | - Muhammed ADAK
- Department of Dermatology, Midyat State Hospital, Mardin,
Turkiye
| | - Can İlker DEMİR
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Kocaeli University, Kocaeli,
Turkiye
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Metin Z, Akca HM, Ozkoca D, Imren IG, Durmaz K, Kara KT, Metin MS, Temiz SA, Caf N, Ozyurt K. Demodex prevalence in mine, textile and food factory workers with dermatosis: a cross-sectional, multicenter study. Arch Dermatol Res 2023; 315:2099-2105. [PMID: 36947195 DOI: 10.1007/s00403-023-02607-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 01/17/2023] [Accepted: 03/09/2023] [Indexed: 03/23/2023]
Abstract
Demodex, a type of mite, lives in human hair follicles. They can multiply very quickly in some conditions and then start to irritate the skin by causing skin disorders. This study aims to investigate if working environment conditions affect the prevalence of Demodex. A cross-sectional, multicenter study was conducted with three different occupational groups: mine, textile and food factory workers (n = 102). Determined industry workers who applied to our outpatient dermatology clinics with the complaint of dermatosis in three different cities were included in the study. Demodex positivity was checked by dermoscopy. Differences between categorical variables examined with Chi-square analysis and T test was used to compare continuous variables between groups. 50% Demodex positivity was found in mine workers, 45.3% in food factory workers and 66.7% in textile manufacturing workers. A high rate of Demodex positivity was observed in all three occupational groups. Although the highest positivity rate was observed in textile manufacturing workers, no significant difference was found between the groups (p = 0.320). The overall prevalence of Demodex in female workers was statistically significantly higher than in male workers (p = 0.029). Exposure of workers to a wide variety of factors in work environments such as textile factories and the fact that women are more sensitive to external factors may have caused the prevalence of Demodex to be higher in these groups. So, a change in the work environment or the use of suitable protective equipment may benefit the treatment of diseases caused by Demodex. But, further studies are needed with larger and various industry groups to make more certain views.
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Affiliation(s)
- Zuhal Metin
- Department of Dermatology, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey.
| | - Hanife Merve Akca
- Department of Dermatology, Faculty of Medicine, Karamanoglu Mehmet Bey University, Karaman, Turkey
| | - Defne Ozkoca
- Department of Dermatology, Zonguldak Ataturk State Hospital, Zonguldak, Turkey
| | - Isıl Gogem Imren
- Department of Dermatology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Koray Durmaz
- Department of Dermatology, Private Bilgi Hospital, Ankara, Turkey
| | - Kevser Tuncer Kara
- Department of Public Health, Faculty of Medicine, Fırat University, Elazig, Turkey
| | - Mahmut Sami Metin
- Department of Dermatology, Adana City Training and Research Hospital, Adana, Turkey
| | - Selami Aykut Temiz
- Department of Dermatology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Nazli Caf
- Department of Dermatology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Kemal Ozyurt
- Department of Dermatology, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
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16
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Chen Y, Knight R, Gallo RL. Evolving approaches to profiling the microbiome in skin disease. Front Immunol 2023; 14:1151527. [PMID: 37081873 PMCID: PMC10110978 DOI: 10.3389/fimmu.2023.1151527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/14/2023] [Indexed: 04/22/2023] Open
Abstract
Despite its harsh and dry environment, human skin is home to diverse microbes, including bacteria, fungi, viruses, and microscopic mites. These microbes form communities that may exist at the skin surface, deeper skin layers, and within microhabitats such as the hair follicle and sweat glands, allowing complex interactions with the host immune system. Imbalances in the skin microbiome, known as dysbiosis, have been linked to various inflammatory skin disorders, including atopic dermatitis, acne, and psoriasis. The roles of abundant commensal bacteria belonging to Staphylococcus and Cutibacterium taxa and the fungi Malassezia, where particular species or strains can benefit the host or cause disease, are increasingly appreciated in skin disorders. Furthermore, recent research suggests that the interactions between microorganisms and the host's immune system on the skin can have distant and systemic effects on the body, such as on the gut and brain, known as the "skin-gut" or "skin-brain" axes. Studies on the microbiome in skin disease have typically relied on 16S rRNA gene sequencing methods, which cannot provide accurate information about species or strains of microorganisms on the skin. However, advancing technologies, including metagenomics and other functional 'omic' approaches, have great potential to provide more comprehensive and detailed information about the skin microbiome in health and disease. Additionally, inter-species and multi-kingdom interactions can cause cascading shifts towards dysbiosis and are crucial but yet-to-be-explored aspects of many skin disorders. Better understanding these complex dynamics will require meta-omic studies complemented with experiments and clinical trials to confirm function. Evolving how we profile the skin microbiome alongside technological advances is essential to exploring such relationships. This review presents the current and emerging methods and their findings for profiling skin microbes to advance our understanding of the microbiome in skin disease.
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Affiliation(s)
- Yang Chen
- Department of Dermatology, University of California San Diego, La Jolla, CA, United States
- Department of Pediatrics, University of California San Diego, La Jolla, CA, United States
- Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, CA, United States
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, CA, United States
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, United States
- Department of Bioengineering, University of California San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, United States
| | - Richard L. Gallo
- Department of Dermatology, University of California San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, United States
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17
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Truncal Acne and Scarring: A Comprehensive Review of Current Medical and Cosmetic Approaches to Treatment and Patient Management. Am J Clin Dermatol 2023; 24:199-223. [PMID: 36539678 DOI: 10.1007/s40257-022-00746-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 12/24/2022]
Abstract
Acne vulgaris is one of the most common skin disorders worldwide. It typically affects skin areas with a high density of sebaceous glands such as the face, upper arms, chest, and/or back. Historically, the majority of research efforts have focused on facial acne vulgaris, even though approximately half of patients with facial lesions demonstrate truncal involvement. Truncal acne vulgaris is challenging to treat and poses a significant psychosocial burden on patients. Despite these characteristics, studies specifically examining truncal acne vulgaris are limited, with treatment guidelines largely derived from facial protocols. Therefore, truncal acne remains an understudied clinical problem. Here, we provide a clinically focused review on the epidemiology, evaluation, and available treatment options for truncal acne vulgaris. In doing so, we highlight knowledge gaps with the goal of spurring further investigation into the management of truncal acne vulgaris.
