Demodicosis as treatment complication of amicrobial pustulosis of the folds

Demodicosis in Different Age Groups and Alternative Treatment Options-A Review

Infestation with Demodex mites is a common occurrence, especially in adults and the elderly. More recent attention has been paid to the presence of Demodex spp. mites in children, even ones without comorbidities. It causes both dermatological and ophthalmological problems. The presence of Demodex spp. is often asymptomatic, thus it is suggested to include parasitological investigation tests in dermatological diagnostics, in addition to bacteriological analysis. Literature reports show that Demodex spp. are related to the pathogenesis of numerous dermatoses, including rosacea or demodicosis gravis, and common eye pathologies reported by patients such as dry eye syndrome or ocular surface inflammatory conditions, such as blepharitis, chalazia, Meibomian gland dysfunction, and keratitis. Treatment of patients is a challenge and is usually prolonged, therefore it is important to carefully diagnose and properly select the therapy regimen for the treatment to be successful, and with minimal side effects, especially for young patients. Apart from the use of essential oils, research is ongoing for new alternative preparations active against Demodex sp. Our review was focused on the analysis of the current literature data on the available agents in the treatment of demodicosis in adults and children.

Massive Demodicosis of the Eyes in a Patient with Sjögren Syndrome: A Case Report

Purpose

Demodex mites infestation, typically asymptomatic, is a problem for patients with weakened immune systems because it often takes the form of symptomatic, massive infection. The Demodex mites play an important role in the occurrence of a range of eye surface diseases such as Demodex blepharitis, Meibomian gland dysfunctions, conjunctivitis and corneal changes. The ocular infection is closely related to the systemic invasion. Our goal was to minimize infestation and alleviate the symptoms of massive demodicosis so as to prevent further damage to the cornea.

Methods

Our research note involves a 61-year old woman diagnosed with secondary Sjögren syndrome due to rheumatoid arthritis. On the background of the autoimmune disease, corneal perforation of the left eye occurred that was cured by surgery. Then during the follow-up visit the patient was found (microscopically) massively infected with Demodex mites and the developed symptoms were particularly severe.

Results

Adequate dry eye syndrome and massive demodicosis therapy significantly reduced the number of Demodex mites and improved the patient’s condition.

Conclusion

We would like to draw the attention of the physicians of different specialties that special care should be taken with respect to the therapy of dry eye syndrome and ocular demodicosis in patients with immunological disorders to achieve therapeutic success and avoid particularly dangerous consequences of these diseases.

Case Studies of Severe Microfilaremia in Four Dogs Naturally Infected With Dirofilaria repens as the Primary Disease or a Disease Complicating Factor

Subcutaneous dirofilariosis in dogs, caused by Dirofilaria repens, is an underdiagnosed disease, now recognized for its zoonotic potential, and growing distribution and prevalence across Europe and Asia. Our understanding of the pathogenicity in human and canine host remains unclear, but case reports suggest that microfilariae (Mf) as well as adult D. repens may directly cause internal organs damage or may be a factor complicating the course of other ailments. The purpose of the study was to report high Mf in dogs and to discuss potential relevance with co-morbidity. Our data from a modified Knott's test performed on 62 infected dogs indicate that the median Mf count in D. repens infections is 675 Mf/ml and we consider microfilaremia above 10,000 Mf/ml as high intensity. This collection of case reports discusses 4 cases of high intensity D. repens microfilaremia in companion dogs; one presenting pathology from a very high intensity of adult D. repens with post-treatment complications, and 3 dogs in which high microfilaremia was detected incidentally during the management of other primary illnesses. To our knowledge this report describes the highest D. repens microfilaremia ever detected in a dog, at 178,000 Mf/ml. The issue of high microfilaremic infections in dogs is poorly studied and there is growing need to identify the presentation and understand the mechanisms of associated pathogenesis in the host-parasite relationship.

Primary facial demodicosis as a health problem and aesthetic challenge: A case report

Colonization of skin by Demodex mites developing as a single facial lesion with a limited range is diagnosed relatively rarely. The presence of this type of skin lesions may hinder and thus delay the diagnostic process and application of appropriate treatment. The persistent cosmetic defect on the face is extremely onerous/embarrassing to the patient and impedes normal functioning. Describe a case of atypical presentation of primary facial demodicosis and its successful treatment. We present a case of a 38-year-old patient who consulted an aesthetic medicine doctor about a skin lesion, that is, erythematous-papular lesion with single pustules persisting for more than half a year around the right eye corner and below the lower eyelid. Previous topical antibiotic treatment has proved ineffective. Diagnosis was targeted at detection of Demodex spp. invasion, which yielded a positive result. Targeted therapy with 1% topical ivermectin was implemented. Complete resolution of the skin lesions was observed after 8.5 weeks of the treatment with no further recurrence. In the case of limited scaly erythematous-papular skin lesions with single pustules, Demodex mites should be considered as an etiological factor or one of the factors in the case of a mixed-etiology lesion. A delayed diagnosis of visible lesions on facial skin has a negative impact on patient's well-being and normal functioning. As diagnosis of primary demodicosis is underestimated, knowledge about this dermatosis and its clinical manifestations should be disseminated among cosmetologists and doctors of various specialties.