Dermoscopy as a clinical tool for the diagnosis of demodicosis: a retrospective intrapatient case-control study.

Dermoscopy has been used for the non-invasive diagnosis of demodicosis. Several studies have evaluated the usefulness of this tool in the diagnosis, however, there are differences in the gold standard (SSSB or KOH test) and criteria of positivity used between studies. Added to this, is the lack of controls and objective quantification of the usefulness of dermoscopic signs in clinically observable and relevant ranges. To validate the usefulness of dermoscopy for the diagnosis of demodicosis by calculating the performance indicators for the different dermoscopic signs. Retrospective intrapatient case-control study, which included adults with suspicion of demodicosis. Dermoscopic photographs and scraping of healthy and lesional skin were obtained. Samples were analyzed microscopically by trained personnel. Photographs were evaluated by determining the presence of Demodex tails (DT), dilated follicular openings (DFO) and dilated blood vessels (DBV) in pre-defined ranges. 64 patients were included (total = 256 samples); the presence of demodex on skin scraping was seen in 69%. Under dermoscopy, the presence of DT in range 11-20/field had a positive likelihood ratio (LR) of 12.10 (95%CI 6.52-22.45) and negative LR 0.32 (95%CI 0.23-0.45). Combined and dichotomized performance for at least one positive sign under dermoscopy (DT > 10/field, DFO > 10/field or DBV > 50% of the field): positive LR 7.14 (95%CI 4.80-10.62) and negative LR 0.11 (95%CI 0.06-0.22). The presence of DT, DFO or DBV has a high correlation with a positive mite test, so the diagnosis of demodicosis could be made only through dermoscopy.

Beyond the Surface: Understanding Demodex and Its Link to Blepharitis and Facial Dermatoses.

Demodex represents the most frequent ectoparasite found in humans. Although Demodex mites are considered commensals of human pilosebaceous units, an abnormally high mite density can cause several ocular and cutaneous symptoms and signs, sometimes to a severe degree. Both Demodex spp. (folliculorum and brevis) play a significant part in eye pathology and facial dermatoses. These mites have been related to blepharitis, ocular rosacea, meibomian gland dysfunction and various skin diseases, including rosacea, demodicosis and seborrheic dermatitis. Understanding the importance of Demodex in both eye and skin conditions is crucial for accurate diagnosis and appropriate management strategies, which may involve targeted treatments to control the mite population and reduce associated symptoms.

Which factors influence Demodex mite density in standardized superficial skin biopsy in patients with rosacea? A prospective cross-sectional analysis.

Rosacea is a chronic cutaneous disease that manifests with facial erythema, telangiectasia, papules and pustules on the central face. Although the pathogenesis is not well established, rosacea appears to have a close relationship with Demodex mites. The aim of the study was to elucidate the factors influencing Demodex mite density by standardized superficial skin biopsy (SSSB) in patients with rosacea. This prospective, cross-sectional study included 200 patients with rosacea. Clinical characteristics of the patients were recorded and SSSB was used to measure Demodex density (Dd). If Dd was < 5 D/cm2 in the first SSSB, SSSB was repeated 4 more times to avoid false negative results. Of 200 patients, 152 (76%) were females and 48 (24%) males with a mean age of 43.47 ± 11.87 years. Ninety-nine patients (49.5%) had erythematotelangiectatic (ETR) and 101 patients (50.5%) had papulopustular (PPR) subtype of rosacea. Among 200 patients, the ratio of cumulative positive results of the consecutive SSSBs were as follows: 1st SSSB = 125 (62.5%), 2nd SSSB = 155 (77.5%), 3rd SSSB = 170 (85%), 4th SSSB = 173 (86.5%) and 5th SSSB = 174 (87%). The ratio of detecting Demodex infestation in the first SSSB was significantly lower in patients with PPR (55/101, 54.5%) than in patients with ETR (70/99, 70.7%). Median total Demodex mite density and D. folliculorum density were significantly higher in the ETR group than in the PPR group. There was a statistically significant relationship between density of Demodex tails in dermoscopy and positive/negative results of Demodex infestation in SSSB. As a conclusion, Demodex mite density by SSSB was influenced by various factors such as subtypes of rosacea, types of Demodex species, and dermoscopic findings.

Evaluation of the relationship between Demodex infestation and obesity in rosacea patients.

