Prospective Study of the Diagnostic Accuracy of the In Vivo Laser Scanning Confocal Microscopy for Ocular Demodicosis
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Demodicosis
Eosinophilic pustular folliculitis (EPF) is classified into Ofuji disease, immunosuppression-associated EPF, and infancy-associated EPF. The association of EPF with Demodex infestation is rarely reported. We report five cases of EPF with Demodex overgrowth. All patients were young females presenting with recurrent, itchy papulopustules on the face for 2 months to 2 years. Laboratory tests revealed eosinophilia ( n = 2) and iron deficiency anemia ( n = 1). Skin biopsy of papulopustular lesions was performed in each patient, and all revealed folliculocentric infiltration with eosinophils. Infundibular pustules containing Demodex mites were found in two patients. All patients had high Demodex densities examined by superficial needle-scraping method (7–18 mites/5 pustules) and/or thumbnail-squeezing method (37–255 mites/cm 2 ). Based on the clinical and laboratory findings, the patients were either first treated as having demodicosis or as having EPF. According to the treatment responses, the cases might represent Demodex -induced EPF or EPF-like reaction (Cases 1–3) or demodicosis superimposed on EPF (Cases 4 and 5). In sum, we report five cases of EPF with Demodex overgrowth (demodicosis). These cases illustrate that the possibility of Demodex overgrowth should be considered in cases of EPF with incomplete treatment response to indomethacin and/or oral corticosteroids. Conversely, EPF should be considered in cases of demodicosis with incomplete responses to antiparasitic treatment.
Demodicosis
Folliculitis
Demodex folliculorum
Papulopustular
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Demodicosis is the term given for cutaneous diseases caused by the human ectoparasitic mites Demodex folliculorum and Demodex brevis which are common commensals of the pilosebaceous units in human beings. We report a 72-year-old female who presented with erythematous papulopustular lesions over both upper and lower eyelids and a few similar lesions on the cheeks of 2 weeks duration with one similar episode in the past. A cyanoacrylate standardized skin surface biopsy showed increased mite density and the patient was successfully treated with acaricides. Demodicosis is often misdiagnosed as contact dermatitis, papulopustular rosacea, or seborrheic dermatitis. A high index of suspicion of demodicosis is needed to arrive at an accurate diagnosis.
Demodicosis
Papulopustular
Demodex folliculorum
Seborrheic Dermatitis
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Rosacea is a common chronic inflammatory disorder affecting the facial skin.Dermoscopy is a noninvasive procedure that is commonly used for the diagnosis of dermatological diseases. This article aims to determine the clinical and dermoscopic manifestations of the rosacea patients and the presence of the accompanying Demodex.The study evaluated 23 patients who were diagnosed with rosacea through clinical and dermoscopic findings. The patients were clinically and dermoscopically photographed and were classified according to the rosacea classification. The presence of Demodex was demonstrated both dermoscopically and through biopsy.There were a total of 23 participants (17 females and 6 males). The ages of the participants ranged between 28 and 75, with an average of 49. Among the 23 participants, 14 were erythematotelangiectatic, 7 were papulopustular, and 2 were rhinophyma. A total of 12 participants (4 males and 8 females) had ocular involvement. The most common dermoscopic finding was a linear vascular structure. A total of 15 patients (11 females and 4 males) had the demodicosis finding.The diagnosis of rosacea and demodicosis through dermoscopic findings is as reliable as a biopsy and it has the advantage of being noninvasive.
