Rare facial dermatological lesions associated with Demodex infection, besides acne vulgaris

Rare facial dermatological lesions associated with Demodex infection, besides acne vulgaris first-author †E-mail:shailendrakapoor@yahoo.com †E-mail:shailendrakapoor@yahoo.com shailendrakapoor@yahoo.com 2300 East Cary Street Richmond, VA 23223, USA 2300 East Cary Street Richmond, VA 23223, USA I have read with great interest the recent article “A meta-analysis of association between acne vulgaris and Demodex infestation” by Zhao et al. ( 2012 2012 ), published in Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology) (another two articles by Zhao et al. ( 2011a 2011a ; 2011b 2011b ) are also related to Demodex infestation). The article is highly thought provoking. Interestingly, Demodex infestation may be associated with a number of other facial dermatological lesions besides acne vulgaris. For instance, Demodex infestation may cause blepharitis (Kosik-Bogacka et al., 2012 2012 ). While Demodex mites can by themselves cause blepharitis, in some cases they may act as carriers of bacteria such as Bacillus oleronius which in turn may play the primary pathogenic role in the development of blepharitis (Szkaradkiewicz et al., 2011 2011 ). Demodex blepharitis is also more common in diabetics. In fact, in one recent study the prevalence of Demodex blepharitis in diabetic patients was as high as 54.8% (Yamashita et al., 2011 2011 ). A higher prevalence rate (as high as 4%) is also seen in human immunodeficiency virus (HIV) patients (Annam et al., 2010 2010 ). A highly effective treatment of Demodex blepharitis is ivermectin administered by the oral route (Filho et al., 2011 2011 ). Demodex infestation can also play an etiopathogenic role in the development of acne rosacea as well as pityriasis rosea (Forton, 2012 2012 ). Demodex infection can also result in primary irritation dermatitis as well as scalp folliculitis and seborrheic dermatitis (Karincaoglu et al., 2009 2009 ). Demodex infection may present in rare cases as “pseudozoster” (Karincaoglu et al., 2008 2008 ). This is commonly seen after prolonged application of topical steroids. Demodex infestation may also rarely cause sebaceous adenomas (Dhingra et al., 2009 2009 ). Physicians should be aware of these rare dermatological rashes and their close associations with Demodex infections. References V Annam , BR Yelikar , AC Inamadar , A Palit , P Arathi . Clinicopathological study of itchy folliculitis in HIV-infected patients . Indian J Dermatol Venereol Leprol , 2010 . 76 ( 3 ): 259 - 262 . 20445296 DOI: 10.4103/0378-6323.62965 http://doi.org/10.4103/0378-6323.62965 . Clinicopathological study of itchy folliculitis in HIV-infected patients KK Dhingra , V Saroha , P Gupta , N Khurana . 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A meta-analysis of association between acne vulgaris and Demodex infestation . J Zhejiang Univ-Sci B (Biomed & Biotechnol) , 2012 . 13 ( 3 ): 192 - 202 . DOI: 10.1631/jzus.B1100285 http://doi.org/10.1631/jzus.B1100285 . A meta-analysis of association between acne vulgaris and Demodex infestation 10.1631/jzus.B1200109 2012-04-05 2012-04-17 2012-04-17 2022-01-05 Copyright © Zhejiang University and Springer-Verlag Berlin Heidelberg 2012 2012 Journal of Zhejiang University-SCIENCE B (Biomedicine and Biotechnology) 05 13