Presence of Demodex spp. on the face and scalp in patients affected by papulopustular rosacea of face.

BACKGROUND: The increased proliferation of Demodex mites in the pilosebaceous unit can be the cause of rosacea flare-ups on the face. Signs and symptoms of the scalp (e.g., itching, dandruff) have sometimes been reported in patients with papulopustular rosacea of face; they may be due to a proliferation of Demodex mites on the scalp. METHODS: To study the Demodex mites count, a standardized skin surface biopsy was performed on the cheek and on the scalp. Microscopic examination and molecular identification of Demodex were performed. Pearson's χ2 Test or Fisher's Exact Test were used to test for any association between categorical variables and outcome. RESULTS: Patients affected by papulopustular rosacea had a greater frequency of Demodex-positive standardized skin surface biopsy than controls at the scalp (35.0% vs. 0%, P=0.033), at the face and/or at the scalp (50% vs. 10%, P=0.032). Demodex positive patients with a Demodex-positive face sample were more frequently found to have a Demodex-positive scalp sample (P=0.035). The predominant species was found to be Demodex folliculorum (92.6% of samples); the species Demodex brevis was identified only in 7.4% of samples. CONCLUSIONS: Demodex folliculorum is more frequently found on the scalp and face of patients with rosacea than controls, even though it is not statistically associated with scalp symptoms. The scalp may be a reservoir area for Demodex mites which could migrate on the face again after an acaricidal treatment.

Detection of demodex mites in papulopustular rosacea using microscopic examination and polymerase chain reaction: a comparative case-control study.

Demodex mite proliferation is frequently involved in the pathogenesis of rosacea. The gold standard for Demodex identification is microscopic examination on a standardized skin surface biopsy. However, this method of sampling can be distressing and painful, especially when performed on hairy sites. In this case-control study, we compared the sensitivity of PCR and microscopic examination in diagnosing a Demodex infestation. Moreover, we investigated the possible correlations between the presence of Demodex mites and clinical characteristics. In total, 20 patients affected by papulopustular rosacea and 10 controls were included. At both microscopic examination and PCR, patients with rosacea presented a greater prevalence of positive samples than controls at the scalp and at the face. Microscopy had sensitivity of 50% at the face and of 46.7% at the scalp. PCR had sensitivity of 93.75% at the face and of 86.7% at the scalp. The positivity of PCR was associated to a higher frequency of facial papules and pustules. Patients with positivity at the face had a more frequent positivity at the scalp. The scalp could represent a reservoir for the Demodex mites, and should be investigated by sensitive and painless methods. PCR performed on painlessly collected samples should be further investigated.

Wound myiasis: the role of entodermoscopy

Abstract: Although wound or traumatic myiasis is common in tropical countries, only recently cases associated with underlying dermatoses, such as seborrheic dermatitis and psoriasis, have been reported. We describe a patient with seborrheic dermatitis and an ulcerated lesion on the scalp, in which the dermatological examination with the aid of dermoscopy allowed the identification of larvae (maggots) compatible with infestation by Cochliomyia hominivorax. Treatment was performed with oral and topical ivermectin, followed by manual extraction of the larvae.

PREHISTORICAL Pediculus humanus capitis INFESTATION: QUANTITATIVE DATA AND LOW VACUUM SCANNING MICROSCOPY / Infestação pré-histórica por Pediculus humanus capitis: análise quantitativa e por microscopia de varredura de baixo vácuo

A pre-Columbian Peruvian scalp was examined decades ago by a researcher from the Oswaldo Cruz Foundation. Professor Olympio da Fonseca Filho described nits and adult lice attached to hair shafts and commented about the origin of head lice infestations on mankind. This same scalp was sent to our laboratory and is the subject of the present paper. Analysis showed a massive infestation with nine eggs/cm2 and an impressive number of very well preserved adult lice. The infestation age was roughly estimated as nine months before death based on the distance of nits from the hair root and the medium rate of hair growth. A small traditional textile was associated with the scalp, possibly part of the funerary belongings. Other morphological aspects visualized by low-vacuum scanning electron microscopy are also presented here for adults and nits.