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18
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Uchida H, Kamata M, Egawa S, Nagata M, Fukaya S, Hayashi K, Fukuyasu A, Tanaka T, Ishikawa T, Tada Y. Newly developed erythema and red papules in the face and neck with detection of demodex during dupilumab treatment for atopic dermatitis improved by discontinuation of dupilumab, switching to upadacitinib or treatment with oral ivermectin: A report of two cases. J Eur Acad Dermatol Venereol 2023; 37:e300-e302. [PMID: 36377632 DOI: 10.1111/jdv.18743] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 11/10/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Hideaki Uchida
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Masahiro Kamata
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Shota Egawa
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Mayumi Nagata
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Saki Fukaya
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Kotaro Hayashi
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Atsuko Fukuyasu
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Takamitsu Tanaka
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Takeko Ishikawa
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yayoi Tada
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
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Chudzicka-Strugała I, Gołębiewska I, Brudecki G, Elamin W, Zwoździak B. Demodicosis in Different Age Groups and Alternative Treatment Options-A Review. J Clin Med 2023; 12:jcm12041649. [PMID: 36836184 PMCID: PMC9961532 DOI: 10.3390/jcm12041649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
Infestation with Demodex mites is a common occurrence, especially in adults and the elderly. More recent attention has been paid to the presence of Demodex spp. mites in children, even ones without comorbidities. It causes both dermatological and ophthalmological problems. The presence of Demodex spp. is often asymptomatic, thus it is suggested to include parasitological investigation tests in dermatological diagnostics, in addition to bacteriological analysis. Literature reports show that Demodex spp. are related to the pathogenesis of numerous dermatoses, including rosacea or demodicosis gravis, and common eye pathologies reported by patients such as dry eye syndrome or ocular surface inflammatory conditions, such as blepharitis, chalazia, Meibomian gland dysfunction, and keratitis. Treatment of patients is a challenge and is usually prolonged, therefore it is important to carefully diagnose and properly select the therapy regimen for the treatment to be successful, and with minimal side effects, especially for young patients. Apart from the use of essential oils, research is ongoing for new alternative preparations active against Demodex sp. Our review was focused on the analysis of the current literature data on the available agents in the treatment of demodicosis in adults and children.
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Affiliation(s)
- Izabela Chudzicka-Strugała
- Department of Medical Microbiology, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Iwona Gołębiewska
- Earth and Life Institute (ELI), Université Catholique de Louvain, Croix du Sud 2, 1348 Louvain-La-Neuve, Belgium
- Correspondence:
| | - Grzegorz Brudecki
- Group 42 (Healthcare), Masdar City, Abu Dhabi P.O. Box 112778, United Arab Emirates
| | - Wael Elamin
- Group 42 (Healthcare), Masdar City, Abu Dhabi P.O. Box 112778, United Arab Emirates
| | - Barbara Zwoździak
- Department of Medical Microbiology, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
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20
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Muacevic A, Adler JR, Berry EG, Taylor MH. A Rare Case of Demodicosis Following Treatment With Oral Fluconazole. Cureus 2023; 15:e33309. [PMID: 36741596 PMCID: PMC9894334 DOI: 10.7759/cureus.33309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/05/2023] Open
Abstract
Demodex folliculorum and Demodex brevis are commensal human ectoparasites that reside within or near hair follicles and have been highly associated with rosacea-like papulopustular skin eruptions. We present an interesting case of recurrent, iatrogenic demodicosis in a 56-year-old man. We suspect this to have been triggered by antifungal therapy given it occurred twice closely following azole treatment. We propose that oral antifungals in the setting of immunosuppression can alter the skin microbiome, facilitating Demodex proliferation.
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21
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Bendezu-Quispe G, Rojas-Zevallos J, Rosales-Rimache J. Type 2 Diabetes Mellitus and Demodex folliculorum Infestation: A Cross-Sectional Study in Peruvian Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13582. [PMID: 36294163 PMCID: PMC9603340 DOI: 10.3390/ijerph192013582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/27/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
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.
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22
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Dursun AT, Bayramgürler D, Demirsoy EO, Şikar Aktürk A, Kıran R, Sayman N. Could there be an association between Hashimoto's thyroiditis and demodex infestation? J Cosmet Dermatol 2022; 21:5141-5147. [PMID: 35486704 DOI: 10.1111/jocd.15005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/03/2022] [Accepted: 04/12/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human demodex mites are parasites that live in the pilosebaceous unit and can result in the disease demodicosis. While demodicosis may occur as a primary skin disease; immunosuppression, and topical or systemic immunosuppressive treatments can cause secondary demodicosis. It is known that thyroid hormones may cause skin changes, such as xerosis, and thereby may also modulate immune responses in the skin. OBJECTIVES The aim of this study is to investigate whether or not that the changes occurring in the skin of patients with Hashimoto's Thyroiditis (HT) predispose to demodex infestation. METHODS Seventy-eight patients being followed for a diagnosis of HT at Kocaeli University Endocrinology Outpatient Clinic, between January 2019 and March 2020, constituted the patient group. The control group consisted of 41 patients who did not have any chronic systemic or dermatological disease and were shown to have no thyroid disease by laboratory tests. Demodex intensity in the malar regions of the patient and control groups was determined using the standardized skin surface biopsy (SSSB) method and compared with each other. RESULTS HT patients were significantly more likely to have increased demodex density and suggestive SSSB results than the controls (p<0.001, p=0.012, respectively). A significant correlation was found between demodex intensity and the findings of xerosis (p=0.010, p=0.011) and spiny follicular papules (p=0.008, p=0.008) in the patient or control groups, respectively. However, a significant correlation was identified between the demodex density and the symptoms of burning-stinging (p=0.028), and feelings of dryness (p=0.018) roughness (p=0.028) only in the control group. CONSLUSION Xerotic skin and/or impaired immune responses as a result of autoimmune changes in patients with HT may lead to secondary demodicosis.
