Espinulosis como manifestación de demodicidosis

A rare clinical manifestation of spinulate demodicosis

“…Demodex mite infestations may play a role in various skin diseases such as chronic blepharitis, keratoconjunctivitis, chronic ear pruritus, and external otitis [2]. Clinical forms of the infestation include pityriasis folliculorum (spinulate demodicosis), rosacea like demodicosis, perioral, periorbital, and periauricular dermatitis, demodex abscess, papulopustular rashes of the scalp, solitary granuloma, facial rash after phototherapy, facial hyperpigmentation, and demodectic alopecia [1][2][3]. There have been a few reports of patients with facial spinulosis associated with demodex mites.…”

“…Microscopic examination of these spicules could reveal several mites and keratin debris protruding through the follicle. It should be kept in mind that follicular spicules may be a clinical manifestation of hypovitaminosis A, chronic renal failure, Crohn disease, lymphoma, monoclonal gammopathy, multiple myeloma, filiform hyperkeratosis, and multiple minute digitate hyperkeratosis [3][4][5].…”

Facial spinulosis caused byDemodex folliculorum: diagnostic assessment by means of reflectance confocal microscopy

“…Demodex folliculorum mites are involved in the pathology of a number of different skin diseases called demodicidoses . We present a case of facial spinulosis caused by D. folliculorum .…”

“…D. folliculorum is found in the human pilosebaceous unit of healthy adults, and is thought to play a role in the development of various skin conditions, including rosacea, perioral dermatitis and pityriasis folliculorum. The causality can be established if the mites are present in large numbers in the epidermis or are present in the dermis, and if the lesions heal after anti‐ Demodex therapy such as topical metronidazole or permethrin …”

“…It can be idiopathic or occur in association with various diseases, including polycythaemia vera, chronic renal failure, Crohn disease, hypovitaminosis A, multiple myeloma and lymphoma. A few publications have highlighted the presence of large numbers of D. folliculorum in these lesions and related it to the condition …”