Demodicosis
Rhinophyma
Papulopustular
Demodex folliculorum
Dermatoscopy
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Demodicosis
Demodex folliculorum
Pyoderma
Amitraz
Erythema
Blepharitis
Folliculitis
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Abstract Background Rosacea is an inflammatory disease with 50% of ocular involvement rate. Primary demodicosis is an eruption caused by Demodex mites, and there is no data about the rate of ocular involvement in primary demodicosis. Aims In this cross‐sectional study, it is aimed to reveal the frequency of Demodex blepharitis in rosacea and primary demodicosis patients. Methods In total, 58 rosacea, 33 primary demodicosis patients, and 31 healthy volunteers were included in the study. Four samples were obtained from eyelashes with a forceps and from facial skin by standardized skin surface biopsy. A positive result is described as detecting at least one Demodex mite on an eyelash or at five mites in the face. The patients were also examined by an ophthalmologist in terms of ocular involvement. Results Both rosacea and primary demodicosis patients had significantly more complaints like burning and stinging in the eyes compared to the control patients ( P = .001). Primary demodicosis and papulopustular rosacea patients had the highest numbers of eyelash mites, respectively, and significantly a higher rate of blepharitis than the control group. Conclusion As a result, the Demodex count was significantly higher in the primary demodicosis and rosacea patients than the control group. We think that every Demodex‐positive patients should be evaluated for also eyelash mites to prevent a possible chronic blepharitis.
Demodicosis
Blepharitis
Eyelash
Demodex folliculorum
Papulopustular
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Demodicosis is the term applied to cutaneous diseases caused by Demodex folliculorum and Demodex brevis. Demodex mites are acquired shortly after birth. They are saprophytic ectoparasites that are found primarily in areas rich in sebaceous glands, like face, scalp, neck. While human demodicosis is a skin disease sui generis, it can mimic many other inflammatory dermatoses. Therefore demodicosis are commonly underdiagnosed, and are masked behind other diagnoses such as papulopustular rosacea, erythemato telangiectasic rosacea, seborrheic dermatitis, perioral dermatitis, contact dermatitis, atopic dermatitis, phyma, seborrhea, etc. Human demodicosis is classified into a primary and secondary form by Chen and Plewig. Absence of pre-existing or concurrent inflammatory dermatosis (acne, rosacea or perioral dermatitis), abnormal increase in mite colonization in active lesions, and remission of the lesions following adequate treatment with topical or systemic acaricides/arachnicides, but not with antibiotics with antiinflammatory effects are diagnostic criteria of primary demodicosis. Secondary demodicosis is defined to skin lesions associated with an abnormal increase of Demodex mites in patients with other known skin or systemic diseases. Clinically, demodicosis has a wide range of variants and may manifest as folliculitis (Pityriasis folliculorum), papulopustular erythema (Rosacea-like demodicosis), blepharoconjunctivitis (demodectic blepharitis), and granulomatous rosacea-like demodicosis (Demodicosis gravis) The pathogenesis of human demodicosis remains largely obscure Here, we discuss the clinical manifestations, pathogenesis of demodicosis, and treatment strategies.
Demodicosis
Demodex folliculorum
Papulopustular
Seborrheic Dermatitis
Blepharitis
Folliculitis
Amitraz
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Demodicosis is a chronic inflammatory skin disease caused by Demodex mites. Abnormal proliferation and density of Demodex mites are essential factors for the occurrence of skin disorders.1 There are many clinical manifestations of demodicosis, such as pityriasis folliculorum type, rosacea-like type, perioral dermatitis–like type, and folliculitis or acne-like type.2 Diagnostic criteria for demodicosis should be based on a suspected skin lesion, confirmed by the abnormal density of Demodex mites and clinical improvement after acaricidal treatment.
Demodicosis
Demodex folliculorum
Folliculitis
Seborrheic Dermatitis
Amitraz
Isotretinoin
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Demodicosis
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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.
Demodicosis
Blepharitis
Meibomian gland
Demodex folliculorum
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Demodicosis caused by infestation with Demodex folliculorum hominis is a parasitic acariasis disease which may affect nasal skin. Acne rosacea with demodicosis must be distinguished from nasal furunculi which require antiinflammatory, hyposensitizing treatment. If the latter fails, it is acna rosacea with demodicosis that must be suspected. The diagnosis is made by investigation of nasal skin scrapings. If the mites are found, the patient should be referred to dermatologist for specific treatment.
Demodicosis
Demodex folliculorum
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