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Affiliation(s)
| | | | | | | | - Rebiay Kıran
- Department of Dermatology, University of Kocaeli, Kocaeli, Turkey
| | - Nilgün Sayman
- Department of Dermatology, University of Kocaeli, Kocaeli, Turkey
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23
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Paichitrojjana A. Demodex: the worst enemies are the ones that used to be friends. Dermatol Reports 2022; 14:9339. [PMID: 36199896 PMCID: PMC9527693 DOI: 10.4081/dr.2022.9339] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 08/23/2021] [Indexed: 12/02/2022] Open
Abstract
Demodex mites are common ectoparasites of the human pilosebaceous units. Most adults are infested with Demodex mites without clinical symptoms. Demodex mite will only become a pathogenic organism when there is an abnormal increase in the number of Demodex mite density. This situation happens when the equilibrium between Demodex mites, skin microenvironment and human immunity system changes. Demodex infestation can cause multiple skin disorders, which are grouped under the term demodicosis or demodicidosis. Clinical manifestations of demodicosis can mimic other known skin diseases such as folliculitis, rosacea, perioral dermatitis, which is why it is often misdiagnosed. Diagnosis criteria consists of relevant correlation of suspected clinical skin lesions, confirmed by the presence of abnormal proliferation of Demodex mites and by clinical cure after acaricidal treatment together with normalization of Demodex mite density. Dermatologists should be aware that demodicosis is not an uncommon skin disease, and there are still many unknowns about it that should be researched further.
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Lee WJ, Kraitman N, Sarriera-Lazaro CJ, Greene J. Rosacea Granulomatosis in a Neutropenic Leukemic Patient. Cureus 2022; 14:e23308. [PMID: 35464516 PMCID: PMC9015070 DOI: 10.7759/cureus.23308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/19/2022] Open
Abstract
Rosacea granulomatosis is a common, chronic skin disorder that primarily affects the central face, namely the cheek, nose, chin, and central forehead. Although rosacea is mainly a disorder of innate and adaptive immunity, a variety of endogenous and exogenous triggers such as Demodex may stimulate it. Often found as commensal organisms in human skin, Demodex can be parasitic if there is a change in the host’s cutaneous environment. This is especially relevant for immunosuppressed patients, who need prompt treatment to prevent further complications. We review the literature regarding rosacea granulomatosis in immunosuppression and present an acute myelogenous leukemia patient with severe neutropenia, which may have promoted the development of rosacea due to Demodex mite proliferation. This local proliferation of the ectoparasite on the face can cause an atypical skin rash that mimics severe infections in the setting of neutropenia.
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25
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BOTSALİ A, YÜREKLİ A. Comparison of the in vitro Demodex folliculorum killing activity of azelaic acid and permethrin. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1061271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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26
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Forton FM. Rosacea, an infectious disease: why rosacea with papulopustules should be considered a demodicosis. A narrative review. J Eur Acad Dermatol Venereol 2022; 36:987-1002. [DOI: 10.1111/jdv.18049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
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27
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Kositz C, Bradley J, Hutchins H, Last A, D'Alessandro U, Marks M. Broadening the range of use cases for ivermectin - a review of the evidence. Trans R Soc Trop Med Hyg 2022; 116:201-212. [PMID: 34323283 PMCID: PMC8890779 DOI: 10.1093/trstmh/trab114] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/30/2021] [Accepted: 07/13/2021] [Indexed: 11/12/2022] Open
Abstract
Ivermectin is a broad-spectrum antiparasitic agent that interferes with glutamate-gated chloride channels found in invertebrates but not in vertebrate species. Mass drug administration (MDA) with ivermectin-based regimes has been a mainstay of elimination efforts targeting onchocerciasis and lymphatic filariasis for more than 3 decades. More recently, interest in the use of ivermectin to control other neglected tropical diseases (NTDs) such as soil-transmitted helminths and scabies has grown. Interest has been further stimulated by the fact that ivermectin displays endectocidal efficacy against various Anopheles species capable of transmitting malaria. Therefore there is growing interest in using ivermectin MDA as a tool that might aid in the control of both malaria and several NTDs. In this review we outline the evidence base to date on these emerging indications for ivermectin MDA with reference to clinical and public health data and discuss the rationale for evaluating the range of impacts of a malaria ivermectin MDA on other NTDs.
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Affiliation(s)
- Christian Kositz
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - John Bradley
- MRC International Statistics and Epidemiology Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Harry Hutchins
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
| | - Anna Last
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
- Hospital for Tropical Diseases, Mortimer Market Capper Street, WC1E 6JB, London, UK
| | - Umberto D'Alessandro
- Disease Control and Elimination, Medical Research Council Unit Gambia at London School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia
| | - Michael Marks
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK
- Hospital for Tropical Diseases, Mortimer Market Capper Street, WC1E 6JB, London, UK
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Lahouel I, Said El Mabrouk R, Hadhri R, Youssef M, Belhadjali H, Zili J. Atypical localization of demodicosis after COVID-19 infection. Clin Case Rep 2022; 10:e05446. [PMID: 35198203 PMCID: PMC8841029 DOI: 10.1002/ccr3.5446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/16/2022] [Accepted: 01/24/2022] [Indexed: 11/12/2022] Open
Abstract
Since its outbreak in December 2019, a consistent number of case reports have been published describing a complex spectrum of skin manifestations associated with COVID-19. We report a first observation of demodicosis of the scalp after a severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection.
