A Survey of Human Face Mites Demodex (Acari, Demodicidae) in Patients with Dermatological Symptoms in Baghdad, Iraq

Demodex spp. mites are external obligate parasites; they are transmitted between hosts through direct contact, and may induce several dermatological symptoms when found in large numbers. However, these symptoms may be similar to other commonly known diseases; this often leads dermatologists to neglect the pathogenic role of these mites. Therefore, a better diagnosis is recommended in order to avoid mistreatment. The aim of this study was to investigate the correlation between Demodex mites and dermatological diseases. Infestation rates in patients suffering from acne, rosacea, folliculitis, and psoriasis were compared with asymptomatic patients, along with the mites’ relation to gender, age, personal hygiene, time of year, and residency. These mites were mainly found in patients with rosacea (66.67%) followed by acne (64.41%), while they were only observed in 48.15% of asymptomatic patients, 40.00% in folliculitis, and 0.00% in psoriasis. The statistical analysis showed a significant relationship between infestation and the previously mentioned dermatological diseases (P<0.01). The infestation rates increased significantly with age, reaching 83.33% in patients above 60 years old, and especially during cold months with higher humidity rates. These mites were also more predominantly found in urban areas (56.10%), followed by rural areas (48.45%). However, there was no significant relationship according to gender or personal hygiene.

Feline Demodicosis Case Report—First Molecular Characterization of Demodex Mites in Romania

Cat demodicosis is uncommon to rare, and is caused by Demodex cati, Demodex gatoi and another unnamed species. The investigated patient was a mix-breed, 10-year-old feline with no dermatological history. Alopecia, erythema, minor erosions and ulcerations and crusts, associated with pruritus and self-trauma, were observed on the head. Dark, agglutinated cerumen was also present in the external ear canal. The agent causing the skin condition in the feline patient was identified as being a Demodex genus mite, based on the specific, morphological characteristics noticed upon the microscopic examination of deep skin scrapes. Biological samples were collected from the patient with to perform a PCR assay for clear species-determination and morphological assessment. PCR amplification of DNA extracted from the Demodex mites produced a single band of ~330 bp, indicating the presence of the D. cati species. The acaricidal treatment consisted of topical treatment using a fluralaner and moxidectin-based spot-on. Upon follow-up appointments, scheduled three times at a monthly interval, the patient failed to provide a positive result upon deep skin scrapes. The negative scrapes were also accompanied by the complete resolution of the existing lesions. In conclusion, this is the first molecular study to highlight the presence of Demodex cati within the feline population of Romania, and the fluralaner-moxidectin spot-on therapy has led to a complete recovery of the feline patient affected by feline demodicosis.

Occurrence of Demodex infestation in chronic blepharitis in a tertiary care hospital in North-East India

Background: Chronic blepharitis is frequently encountered by ophthalmologists. Demodex mites (Demodex folliculorum and Demodex brevis) can play a role in its pathogenesis, especially in treatment-resistant cases. Demodex infestation often remains underdiagnosed and undertreated. Definitive diagnosis can be made with lash-sampling. Objective of the study was to find the association between Demodex infestation and chronic blepharitis.Methods: The study included 80 patients diagnosed with chronic blepharitis and 80 controls without blepharitis. Four eyelashes were epilated from each lower and upper lids of the right and left eye (a total of sixteen samples) of each participant. Eyelash samples were examined under a light microscope and Demodex species were identified and counted.Results: Demodex mites were detected in 45 cases (56.25%) and 14 controls (17.5%). Significant association was found between demodex infestation and blepharitis as odd’s ratio was found to be 6.0612 and p value <0.0001. D. folliculorum was detected in 42 cases, D. brevis in 2 cases while in one case, both were detected. The mean age for Demodex positive cases and controls were 49.78±13.25 and 64±7.86 years, respectively. Amongst the cases, Demodex was detected in 57.69% males (30 out of 52) and 53.55% females (15 out of 28).Conclusions: There is significant co-relation between Demodex infestation and chronic blepharitis. Demodex infestation should be part of the differential diagnosis of chronic blepharitis.

Survey of Human Face Mites Demodex Owen, 1843 (Acari, Demodicidae) in Patients with Blepharitis and Chalazia in Iraq

Demodex species are external parasites; they are transmitted via direct contact, and when present in elevated numbers it may induce several ocular diseases. However, the symptoms are very similar to other diseases; hence, its’ role is often neglected. Therefore, an accurate diagnosis is important in order to avoid mistreatment. In this study, infestation rates in both blepharitis and chalazia were compared to an asymptomatic group, with relation to gender, age, personal hygiene, time of year, and residency. All specimens were examined immediately after collection. The aim of this study was to investigate the relationship between Demodex mites and ocular diseases. These mites were predominantly found in patients with chalazia (62.50%) followed by blepharitis (58.91%), while they were only observed in (22.64%) of asymptomatic patients, statistical analysis showed a significant relationship between infestation and both ocular diseases (P<0.01). The infestation rates increased significantly with age reaching (100%) in patients above 70 years old, and especially during cold months with high humidity. These mites were also found in rural areas (57.59%), followed by urban areas (44.09%) and a significant relationship was found between residency and infestation rate (P≤0.05). However, no significant relationship was found according to gender nor personal hygiene.