BACKGROUND: The changes in the skin caused by obesity may predispose patients with rosacea to Demodex infestation (DI). Besides, identifying predisposing factors in these patients is important for initial treatment plan. AIMS: The main purpose of this study is to determine the relationship between DI and obesity in patients with rosacea. METHODS: Sociodemographic characteristics, body mass index, and clinical features of 130 rosacea patients were recorded. Demodex density was measured by noninvasive standard skin biopsy, and a determination of ≥5/cm2 mites was regarded as positive for DI. Patients with a BMI of 30 and above were categorized as the obese group, and those with a BMI below 30 were classified as the nonobese group. Moreover, patients were divided according to DI into positive and negative. These groups were compared with each other. RESULTS: Upon comparing the patients with and without obesity, it was noted that the obese patients had significantly higher rates of erythematotelangiectatic type rosacea, rosacea severity, and flushing complaints. Furthermore, results show that the DI was significantly more common in obese patients. The most determinant factors for predicting DI in rosacea patients were papulopustular type rosacea, obesity, and rosacea severity, respectively. CONCLUSIONS: In this study, DI was found to be more common in obese patients with rosacea. Besides, obesity was found to be one of the most determining factors in detecting DI in patients with rosacea.

Unveiling the Role of Endoplasmic Reticulum Stress Pathways in Canine Demodicosis.

Canine demodicosis is a prevalent skin disease caused by overpopulation of a commensal species of Demodex mite, yet its precise cause remains unknown. Research suggests that T-cell exhaustion, increased immunosuppressive cytokines, induction of regulatory T cells and increased expression of immune checkpoint inhibitors may contribute to its pathogenesis. This study aimed to gain a deeper understanding of the molecular changes occurring in canine demodicosis using mass spectrometry and pathway enrichment analysis. The results indicate that endoplasmic reticulum stress promotes canine demodicosis through regulation of three linked signalling pathways: eIF2, mTOR, and eIF4 and p70S6K. These pathways are involved in the modulation of Toll-like receptors, most notably TLR2, and have been shown to play a role in the pathogenesis of skin diseases in both dogs and humans. Moreover, these pathways are also implicated in the promotion of immunosuppressive M2 phenotype macrophages. Immunohistochemical analysis, utilising common markers of dendritic cells and macrophages, verified the presence of M2 macrophages in canine demodicosis. The proteomic analysis also identified immunological disease, organismal injury and abnormalities and inflammatory response as the most significant underlying diseases and disorders associated with canine demodicosis. This study demonstrates that Demodex mites, through ER stress, unfolded protein response and M2 macrophages contribute to an immunosuppressive microenvironment, thereby assisting in their proliferation.

The Association Between Acne Vulgaris, Acne Vulgaris with Nonspecific Facial Dermatitis, and Demodex Mite Presence.

Background: Demodex mites can lead to various skin disorders, from non-specific dermatitis to conditions that mimic other diseases, making it challenging to diagnose accurately. Additionally, it has been reported that Demodex mites can cause skin conditions such as perioral dermatitis, pustular folliculitis, pityriasis folliculorum, blepharitis, and rosacea. Due to conflicting studies, there is a debate regarding the link between Demodex mites and acne vulgaris. This study aims to determine the prevalence of Demodex mites on the faces of individuals with acne vulgaris, acne with nonspecific facial dermatitis, and healthy facial skin to clarify the association. Materials and Methods: This observational case-control study involved 120 participants aged 18-37: 40 individuals with acne vulgaris only, 40 with acne and nonspecific facial dermatitis, and 40 healthy controls. The same dermatologist examined and diagnosed all participants to ensure accuracy before being grouped. The Standardized Skin Surface Biopsy (SSSB) method was used to detect Demodex mites in all three study groups. Furthermore, additional samples were collected randomly from acne lesions using the Superficial Needle Scraping (SNS) method in the two acne groups. Results: The study found no significant difference in Demodex prevalence and high Demodex density rate between patients with only acne vulgaris and the control group (p>0.05). However, acne patients with nonspecific facial dermatitis had a higher rate of Demodex prevalence and high Demodex density rate than the only acne vulgaris and control group (p<0.05). The clinical symptoms of nonspecific facial dermatitis in acne patients strongly associated with Demodex mites are patchy red, dry, scaly skin, roughness, insect bite-like papules, and flushing. Conclusion: Demodex prevalence and high Demodex density rate are not associated with acne vulgaris. Still, it is associated with acne and nonspecific facial dermatitis, particularly in patients with patchy redness, dry, scaly skin, roughness, insect bite-like papules, and flushing.

Relationship between surgical rhinoplasty and Demodex infestation: a case-control study.