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Affiliation(s)
- Ines Lahouel
- Dermatology departmentFattouma Bourguiba HospitalUniversity of MedicineMonastirTunisia
- Dermo‐respiratory research laboratoryUniversity of MedicineMonastirTunisia
| | - Randa Said El Mabrouk
- Dermatology departmentFattouma Bourguiba HospitalUniversity of MedicineMonastirTunisia
- Dermo‐respiratory research laboratoryUniversity of MedicineMonastirTunisia
| | - Rim Hadhri
- Anatomo‐pathology departmentFattouma Bourguiba HospitalUniversity of MedicineMonastirTunisia
| | - Monia Youssef
- Dermatology departmentFattouma Bourguiba HospitalUniversity of MedicineMonastirTunisia
- Dermo‐respiratory research laboratoryUniversity of MedicineMonastirTunisia
| | - Hichem Belhadjali
- Dermatology departmentFattouma Bourguiba HospitalUniversity of MedicineMonastirTunisia
- Dermo‐respiratory research laboratoryUniversity of MedicineMonastirTunisia
| | - Jameleddin Zili
- Dermatology departmentFattouma Bourguiba HospitalUniversity of MedicineMonastirTunisia
- Dermo‐respiratory research laboratoryUniversity of MedicineMonastirTunisia
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29
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Gutiérrez B, Soto R, Catalán A, Araya JE, Fuentes M, González J. Demodex folliculorum (Trombidiformes: Demodicidae) and Demodex brevis Prevalence in an Extreme Environment of Chile. JOURNAL OF MEDICAL ENTOMOLOGY 2021; 58:2067-2074. [PMID: 34331059 DOI: 10.1093/jme/tjab120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Indexed: 06/13/2023]
Abstract
The prevalence of mites of the genus Demodex and their associations with host age, gender, workplace, and comorbid skin and ocular conditions were studied in participants in Antofagasta, Chile, which is in a region with an extreme environment. We examined 680 participants aged 18-88 yr using standardized surface skin biopsies. Among them, Demodex had a prevalence of 13.5 % (95% confidence interval, 10.88-16.17). A slightly higher prevalence was observed in males (51.1%; 95% confidence interval, 40.9-61.3; nonsignificant) and participants in the 69-88 yr age group (50.0%; 95% confidence interval, 23.8-76.2; P < 0.05). Regarding the species involved, Demodex folliculorum was found in 89.1% (CI 82.7-95.5) of cases, while D. brevis was found in the remaining 10.9% of cases. A higher prevalence (25.0% CI 16.1-33.91) was observed in participants who worked indoors in generally enclosed and dust-rich environments (such as theaters, libraries, and administrative offices). There was also a strong association between Demodex prevalence and conjunctival hyperemia, with 35.9% (95% confidence interval, 9.1-35; OR 17.9) of the Demodex positive participants having this pathology compared to 10.3% of the noninfested participants. In summary, the prevalence of Demodex in Antofagasta, Chile (13.5%) was toward the lower end of the range reported among other regions around the world. Environmental factors such as exposure to the sun (including ultraviolet rays) or environmental pollution may affect the mites. In addition, Demodex genetics (related to virulence) and the ocular or skin microbiota may positively or negatively influence infestation and pathology.
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Affiliation(s)
- Bessy Gutiérrez
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Rodrigo Soto
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Alejandro Catalán
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Jorge E Araya
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Margarita Fuentes
- Public Health Unit, Faculty of Medicine and Odontology, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
| | - Jorge González
- Molecular Parasitology Unit, Medical Technology Department, Faculty of Health Sciences, University of Antofagasta, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile
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30
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Zahr Allayali A. Facial Spinulate Demodicosis. Clin Cosmet Investig Dermatol 2021; 14:1211-1214. [PMID: 34548801 PMCID: PMC8449553 DOI: 10.2147/ccid.s326676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
Hyperkeratotic spicules are rare cutaneous lesions associated with underlying systemic illnesses. In more recent times, facial spinulate demodicosis has been suggested as an etiological factor. Demodicosis is a common dermatological condition characterized by the presence of Demodex mites in the pilocutaneous follicles. This report describes the case of a 40-year-old otherwise healthy woman who reported having undetected facial follicular spicules as a result of demodicosis. The diagnosis was confirmed by physical examination and skin punch biopsy. Initial treatment with 5% permethrin did not resolve the rash. As such, 1% Ivermectin was prescribed, after which the rash resolved completely within 3 weeks.
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Affiliation(s)
- Ahmed Zahr Allayali
- Department of Internal Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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31
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Zhiltsova EE, Politov SA, Bakovetskaya OV, Kochetkova DL, Egorova EA. Evaluation of the sexual and age structure of infestation by the Demodex mite and percentage of complications of acne-related dermatoses with secondary demodicosis, depending on their severity. CONSILIUM MEDICUM 2021. [DOI: 10.26442/20751753.2021.8.201182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background. The article provides a detailed review of the etiopathogenetic, clinical and diagnostic aspects of demodectic skin of the face, considers the modern classification of this pathological condition, provides statistical data on the sex and age structure of population invasion by a tick of the genus Demodex, as well as the percentage of complications with secondary demodicosis of acneform dermatoses (rosacea and perioral dermatitis).
Aim. To reveal the percentage of complications of the course of acneform dermatoses (perioral dermatitis and rosacea) with demodicosis, depending on the severity of the underlying disease, as well as the sex and age structure of the invasion among the patients of the study group.
Materials and methods. In our own study, we assessed the sex and age structure of the Demodex mite infestation and the percentage of complications of rosacea and perioral dermatitis with secondary demodicosis, depending on their severity. The severity of clinical manifestations of rosacea was assessed using the rosacea diagnostic assessment scale; the PODSI index was used for perioral dermatitis. Before the start of the course of therapy and after its completion, all patients underwent a microscopic examination of scrapings from the skin of the face in order to detect a diagnostically significant number of individuals of the Demodex genus tick (5 or more). If a tick was found in scrapings, along with standard therapy drugs, patients were locally prescribed 1% ivermectin cream once a day for a course of 2 to 4 months, depending on the severity of the clinical manifestations of dermatosis.
Results. It was found that the incidence of Demodex invasion in the study group increased in direct proportion to the severity of the clinical manifestations of dermatoses and the age of the patients. It was also found that among the patients of the study group, demodicosis was registered in women almost twice as often as in men. Topical use of 1% ivermectin cream has shown a high profile of the efficacy and safety of this drug.
Conclusion. After the completing the treatment course, complete elimination of Demodex, confirmed by laboratory, was achieved in 100% of patients with demodicosis in the study group. There were no adverse events or side effects while taking the drug.
