Density of Demodex folliculorum in facial dermatosis

Orapin Phutthanuphapant; Vesarat Wessagowit; Rutsanee Akarapha; Suthruth Reangchainam

Authors

Orapin Phutthanuphapant INSTITUTE OF DERMATOLOGY, BANGKOK, THAILAND
Vesarat Wessagowit INSTITUTE OF DERMATOLOGY, BANGKOK, THAILAND
Rutsanee Akarapha INSTITUTE OF DERMATOLOGY, BANGKOK, THAILAND
Suthruth Reangchainam INSTITUTE OF DERMATOLOGY, BANGKOK, THAILAND

Keywords:

Demodex mite, Demodex density, facial dermatosis

Abstract

Background : Demodex folliculorum (DF) is found in human pilosebaceous units. Various clinical forms have been defined. As the Demodex mite is also present in many healthy individuals, it has been suggested that the mite may have a pathogenic role when it is present in high densities. Moreover, some authors have proposed that a mite density above 5/cm² may be a criterion for the diagnosis of demodicidosis.

Objective : To compare the DF density in facial dermatosis patients and healthy subjects.

Methods : Cross sectional study. One hundred fifty patients with facial dermatosis and 150 age and sex matched healthy subjects were enrolled to this study. Standardized skin surface biopsies (SSSB) were performed from three regions (forehead, cheek and nasal dorsum) and suspected lesions. We determined the mite positivities, the mean mite counts in both groups, the mean mite density at each facial site and in the facial dermatosis subgroups, and the mite densities above 5/cm². Non parametric statistical tests were used in the study.

Results DF was found in 59 (39.3%) of the 150 facial dermatosis patients and in 45 (30%) of 150 controls. A mean mite density in the facial dermatosis group (1.46±3.78; range 0-27.33) was significantly higher than that in controls (0.55±1.70; range 0-16.67). The cheek was the most frequently and heavily infested facial region. Our study demonstrates a high density of DF in 1 case with facial eczematous eruptions (27.33/ cm²),1 case with acne vulgaris (26.33/ cm²) and 1 case from healthy subject(16.67/ cm²). When the various clinical types of facial dermatosis were considered separately, Demodex density was statistically higher than in controls in the patients presented with facial eczematous eruptions (mean= 1.9/cm²; p=0.001) and folliculitis (mean= 3.6/cm²; p=0.002).

Conclusions The density of DF was significantly higher in facial dermatosis patients than controls, especially those with eczematous eruptions and folliculitis.

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