Upper Eyelid Nodule - An Unusual Presentation of Ocular Demodicosis

Introduction: Demodex mite is an external parasite which is implicated in various ocular conditions like anterior blepharitis, posterior blepharitis, meibomian gland dysfunction, chalazia and others. Although demodex has been shown to be a causative agent of chalazia, occurrence of a solitary inflammatory nodule due to demodex infestation has not been reported in literature. Case: Our case describes the occurrence of an upper eyelid mass in a 62-year-old female which was found to have an associated demodex infestation. Conclusion: This is the first report of demodex infestation presenting as a nodular eyelid mass. This parasite needs to be considered in the differential diagnosis of eyelid masses as this condition requires specific management.

First case of Phthirus pubis and Demodex co-infestation of the eyelids: a case report

Background Phthirus pubis is an obligate parasite of human beings. Demodex spp. is a much more common parasite of human beings. However, P. pubis infestation accompanied by Demodex mite infestation in eye has not been reported. Case presentation We report the first case of Phthirus pubis and Demodex co-infestation on a 48-years-old woman. She presented to the hospital with itching and burning at her right eye for 2 weeks. Slit lamp examination revealed multiple nits and adults of P. pubis anchored to both upper and lower eyelashes. Eyelashes were trimmed, moxifloxacin eye ointment and fluorometholone eye drops were initiated daily. However, itching didn’t improve after 2 weeks of treatment. Light microscopy examination of eyelashes revealed infestation with Demodex. The patient was treated with lid scrubs with 25% tea tree oil daily for 4 weeks and was completely cured. Conclusion Our report shows the importance of an early and comprehensive diagnosis, because both phthiriasis palpebrarum and demodicosis can be confused with blepharitis.

Case of Angular Blepharitis Caused by Demodex folliculorum

Angular blepharitis is inflammation of the eyelid skin at the lateral canthus, most commonly caused by Staphylococcus and Moraxella species. The Demodex mite is an external parasite that often infests the human eyelid margin and has been implicated in both anterior and posterior blepharitis. The authors describe the case of a 43-year-old female who presented for evaluation of a 3-month history of bilateral canthal eyelid irritation, consistent with angular blepharitis. This is a case report and review of relevant literature. Skin biopsy showed evidence of Demodex folliculorum infestation. Multiple D. folliculorum organisms were visualized within the hair follicles and on the surface, along with pockets of acute and chronic nongranulomatous inflammation surrounding hair follicles. The patient was treated with tea tree oil applied to her eyelids and eyelashes twice daily with complete resolution of symptoms. To our knowledge, this is the first report of angular blepharitis with histopathologic confirmation of Demodex infestation. In this discussion, we cover manifestations of the Demodex mite, angular blepharitis, and treatment options. Due to the lack of literature regarding this entity, we feel that it may be an underrecognized periocular and dermatologic condition that can lead to misdiagnosis, visits to multiple practitioners, and significant functional and cosmetic sequelae to the patient. Demodex infestation should be considered on the differential diagnosis for cases of refractory angular blepharitis, particularly when unresponsive to topical steroids. Based on results from treating Demodex anterior and posterior blepharitis and this case, treatment with tea tree oil should be considered.

Increased Demodex Density in Patients Hospitalized for Worsening Heart Failure

Infection is an important factor leading to the exacerbation of heart failure (HF), resulting in hospitalization. Demodex species are obligatory parasites in human skin, and increased density was reported in immunocompromised patients. In this study, we aimed to investigate the Demodex density in hospitalized HF patients compared to that of healthy controls. Methods: This study included 36 HF patients and 36 age and sex-matched healthy controls. Five standardized biopsies were taken from the face of participants and assessed for Demodex by a light microscope. Results: At least one Demodex mite was detected in 20 HF patients and nine of the control group. The number of Demodex mites was significantly higher in the HF group (median 1; min. 0 and max. 10) compared to the control group (median 0; minimum. 0 and maximum. 3). Demodicidosis was positive in 14 of the HF patients. Demodicidosis was not detected in the control group. Conclusions: This study showed that Demodex positivity is more common in HF patients hospitalized for HF exacerbation. Demodicidosis should be considered in hospitalized HF patients.