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32
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Altemir A, Lobato-Berezo A, Pujol RM. Scalp demodicosis developing in a patient with frontal fibrosing alopecia: a clinical and trichoscopic mimicker of active disease. Int J Dermatol 2021; 61:e134-e136. [PMID: 34242406 DOI: 10.1111/ijd.15775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 06/08/2021] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Arcadi Altemir
- Department of Dermatology, Hospital Universitari Sagrat Cor, Grupo Hospitalario Quirónsalud, Barcelona, Spain
| | | | - Ramon M Pujol
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar, Barcelona, Spain
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33
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Forton FMN, De Maertelaer V. Which factors influence Demodex proliferation? A retrospective pilot study highlighting a possible role of subtle immune variations and sebaceous gland status. J Dermatol 2021; 48:1210-1220. [PMID: 33969532 DOI: 10.1111/1346-8138.15910] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/30/2021] [Indexed: 11/27/2022]
Abstract
Demodex folliculorum and brevis are commensal mites that live in low densities in human pilosebaceous follicles as part of the normal adult microbiota, but that give rise to demodicosis and, possibly, rosacea, when they proliferate excessively. This proliferation is favored by various factors, including age, marked immunosuppression, sebaceous gland hyperplasia, and hypervascularization-related factors. To study possible factors influencing mite proliferation, we explored the effects of different variables on Demodex densities (Dd) in a retrospective study of two groups of subjects selected on the basis of their clinical diagnosis: Demodex+, consisting of subjects with demodicosis or with centro-facial papulopustules suggesting rosacea (n = 844, mean Dd 263.5 ± 8.9 D/cm2 ), and Demodex-, consisting of subjects with other facial dermatoses or healthy facial skin (n = 200, mean Dd 2.3 ± 0.4 D/cm2 ). Demodex densities were measured using two consecutive standardized skin surface biopsies (SSSB1 [superficial] and SSSB2 [deep]) taken from the same facial site on each subject. In the Demodex+ group: the SSSB1 decreased with age in women (p = 0.004), and the SSSB2 increased with age in men (p = 0.001) (the pattern was similar for SSSB1 + 2, but not statistically significant); Dds were lower in those who had received cortisone (either topically or systemically); 13 subjects (1.5%) had known immunosuppression, 62 (7.3%) had hypothyroidism, and in 20 (3.6% of the women) there was a reported link with pregnancy; 78 of the subjects (9.2%) were part of a pair from the same family or household; when associated bacterial infection was suspected, Staphylococcus epidermidis was often isolated. Our results suggest close interactions between the mite, sebaceous gland size and function, and subtle variations of immune status. Potential factors influencing Demodex proliferation should be further investigated, including hypothyroidism, pregnancy, corticosteroid administration, Staphylococcus epidermidis, contagiousity, and genetic background.
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Affiliation(s)
| | - Viviane De Maertelaer
- Institut de Recherche Interdisciplinaire en Biologie humaine et moléculaire (IRIBHM), Université libre de Bruxelles (ULB), Brussels, Belgium
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34
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Sonthalia S, Agrawal M, Bhatia J, Zeeshan M, Elsamanoudy S, Tiwary P, Bhat YJ, Jha A, Bosseila M. Entodermoscopy Update: A Contemporary Review on Dermoscopy of Cutaneous Infections and Infestations. Indian Dermatol Online J 2021; 12:220-236. [PMID: 33959518 PMCID: PMC8088165 DOI: 10.4103/idoj.idoj_559_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/16/2020] [Accepted: 12/20/2020] [Indexed: 01/11/2023] Open
Abstract
Infectious cutaneous diseases are very common, especially in certain geographic and tropical regions. Sometimes they may simulate other dermatoses, ordering verification of diagnosis with particular investigations. Dermoscopy is among one of the most important tools readily available in the outpatient setting for the dermatologist to confirm the diagnosis. In this up-to date review, literature concerning the various dermoscopic features of parasitic, viral, dermatophytic and bacterial cutaneous infections is composed. In addition artefacts as well as practical issues in dermoscopy usage are discussed; with the aim to empower dermatologists to promptly and non-invasively diagnose and manage cutaneous infections and infestations.
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Affiliation(s)
| | - Mahima Agrawal
- Department of Dermatology and STD, Lady Hardinge Medical College and ASS Hospitals, New Delhi, India
| | | | - Md Zeeshan
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Solwan Elsamanoudy
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Pankaj Tiwary
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Yasmeen Jabeen Bhat
- Department of Dermatology, Venereology & Leprosy, Government Medical College, Srinagar, J&K, India
| | - Abhijeet Jha
- Department of Skin and V.D., Patna Medical College and Hospital, Patna, Bihar, India
| | - Manal Bosseila
- Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt
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35
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Sener S, Karaman U, Kiran TR, Colak C, Aslan A, Direkel S. Role of Adenosine Deaminase in Patients with Erythematotelangiectatic Rosacea and Demodex folliculorum Positivity. IRANIAN JOURNAL OF PARASITOLOGY 2020; 15:596-601. [PMID: 33884017 PMCID: PMC8039488 DOI: 10.18502/ijpa.v15i4.4870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Adenosine deaminase (ADA) is an aminohydrolase involved in the catabolism of purine nucleotides and irreversibly deaminizes adenosine and deoxyadenosine to inosine and deoxyinosine. ADA enzyme deficiency results in the loss of functional properties of B and T lymphocytes. Demodex species have been reported to be transmitted between humans through close contact and to play a role in the pathogenesis of rosacea, acne vulgaris, perioral dermatitis, seborrhoeic dermatitis, micropapillary-pruritic dermatitis and blepharitis. The present study aimed to compare serum ADA levels in D. folliculorum positive patients with the healthy control individuals. Methods Serum ADA levels were examined for 30 patients diagnosed with erythematotelangiectatic rosacea and 40 healthy individuals in Malatya Inonu University in 2017. Standardized skin surface biopsy (SSSB) method was used to diagnose D. folliculorum. A significant decrease was found in the ADA levels of Demodex-positive rosacea patients when compared to the control group. Results ADA levels were decreased in the Demodex-positive group. The mean ADA level in patient group was significantly lower than the mean in the control group (P<0.001). There was no significant difference between the patient and control groups in terms of age and gender. Conclusion During and after treatment of Demodex-positive rosacea patients, determination of ADA levels may give more detailed information on the immune mechanisms.
