.: DERLEME
Demodicosis
Demodikoz
Turkiye Klinikleri J Med Sci. 2019;39(2):231-6
doi: 10.5336/medsci.2018-62140
Makale Dili: EN
Tam Metin
ABSTRACT
Demodicosis is the term applied to cutaneous diseases caused by Demodex folliculorum and Demodex brevis. Demodex mites are acquired shortly after birth. They are saprophytic ectoparasites that are found primarily in areas rich in sebaceous glands, like face, scalp, neck. While human demodicosis is a skin disease sui generis, it can mimic many other inflammatory dermatoses. Therefore demodicosis are commonly underdiagnosed, and are masked behind other diagnoses such as papulopustular rosacea, erythemato telangiectasic rosacea, seborrheic dermatitis, perioral dermatitis, contact dermatitis, atopic dermatitis, phyma, seborrhea, etc. Human demodicosis is classified into a primary and secondary form by Chen and Plewig. Absence of pre-existing or concurrent inflammatory dermatosis (acne, rosacea or perioral dermatitis), abnormal increase in mite colonization in active lesions, and remission of the lesions following adequate treatment with topical or systemic acaricides/arachnicides, but not with antibiotics with antiinflammatory effects are diagnostic criteria of primary demodicosis. Secondary demodicosis is defined to skin lesions associated with an abnormal increase of Demodex mites in patients with other known skin or systemic diseases. Clinically, demodicosis has a wide range of variants and may manifest as folliculitis (Pityriasis folliculorum), papulopustular erythema (Rosacea-like demodicosis), blepharoconjunctivitis (demodectic blepharitis), and granulomatous rosacea-like demodicosis (Demodicosis gravis) The pathogenesis of human demodicosis remains largely obscure Here, we discuss the clinical manifestations, pathogenesis of demodicosis, and treatment strategies.
Keywords: Demodicosis; pathogenesis; clinical manifestations; treatment
Demodicosis is the term applied to cutaneous diseases caused by Demodex folliculorum and Demodex brevis. Demodex mites are acquired shortly after birth. They are saprophytic ectoparasites that are found primarily in areas rich in sebaceous glands, like face, scalp, neck. While human demodicosis is a skin disease sui generis, it can mimic many other inflammatory dermatoses. Therefore demodicosis are commonly underdiagnosed, and are masked behind other diagnoses such as papulopustular rosacea, erythemato telangiectasic rosacea, seborrheic dermatitis, perioral dermatitis, contact dermatitis, atopic dermatitis, phyma, seborrhea, etc. Human demodicosis is classified into a primary and secondary form by Chen and Plewig. Absence of pre-existing or concurrent inflammatory dermatosis (acne, rosacea or perioral dermatitis), abnormal increase in mite colonization in active lesions, and remission of the lesions following adequate treatment with topical or systemic acaricides/arachnicides, but not with antibiotics with antiinflammatory effects are diagnostic criteria of primary demodicosis. Secondary demodicosis is defined to skin lesions associated with an abnormal increase of Demodex mites in patients with other known skin or systemic diseases. Clinically, demodicosis has a wide range of variants and may manifest as folliculitis (Pityriasis folliculorum), papulopustular erythema (Rosacea-like demodicosis), blepharoconjunctivitis (demodectic blepharitis), and granulomatous rosacea-like demodicosis (Demodicosis gravis) The pathogenesis of human demodicosis remains largely obscure Here, we discuss the clinical manifestations, pathogenesis of demodicosis, and treatment strategies.
Keywords: Demodicosis; pathogenesis; clinical manifestations; treatment
ÖZET
Demodikoz; Demodeks follikulorum ve Demodeks brevis tarafından oluşturulan deri hastalığını tanımlamak için kullanılan bir terimdir. Demodeksler saprofitik ektoparazitlerdir ve yüz, skalp, boyun gibi sebase bezlerden zengin alanlarda bulunurlar. Demodikoz, çok sayıda inflamatuar dermatozu taklit edebilir. Bu nedenle sıklıkla tanısı atlanır ve hastalar papülopüstüler rozase, eritemato telenjiyektazik rozase, seboreik dermatit, perioral dertmatit, kontakt dermatit, atopik dermatit, fima, sebore gibi tanılar alır. İnsan demodikozu Chen ve Plewig tarafından primer ve sekonder olarak sınıflandırılmıştır. Primer demodikoz tanısı; eşlik eden inflamatuar bir dermatozu (akne, rozase, perioral dermatit) olmayan, aktif lezyonlarda artmış parazit varlığı gösterilen ve tablonun antiinflamatuvar etkili antibiyotikler ile değil, topikal veya sistemik akarisid tedaviyle düzeldiği hastalar için kullanılır. Sekonder demodikoz ise bilinen bir deri veya sistemik hastalığı olan hastalarda demodeks yoğunluğunun artmasına denilir. Demodikozun çeşitli klinik varyantları vardır. Bunlar follikülit (pitriyazis follikulorum), papülopüstüler eritem (rozase benzeri demodikoz), blefarokonjuktivit (demodektik blefarit) ve granülomatöz rozase benzeri demodikozdur (demodikoz gravis). Hastalığın patogenezi tam olarak aydınlatılamamıştır. Bu derlemede demodikozun klinik özellikleri, patogenezi ve tedavisi anlatılmıştır.