Background/aim: Human Demodex mites are parasites that live in the pilosebaceous unit and can cause demodicosis. While demodicosis may occur as a primary skin disease, it may also result from immunosuppression and topical or systemic immunosuppressive therapies. Surgical rhinoplasty is one of the most commonly performed cosmetic procedures, and it is the cause of a variety of cutaneous complications, particularly acne, as it affects the skin's adnexal structures. Thus, this study aimed to investigate whether the cutaneous changes in surgical rhinoplasty patients render them vulnerable to Demodex infestation. Materials and methods: Individuals who had undergone rhinoplasty (patients) and age- and sex-matched healthy volunteers (controls) were included in this prospective case-control study. To determine the Demodex density, samples were collected from the malar and nasal regions of both the patients and controls using the standard superficial skin biopsy method. Results: A total of 50 rhinoplasty patients and 50 healthy controls were enrolled in the study. The Demodex density on the nose was significantly higher in the rhinoplasty patients (p = 0.0001). Furthermore, the frequency of xerosis and pustules was significantly higher in the rhinoplasty patients compared to the control group (p = 0.046 and p = 0.001, respectively). Conclusion: Surgical rhinoplasty may be a risk factor for demodicosis, and patients will recover faster after surgery with proper diagnosis and treatment.

Demodex spp / Dermodex spp

Los ácaros ectoparásitos del género Demodex spp (>140 especies) pertenecen a la familia Demodicidae, superfamilia Cheyletoidea, suborden Prostigmata, orden Trombidiformes, superorden Acariformes. Fueron descritos por primera vez en 1841 por Henle y Berger. El término Demodex deriva del griego: demos = grasa y dex = gusano incrustado. Tienen una longitud de 0.2- 0.4 mm, son transparentes y elongados. Su cuerpo se divide en tres secciones principales: 1) gnatosoma, región anterior, en donde se encuentra la apertura bucal; 2) podosoma, región en la que se encuentran sus cuatro pares de patas; y 3) el opistoma, región caudal o cola. Se adquieren poco después del nacimiento y se consideran parte del microbiota normal de muchos mamíferos, así como también del ser humano, en particular de la unidad pilosebácea. Por lo tanto, se ubican principalmente en el rostro, cuero cabelludo y región superior del tronco. Todas estas áreas corporales se caracterizan por la alta secreción sebácea, alimento primordial para el crecimiento y desarrollo de este ácaro; razón por la cual, además, su densidad aumenta durante la pubertad, periodo cuando proliferan las glándulas sebáceas. Dentro de las especies del género, encontramos exclusivamente en humanos, a D. folliculorum (440 µm), habitando frecuentemente el infundíbulo folicular y D. brevis (240 µm), que se localiza predominantemente en los ductos sebáceos y glándulas tarsales a nivel ocular.(AU)

IgE AND IgG antibody responses to Dermatophagoides pteronyssinus in dogs with demodicosis and atopic dermatitis / Respostas de anticorpos IgE E IgG específicos à Dermatophagoides pteronyssinus em soros de cães com demodicose e dermatite atópica

Canine demodicosis is a common inflammatory parasitic skin disease caused by Demodex mites. House dust mites, such as Dermatophagoides spp., play an important role in the pathogenesis of canine atopic dermatitis (AD). The goal of this experimental work was to investigate whether demodectic dogs could be previously exposed/sensitized to house dust mites' antigens. First the prevalence of demodicosis in a southeastern region of Brazil was investigated by analyzing clinical files of dogs that were admitted to a Veterinary Hospital. Subsequently, the IgG responses to Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df) and IgE to D.pteronyssinus (Dp) were evaluatedin two groups, AD or demodicosis dogs. Additionally, the major IgE-binding Dp proteins that are recognized by sera from dogs with demodicosis and AD were evaluated. A total of 2,599 clinical files were analyzed to identify the major parasitic skin diseases in dogs from this region, considering the age, sex and breed of the animals. The epidemiological study identified 111 animals with skin diseases; from these 20.7% presented demodicosis. Afterwards, serum samples were obtained from another groups of demodicosis, AD, and healthy dogs, and analyzed for Dp and Df-specific IgG, and IgE antibody levels, Dp IgG avidity by ELISA and IgE-binding Dp-specific proteins by immunoblot. IgG and IgE antibodies to Dp were detected in sera from additional groups of dogs with AD, demodicosis or healthy, with higher IgE levels to Dp in AD than demodectic or healthy dogs. IgG to Df was detected, despite with smaller levels compared to Dp in sera from demodectic dogs, and also in healthy dogs. Immunoblot showed IgE-binding to Dp proteins in sera of dogs with demodicosis and AD; with strong reactivity for the 72 and 116 kDa antigens detected by sera from demodicosis dogs. However, sera from healthy dogs >12 months old also presented reactivity to these bands. In conclusion, the detection of Dp-IgG and IgE antibodies in sera from demodectic dogs indicates previous exposure and sensitization to the house dust mite, respectively, more than cross-reactivity between demodex mites and Dp antigens detected by canine antibodies. Additionally, higher Dp-specific IgE levels were found in dogs with AD compared with those with demodicosis or healthy, suggesting that Dp-specific IgE could better discriminate dogs with AD from healthy ones or even those with demodicosis.