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Affiliation(s)
- Serpil Sener
- Department of Dermatology, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ulku Karaman
- Department of Medical Parasitology, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Tugba Raika Kiran
- Faculty of Engineering and Natural Sciences Biomedical Engineering, Iskenderun Technical University, Hatay, Turkey
| | - Cemil Colak
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Ali Aslan
- Department of Physiology, Faculty of Medicine, Ordu University, Ordu, Turkey
| | - Sahin Direkel
- Department of Medical Microbiology, Faculty of Medicine, Giresun University, Giresun, Turkey
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36
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The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea? Dermatol Ther (Heidelb) 2020; 10:1229-1253. [PMID: 33095403 PMCID: PMC7649190 DOI: 10.1007/s13555-020-00458-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Indexed: 12/15/2022] Open
Abstract
Rosacea is a common facial dermatosis but its definition and classification are still unclear, especially in terms of its links with demodicosis. Triggers of rosacea (ultraviolet light, heat, spicy foods, alcohol, stress, microbes) are currently considered to induce a cascading innate and then adaptive immune response that gets out of control. Recent histological and biochemical studies support the concept that this inflammatory response is a continuum, already present from the onset of the disease, even when no clinical signs of inflammation are visible. The Demodex mite is beginning to be accepted as one of the triggers of this inflammatory cascade, and its proliferation as a marker of rosacea; moreover, the papulopustules of rosacea can be effectively treated with topical acaricidal agents. Demodex proliferation appears to be a continuum process in rosacea, and may not be clinically visible at the onset of the disease. Molecular studies suggest that Demodex may induce tolerogenic dendritic cells and collaborate with vascular endothelial growth factor (VEGF) to induce T cell exhaustion and favor its own proliferation. These interactions among VEGF, Demodex, and immunity need to be explored further and the nosology of rosacea adapted accordingly. However, treating early rosacea, with only clinically visible vascular symptoms, with an acaricide may decrease early inflammation, limit potential flare-ups following laser treatment, and prevent the ultimate development of the papulopustules of rosacea. The effectiveness of this approach needs to be confirmed by prospective controlled clinical trials with long-term follow-up. Currently, the evidence suggests that patients with only vascular symptoms of rosacea should be carefully examined for the presence of follicular scales as signs of Demodex overgrowth or pityriasis folliculorum so that these patients, at least, can be treated early with an acaricidal cream.
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Hung KH, Tan HY, Chen HC, Yeh LK. Clinical characteristics and topographic findings of corneal ectasia in patients with symptomatic Demodex blepharitis. Taiwan J Ophthalmol 2020; 11:146-155. [PMID: 34295620 PMCID: PMC8259524 DOI: 10.4103/tjo.tjo_45_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 07/09/2020] [Indexed: 12/04/2022] Open
Abstract
PURPOSE: The purpose of this study is to present characteristics and topographic findings of patients with corneal ectasia and symptomatic ocular demodicosis. MATERIALS AND METHODS: A retrospective, noncomparative study. Twenty-one patients with symptomatic ocular demodicosis and corneal ectasia since 2017 to 2019 were enrolled. Patients with dry eye syndrome and meibomian gland dysfunction were identified and treated. Demographic data, topography, and clinical data were collected. All patients underwent lash sampling to confirm Demodex mite infestation by direct visualization under the microscope. RESULTS: Twenty-one ectasia patients (36 eyes) were enrolled with male preponderance (M:F =18:3). Mean age (years) was 28.6 ± 8.12. Of the 21 cases reviewed, the average number of topography taken was 6.8 within 43.8 months of follow-up. Corneal ectasia was characterized by focal thinning area beside central cornea, with corresponding mean thickness of 487.1 μm and 518 μm, respectively. All ectasia patients were combined with Demodex blepharitis and associated symptoms, proven by direct microscopic examination. After treatment with eyelid cleanser (OCuSOFT® Lid Scrub® PLUS), warm compress, and improved daily hygiene, ocular demodicosis and topographic changes were controlled and even reversed. CONCLUSION: Our results indicated that ocular demodicosis may be potentially associated with corneal ectasia. Demodex blepharitis still remains an overlooked differential diagnosis in clinic; however, it may be one of the risk factors triggering eye rubbing. Comorbidity of lid infestation with eye rubbing may lead to corneal ectasia, even in elder patients with thick cornea. Therefore, meticulous examination and intensive treatment were highly recommended in this group of patients.
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Affiliation(s)
- Kuo-Hsuan Hung
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou.,College of Medicine, Chang-Gung University, Kuei Shan Hsiang, Tao Yuan Hsien, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsin-Yuan Tan
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou.,College of Medicine, Chang-Gung University, Kuei Shan Hsiang, Tao Yuan Hsien, Taiwan
| | - Hung-Chi Chen
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou.,College of Medicine, Chang-Gung University, Kuei Shan Hsiang, Tao Yuan Hsien, Taiwan
| | - Lung-Kun Yeh
- Department of Ophthalmology, Chang-Gung Memorial Hospital, Linkou.,College of Medicine, Chang-Gung University, Kuei Shan Hsiang, Tao Yuan Hsien, Taiwan
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38
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Abstract
Demodex is the most common parasite living on humans and yet little is understood about its pathogenicity with respect to the ocular surface. An increasing interest in Demodex over the past 20-years has increased our understanding of this mite and its pathogenetic role. This article begins with a review of the anatomy, life cycle, mode of transmission and advances in genetics that can distinguish between Demodex folliculorum and Demodex brevis, the only two Demodex species in humans. Additionally, a review of diagnostic procedures and existing and emerging ocular and systemic management options are presented. Despite the increasing interest in Demodex in the literature, there remains numerous obstacles for future studies, hence a section of this review is dedicated to the identification and proposal for future considerations. The lack of uniformity with respect to terminology, diagnostic technique and management approach for Demodex remain as obstacles for future study comparisons. This review summarised the current knowledge on Demodex and hopes to offer some recommendations for future directions in the study of Demodex in humans.
