PREVALENCE OF DEMODEX ECTOPARASITES AMONG HUMANS IN ORDU PROVINCE IN TURKEY

Demodex folliculorum and Demodex brevis are common ectoparasites in humans. Demodex parasite infestations have not been determined in the province of Ordu. We determined the prevalence of Demodex species among humans in Ordu Provience, Turkey. Seven hundred ninety-nine subjects (438 males and 361 females) aged ≥ 18 years living in the central districts of Ordu Province, Turkey, were selected using the World Health Organization cluster sampling method. A superficial skin biopsy of the face was obtained from each subject. Six hundred sixty-nine subjects (83.7%) had a Demodex parasite. Factors significantly associated with the presence of Demodex infestation were: female gender, employment in the private sector, people who only occasionally wash their face and district of residence. Since Demodex ectoparasites were common in Ordu Province, it is suggested that the diagnosis and treatment of this ectoparasite should be carried out in the hospitals of this region.

[The first case of Hypoderma tarandi-associated human myiasis in Greenland]

We present the first case of human myiasis in Greenland caused by the warble fly Hypoderma tarandi. Noticing a persisting, migrating, stinging facial sensation, a female patient eventually extirpated a larva from her upper eyelid, and the larva was confirmed to species level using DNA-based methods. A high prevalence of H. tarandi in reindeer, the main reservoir host, and increasing populations of musk ox may imply an increased risk of zoonotic transmission. Although diagnosis is challenging, rapid intervention is crucial to reduce the risk of ophthalmomyiasis.

[PCR-based genotype classification of Blastocystis hominis isolates from college students of Guangxi]

Fifty-three Blastocystis hominis isolates were separated from the fecal specimens of carriers in college students from Guangxi and cultivated in vitro, and the genetic DNA was extracted. All the isolates were genotyped by PCR using seven pairs of known sequence-tagged site (STS) primers. The results showed there were five subtypes in the 53 isolates. Subtype 3 was the most popular one (32.1%, 17/53), followed by subtype 7 (9.4%, 5/53). Subtypes 1 (7.6%, 4/53), 4 (7.6%, 4/53), and 6 (1.9%, 1/53) were detected, while subtypes 2 and 5 were not detected. The genotypes of the other 22 isolates were unknown which were negative to all the STS primers.

Influence of temperature and medium on viability of Demodex folliculorum and Demodex brevis (Acari: Demodicidae)

Demodex folliculorum and D. brevis are cosmopolitan, obligatory parasites. Epidemiological studies have established a clear association between these species and various facial diseases in humans. However, not much is known of the ecology of these mites, also because it has proven difficult to culture them. Here we report a laboratory study on the (combined) effects of temperature and culture medium on the viability of both species. Results showed significant differences in the survival time of D. folliculorum and D. brevis among different temperatures and media. Pair-wise comparisons revealed that both species survived longest in serum medium, at a temperature of 16-22 °C. Therefore, we conclude that these conditions allow preservation and maintenance of both Demodex mites.

[Cervico-facial hydatidosis. Report of 17 cases]

BACKGROUND

Cervico-facial hydatid cyst is rare. It accounts for 1 % of echinococcosis locations.

AIM

To describe the epidemiological, clinical and therapeutic aspects of cervico-facial hydatid cysts based on our clinical experience and data in the literature.

METHODS

A retrospective study was made concerning 17 patients with cervico-facial hydatid cyst treated surgically over a 25-year period from 1982 to 2006.

RESULTS

Mean patient age was 27 years (range 2-79). Hydatid cyst localization was: cervical muscle (7 cases), thyroid gland (5 cases), parotid gland (2 cases), cervico-thoracic (1 case), larynx (1 case) and cheek (1 case). Hydatic origin of the cyst was suspected for 6 patients (35.3 %) preoperatively. Surgical treatment was used in all cases and adapted to each case. Diagnosis was always confirmed by macroscopic aspects and pathology.

CONCLUSION

Hydatid cysts are rarely found in the cervico-facial region, even in highly endemic zone. The manifestation of symptoms depends on the location and the size of the cyst. Positive diagnosis can be difficult during preoperative period. Exclusively surgical treatment is indicated, ideally for total pericystic resection without rupture.

Cytologic detection of Demodex folliculorum in cases with persisting skin disorders

OBJECTIVE

To examine sebum from the face ofpatients with persisting skin disorders to investigate the cause of pathologic changes.