Demodicose canina é uma doença inflamatória comum da pele causada por ácaros do gênero Demodex. Ácaros da poeira doméstica como Dermatophagoides spp. desempenham papel importante na patogênese da dermatite atópica canina (DA). O objetivo desse trabalho experimental foi investigar se cães com demodicose poderiam ser previamente expostos/sensibilizados com antígenos de ácaros da poeira doméstica. A princípio, investigou-se a prevalência de demodicose em uma região sudeste do Brasil, analisando-se prontuários clínicos de cães admitidos em um Hospital Veterinário. Posteriormente, as respostas de IgG a Dermatophagoides pteronyssinus (Dp) e D. farinae (Df) e IgE a D. pteronyssinus (Dp) foram avaliadas em dois grupos, DA ou demodicose. Também foram avaliadas as principais proteínas Dp reconhecidas por anticorpo IgE presente em soros de cães com demodicose e DA. Um total de 2.599 prontuários clínicos foram analisados para identificar as principais doenças parasitárias da pele em cães dessa região, considerando a idade, sexo e raça dos animais. O estudo epidemiológico detectou 111 animais com doenças de pele e destes, 20,7% apresentavam demodicose. Posteriormente, amostras de soro foram obtidas de outros grupos de cães com demodicose, DA ou saudáveis, e analisadas quanto aos níveis de IgG e IgE específicos para Dp e Df, avidez de IgG a Dp por ELISA e proteínas específicas de Dp reconhecidas por IgE por immunoblot. Anticorpos IgG e IgE para Dp foram detectados em soros de grupos adicionais de cães com DA, demodicose ou saudáveis, com níveis mais altos de IgE para Dp na DA do que no soro de animais saudáveis. Níveis de IgG específicos para Df foram detectados, apesar serem menores em comparação com os detectados para Dp em soros de cães demodéticos, e também em cães saudáveis. A análise de immunoblot demonstrou detecção de IgE para proteinas de Dp em soros de cães com demodicose e DA; com forte reatividade para os antígenos de 72 e 116 kDa detectados por soros de cães com demodicose. No entanto, soros de cães saudáveis > 12 meses de idade também apresentaram reatividade a essas bandas. Em conclusão, a detecção de anticorpos Dp-IgG e IgE específicos em soros de cães demodéticos indica exposição prévia e sensibilização aos ácaros, respectivamente, mais do que reatividade cruzada entre ácaros Demodex e antígenos Dp detectados por anticorpos caninos. Além disso, níveis de Dp-IgE específicos mais elevados encontrados em cães com DA, sugerem que esses anticorpos poderiam discriminar melhor cães com DA daqueles saudáveis ou mesmo demodéticos.

Feline demodicosis in Santa Catarina state, Brazil / Demodicose felina em Santa Catarina, Brasil

Feline demodicosis is considered a rare dermatopathy and can be caused by Demodex cati, Demodex gatoi and a third species not yet named. An adult male feline was attended with severe pruritus for 9 months and a history of treatment with cephalexin and prednisolone, with progressive worsening. On physical examination, there was alopecia, hyperkeratosis, abrasions and erythema on the head, neck, lumbosacral region, tail and pelvic limbs, in addition to the presence of fleas. For pulicosis, selamectin spot on was prescribed every 30 days and use of amitraz in the environment every seven days. In order to control secondary infection, weekly baths with chlorhexidine were recommended. Deep skin scraping and hair plucking were performed for trichogram and parasitological skin examination, respectively, with diagnoses of demodicosis by Demodex cati, and mycotic dermatitis associated with secondary bacterial infection. The treatment was modified to use selamectin every 2 weeks, but the tutor did not return and reported, after several months, that he had done therapy with selamectin only every 30 days and discontinued baths. For this feline, it was not possible to associate demodicosis with other comorbidities. It is believed that the generalized presentation of the disease occurred due to the pruritus caused by pulicosis.