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Affiliation(s)
- Etty Bitton
- École d'optométrie, Université de Montréal, Montreal, Québec, Canada
| | - Sarah Aumond
- École d'optométrie, Université de Montréal, Montreal, Québec, Canada
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39
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Hedberg ML, Chibnall RJ, Compton LA. Symptomatic vulvar demodicosis: A case report and review of the literature. J Cutan Pathol 2020; 47:1063-1066. [PMID: 33448447 DOI: 10.1111/cup.13816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 11/27/2022]
Abstract
Demodex folliculorum is a mite that commonly inhabits the pilosebaceous units of facial skin, particularly in a perioral and periorbital distribution. While typically an incidental and asymptomatic parasite, Demodex spp. are proposed to contribute to the pathogenesis of facial folliculitis, chronic blepharitis and papulopustular rosacea. Reports of demodicosis in anatomic locations other than the face are exceedingly rare. Here we report a 36-year-old woman with symptomatic Demodex spp. infestation of Fordyce spots of the labia minora. She was referred to dermatology after a 9-month history of tender red bumps on the vulva that would arise and drain over a 24 to 72 hours period, several times per week. Physical examination revealed erythema of the labia minora and introitus with a 4 mm, pink, dome-shaped soft papule on the left labium minus. Wet mount, microbiologic cultures and sexually transmitted infection (STI) screenings were unremarkable. Histopathologic examination revealed a well-circumscribed nodule of suppurative granulomatous inflammation arising in a background of mucosa with Fordyce spots, the majority of which were infiltrated by Demodex spp. Treatment with oral ivermectin and topical metronidazole cream resulted in a symptom-free period of 22 months. This case represents an unusual presentation of symptomatic Demodex infestation.
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Affiliation(s)
- Matthew L Hedberg
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Rebecca J Chibnall
- Department of Dermatology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Leigh A Compton
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA.,Department of Dermatology, Washington University School of Medicine, St. Louis, Missouri, USA
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40
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Chin LD, Parvinnejad N, Haber RM. Pityriasis in dermatology: an updated review. Int J Dermatol 2020; 60:141-158. [PMID: 32783190 DOI: 10.1111/ijd.15097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/30/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022]
Abstract
Dermatology has a very distinctive lexicon. The term pityriasis refers to several dermatologic conditions which all feature scaling of the skin. According to the Merriam-Webster dictionary, the term pityriasis was first used in print in 1684. Although the diseases beginning with the name pityriasis are of diverse causation, they do represent important dermatologic diseases, with some common and others quite rare. It is important for dermatologists to be aware and updated on all pityriasis conditions in dermatology.
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Affiliation(s)
- Laura D Chin
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Nikoo Parvinnejad
- Department of Pathology & Laboratory Medicine, University of Calgary, Calgary, AB, Canada
| | - Richard M Haber
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, AB, Canada
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41
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Panzer R, Krebs S. Mites, caterpillars and moths. J Dtsch Dermatol Ges 2020; 18:867-880. [PMID: 32776473 DOI: 10.1111/ddg.14207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/11/2020] [Indexed: 11/29/2022]
Abstract
Besides conditions such as scabies and hypersensitivity to house dust mites, other diseases caused by mites and caterpillars tend to be more uncommon in everyday practice. Nevertheless, there is a broad spectrum of medically relevant disorders associated with these arthropods. Mites may act as parasites that infect or colonize the skin (e.g., scabies, pseudoscabies, demodicosis) or they may pierce the host's skin and feed on tissue fluid and blood (trombiculosis). In the latter case, they also play a role as vectors transmitting Orientia tsutsugamushi, the pathogen that causes Tsutsugamushi fever. In addition to house dust mites, storage mites, too, are characterized by their allergenic potential. The terms erucism and lepidopterism are used for the various diseases caused by caterpillars and moths. Both terms are not used consistently. With respect to pathogenesis, various mechanisms have been described, including type I and type IV hypersensitivity as well as irritant and toxin-induced reactions. In Germany, skin reactions following exposure to the hairs of oak processionary caterpillars are particularly common. Extracutaneous manifestations including nausea, vomiting, hemorrhage, arthropathy or even life-threatening reactions have been reported in association with certain exotic species. Some species act as parasites by feeding on blood or tears. As natural silk can cause immediate and delayed-type hypersensitivity reactions, workers in the silk industry may develop allergic asthma, rhinitis, or conjunctivitis. Consumption of silkworm pupae is associated with the risk of food allergy.
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Affiliation(s)
- Rüdiger Panzer
- Department of Dermatology and Venereology, University Medical Center, Rostock, Germany
| | - Susanne Krebs
- Department of Dermatology and Venereology, University Medical Center, Rostock, Germany
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Panzer R, Krebs S. Milben, Raupen und Falter. J Dtsch Dermatol Ges 2020; 18:867-882. [DOI: 10.1111/ddg.14207_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 06/11/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Rüdiger Panzer
- Klinik und Poliklinik für Dermatologie und Venerologie Universitätsmedizin Rostock
| | - Susanne Krebs
- Klinik und Poliklinik für Dermatologie und Venerologie Universitätsmedizin Rostock
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Zhang AC, Muntz A, Wang MTM, Craig JP, Downie LE. Ocular Demodex: a systematic review of the clinical literature. Ophthalmic Physiol Opt 2020; 40:389-432. [PMID: 32691894 DOI: 10.1111/opo.12691] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE There is increasing clinical and research interest in the potential contribution of Demodex to ocular surface disease. The aim of this systematic review was to summarise and synthesise current clinical evidence relating to the aetiology, diagnosis and treatment of ocular Demodex. RECENT FINDINGS A comprehensive literature search was performed in OVID Medline, OVID Embase, and clinical trial registries, for studies published between 1990 and August 2019, examining Demodex on the ocular surface. The review included primary clinical research studies and systematic reviews of primary clinical research studies, where Demodex was considered in the context of the ocular surface and/or adnexa. Studies were categorised using the National Health and Medical Research Council evidence hierarchy. Risk of bias assessment was performed using validated tools for studies categorised as providing Level I or II evidence. A total of 87 studies were eligible for inclusion, including two systematic reviews. Most studies (60%) were observational, describing the prevalence of ocular Demodex in different clinical populations. There was a high degree of variability in the epidemiological data derived from cross-sectional aetiology studies. There was mostly consistent evidence to support an association between ocular Demodex and chronic blepharitis. Seven diagnostic test-accuracy studies were identified, which considered a range of techniques, including slit lamp examination for cylindrical eyelash collarettes and/or eyelash manipulation techniques, light microscopic evaluation of epilated eyelashes and in vivo confocal microscopy. There is currently no accepted gold-standard diagnostic method for ocular Demodex. For intervention studies, there was one systematic review, 11 published randomised trials, six trial registry entries, and nine case series. Despite a number of recent trials, the appropriate treatment regimen for ocular Demodex (including the optimal criteria and timing of an intervention) is not clearly established. CONCLUSIONS This comprehensive narrative synthesis has captured the landscape of clinical evidence relating to the prevalence, aetiology, diagnosis and treatment of ocular Demodex. There remain opportunities to enhance understanding of its role in ocular surface disease, best diagnostic approaches and optimal treatment protocols.
