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

Logger, Jade G M; Peppelman, Malou; Erp, P.E.J. van; Jong, E.M.G.J. de; Nguyen, Kim Phuong; Driessen, R.J.B.

doi:10.1080/09546634.2020.1741501

Cited by 8 publications

(18 citation statements)

References 61 publications

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“…100 Whether and how HF mites contribute to human HF physiology is unknown, but they can elicit both proinflammatory and immunosuppressive responses, 101,102 with major HF inflammation, most prominently in eyelash HFs 103,104 and rosacea-associated vellus HFs. [105][106][107] A role for Demodex has also been postulated in seborrhoeic dermatitis and androgenetic alopecia. [108][109][110][111] Demodex folliculorum stimulates pro-inflammatory cytokine release [e.g.…”

Section: Mitesmentioning

confidence: 99%

Exploring the human hair follicle microbiome*

et al. 2021

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Section: Mitesmentioning

confidence: 99%

Exploring the human hair follicle microbiome*

et al. 2021

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“…Ivermectin quickly became established, together with azelaic acid, as a first-line treatment for PPR in mild rosacea [2,183,184,223,[226][227][228][229], and combined with orally administered doxycycline in moderate to severe rosacea [173,230,231]. However, its efficacy may, at least in part, be explained by its other important property: acaricidal effects against the Demodex mite [172,173,225,228,230,[232][233][234][235][236]. Indeed, two other acaricidal treatments which have no known anti-inflammatory properties also improve clinical symptoms of rosacea: permethrin (5% applied twice daily) improved the vascular component of rosacea (erythema [221], telangiectasia [220]), and benzyl benzoate was shown to be an effective treatment for PPR [159,160].…”

Section: More Superficial and Smallermentioning

confidence: 99%

The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea?

Forton¹

2020

Dermatol Ther (Heidelb)

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Rosacea is an inflammatory continuum, with all characteristics being already present from the onset of the disease, even if not clinically visible. Demodex proliferation also appears to be a continuum process in rosacea, and high Demodex density is beginning to be accepted as an important trigger of the inflammatory cascade and as a marker of rosacea: moreover, papulopustules of rosacea can be treated using acaricides. Immunological studies are providing new hypotheses according to which Demodex may induce tolerogenic dendritic cells and collaborate with VEGF to induce T cell exhaustion favoring its own proliferation. This proliferation may not be clinically visible initially. The interactions among VEGF, Demodex, and immunity need to be explored, and the nosology of rosacea definitions adapted accordingly. The effectiveness of treating any patient who only has visible vascular symptoms with an acaricidal cream needs to be confirmed in prospective controlled clinical trials with long-term follow-up, but it is already important to detect patients with pityriasis folliculorum among those with only vascular symptoms of rosacea in order to treat at least these patients with an acaricidal cream. DIGITAL FEATURES This article is published with digital features to facilitate understanding of the article. You can access the digital features on the article's associated Figshare page. To view digital features for this article go to

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“…This outcome resulted in an ES of 8.37, the highest observed in all included studies. In another study, after a 12-week treatment, Demodex mites had decreased from 13 (0.0–203) to 0 (0.0–10) [21] (Fig. 5a, b).…”

Section: Discussionmentioning

confidence: 99%

“…The safety data reported in the studies are not consistent. Logger et al [21] reported mild and self-limiting adverse events (AEs) in 11 of 20 patients, including stinging/burning, increased facial erythema, itching, and facial skin dryness, while there were no AEs observed in studies of Schaller et al [16] and Holzchuh et al [26] (Table 1). In addition to our research, a systematic review had evaluated the safety of 6 clinical trials using standard dose (<400 µg/kg) systemic ivermectin and all the AEs reported in the reviewed studies were mostly mild or moderate, with the most common complaints of transient blurred vision, itching or pain in the eye, scotomas or seeing flashes of light, all disappearing gradually in a few days [36].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Different Anti-Demodex Strategies: A Systematic Review and Meta-Analysis

Wei¹,

Reisinger²,

French³

et al. 2022

Dermatology

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Background: Demodex mites are related to some inflammatory diseases such as rosacea and blepharitis and could be harmful in patients with immunodeficiency or immunosuppression, especially notable in patients using biologic like dupilumab. In order to have an objective observation of different anti-Demodex strategies, we conducted this study, based on interventional clinical evidence with quantified Demodex mite data. Methods: We used the PubMed, Embase, ClinicalTrials.gov, Medline, and International Clinical Trials Registry Platform (ICTRP) as databases. To assess the risk of bias, the RoB2 and ROBINS-I tools were used. The certainty of evidence was assessed following the GRADE guideline. Furthermore, the effect sizes (ESs) of different strategies were compared in different time periods (0–1, 1–2, 2–3, >3 months), as well as Demodex decrease rates. Results: 1,618 studies were identified in the databases, with 21 of which included in the final quantitative synthesis. Interventions in these studies included ivermectin, tea tree oil (TTO), permethrin, crotamiton, metronidazole, light therapies, combined therapies, and other therapies. During 0–1 month, the ES varied from 0.07 (cleanser) to 1.95 (systemic ivermectin-metronidazole). During 1–2 months, the ES varied from 0.88 (topical permethrin) to 4.40 (topical ivermectin). During 2–3 months, the ES varied from 0.79 (topical permethrin) to 8.37 (topical ivermectin). During the time of 3 months, the ES varied from 0.59 (topical permethrin) to 2.25 (intense pulsed light [IPL]). In terms of Demodex decrease rates, topical ivermectin, TTO, permethrin, IPL, and baby shampoo had achieved a nearly 100% decrease. The reported adverse events were mostly mild, without severe adverse events reported in any of the studies. Conclusions: We found ivermectin (topical and systemic), ivermectin-metronidazole (topical), and TTO (topical) are promising anti-Demodex interventions. In addition to traditional pharmacotherapy, light therapies, especially IPL and skin cleansing, could also be considered as effective methods to control Demodex mite infestation.

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

Cited by 8 publications

References 61 publications

Exploring the human hair follicle microbiome*

Exploring the human hair follicle microbiome*

The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea?

Comparison of Different Anti-Demodex Strategies: A Systematic Review and Meta-Analysis

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