Demodex: the worst enemies are the ones that used to be friends
https://doi.org/10.4081/dr.2022.9339
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Demodex mites are common ectoparasites of the human pilosebaceous units. Most adults are infested with Demodex mites without clinical symptoms. Demodex mite will only become a pathogenic organism when there is an abnormal increase in the number of Demodex mite density. This situation happens when the equilibrium between Demodex mites, skin microenvironment and human immunity system changes. Demodex infestation can cause multiple skin disorders, which are grouped under the term demodicosis or demodicidosis. Clinical manifestations of demodicosis can mimic other known skin diseases such as folliculitis, rosacea, perioral dermatitis, which is why it is often misdiagnosed. Diagnosis criteria consists of relevant correlation of suspected clinical skin lesions, confirmed by the presence of abnormal proliferation of Demodex mites and by clinical cure after acaricidal treatment together with normalization of Demodex mite density. Dermatologists should be aware that demodicosis is not an uncommon skin disease, and there are still many unknowns about it that should be researched further.
Aylesworth R, Vance JC. Demodex folliculorum and Demodex brevis in cutaneous biopsies. J Am Acad Dermatol 1982;7:583-9. DOI: https://doi.org/10.1016/S0190-9622(82)70137-9
Acosta FJ, Planas L, Penneys N. Demodex mites contain immunoreactive lipase. Arch Dermatol. 1989;125:1436-7.
Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol 2007;157:474-81. DOI: https://doi.org/10.1111/j.1365-2133.2007.08028.x
Spickett SG. Studies on Demodex folliculorum Simon. Parasitology 1961;51:181–92. DOI: https://doi.org/10.1017/S003118200006858X
Sędzikowska A, Bartosik K, Przydatek-Tyrajska R, Dybicz M. Shared Makeup Cosmetics as a Route of Demodex folliculorum Infections. Acta Parasitol 2021;66:631-7. DOI: https://doi.org/10.1007/s11686-020-00332-w
Sengbusch HG, Hauswirth JM. Prevalence of hair follicle mites, Demodex folliculorum and Demodex brevis, in a selected human population in Western New York, USA. J Med Entomol 1986;23:384-8. DOI: https://doi.org/10.1093/jmedent/23.4.384
Özer TT, Akyürek Ö, Durmaz S. Association between Demodex folliculorum and Metabolic syndrome. J Cosmet Dermatol 2020;19:3145-9. DOI: https://doi.org/10.1111/jocd.13721
Karincaoglu Y, Seyhan ME, Bayram N, et al. Incidence of Demodex folliculorum in patients with end stage chronic renal failure. Ren Fail 2005;27:495-9. DOI: https://doi.org/10.1080/08860220500198037
Ivy SP, Mackall CL, Gore L, et al. Demodicidosis in childhood acute lymphoblastic leukemia: an opportunistic infection occurring with immunosuppression. J Pediatr 1995;127:751-4. DOI: https://doi.org/10.1016/S0022-3476(95)70168-0
Fujiwara S, Okubo Y, Irisawa R, Tsuboi R. Rosaceiform dermatitis associated with topical tacrolimus treatment. J Am Acad Dermatol 2010;62:1050-2. DOI: https://doi.org/10.1016/j.jaad.2009.01.029
Demirdağ HG, Özcan H, Gürsoy Ş, et al. The effects of sebum configuration on Demodex spp. Density. Turk J Med Sci 2016;46:1415-21. DOI: https://doi.org/10.3906/sag-1504-77
Thoemmes MS, Fergus DJ, Urban J, Tautwein M, Dunn RR. Ubiquity and diversity of human-associated Demodex mite. PLoS One 2014;9:e106265. DOI: https://doi.org/10.1371/journal.pone.0106265
Desch CE. Human hair follicle mites and forensic acarology. Exp Appl Acarol 2009;49:143-6. DOI: https://doi.org/10.1007/s10493-009-9272-0
Esenkaya Taşbent F, Dik B. A dog related Demodex spp. infestation in a student: a rare Demodex case. Mikrobiyol Bul 2018;52:214-20. DOI: https://doi.org/10.5578/mb.66410
Ferreira D, Sastre N, Ravera I, Altet L, et al. Identification of a third feline Demodex species through partial sequencing of the 16S rDNA and frequency of Demodex species in 74 cats using a PCR assay. Vet Dermatol 2015;26:239. DOI: https://doi.org/10.1111/vde.12206
Tani K, Une S, Hasegawa A, et al. Infestivity of Demodex canis to hamster skin engrafted onto SCID mice. J Vet Med Sci 2005;67:445-8. DOI: https://doi.org/10.1292/jvms.67.445
Akilov OE, KY. Association between human demodicosis and HLA class I. Clin Exp Dermatol. 2003;28:70-3. DOI: https://doi.org/10.1046/j.1365-2230.2003.01173.x
Akilov OE, Mumcuoglu KY. Immune response in demodicosis. J Eur Acad Dermatol Venereol 2004;18:440-4. DOI: https://doi.org/10.1111/j.1468-3083.2004.00964.x
Gazi U, Taylan-Ozkan A, Mumcuoglu KY. Immune mechanisms in human and canine demodicosis: A review. Parasite Immunol 2019;41:e12673. DOI: https://doi.org/10.1111/pim.12673
Kalincaoglu Y, Tepe B, Kalayci B, Seyhan M. Pseudozoster clinical presentation of Demodex infestation after prolonged topical steroid use. Clin Exp Dermatol 2008;33:740-2. DOI: https://doi.org/10.1111/j.1365-2230.2008.02854.x
Ní Raghallaigh S, Powell FC: The cutaneous microenvironment in papulopustular rosacea. Br J Dermatol 2009;161:25.