Scale and Pustule on Dermoscopy of Rosacea: A Diagnostic Clue for Demodex Species

Background: Demodex mites are highly found in the skin of patients with rosacea.The diagnosis of Demodex can be made by standardized skin surface biopsy. Dermoscopy is a tool used in the noninvasive diagnosis of various dermatological diseases. Objectives: To determine whether dermoscopic features of demodicosis are associated with the result of standardized skin surface biopsy in patients with rosacea and to compare dermoscopic features of rosacea in Demodex-positive and negative samples and Demodex type. Methods: A total of 30 patients (7 male, 23 female) were included in the study. Dermoscopic examination was performed on both the clinically most severely affected areas and adjacent healthy skin. The skin surface biopsy sample was taken from the same place from where the dermoscopic image was taken. Results: A total of 83 (lesion n = 60, non-lesion n = 23) areas were evaluated. Demodex was detected in 60.2% (n = 50) of the samples. Half of these samples revealed only Demodex folliculorum, and the remaining half revealed D folliculorum and Demodex brevis. Of theDemodex-positive samples, 88% had Demodex tails (P =0.001) and68% Demodex follicular openings (P = 0.002) on dermoscopy. In D folliculorum+D brevis-positive samples, the rate of scale and pustule was higher than D folliculorum-positive samples (P = 0.017 and P = 0032,respectively). Conclusions: The sensitivity and specificity of Demodex tail are higher than Demodex follicular opening and scale and pustule detection with dermoscopy and may indicate the coexistence of both D folliculorum and D brevis.

Demodicosis in humans as a current problem in dermatology and ophthalmology

Introduction. Human Demodex mites (Demodex folliculorum and Demodex brevis) are ectoparasites living inside the sebaceous glands and hair follicles. In most people, their presence is of no consequence. However, several conditions or various external factors might contribute to pathological Demodex infestation resulting in demodicosis. Many different cutaneous diseases can resemble demodicosis leading to misdiagnosis.Aim. This paper aims to present information about demodicosis and provides a clear clinical portrait of demodicosis in order to distinguish it from other mimicking inflammatory dermatoses. Material and Methods. The literature search was conducted in the English and Polish language via the PubMed database and Main Medical Library. The articles regarding Demodex infestation were selected. Results. There is some evidence about the role of Demodex in the development of rosacea, blepharitis and clinical correlation between them.Conclusions. More attention should be drawn to Demodex as it plays a significant role in the development of various clinical entities in both dermatology and ophthalmology.

Coptis chinensis Franch Directly Inhibits Proteolytic Activation of Kallikrein 5 and Cathelicidin Associated with Rosacea in Epidermal Keratinocytes

Rosacea is a common and chronic inflammatory skin disease that is characterized by dysfunction of the immune and vascular system. The excessive production and activation of kallikerin 5 (KLK5) and cathelicidin have been implicated in the pathogenesis of rosacea. Coptis chinensis Franch (CC) has been used as a medicinal herb in traditional oriental medicine. However, little is known about the efficacy and mechanism of action of CC in rosacea. In this study, we evaluate the effect of CC and its molecular mechanism on rosacea in human epidermal keratinocytes. CC has the capacity to downregulate the expression of KLK5 and cathelicidin, and also inhibits KLK5 protease activity, which leads to reduced processing of inactive cathelicidin into active LL-37. It was determined that CC ameliorates the expression of pro-inflammatory cytokines through the inhibition of LL-37 processing. In addition, it was confirmed that chitin, an exoskeleton of Demodex mites, mediates an immune response through TLR2 activation, and CC inhibits TLR2 expression and downstream signal transduction. Furthermore, CC was shown to inhibit the proliferation of human microvascular endothelial cells induced by LL-37, the cause of erythematous rosacea. These results demonstrate that CC improved rosacea by regulating the immune response and angiogenesis, and revealed its mechanism of action, indicating that CC may be a useful therapeutic agent for rosacea.

Prevalence of Ocular Demodicosis and Ocular Surface Conditions in Patients Selected for Cataract Surgery

The aim of the study was to analyze the prevalence of ocular demodicosis and ocular surface conditions in patients selected for cataract surgery. Eyelashes from 73 patients selected for cataract surgery were evaluated at ×40 and ×100 magnification using light microscopy. The anterior segment was assessed with the slit lamp. Additionally, Schirmer I and break up time (BUT) tests were carried out before surgery and 1 and 3 months postoperatively. A specially designed questionnaire containing e.g., information about chronic skin and eye diseases, previous ophthalmic surgeries, and patient’s hygiene habits was used to assess the demographic variables. A majority of patients were at the age of 70–79 years, and there were more females (83%) in the study group. Demodex folliculorum was found in 48% of the patients. There was a correlation between the number of parasites and the presence of blepharitis, discharge at eyelid margins, and conjunctival hyperemia. Schirmer I and BUT test results were lower in patients with Demodex infestation before and after cataract surgery. The higher number of mites was correlated with lower Schirmer I test results postoperatively. The presence of Demodex mites influences the conjunctiva and lid margins leading to inflammation. The higher number of Demodex mites disturbs the tear film over time after cataract surgery.