Anahtar Kelimeler: Demodikoz; patojen; klinik belirtiler; tedavi
Demodikoz; Demodeks follikulorum ve Demodeks brevis tarafından oluşturulan deri hastalığını tanımlamak için kullanılan bir terimdir. Demodeksler saprofitik ektoparazitlerdir ve yüz, skalp, boyun gibi sebase bezlerden zengin alanlarda bulunurlar. Demodikoz, çok sayıda inflamatuar dermatozu taklit edebilir. Bu nedenle sıklıkla tanısı atlanır ve hastalar papülopüstüler rozase, eritemato telenjiyektazik rozase, seboreik dermatit, perioral dertmatit, kontakt dermatit, atopik dermatit, fima, sebore gibi tanılar alır. İnsan demodikozu Chen ve Plewig tarafından primer ve sekonder olarak sınıflandırılmıştır. Primer demodikoz tanısı; eşlik eden inflamatuar bir dermatozu (akne, rozase, perioral dermatit) olmayan, aktif lezyonlarda artmış parazit varlığı gösterilen ve tablonun antiinflamatuvar etkili antibiyotikler ile değil, topikal veya sistemik akarisid tedaviyle düzeldiği hastalar için kullanılır. Sekonder demodikoz ise bilinen bir deri veya sistemik hastalığı olan hastalarda demodeks yoğunluğunun artmasına denilir. Demodikozun çeşitli klinik varyantları vardır. Bunlar follikülit (pitriyazis follikulorum), papülopüstüler eritem (rozase benzeri demodikoz), blefarokonjuktivit (demodektik blefarit) ve granülomatöz rozase benzeri demodikozdur (demodikoz gravis). Hastalığın patogenezi tam olarak aydınlatılamamıştır. Bu derlemede demodikozun klinik özellikleri, patogenezi ve tedavisi anlatılmıştır.
Anahtar Kelimeler: Demodikoz; patojen; klinik belirtiler; tedavi
REFERANSLAR:
- Chovatiya RJ, Colegio OR. Demodicosis in renal transplant recipients. Am J Transplant. 2016;16(2):712-6. [Crossref] [PubMed]
- Kito Y, Hashizume H, Tokura Y. Rosacea-like demodicosis mimicking cutaneous lymphoma. Acta Derm Venereol. 2012;92(2):169-70.[Crossref] [PubMed]
- Dessinioti C, Antoniou C, Katsambas A. Acneiform eruptions. Clin Dermatol. 2014;32(1): 24-34. [Crossref] [PubMed]
- Turgut Erdemir A, Gurel MS, Koku Aksu AE, Bilgin Karahalli F, Incel P, Kutlu Haytoğlu NS, et al. Reflectance confocal microscopy vs. standardized skin surface biopsy for measuring the density of Demodex mites. Skin Res Technol. 2014;20(4):435-9. [Crossref] [PubMed]
- Eismann R, Bramsiepe I, Danz B, Wohlrab J, Marsch WCh, Fiedler E. Abscessing nodular demodicosis--therapy with ivermectin and permethrin. J Eur Acad Dermatol Venereol. 2010;24(1):79-81. [Crossref] [PubMed]
- Hsu CK, Hsu MM, Lee JY. Demodicosis: a clinicopathological study. J Am Acad Dermatol. 2009;60(3):453-62. [Crossref] [PubMed]
- Chen W, Plewig G. Human demodicosis: revisit and a proposed classification. Br J Dermatol. 2014;170(6):1219-25. [Crossref]
- Forton FM. Papulopustular rosacea, skin immunity and Demodex: pityriasis folliculorum as a missing link. J Eur Acad Dermatol Venereol. 2012;26(1):19-28. [Crossref] [PubMed]
- Karincaoglu Y, Tepe B, Kalayci B, Seyhan M. Pseudozoster clinical presentation of Demodex infestation after prolonged topical steroid use. Clin Exp Dermatol. 2008;33(6): 740-2. [Crossref] [PubMed]
- Damian D, Rogers M. Demodex infestation in a child with leukaemia: treatment with ivermectin and permethrin. Int J Dermatol. 2003;42(9):724-6. [Crossref] [PubMed]
- Jansen T, Kastner U, Kreuter A, Altmeyer P. Rosacea-like demodicidosis associated with acquired immunodeficiency syndrome. Br J Dermatol. 2001;144(1):139-42. [Crossref] [PubMed]
- Antille C, Saurat JH, Lübbe J. Induction of rosaceiform dermatitis during treatment of facial inflammatory dermatoses with tacrolimus ointment. Arch Dermatol. 2004;140(4):457-60.[Crossref] [PubMed]
- Sanfilippo AM, English JC 3rd. Resistant scalp folliculitis secondary to Demodex infestation. Cutis. 2005;76(5):321-4.
