What's eating you? Oak leaf itch mite (Pyemotes herfsi).
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The role of Demodex folliculorum in perioral dermatitis is not satisfactory explained. Our purpose was to assess the density of D. folliculorum in perioral dermatitis and evaluate the relationship of the mite count to previous therapy with topical steroids. A standardized skin surface biopsy of the chin was performed in 82 female patients with perioral dermatitis and in 70 control female subjects. Patients who received previous topical steroid therapy had a significantly higher mite density than the patients who had received no topical steroids (p<0.001). In the latter group of patients, the mite density did not differ significantly from that of the control group (p=0.629). Mite density increased significantly with the length of treatment with topical steroids (p<0.001). Our results suggest that increased density of D. folliculorum in perioral dermatitis is a secondary phenomenon, associated with topical steroid therapy.
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Lice and mites are highly contagious obligate parasites of humans and are spread by close, direct contact. Head, body, and pubic lice produce severely pruritic eruptions in their respective locations. Diagnosis is readily made by finding lice or nits on hair shafts, except in the case of body lice, which are found on the seams of clothing. Scabies often presents as a more generalized pruritic rash. Diagnosis is confirmed by finding the mite in a characteristic skin burrow. Crusted (Norwegian) scabies, a rare variant consisting of infestation by thousands of mites, occurs in patients with neurologic or immunodeficiency disorders. Secondary bacterial infections and eczematous changes may complicate both pediculosis and scabies. Infestations are easily treated with use of an appropriate pediculicide or scabicide and environmental-control measures.
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A hypertensive elderly male on amlodipine presented with a palpable purpuric rash on both legs followed by shoulder, buttocks, and back with foot ulcer, which was found to be leukocytoclastic vasculitis on skin biopsy. The patient recovered completely on discontinuation of amlodipine and short-term steroid.
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In 16 out of 18 patients with rosacea, mites of the species, Demodex folliculorum were isolated in mostly great numbers from lesions of the facial skin. In patients with perioral dermatitis, the mite was demonstrated in 17 out of 29 patients. All patients, however, including those where no mites were found, could be completely cured by nightly application of hexachlorocyclohexane 0.25% (Jacutin). The average treatment time was 7 weeks for rosacea and 5 weeks for perioral dermatitis. 2 patients with rosacea and 4 patients with perioral dermatitis relapsed, but cleared again after treatment was repeated. The initial flare-up of the dermatitis, which is observed regularly after starting the Jacutin-therapy, is described. Quantitative aspects of Demodex infestation and its histopathological alterations are discussed in relation to present-day knowledge.
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Scabies is caused by infestation with a parasitic mite Sarcoptes scabiei var hominis. The itch and rash appear to be largely the result of a delayed (type IV) allergic reaction to the mite, its eggs and excreta. Scabies is spread by a mite transferring to the skin surface of an unaffected person, usually by skin to skin contact with an infested person, but occasionally via contaminated bed linen, clothes or towels. In crusted scabies, mites are also dispersed within shed scales, enabling the condition to be contracted from contaminated surfaces. Patients with classical scabies usually present with an itchy non-specific rash. Often, the history alone can be 0032-6518 virtually diagnostic. An intense itch, affecting all body regions except the head, typically worse at night, appearing to be out of proportion to the physical evidence, with a close contact also itching, should prompt serious consideration of scabies. The generalised hypersensitivity rash consists of erythematous macules and papules with excoriation. Close inspection will reveal burrows usually up to 1 cm in length. The pathognomic sign of scabies is the presence of burrows. The crusted variant of scabies may not be itchy. It is characterised by areas of dry, scaly, hyperkeratotic and crusted skin, particularly on the extremities. Referral to secondary care should be considered in the following cases: diagnostic doubt; patient under two months of age; lack of response to two ourses of different insecticides; crusted scabies; or history suggests a isk of sexually transmitted infection. Outbreaks of scabies in institutions should be referred to the local health protection services.
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Sarcoptes scabiei
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We have analyzed the clinical, analytical, radiologic, therapeutic an evolutive of cases of systemic mastocytosis (SM) skin lesions. The diagnostic of MS is difficult in the absence of skin lesions.
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