Ní Raghallaigh S, Bender K, Lacey N, et al. The fatty acid profile of the skin surface lipid layer in patients with papulopustular rosacea. Br J Dermatol 2012;166:279-87. DOI: https://doi.org/10.1111/j.1365-2133.2011.10662.x
Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol 1993;128:650-9. DOI: https://doi.org/10.1111/j.1365-2133.1993.tb00261.x
Jimenez-Acosta F, Planas L, Penneys N. Demodex mites contain immunoreactive lipase. Arch Dermatol 1989;125:1436-7. DOI: https://doi.org/10.1001/archderm.1989.01670220134028
Moran EM, Foley R, Powell FC. Demodex and rosacea revisited. Clin Dermatol 2017;35:195-200. DOI: https://doi.org/10.1016/j.clindermatol.2016.10.014
Jarmuda S, O'Reilly N, Żaba R, et al. Potential role of Demodex mites and bacteria in the induction of rosacea. J Med Microbiol 2012;61:1504-10. DOI: https://doi.org/10.1099/jmm.0.048090-0
Fischer K, Walton S. Parasitic mites of medical and veterinary importance--is there a common research agenda? Int J Parasitol 2014;44:955-67. DOI: https://doi.org/10.1016/j.ijpara.2014.08.003
O'Reilly N, Menezes N, Kavanagh K. Positive correlation between serum immunoreactivity to Demodex-associated Bacillus proteins and erythematotelangiectatic rosacea. Br J Dermatol 2012;167:1032-6. DOI: https://doi.org/10.1111/j.1365-2133.2012.11114.x
Ionescu MA, Joly F, Bombard E, et al. TLR-2, cathelicidin-LL37 and kallikrein-5 targeting in rosacea: In tubo, ex vivo and in vivo studies. J Am Acad Dermatol 2015;72:65. DOI: https://doi.org/10.1016/j.jaad.2015.02.271
Koller B, Muller Wiefel AS, Rupec R, et al. Chitin modulates innate immune responses of keratinocytes. PLoS One 2011;6:e16594. DOI: https://doi.org/10.1371/journal.pone.0016594
Yamasaki K, Kanada K, Macleod DT, et al. TLR2 expression is increased in rosacea and stimulates enhanced serine protease production by keratinocytes. J Invest Dermatol 2011;131:688-97. DOI: https://doi.org/10.1038/jid.2010.351
Casas C, Paul C, Lahfa M, et al. Quantification of Demodex folliculorum by PCR in rosacea and its relationship to skin innate immune activation. Exp Dermatol 2012;21:906-10. DOI: https://doi.org/10.1111/exd.12030
Erbagci Z, Ozgoztasi O. The significance of Demodex folliculorum density in rosacea. Int J Dermatol 1998;37:421-5. DOI: https://doi.org/10.1046/j.1365-4362.1998.00218.x
Karincaoglu Y, Bayram N, Aycan O, Esrefoglu M. The clinical importance of demodex folliculorum presenting with nonspecific facial signs and symptoms. J Dermatol 2004;31:618-26. DOI: https://doi.org/10.1111/j.1346-8138.2004.tb00567.x
Aktaş Karabay E, Aksu Çerman A. Demodex folliculorum infestations in common facial dermatoses: acne vulgaris, rosacea, seborrheic dermatitis. An Bras Dermatol 2020;95:187-93. DOI: https://doi.org/10.1016/j.abd.2019.08.023
Forton F, De Maertelaer V. Rosacea-like demodicosis and papulopustular rosacea may be two phenotypes of the same disease, and pityriasis folliculorum may be their precursor: response to the comment of Tatu. J Eur Acad Dermatol Venereol 2019;33:e47-8. DOI: https://doi.org/10.1111/jdv.15162
Akçınar UG, Ünal E, Doğruman Al F. Demodex spp. as a possible aetiopathogenic factor of acne and relation with acne severity and type. Postepy Dermatol Alergol 2018;35:174-81. DOI: https://doi.org/10.5114/ada.2018.75239
Yun CH, Yun JH, Baek JO, et al. Demodex Mite Density Determinations by Standardized Skin Surface Biopsy and Direct Microscopic Examination and Their Relations with Clinical Types and Distribution Patterns. Ann Dermatol 2017;29:137-42. DOI: https://doi.org/10.5021/ad.2017.29.2.137
Yasak Guner R, Tosun M, Akyol M, Hayta SB. Demodex infestation as a cause of sensitive skin in a dermatology outpatient clinic. J Cosmet Dermatol. 2021 May 22. Online ahead of print. DOI: https://doi.org/10.1111/jocd.14246
Douglas A, Zaenglein AL. A case series of demodicosis in children. Pediatr Dermatol 2019;36:651-4. DOI: https://doi.org/10.1111/pde.13852
Forton FMN, De Maertelaer V. Rosacea and Demodicosis: Little-known Diagnostic Signs and Symptoms. Acta Derm Venereol 2019;99:47-52.