STUDY DESIGN

This study included 39 skin scrapings containing sebum obtained from the face of patients who presented with persisting skin disorders. Samples were taken from forehead, chin, cheeks, nose and lesions of facial skin. They were mixed with a drop of oil to dissolve the sebum and were covered with a cover glass. The specimens were labeled according to the part of the face from which were taken. Then the glass slides were placed immediately under the microscope and the obtained material was carefully examined using 20-40x magnification.

RESULTS

Demodex mites were detected in 23 patients. Their skin scrapings revealed degenerated and dead cells, fat and slowly moving, tiny demodex mites. The chin, nose and the forehead were the preferred facial areas. A large number of mites were seen in skin scrapings from 5 patients aged 65-82 years.

CONCLUSION

Infestation of demodex mites on the skin, combined with a weakened immune system, can cause various therapy-resistant skin disorders. Demodecosis should be taken into consideration, and its investigation is quite simple, although it remains a therapeutic challenge.

[Investigation of Demodex sp. using cellophane tape method among university students]

Demodex sp. is an obligatory ectoparasite of pilosebaceous units in humans. This study was carried out in order to investigate the frequency of Demodex sp. among high school students. For this purpose 75 women and 96 men, making a total of 171 students, were studied. Cellophane-tape preparations taken from their face, especially at the base of the nose, underside of the jaw and the side of the forehead, were examined microscopically. Demodex sp. was found to be positive in five (2.9%) cases.

Role of ivermectin in the treatment of severe orbital myiasis due to Cochliomyia hominivorax

We describe 2 patients with severe orbital myiasis due to Cochliomyia hominivorax (of the order Diptera and the family Calliphoridae) who had underlying skin carcinomas and were treated with oral ivermectin and debridement. We suggest that ivermectin plays an important role in the treatment of severe cases of myiasis.

Cutaneous lupoid leishmaniasis: a case report

Cutaneous leishmaniasis is a disease transmitted by the sandfly. During the course of the disease, all classical stages of the development of leishmaniasis from small erythematous papules to nodules to ulcerative lesions can be seen. We report a case of lupoid leishmaniasis (LL) treated with daily intramuscular injections of meglumine antimoniate for 20 days with marked improvement of clinical features.

Prevalence of Demodex in Health Personnel Working in the Autopsy Room

The health personnel working in the autopsy rooms and laboratories are considered among the professional groups carrying a high risk of contamination with infection. In this study, we have investigated the prevalence of Demodex, which provides a convenient environment for bacteria and acts as a vector for certain microorganisms, in the health personnel working in autopsy rooms. The study, which was cross-sectional, was conducted on 58 health personnel working in autopsy rooms. A questionnaire was administered to the individuals. Specimens were obtained from 4 different regions of the face using the standard skin-surface biopsy technique. The data obtained were then evaluated statistically. This study group consisted of 76% males and 24% females. The prevalence of Demodex was 26%. Demodex was found to occur more frequently in women. The most frequent occurrence of Demodex was seen among people with darker complexion and in cheek localizations. We believe that Demodex, which has a role in the pathogenesis of dermatologic diseases, provides a convenient environment for bacteria, and acts as a vector for some pathogenic microorganisms, poses a risk as far as individuals working in the autopsy room are concerned.

A woman and her son with abnormal complicated anthrponotic cutaneous leishmaniasis

Anthroponotic cutaneous leishmaniasis (ACL.) is known to cause single, self-healing and uncomplicated lesion mainly on the face. This paper presents a son and his mother with positive leishmaniasis IHAT (1/128 and 1/1924 respectively). The two isolates by enzymatic electrophoresis characterization proved to be Leishmania tropica that causes ACL. The son had two large ulcerative ACL on his left hand. The mother had a large ulceration and progressive erosion of the soft tissue (the right cheek and right eye) and the cartilage of the nose disfiguring and debilitating her face. The histpathological examination of the biopsy material obtained from the mother but not the material from her son, showed typical pathological picture of the basal cell carcinoma. No doubt, there are progressive changes in the pathogenesis of L. tropica and that it is one of the predisposing factor of the skin cell carcinoma.

