Demodex spp. Infestation Associated with Treatment-Resistant Chalazia and Folliculitis

Abstract

ÖZDemodikozis demodex akarları ile gelişen pilosebase ünitenin ektoparazitidir. Demodikozis primer bir deri hastalığı olabileceği gibi folikülit, rozasea gibi inflamatuar dermatozlara sekonder olarak da görülebilir. Demodex blefariti yaygın görülen enfeksiyöz göz hastalığıdır, ancak sıklıkla ihmal edilir. Bu akarlar lipaz enzimleri içerir ve yüzeylerinde bakteri taşırlar. Demodex spp. enfestasyonu giderek artan bir şekilde halk sağlığı sorunu haline gelmiştir. 29 yaşında erkek hasta dermatoloji polikliniğine 4 yıl önce başlayan yüzde papül ve püstüller şikayeti ile başvurdu. Mikrobiyoloji laboratuvarında standart deri biyopsi örneği incelendi ve yüzünde Demodex folliculorum akarı saptandı. (+3 ABSTRACTDemodecidosis is an ectoparasitosis of pilosebaceous unit caused by demodex mites. The disease may be a primary skin disease or a secondary disease to inflammatory dermatoses such as folliculitis and rosacea. Demodex spp. blepharitis is an infectious ocular disease that is common but always neglected. These mites contain lipase enzymes that help carry bacteria on the surface. The infestation of Demodex spp. has increasingly become a public health concern. A 29-year-old male patient was admitted to our dermatology clinic with a complaint of papules and pustules on his face, which started 4 years ago. A standardized skin biopsy specimen was evaluated in our microbiology laboratory, and we detected Demodex folliculorum mites on his face (3+). There was pruritus of his eyes. A total of four eyelashes were epilated and were then examined under a light microscope for the presence of Demodex infestation. In this study, we discussed the association between acne rocacea, blepharitis, and demodex mites.

Quantitative Analysis of the Bacteria in Blepharitis With Demodex Infestation

“…Our current results challenge these approaches. The anti-demodex therapy was emphasized by some previous studies ( Cheng et al, 2015 ; Akcinar et al, 2016 ). Therefore, apart from the application of antibacterial agents, a combination of anti-demodex therapy to reduce demodex count should be considered.…”

“…Therefore, D. folliculorum was supposed to cause chronic anterior blepharitis, while D. brevis has been considered to cause posterior blepharitis ( Cheng et al, 2015 ). Meanwhile, there have been some studies that have suggested that metronidazole and tea tree oil are effective choices for the treatment of demodex infestation in blepharitis ( Cheng et al, 2015 ; Akcinar et al, 2016 ). However, most people who have these obligate mites are healthy and there is no rigorous evidence demonstrating that Demodex mite infestation promotes bacterial infection in blepharitis ( Clifford and Fulk, 1990 ; Bezza Benkaouha et al, 2015 ).…”

A Clinical Scoring System for Diagnosis of Ocular Demodicosis

“…These mites are transmitted through close person-to-person contact, but the pathogenic mechanism is not fully understood [ 3 ]. D. folliculorum and D. brevis are more often found in the eyelashes and ears, and may also be found in other sites, especially in the forehead and nose region [ 2 , 4 – 7 ]. Although many recent studies suggest that these parasites play a role in the etiopathogenesis of disorders such as skin diseases and facial blepharitis, others regard the presence of mites in the pilosebaceous follicles as harmless [ 8 ].…”