Helou W, Avitan-Hersh E, Bergman R. Demodex Folliculitis of the Scalp:Clinicopathological Study of an Uncommon Entity. Am J Dermatopathol 2016;38:658-63. DOI: https://doi.org/10.1097/DAD.0000000000000512
Bachmeyer C, Moreno-Sabater A. Demodex folliculitis. CMAJ 2017;189:E865. DOI: https://doi.org/10.1503/cmaj.161323
Schaller M, Sander CA, Plewig G. Demodex abscesses: clinical and therapeutic challenges. J Am Acad Dermatol 2003;49:S272-274. DOI: https://doi.org/10.1016/S0190-9622(03)00743-6
Lee JY, Hsu CH. Granulomatous rosacea-like demodicidosis. Dermatol Online J 2007;13:9. DOI: https://doi.org/10.5070/D36NF1D13J
Sabater-Marco V, Escutia-Muñoz B, Botella-Estrada R. Eosinophilic follicular reaction induced by Demodex folliculorum mite: a different disease from eosinophilic folliculitis. Clin Exp Dermatol 2015;40:413-5. DOI: https://doi.org/10.1111/ced.12566
Klemm E, Haroske G, Wollina U. Otitis externa and myringitis due to demodicidosis. Acta Dermatovenerol Alp Pannonica Adriat 2009;18:73-6.
Hedberg ML, Chibnall RJ, Compton LA. Symptomatic vulvar demodicosis: A case report and review of the literature. J Cutan Patho 2020;47:1063-6. DOI: https://doi.org/10.1111/cup.13816
Zhao YE, Peng Y, Wang XL, et al. Facial dermatosis associated with Demodex: a case-control study. J Zhejiang Univ Sci B 2011;12:1008-15. DOI: https://doi.org/10.1631/jzus.B1100179
Sakuntabhai A, Timpatanapong P. Topical steroid induced chronic demodicidosis. J Med Assoc Thai 1991;74:116-9.
Sarac G, Cankaya C, Ozcan KN, et al. Increased frequency of Demodex blepharitis in rosacea and facial demodicosis patients. J Cosmet Dermatol 2020;19:1260-5. DOI: https://doi.org/10.1111/jocd.13150
Zhang AC, Muntz A, Wang MTM, et al. Ocular Demodex: a systematic review of the clinical literature. Ophthalmic Physiol Opt 2020;40:389-432. DOI: https://doi.org/10.1111/opo.12691
Moris García V, Valenzuela Vargas G, Marín Cornuy M, Aguila Torres P. Ocular demodicosis: A review. Arch Soc Esp Oftalmol (Engl Ed) 2019;94:316-22. DOI: https://doi.org/10.1016/j.oftal.2019.04.003
Zhao YE, Hu L, Wu LP, Ma JX. A meta-analysis of association between acne vulgaris and Demodex infestation. J Zhejiang Univ Sci B 2012;13:192-202. DOI: https://doi.org/10.1631/jzus.B1100285
Chen W, Plewig G. Human demodicosis: revisit and a proposed classification. Br J Dermatol 2014;170:1219-25. DOI: https://doi.org/10.1111/bjd.12850
Forton FM, Germaux M-AE, Thibaut SC, et al. Demodicosis: descriptive classification and status of rosacea, in response to prior classification proposed. J Eur Acad Dermatol Venereol 2015;29:829-32. DOI: https://doi.org/10.1111/jdv.12926
Forton FM, De Maertelaer V. Two Consecutive Standardized Skin Surface Biopsies: An Improved Sampling Method to Evaluate Demodex Density as a Diagnostic Tool for Rosacea and Demodicosis. Acta Derm Venereol 2017;97:242-8. DOI: https://doi.org/10.2340/00015555-2528
Huang HP, Hsu CK, Lee JY. A new superficial needle-scraping method for assessing Demodex density in papulopustular rosacea. J Cosmet Dermatol 2020;19:896-900. DOI: https://doi.org/10.1111/jocd.13082
Friedman P. Sabban EC. Cabo H. Usefulness of dermoscopy in the diagnosis and monitoring treatment of demodicidosis. Dermatol Pract Concept 2017;7:35-8. DOI: https://doi.org/10.5826/dpc.0701a06