- Aytekin S. Outbreak of demodex folliculitis on the face and upper trunkduring 311-nm UVB therapy for psoriasis. J Eur Acad Dermatol Venereol. 2004;18(2):236-8. [Crossref] [PubMed]
- Karincaoglu Y, Tepe B, Kalayci B, Atambay M, Seyhan M. Is Demodex folliculorum an aetiological factor in seborrhoeic dermatitis? Clin Exp Dermatol. 2009;34(8):e516-20. [Crossref] [PubMed]
- Gerber PA, Kukova G, Buhren BA, Homey B. Density of Demodex folliculorum in patients receiving epidermal growth factor receptor inhibitors. Dermatology. 2011;222(2):144-7.[Crossref] [PubMed]
- Erbagci Z, Erbagci I, Erkiliç S. High incidence of demodicidosis in eyelid basal cell carcinomas. Int J Dermatol. 2003;42(7):567-71. [Crossref] [PubMed]
- Forton FM, Germaux MA, Thibaut SC, Stene JJ, Brasseur TV, Mathys CL, et al. Demodicosis: descriptive classification and status of Rosacea, in response to prior classification proposed. J Eur Acad Dermatol Venereol. 2015;29(4):829-32. [Crossref] [PubMed]
- Forton F, Germaux MA, Brasseur T, De Liever A, Laporte M, Mathys C, et al. Demodicosis and rosacea: epidemiology and significance in daily dermatologic practice. J Am Acad Dermatol. 2005;52(1):74-87. [Crossref] [PubMed]
- Baima B, Sticherling M. Demodicidosis revisited. Acta Derm Venereol. 2002;82(1):3-6.[Crossref] [PubMed]
- Liu J, Sheha H, Tseng SC. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010;10(5):505-10.[Crossref] [PubMed] [PMC]
- Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007;157(3):474-81. [Crossref] [PubMed]
- 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(5):1124-6. [Crossref] [PubMed]
- Forton F. Standardized skin surface biopsy: method to estimate the Demodex folliculorum density, not to study the Demodex folliculorum prevalence. J Eur Acad Dermatol Venereol. 2007;21(9):1301-2. [Crossref] [PubMed]
- Forton F, Song M. Limitations of standardized skin surface biopsy in measurement of the density of Demodex folliculorum. Br J Dermatol. 1998;139(4):697-700. [Crossref] [PubMed]
- Segal R, Mimouni D, Feuerman H, Pagovitz O, David M. Dermoscopy as a diagnostic tool in demodicidosis. Int J Dermatol. 2010;49(9): 1018-23. [Crossref] [PubMed]
- Maier T, Sattler E, Braun-Falco M, Ruzicka T, Berking C. High-definition optical coherence tomography for the in vivo detection of demodex mites. Dermatology. 2012;225(3):271-6. [Crossref] [PubMed]
- Mueller RS. Treatment protocols for demodicosis: an evidencebased review. Vet Dermatol. 2004;15(2):75-89. [Crossref] [PubMed]
- Aytekin S, Göktay F. [Demodicosis]. TurkiyeKlinikleri J Dermatol-Special Topics. 2015; 8(3):35-41.
- Aydogan K, Alver O, Tore O, Karadogan SK. Facial abscess-like conglomerates associated with Demodex mites. J Eur Acad Dermatol Venereol. 2006;20(8):1002-4. [Crossref] [PubMed]
- Hay RJ, Steer AC, Engelman D, Walton S. Scabies in the developing world--its prevalence, complications, and management. Clin Microbiol Infect. 2012;18(4):313-23. [Crossref] [PubMed]
- Koo H, Kim TH, Kim KW, Wee SW, Chun YS, Kim JC. Ocular surface discomfort and Demodex: effect of tea tree oil eyelid scrub in Demodex blepharitis. J Korean Med Sci. 2012;27(12):1574-9. [Crossref] [PubMed] [PMC]
- Jarmuda S, O?Reilly N, Zaba R, Jakubowicz O, Szkaradkiewicz A, Kavanagh K. Potential role of Demodex mites and bacteria in the induction of rosacea. J Med Microbiol. 2012;61(Pt 11):1504-10. [Crossref] [PubMed]
.: İşlem Listesi