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Affiliation(s)
- Alexis Ceecee Zhang
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Michael T M Wang
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
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Neema S, Subramaniyan R, Kinra P. Demodex induced facial frictional melanoses. Australas J Dermatol 2020; 61:e490-e492. [PMID: 32686077 DOI: 10.1111/ajd.13378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 05/30/2020] [Indexed: 01/23/2023]
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Palpebral and facial skin infestation by Demodex folliculorum. Cont Lens Anterior Eye 2020; 43:115-122. [DOI: 10.1016/j.clae.2019.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 09/03/2019] [Accepted: 09/04/2019] [Indexed: 10/26/2022]
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Fishman HA, Periman LM, Shah AA. Real-Time Video Microscopy of In Vitro Demodex Death by Intense Pulsed Light. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2020; 38:472-476. [PMID: 31985328 DOI: 10.1089/photob.2019.4737] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective: To directly observe the in vitro real-time effects of intense pulsed light (IPL) on a Demodex mite extracted from an eyelash of a patient with ocular rosacea. Background: Demodex is a risk factor in the pathogenesis of oculofacial rosacea, meibomian gland dysfunction (MGD), and dry eye disease (DED). Recent studies suggested IPL to control or eradicate Demodex organisms in the periocular area. Despite encouraging reports, the direct effect of IPL on Demodex is not well understood. Methods: An eyelash infested with Demodex was epilated from a 62-year-old female patient with oculofacial rosacea. Following isolation and adherence of a mite onto a microscope slide, real-time video microscopy was used to capture live images of the organism before, during, and after administration of IPL pulses. IPL pulses were delivered with the M22 IPL (Lumenis), with IPL settings used for treatment of DED due to MGD (the "Toyos protocol"). A noncontact digital laser infrared thermometer was used to measure the temperature of the slide. Results: Before the IPL pulses, legs of the Demodex mite spontaneously moved in a repetitive and semicircular motion. During administration of IPL, spontaneous movements of the legs continued. Immediately after administration of five IPL pulses, the temperature of the slide increased from room temperature to 49°C. Immediately afterward, the Demodex mite became completely immobilized. The legs appeared retracted, smoother, less corrugated, bulkier, and less well-defined. Movement of the Demodex mite was not observed at the hourly inspections for 5 h and after 24 h following the application of IPL pulses. Conclusions: Our video directly demonstrates the effect of IPL on a live Demodex mite extracted from a freshly epilated eyelash. The results suggest that IPL application with settings identical to those used for treatment of DED due to MGD causes a complete destruction of the organism.
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Yorulmaz A, Yalcin B, Tamer E, Kaya M, Koca B. Dramatic response to metronidazole in a patient with pemphigus foliaceus. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2020. [DOI: 10.4103/ijdd.ijdd_69_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Molho-Pessach V, Meltser A, Kamshov A, Ramot Y, Zlotogorski A. STAT1 gain-of-function and chronic demodicosis. Pediatr Dermatol 2020; 37:153-155. [PMID: 31637766 DOI: 10.1111/pde.14011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Heterozygous STAT1 gain-of-function (GOF) mutations result in a combined form of immunodeficiency which is the most common genetic cause of chronic mucocutaneous candidiasis (CMC). We present a pedigree with a GOF mutation in STAT1, manifesting with chronic demodicosis in the form of a facial papulopustular eruption, blepharitis, and chalazion. So far, demodicosis has been described in only one family with STAT1-GOF mutation. We suggest that chronic demodicosis is an under-recognized feature of the immune dysregulation disorder caused by STAT1 gain-of-function mutations.
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Affiliation(s)
- Vered Molho-Pessach
- Department of Dermatology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,The Center for Genetic Diseases of the Skin and Hair, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Arnon Meltser
- The Center for Genetic Diseases of the Skin and Hair, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Yuval Ramot
- Department of Dermatology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,The Center for Genetic Diseases of the Skin and Hair, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,The Center for Genetic Diseases of the Skin and Hair, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Clanner-Engelshofen BM, French LE, Reinholz M. Methods for extraction and ex-vivo experimentation with the most complex human commensal, Demodex spp. EXPERIMENTAL & APPLIED ACAROLOGY 2020; 80:59-70. [PMID: 31834574 DOI: 10.1007/s10493-019-00450-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
Demodex spp. mites are the most complex organisms of the human skin microbiome and were discovered more than 175 years ago, yet only little basic research is published about them. As they can be pathophysiologically relevant ectoparasites associated with rosacea, pityriasis folliculorum, and other inflammatory skin diseases, more research should be encouraged. Being a large microorganism or a tiny animal, there are no established basic methods to handle these mites. Here, we describe techniques enabling the extraction of Demodex mites from human skin, their analysis in different ex-vivo settings, the lysis of their exoskeleton, their preservation by freezing, and observation microscopically using specific fluorescent dyes or their inherent autofluorescence. These procedures should facilitate future Demodex research and fuel further the generation of knowledge. Furthermore it is intended to ultimatively enable the mite's cultivation in vitro and reveal its pathophysiological mechanisms.
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Affiliation(s)
- Benjamin M Clanner-Engelshofen
- Department of Dermatology and Allergy, University Hospital, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital, Ludwig-Maximilian-University Munich, Frauenlobstr. 9-11, 80337, Munich, Germany.
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