Há décadas um escalpo peruano, datado do período pré-colombiano, foi examinado por um pesquisador da Fundação Oswaldo Cruz. O Professor Olympio da Fonseca Filho descreveu lêndeas e adultos fixos a fios de cabelos e fez comentários sobre a origem da infecção por piolhos na espécie humana. Este mesmo escalpo foi enviado ao nosso laboratório e é objeto deste artigo. Sua análise mostrou maciça infestação, com nove lêndeas/cm2 em impressionante número de adultos muito bem preservados. O tempo de infestação foi estimado em cerca de nove meses antes da morte, baseado na maior distância entre lêndeas e o couro cabeludo, levando em consideração taxa média de crescimento capilar de 1 cm por mês. Um pequeno pedaço de tecido tradicional peruano foi encontrado associado ao escalpo, provavelmente pertencente ao conjunto de peças usado no ritual funerário. Aqui, apresentamos alguns aspectos morfológicos de adultos e lêndeas vizualizados por microscopia eletrônica de varredura de baixo vácuo.

Larva migrans em glândula sebácia do couro cabeludo

A case of larva migrans or serpiginous linear dermatitis on the scalp of a teenager is reported. An ancylostomid larva was found within a sebaceous gland acinus. The unusual skin site for larva migrans as well as the penetration through the sebaceous gland are highlighted. The probable mechanism by which the parasite reached the skin adnexa is discussed

Tratamiento de la pediculosis capitis en niños con permetrina al 1 por ciento en champú o loción / Treatment of pediculosis capitis in children with 1 percent permethrin shampoo or lotion

A clinical and entomological trial was carried out in 88 head louse (pediculus humanus capitis) infested children treated with a single dose of 1 percent permethrin shampoo or lotion. The sex distribution was 47 males and 41 females with ages ranging between 5 and 14 years old. In order to assess the efficiency of treatments, search for adult forms, nymphs and eggs (nits) of the parasite was performed in each of the children, before and after treatment (30 minutes, 7 days and 21 days). The entomological evaluations consisted in stereoscopic and microscopic examination of a mean of 12 hair samples taken from the retroauricular and occipital regions of each of the children, the biological condition of eggs, viable (inmature, mature), dead ans empty, was recorded. The cure rates, both clinical and entomological, obtained were 91,5 percent for shampoo and 95.2 percent for lotion. No adverse reactions with the 2 formulations used were reported. In conclusion, 1 percent permethrin shampoo or lotion is an effective and safe treatment for pediculosis capitis

Prevalencia y estacionalidad de la Pediculosis capitis en la población infanto-juvenil de la región sanitaria, Buenos Aires, Argentina / Prevalence and seasonal variation of Pediculosis capitis in the population under sixteen year of age of the health region of Buenos Aires, Argentina

Se estudió la prevalencia de la Pediculosis capitis como enfermedad parasitaria durante el año calendario 1-8-1992 al 31-7-1993, en la Región Sanitaria XI de la provincia de Buenos Aires, Argentina, que comprende 15 partidos del Este Noreste de la provincia de Buenos Aires y otras zonas de influencia del Hospital Interzonal de Agudos, Especialidad Pediatría "Sor María Ludovica", cabecera de dicha Región Sanitaria. Se examinaron un total de 552 individuos de nivel social medio a medio bajo de la población infanto-juvenil de 0 a 16 años, tomados al azar en 52 muestreos semanales consecutivos, considerándose como positivos para esta enfermedad a aquellos parasitados al momento del diagnóstico. Los resultados se expresan en términos de prevalencia analizándose su variación mensual y estacional. La prevalencia fue relativamente alta en todos los meses, con valores mínimos en febrero (12 por cento) y máximos en agosto (56,8 por cento), siendo la media anual de 38, 04 por cento (+/- 4,05). Estacionalmente, su menor valor corresponde al Verano (16,8 por cento), siendo muy semejantes los valores para las restantes estaciones, manteniéndose siempre superiores al 38 por cento