[Unilateral occurrence of blowfly maggots in the face of a decomposing body]

The corpse of a 41-year-old medical doctor was found in his bed. The body was partially dried out; parts of the hip region were skeletonized due to maggot activity. In the facial region of the corpse, blowfly maggots (Lucilia (Phaenicia) sericata [Meigen]) were found exclusively in one eye socket. This is an unusual occurrence since on that side, a bedlight (40 W light bulb) had been burning during the seven week post mortem interval. All other lights in the apartment were switched off, and no direct sunlight could enter the space where the body was found (only a TV set had been running all the time, ca. 2 m away from the head at the foot end of the bed). Obviously, the maggots who usually flee light had used up the one eye that was further away from the bedlight as a feeding source. Since the continuing mummification of the corpse led to a substantial restriction of feeding material, the maggots finally switched to the eye that the light was shining on.

Factors affecting the frequency of ear canal and face infestation by Otodectes cynotis in the cat

Otodectes cynotis is responsible for at least 50% of canker cases diagnosed in cats world-wide. The role of Demodex cati in the pathogenesis of otitis and acne is still obscure. The aims of this study were to estimate the prevalence of O. cynoyis and D. cati infestations in clinically normal cats in northern Greece, to determine the factors that are associated with the probability and severity of infestation in the cat, and to examine the importance of these mites in the pathogenesis of feline acne. Samples from 161 cats were examined by flushing the ear canals and by taking skin scrapings of the chin and lip area. The results were combined with various factors (sex, age, living style, hair coat type and presence of pruritus, of ear discharge, of acne-like lesions) in order to carry out a risk analysis. Two separate logistic regression analyses were performed. One, on the infestation/non-infestation potential with O. cynotis and the other, on the degree of such infestation as mild-to-moderate (< or =5 mites/field) or severe (>5 mites/field). D. cati was not detected in any of the 161 cats. The prevalence of O. cynotis was estimated at 25.5% (95% confidence interval (CI) 19-32). The rate of mite infestation was higher with the presence of ear discharge (odds ratio 9, 95% CI 3.3-24.5), periaural pruritus (odds ratio 3.6, 95% CI 1.8-8) and acne-like lesions (odds ratio 3.3, 95% CI 1.2-9). Cats with mild-to-moderate degree of infestation had 18 times higher chance of exhibiting an ear discharge than those with a severe infestation. The log-odds of mild-to-moderate parasitism were linearly related to the age.

Migratory facial swelling due to gnathostomiasis

Two cases of facial gnathostomiasis in female Thai patients are described. Gnathostomiasis is caused by a roundworm, Gnathostoma spinigerum. In both patients the disease was characterised by intermittent and migratory swelling of the face. At present no effective therapy is available. Surgical removal of the parasite would be a curative treatment; it is however, rarely successful due to the parasite moving relatively rapidly within the soft tissues. The disease can be prevented by avoiding undercooked meat including fish. In endemic areas such as Southeast Asia, gnathostomiasis must be considered in cases of oro-facial swelling of otherwise unknown cause.

Effects of route of inoculation on the site of development of Caryospora bigenetica (Apicomplexa: Eimeriidae)

The sites of infection by Caryospora bigenetica in Swiss-Webster mice (Mus musculus) were demonstrated after 7 routes of inoculation: oral, intraperitoneal, intravenous, intramuscular, subcutaneous, dermal, and intraocular. All mice exhibited clinical signs of dermal coccidiosis 9 days after inoculation regardless of the inoculation route. Signs included swelling of the facial tissue, footpads, and scrota (male mice). Developmental stages of the parasite were found in the muzzle, tongue, footpad, lumbar subcutaneous tissue, biceps femoris muscle, conjunctiva, and eye; the latter 3 sites represent new sites of development. The site of development of the parasite in the host tissue was independent of experimental inoculation route.

Elaeophorosis in white-tailed deer: pathology of the natural disease and its relation to oral food impactions

The lesions of naturally occurring elaeophorosis in white-tailed deer (Odocoileus virginianus) were studied. Arterial changes caused by adult Elaeophora schneideri occurred mainly in cephalic arteries and were characterized by circumferential intimal thickening, disruption of the internal elastic lamina, and verminous thrombosis. Microfilariae caused focal necrosis and fibrosis in the myocardium, but produced only minor changes in other tissues. Radiographic studies indicated that E. schneideri can cause impairment of the cephalic arterial circulation in white-tailed deer. Eleven of 14 (78%) infected deer had oral food impactions, with sublingual impactions being most common. Seven deer with impactions had other oral pathologic conditions, such as gingivitis, loose or absent premolar and/or molar teeth, and remodeling and/or lysis of mandibular bone. The evidence indicates a relation between food impactions and infection by E. schneideri in white-tailed deer, but no definitive connection was established.