A demodicose felina é considerada uma dermatopatia rara e pode ser causada pelos ácaros Demodex cati,Demodex gatoi e uma terceira espécie ainda não nomeada. Foi atendido um felino adulto apresentando prurido intenso há 9 meses e histórico de tratamento com cefalexina e prednisolona, com piora progressiva. Ao exame físico, havia alopecia, hiperqueratose, escoriações e eritema em cabeça, pescoço, região lombossacra, cauda e membros pélvicos, além da presença de pulgas. Para puliciose, foram prescritos selamectina spot on a cada 30 dias e uso de amitraz no ambiente a cada sete dias e, para controle da infecção secundária pelas escoriações, foram recomendados banhos semanais com clorexidine. Realizaram-se raspado de pele profundo e arrancamento de pelos para tricograma e exame parasitológico de pele, respectivamente, com diagnósticos de demodicose por Demodex cati, e dermatite micótica associada a infecção bacteriana secundária. O tratamento foi modificado para uso de selamectina a cada 2 semanas, mas tutor não retornou e informou, após vários meses, ter feito terapia com selamectina apenas a cada 30 dias e descontinuidade dos banhos. Não foi possível associar a demodicose, para este felino, a outras comorbidades e acredita-se que a apresentação generalizada da doença tenha se dado pelo prurido causado pela puliciose.

Demodicose felina em Santa Catarina, Brasil / Feline demodicosis in Santa Catarina state, Brazil

A demodicose felina é considerada uma dermatopatia rara e pode ser causada pelos ácaros Demodex cati, Demodex gatoi e uma terceira espécie ainda não nomeada. Foi atendido um felino adulto apresentando prurido intenso há 9 meses e histórico de tratamento com cefalexina e prednisolona, com piora progressiva. Ao exame físico, havia alopecia, hiperqueratose, escoriações e eritema em cabeça, pescoço, região lombossacra, cauda e membros pélvicos, além da presença de pulgas. Para puliciose, foram prescritos selamectina spot on a cada 30 dias e uso de amitraz no ambiente a cada sete dias e, para controle da infecção secundária pelas escoriações, foram recomendados banhos semanais com clorexidine. Realizaram-se raspado de pele profundo e arrancamento de pelos para tricograma e exame parasitológico de pele, respectivamente, com diagnósticos de demodicose por Demodex cati, e dermatite micótica associada a infecção bacteriana secundária. O tratamento foi modificado para uso de selamectina a cada 2 semanas, mas tutor não retornou e informou, após vários meses, ter feito terapia com selamectina apenas a cada 30 dias e descontinuidade dos banhos. Não foi possível associar a demodicose, para este felino, a outras comorbidades e acredita-se que a apresentação generalizada da doença tenha se dado pelo prurido causado pela puliciose.

Feline demodicosis is considered a rare dermatopathy and can be caused by Demodex cati, Demodex gatoi and a third species not yet named. An adult male feline was attended with severe pruritus for 9 months and a history of treatment with cephalexin and prednisolone, with progressive worsening. On physical examination, there was alopecia, hyperkeratosis, abrasions and erythema on the head, neck, lumbosacral region, tail and pelvic limbs, in addition to the presence of fleas. For pulicosis, selamectin spot on was prescribed every 30 days and use of amitraz in the environment every seven days. In order to control secondary infection, weekly baths with chlorhexidine were recommended. Deep skin scraping and hair plucking were performed for trichogram and parasitological skin examination, respectively, with diagnoses of demodicosis by Demodex cati, and mycotic dermatitis associated with secondary bacterial infection. The treatment was modified to use selamectin every 2 weeks, but the tutor did not return and reported, after several months, that he had done therapy with selamectin only every 30 days and discontinued baths. For this feline, it was not possible to associate demodicosis with other comorbidities. It is believed that the generalized presentation of the disease occurred due to the pruritus caused by pulicosis.