Sattler EC, Maier T, Hoffmann VS, et al. Noninvasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy: reply from the authors. Br J Dermatol 2013;169:213-5. DOI: https://doi.org/10.1111/bjd.12281
Rufli T, Mumcluoglu Y. The hair follicle mite demodex folliculorum and demodex brevis: biology and medical important. A review. Dermatologica 1981;162:1-11. DOI: https://doi.org/10.1159/000250228
Forton F, Song M. Limitations of standardized skin surface biopsy in measurement of the density of Demodex folliculorum. A case report. Br J Dermatol 1998;139:697-700. DOI: https://doi.org/10.1046/j.1365-2133.1998.02471.x
Aşkin U, Seçkin D. Comparison of the two techniques for measurement of the density of Demodex folliculorum: standardized skin surface biopsy and direct microscopic examination. Br J Dermatol 2010;162:1124-6. DOI: https://doi.org/10.1111/j.1365-2133.2010.09645.x
Jacob S, VanDaele MA, Brown JN. Treatment of Demodex-associated inflammatory skin conditions: A systematic review. Dermatol Ther 2019;32:e13103. DOI: https://doi.org/10.1111/dth.13103
Sarac G. A comparison of the efficacy and tolerability of topical agents used in facial Demodex treatment. J Cosmet Dermatol 2019;18:1784-7. DOI: https://doi.org/10.1111/jocd.12986
Lam NSK, Long XX, Li X, et al. Comparison of the efficacy of tea tree (Melaleuca alternifolia) oil with other current pharmacological management in human demodicosis: A Systematic Review. Parasitology 2020;147:1587-613. DOI: https://doi.org/10.1017/S003118202000150X
T rave I, Merlo G, Cozzani E, Parodi A. Real-life experience on effectiveness and tolerability of topical ivermectin in papulopustular rosacea and antiparasitic effect on Demodex mites. Dermatol Ther 2019;32:e13093. DOI: https://doi.org/10.1111/dth.13093
Baima B, Sticherling M. Demodicidosis revisited. Acta Derm Venereol 2002;82:3-6. DOI: https://doi.org/10.1080/000155502753600795
Hecht I, Melzer-Golik A, Sadi Szyper N, Kaiserman I. Permethrin Cream for the Treatment of Demodex Blepharitis. Cornea 2019;38:1513-8. DOI: https://doi.org/10.1097/ICO.0000000000002013
Salem DA, El-Shazly A, Nabih N, et al. Evaluation of the efficacy of oral ivermectin in comparison with ivermectin-metronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum. Int J Infect Dis 2013;17:e343-7. DOI: https://doi.org/10.1016/j.ijid.2012.11.022
da Rocha MC, Travassos AR, Uva L, et al. Demodicosis Treatment with Systemic Ivermectin. Skinmed 2017;15:293-5.
Nakata Y, Fuse T, Yamato K, et al. A Single Amino Acid Substitution in the Third Transmembrane Region Has Opposite Impacts on the Selectivity of the Parasiticides Fluralaner and Ivermectin for Ligand-Gated Chloride Channels. Mol Pharmacol 2017;92:546-55. DOI: https://doi.org/10.1124/mol.117.109413
Cogen AL, Nizet V, Gallo RL. Skin microbiota: a source of disease or defence? Br J Dermatol 2008;158:442-55. DOI: https://doi.org/10.1111/j.1365-2133.2008.08437.x
Dahl MV, Ross AJ, Schlievert PM. Temperature regulates bacterial protein production: possible role in rosacea. J Am Acad Dermatol 2004;50:266-72. DOI: https://doi.org/10.1016/j.jaad.2003.05.005
Lacey N, Ní Raghallaigh S, Powell FC. Demodex mites--commensals, parasites or mutualistic organisms? Dermatology 2011;222:128-30. DOI: https://doi.org/10.1159/000323009
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