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.

Case of Wound Myiasis in a Squamous Cell Carcinoma Lesion of the Scalp.

Myiasis refers to the infestation of living humans and vertebrate animals by dipterous larvae. Many organs can be infested by fly larvae, but cutaneous and wound myiases are the most frequently encountered clinical forms. Persistent ulcer or non-healing wound is one of the symptoms of squamous cell carcinoma which is the second most common skin cancer in the world. Here we report a case of an elderly man with a severe wound myiasis in a squamous cell carcinoma lesion of the scalp. The maggots were confirmed to be Lucilia sericata which are widespread flies in Japan. Human myiasis is rarely reported in Japan, but patients with necrotic, hemorrhaging, or pus-filled wounds are susceptible to infestation. It is necessary for doctors and nurses to ensure that their patients change their dressings daily and keep their wounds clean.

A case report of cutaneous leishmaniasis: a misleading clinical presentation.

BACKGROUND: The diagnosis of cutaneous leishmaniasis (CL) is often difficult because of the diversity of clinical presentations, its often-misleading appearance and the very long incubation period (time between the endemic stay and the onset of skin lesions). CASE: We report the case of an otherwise healthy 67-year-old man who presented with inflammatory skin lesions on the scalp and face for the past 7 years. The lesions were first mistaken as cutaneous sarcoidosis, mycobacterial infection, and cutaneous lymphoma. Finally, the diagnosis was made by RT-PCR analysis on a punch-biopsy specimen, which was positive for Leishmania infantum. DISCUSSION AND CONCLUSION: To date, the choice of treatment for complex cutaneous leishmaniases is based on the Leishmania species. Our patient successfully responded to liposomal amphotericin B.

Furuncular myiasis of the scalp associated with pigmented basal cell carcinoma: First case diagnosed in Albania.

We are reporting a case of myiasis associated with pigmented basal cell carcinoma. This is the first reported case from Albania and Balkan peninsula. Correct diagnosis and prompt treatment may prevent a disastrous and destructive course of the disease and may lead to improved quality of life.

"Eczema" of the nape: A marker of pthiriasis capitis.

Pthirus pubis usually infests the pubis, inguinal folds, buttocks and perianal region. In hairy males or when the infestation is longstanding, this louse can also occur on the thighs, abdomen, chest, axillae and beard. Eyelashes may be involved in children. The involvement of the scalp is very rare. We describe four girls with P. pubis infestation located exclusively on the scalp which was characterized by a rash on the nape that can suggest a head and neck form of atopic dermatitis.

Dermatobia hominis 'the human botfly' presenting as a scalp lesion.

Owing to increasing international travel, physicians will encounter more infectious diseases acquired overseas, which may be bacterial, fungal or parasitic in nature. 1 Knowledge of the geographic distribution of specific diseases permits the formulation of a differential diagnosis in the context of clinical presentation. Parasitic infestations of the maxillofacial tissues can be caused by a host of different ectoparasites, for example, myiasis, a frequently misdiagnosed disease of tourists returning from exotic locations. For those natives and travellers who are subject to these 'infestations', the experience can be both alarming and very distressing.

Phthirus pubis Infestation of the Scalp: A Case Report and Review of The Literature.

Phthirus pubis usually infests the pubis, groin, buttocks and perianal region. It can sometimes infest the thighs, abdomen, chest, axillae and beard. Eyelashes and eyebrows may be involved in children. The involvement of the scalp is very rare. We describe a case of P. pubis infestation located exclusively on the scalp in an adult woman. Neither lice/nits nor skin lesions were observed elsewhere, including eyebrows, eyelashes, axillae, pubis, buttocks and perianal region (the patient was hairless in the axillae and pubis). A review of the literature is enclosed.

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.

Wound myiasis: the role of entodermoscopy.

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.

Fluctuating lesion of the scalp after a journey to the tropics: a case of furunculoid myiasis.

Fluctuating lesions or furuncles of the scalp occur frequently in dermatological practice. This clinical condition is often caused by gram positive bacteria (e.g. staphylococcal or streptococcal skin infection) or fungal infection (e.g. Kerion celsi). However, a rare diagnosis such as myiasis might be considered, especially if a journey to an endemic area is reported. Herein, we present a case of furunculoid myiasis of the scalp and review the pathogenesis and therapeutic options to treat this condition.

Maggots in the Brain: Sequelae of Ignored Scalp Wound.

A 26-year-old male had suffered a burn injury to his scalp in childhood and ignored it. He presented with a complaint of something crawling on his head. Inspection of his scalp revealed multiple maggots on the brain surface with erosion of overlying bone and scalp. He was successfully managed by surgical debridement and regular dressing.

Arrestant Effect of Human Scalp Components on Head Louse (Phthiraptera: Pediculidae) Behavior.

Relevant evidence has shown that parasites process host-related information using chemical, visual, tactile, or auditory cues. However, the cues that are involved in the host-parasite interaction between Pediculus humanus capitis (De Geer 1767) and humans have not been identified yet. In this work, we studied the effect of human scalp components on the behavior of adult head lice. Filter paper segments were rubbed on volunteers' scalps and then placed in the experimental arena, where adult head lice were individually tested. The movement of the insects was recorded for each arena using the software EthoVision. Average movement parameters were calculated for the treatments in the bioassays such as total distance, velocity, number of times a head louse crossed between zones of the arena, and time in each zone of the arena. We found that scalp components induced head lice to decrease average locomotor activity and to remain arrested on the treated paper. The effect of the ageing of human scalp samples in the response of head lice was not statistically significant (i.e., human scalp samples of 4, 18, 40, and 60 h of ageing did not elicit a significant change in head louse behavior). When we analyzed the effect of the sex in the response of head lice to human scalp samples, males demonstrated significant differences. Our results showed for the first time the effect of host components conditioning head lice behavior. We discuss the role of these components in the dynamic of head lice infestation.

Tick Bite Alopecia: A Report and Review.

Tick bites can cause a number of local inflammatory reactions, which are often difficult to differentiate from those induced by other arthropod bites or stings. These include erythematous nodular or pustular lesions, erosive plaques, annular lesions of erythema chronicum migrans, and both scarring and nonscarring inflammatory alopecia. We report a case of nonscarring alopecia in a 21-year-old male who reported a recent history of tick bite to the scalp. The biopsy demonstrated a dense pseudolymphomatous inflammatory infiltrate with numerous eosinophils associated with hair follicle miniaturization and an elevated catagen-telogen count. Signs of external rubbing, including lichen simplex chronicus and the "hamburger sign", were also visualized and are indicative of the associated pruritus. To the authors' knowledge, this is the fifth report of nonscarring tick bite alopecia in the literature and the first in an adult patient. This text will review the classic clinical presentation, histologic findings, and proposed mechanism of tick bite alopecia.

Rhipicephalus sanguineus (ACARI: IXODIDAE) BITING A HUMAN BEING IN PORTO ALEGRE CITY, RIO GRANDE DO SUL, BRAZIL.

We report the finding of a female brown dog tick, Rhipicephalus sanguineus (Acari: Ixodidae) on the scalp of a male patient inPorto Alegre, Rio Grande do Sul, Brazil. Human parasitism by this tick is rare and has seldomly been reported in the literature, despite its recognized importance since it can act as a vector of Rickettsia rickettsii, the agent of spotted fever.