Aspectos clínicos e histológicos da demodicose canina localizada e generalizada / Clinical and histological aspects of localized and generalized canine demodicosis

Demodicose é uma afecção cutânea causada pelo ácaro Demodex sp. diagnosticada com frequência na rotina clínica veterinária. Objetivou-se descrever as manifestações clínicas e histológicas de cães com demodicose nas formas localizada e generalizada, relacionando a quantidade de ácaros e os achados microscópicos ao quadro clínico. Foram estudados 46 cães, sendo 28 com demodicose generalizada e 18 com a forma localizada da doença, dos quais todos possuíam raspados de pele positivo. Destes caninos foram anotados dados de lesões macroscópicas em ficha dermatológica e coletaram-se amostras de pele para estudo microscópico. A análise histológica foi realizada por três avaliadores e os dados registrados sem comunicação entre os mesmos, sendo considerado o resultado que mais ocorreu. Alopecia, descamação, eritema e crostas foram lesões clínicas comuns às duas formas de apresentação da doença que mais ocorreram. Inflamação histológica dermal grave ocorreu especialmente nos cães com doença localizada e generalizada que possuíam piodermite concomitante e ácaros Demodex sp. foram visualizados com intensidade entre moderada e acentuada na maioria dos cães com ambas as formas da enfermidade. Perifoliculite foi a alteração folicular microscópica mais evidenciada nos caninos deste estudo, seguida por foliculite mural e furunculose que tiveram maior ocorrência relativa nos cães com demodicose localizada. De acordo com os resultados obtidos verificou-se que a gravidade das lesões histológicas não corresponde necessariamente à forma de apresentação clínica da enfermidade, além disso, a quantidade de ácaros não demonstrou ser indicativa de lesões clínicas localizadas ou generalizadas, bem como não é possível diferenciar a doença clínica através do exame histopatológico.(AU)

Demodicosis is a skin condition caused by Demodex mite, frequently diagnosed in clinical routine. The purpose of this study was to compare the clinical and histological manifestations of localized and generalized demodicosis in dogs, relating the amount of mites and microscopic lesions. The study group was formed by 46 dogs, 28 with generalized demodicosis, and 18 with the localized form of the disease, all of them with positive skin scrapings. Macroscopic lesions data in dermatological form were noted, and skin samples were collected for microscopic study. The histopathological analysis was individually performed by three reviewers without intercommunication, being considered the result that more occurred. Alopecia, scaling, erythema, and crusting were the most common clinical lesions in both forms of the disease. Histological severe dermatitis occurred especially in dogs with localized and generalized disease that had concomitant pyoderma and Demodex sp. mites were visualized with intensity moderate and severe in the most dogs with both forms of the diseases. Perifolliculitis was the most evident microscopic follicular change in this study, followed by folliculitis and furunculosis wall, which had higher relative occurrence in dogs with localized demodicosis. According to the results obtained, the severity of histologic lesions does not necessarily correspond to the clinical presentation of the disease, in addition to the amount of mites that apparently is not indicative of localized or generalized clinical lesions, and cannot differentiate clinical disease by histopathology.(AU)

Emphasizing the diagnosis and treatment of Demodex blepharitis / 中华实验眼科杂志

Blepharitis is one of the common eye diseases,it may cause ocular irritation symptoms,and even cause damage of visual function,if it involves the meibomian gland and cornea.Recent studies have shown that Demodex infestation may be an important but under-estimated cause of blepharitis,its diagnosis and treatment become the focus of blepharitis research,clinical doctors should pay adequate attention to this.Demodex blepharitis still faces many uncertain problems and challenges.In this paper,the controversial problems of Demodex blepharitis diagnosis and treatment,combined with domestic and foreign research results and the author's experience was analyzed,and we also discussed that how to improve the accuracy of clinical diagnosis and improve the treatment effect of Demodex blepharitis.Herein,we emphasize on the diagnosis and treatment options of Demodex blepharitis.Early detection of the pathogen and prompt treatment would ultimately improve the prognosis of Demodex blepharitis.

Demodex Mite Density Determinations by Standardized Skin Surface Biopsy and Direct Microscopic Examination and Their Relations with Clinical Types and Distribution Patterns

