Role of Demodex mite infestation in rosacea: A systematic review and meta-analysis

Chang, Yin Yi; Huang, Yu‐Chen

doi:10.1016/j.jaad.2017.03.040

Cited by 84 publications

(75 citation statements)

References 29 publications

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“…SSSB is a sampling method in which 1 cm 2 of the superficial part of the horny layer and its follicular content is collected . In our patients, the skin and the microscope slides were first cleaned with ether, and two SSSBs were then performed consecutively at the same place, allowing measurement of two Dds (superficial, SSSB1; and deep, SSSB2) .…”

Section: Methodsmentioning

confidence: 99%

“…47 These findings are supported in a recent meta-analysis including a total of 1513 patients with rosacea (from 23 case-control studies, of which 12 had a maximum quality score of 9, five of 8, five of 7 and one of 6), which reported that Dds in patients with ETR were significantly higher than in control patients (standardized mean difference 2Á7, 95% confidence interval 1Á3-4Á1) and lower than in patients with PPR (standardized mean difference À0Á9, 95% confidence interval À2Á0 to À0Á2). 48 To our knowledge, Dds have not previously been studied in patients with ETR using two consecutive SSSBs. We therefore compared the Dds evaluated using this technique in patients with ETR with those of healthy controls, patients with rosacea with papulopustules, patients with demodicosis and patients with other facial dermatoses.…”

mentioning

confidence: 95%

“…In a prospective study, Dds assessed using polymerase chain reaction were similar in patients with ETR and those with PPR, but in another prospective study using reflectance confocal microscopy, Dd was higher in patients with PPR than in those with ETR, in whom it was higher than in the control group . These findings are supported in a recent meta‐analysis including a total of 1513 patients with rosacea (from 23 case–control studies, of which 12 had a maximum quality score of 9, five of 8, five of 7 and one of 6), which reported that Dds in patients with ETR were significantly higher than in control patients (standardized mean difference 2·7, 95% confidence interval 1·3–4·1) and lower than in patients with PPR (standardized mean difference −0·9, 95% confidence interval −2·0 to −0·2) …”

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confidence: 99%

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Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis: a case–control study

Forton¹,

Maertelaer²

2019

Br J Dermatol

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Summary Background Facial densities of Demodex mites have been observed to be greater in patients with demodicosis and papulopustular rosacea than in healthy control patients. In patients with erythematotelangiectatic rosacea (ETR), this density has been observed to be similar to or greater than that of healthy controls. Erythema and telangiectasia, characteristics of ETR, are often observed among patients with pityriasis folliculorum, a discreet demodicosis, suggesting a possible link between these conditions. Objectives To compare the facial Demodex densities of patients with clinical ETR and patients with healthy skin, demodicosis, rosacea with papulopustules, and other facial dermatoses. Methods In this retrospective study, we recorded Demodex densities measured using two consecutive standardized skin surface biopsies (SSSB1 and SSSB2) in 23 patients with ETR, 20 healthy control patients, 590 patients with demodicosis, 254 with rosacea with papulopustules and 180 with other facial dermatoses. Results Patients with ETR had higher Demodex densities (D cm−2) than did the healthy controls (mean ± SEM; SSSB1: 15·7 ± 6·3 vs. 1·8 ± 1·1 D cm−2, P = 0·042; SSSB2: 38·0 ± 13·7 vs. 5·1 ± 2·1 D cm−2, P = 0·026) and patients with other dermatoses (SSSB1: 0·4 ± 0·1 D cm−2, P = 0·004; SSSB2: 1·3 ± 0·3 D cm−2, P = 0·004), but lower densities than patients with demodicosis (SSSB1: 82·7 ± 4·2 D cm−2, P = 0·008; SSSB2: 172·2 ± 7·7 D cm−2, P = 0·001) or rosacea with papulopustules (SSSB1: 86·6 ± 7·3 D cm−2, P = 0·027; SSSB2: 197·0 ± 12·1 D cm−2, P = 0·002). Conclusions ETR may be associated with nonvisible Demodex proliferation, possibly corresponding to a subclinical stage of demodicosis. Dermatologists should be aware of this potential association and look for subclinical demodicosis in patients with ETR, so that topical acaricidal treatment can be offered if Demodex density is high.

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Section: Methodsmentioning

confidence: 99%

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confidence: 95%

mentioning

confidence: 99%

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Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis: a case–control study

Forton¹,

Maertelaer²

2019

Br J Dermatol

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“…1 Patients with rosacea have significantly higher prevalence and degrees of Demodex mite infestation, which may play a role in the pathogenesis of this condition by inducing inflammation. 3…”

Section: Case Continuedmentioning

confidence: 99%

A new facial rash

Sun¹,

Muir²

2020

Aust J Gen Pract

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“…Rosacea is a chronic inflammatory skin disorder of uncertain etiology, characterized by among others papules, pustules, erythema, telangiectasia, and flushing (14)(15)(16). Demodex mites have been implicated in rosacea etiology (14,(17)(18)(19), and studies show that the Demodex population is markedly increased in patients with rosacea compared to healthy controls (20)(21)(22)(23)(24)(25).…”

Section: Introductionmentioning

confidence: 99%

Value of reflectance confocal microscopy for the monitoring of rosacea during treatment with topical ivermectin

Logger

Peppelman²,

Erp

et al. 2020

Journal of Dermatological Treatment

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Background: Reflectance confocal microscopy (RCM) enables noninvasive Demodex mite detection in rosacea. Objective scoring of rosacea severity is currently lacking. Objectives: To determine the value of RCM for monitoring Demodex, inflammation and vascular parameters in rosacea during treatment. Methods: In 20 rosacea patients, clinical and RCM examination were performed before, during, and 12 weeks after a 16-week treatment course with topical ivermectin. Using RCM, number of mites and inflammatory cells, epidermal thickness, and vascular density and diameter were measured. RCM features were correlated with clinical assessment. Results: Treatment resulted in clinical reduction of inflammatory lesions. Mites were detected in 80% of patients at baseline, 30% at week 16, and 63% at week 28. The number of mites reduced significantly during treatment, but no changes in inflammatory cells, epidermal thickness or vascular parameters were observed. Correlation between number of inflammatory lesions and mites was low. None of the RCM variables were significant predictors for clinical success. Conclusions: RCM enables anti-inflammatory effect monitoring of topical ivermectin by determining mite presence. Quantifying exact mite number, and inflammatory and vascular characteristics is challenging due to device limitations. In its current form, RCM seems of limited value for noninvasive follow-up of rosacea in clinical practice.

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Role of Demodex mite infestation in rosacea: A systematic review and meta-analysis

Cited by 84 publications

References 29 publications

Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis: a case–control study

Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis: a case–control study

A new facial rash

Value of reflectance confocal microscopy for the monitoring of rosacea during treatment with topical ivermectin

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