BACKGROUND: Demodicosis is a parasitic skin disease caused by Demodex mites, and the determination of mite density per square centimeter is important to diagnose demodicosis. Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are commonly used to determine Demodex mites density (Dd). However, no study has previously compared these two methods with respect to clinical types and distribution patterns of demodicosis. OBJECTIVE: The aim of this study was to compare the value of SSSB and DME findings in reference to the clinical types and distribution patterns of demodicosis. METHODS: The medical records of 35 patients diagnosed with demodicosis between December 2011 and June 2015 were retrospectively reviewed. Demodicosis was classified according to four clinical types (pityriasis folliculorum, rosacea type, acne type, and perioral type) and three distribution patterns (diffuse pattern, U-zone pattern, and T-zone pattern). Two samples, one for SSSB and one for DME, were obtained from a lesion of each patient. RESULTS: In all patients, mean Dd and the proportion with a high Dd (>5D/cm²) by DME (14.5±3.3, 80.0%, respectively) were higher than by SSSB (5.5±1.3, 37.1%, respectively; p<0.01, p=0.02, respectively). In terms of clinical types, for rosacea type, mean Dd and proportion with a high Dd by DME (12.4±3.5, 84.6%, respectively) were significantly greater than those determined by SSSB (3.6±1.2, 23.1%; p=0.04, p=0.04, respectively). In terms of distribution pattern, for the diffuse pattern, mean Dd and the proportion with a high Dd by DME (17.5±3.7, 100%, respectively) were significantly higher than those determined by SSSB (6.0±2.7, 26.7%; p<0.01, p<0.01, respectively). CONCLUSION: The results of our study revealed that DME is a more sensitive method for detecting Demodex than SSSB, especially in patients with diffuse pattern and suspected rosacea type. Further research is needed to confirm this finding.

Skin impression with acetate tape in Demodex canis and Scarcoptes scabiei var. vulpes diagnosis / Impressão cutânea com fita de acetato no diagnóstico de Demodex canis e Sarcoptes scabiei var. vulpes

This study compares the efficacy of skin impression with acetate tape and the deep skin scraping test to find D. canis and S. scabiei in dogs. During six months, 134 samples were collected by both techniques from 115 dogs treated at the dermatology service of the Veterinary Hospital of the Federal University of Santa Maria (HVU-UFSM). Of these patients, 27 had demodicosis and 12 had scabies. The impression with acetate tape test (ITT) was shown to be significantly superior to the deep skin scraping test (DSST) in finding D. canis and S. scabiei mites (p = 0.007). Based on our results we could conclude that acetate tape impression is a reliable method for diagnosing and monitoring therapy of dermatopathies caused by mites and can be used to replace the traditional deep skin scraping method. In addition, since it is less traumatic for the dog, this method shows more acceptance by the owner.

Este estudo compara a eficácia da impressão cutânea com fita de acetato ao raspado cutâneo profundo para a pesquisa de D. canis e S. scabiei. Em um período de seis meses, foram coletadas 134 amostras de cada uma das técnicas de um total de 115 cães atendidos na rotina dermatológica do Hospital Veterinário Universitário da Universidade Federal de Santa Maria (HVU-UFSM). Desses pacientes, 27 cães apresentavam sarna demodécica e 12 cães, escabiose. A impressão cutânea com fita de acetato, quando comparada ao raspado cutâneo profundo, demonstrou ser significativamente superior na pesquisa dos ácaros D. canis e S. scabiei (p = 0,007). Conclui-se que o método da fita de acetato pode ser usado em substituição ao raspado profundo de pele para o diagnóstico e controle da terapia das enfermidades dermatológicas produzidas por ácaros. Além de ser um método sensível, ele é menos traumático para o animal, sendo, dessa forma, mais aceito pelo proprietário.

The Demodex mites and their relation with seborrheic and atopic Dermatitis

OBJECTIVE@#To determine the prevalence of seborrhoeic dermatitis (SD) and atopic dermatitis (AD) between the Demodex folliculorum (D. folliculorum) positive and D. folliculorum negative patients and to investigate any possible relationship between the D. folliculorum mites and the presence of SD and AD.@*METHODS@#In this cross sectional study, authors collected samples from the skin around the nasal tip of 180 randomized patients who reffered to Amir Al-Momenin Hospital dermatology clinic for skin erythema, scaling and pruritis, to examine the precence of demodicosis (D. folliculorum) infestation under optical microscope. Then authors assessed the prevalence of SD and AD between the D. folliculorum positive and D. folliculorum negative patients. Finally, data analysis using SPSS software and Chi-square test were performed.@*RESULTS@#Our study showed no significant association between the demodicosis (D. folliculorum) and SD (P=0.68) and AD (P=0.70) prevalence.@*CONCLUSIONS@#According to the result of this study, the eradication of Demodex mites probably is not effective to reduces the prevalence of both dermatitis. However further investigation on a larger scale in a case-control study in this area is recommended.

The Demodex mites and their relation with seborrheic and atopic Dermatitis

Objective: To determine the prevalence of seborrhoeic dermatitis (SD) and atopic dermatitis (AD) between the Demodex folliculorum (D. folliculorum) positive and D. folliculorum negative patients and to investigate any possible relationship between the D. folliculorum mites and the presence of SD and AD. Methods: In this cross sectional study, authors collected samples from the skin around the nasal tip of 180 randomized patients who reffered to Amir Al-Momenin Hospital dermatology clinic for skin erythema, scaling and pruritis, to examine the precence of demodicosis (D. folliculorum) infestation under optical microscope. Then authors assessed the prevalence of SD and AD between the D. folliculorum positive and D. folliculorum negative patients. Finally, data analysis using SPSS software and Chi-square test were performed. Results: Our study showed no significant association between the demodicosis (D. folliculorum) and SD (P=0.68) and AD (P=0.70) prevalence. Conclusions: According to the result of this study, the eradication of Demodex mites probably is not effective to reduces the prevalence of both dermatitis. However further investigation on a larger scale in a case-control study in this area is recommended.

Dermatite multifatorial em um canino / Multifactorial dermatitis in a dog

Relatou-se um caso clínico de dermatite multifatorial em cão, envolvendo Demodex canis, Sporothrix schenckii e bactérias dos gêneros Staphylococcus e Streptococcus. O animal, macho, da raça Pit Bull, com um ano e três meses de idade, apresentou lesões úmidas, hiperêmicas, descamativas e ulcerativas nas regiões do pescoço e do tórax. Exames laboratoriais confirmaram o diagnóstico de infecção concomitante por fungo, bactéria e parasito. A terapia antimicrobiana com moxidectina, itraconazol e amoxicilina foi efetiva, com remissão dos sinais clínicos após 30 dias de tratamento. Este relato salienta a importância do diagnóstico de certeza, que foi determinante para estabelecimento da terapêutica adequada e recuperação do animal.

A clinical case of dermatitis multifactorial in a dog was reported, involving Demodex canis, Sporothrix schenckii, and bacteria of the genera Staphylococcus and Streptococcus. The animal, male, Pit Bull, with a year and three months of age had soaked lesions, was hyperemic, scaly and had an ulcer in the neck and chest. Laboratory tests confirmed the diagnosis of concomitant infection by fungi, bacteria and parasites. Antimicrobial therapy with moxidectin, itraconazol and amoxicillin was effective, with remission of clinical signs after 30 days of treatment. This report emphasizes the importance of an accurate diagnosis, which was crucial to establish the correct treatment and recovery of the animal.

Demodicose suína no norte do estado do Rio de Janeiro: relato de caso / Demodicosis in northern Rio de Janeiro State: case report

Um leitão oriundo de um criatório do norte do estado do Rio de Janeiro, mantido no biotério do Hospital Veterinário da Universidade Estadual do Norte Fluminense Darcy Ribeiro e utilizado como caso piloto de projeto de pesquisa para investigações sobre o acesso videolaparoscópico retal (NOTES - Natural Orifice Translumenal Endoscopic Surgery), foi eutanasiado e necropsiado. Amostras do ponto de acesso do tubo de inserção na região mucocutânea anal foram colhidas, fixadas em formalina neutra tamponada a 10%, processadas por inclusão em parafina e coradas pela hematoxilina e eosina para histologia. Observou-se o comprometimento de folículos que, dilatados, exibiam formações que lembravam Demodex spp. cortados em vários sentidos e, por se tratar de ácaros espécie-específicos, concluiu-se como D. phylloides. Na citopatologia, o ácaro foi recuperado e identificado a fresco, mostrando-se alongado, com quatro pares de patas ventrais e no terço anterior do corpo. Este se refere ao primeiro registro de demodicose suína no estado do Rio de Janeiro.

A piglet derived from a farm in northern Rio de Janeiro State, maintained at the Animal Veterinary Hospital of Universidade Estadual do Norte Fluminense Darcy Ribeiro and used as a pilot case for a research project on access to research video-laparoscopic rectal (NOTES - Natural Orifice Endoscopic Surgery Translumenal) was euthanized and necropsied. Samples from the access point of the insertion tube in mucocutaneous anal region were collected, fixed in buffered formalin 10%, processed by embedding in paraffin and stained with hematoxylin and eosin for histopathology. The impairment of follicles that exhibited dilated formations resembling Demodex spp. cut in various directions and due to the mite species-specific was observed, and was concluded as D. phylloides. The mite was recovered and freshly identified by cytopathology. It was elongated, with four pairs of legs, at ventral and anterior third of the body. This refers to the first report of swine demodicosis in Rio de Janeiro State.