Cutaneous Manifestations of Parasitic Infections in HIV/AIDS
Clay J. Cockerell, Antoanella Calame in Cutaneous Manifestations of HIV Disease, 2012
Treatment of conditions associated with the Demodex mites includes topical and oral agents. Good facial hygiene with regular cleansing and avoidance of occlusive agents, such as heavy creams and makeups, is essential to managing these problems. Topically, salicylic acid and retinoids may prove beneficial by promoting desquamation of epidermal cells, which allows quicker shedding of mites and the associated waste products. Topical 1% lindane lotion, 1% gamma benzene hexachloride lotion, 1% permethrin cream rinse, or sulfur has also been used to treat demodicidosis in AIDS patients. Orally, metronidazole may offer clinical benefit, though the exact mechanism is uncertain as mites can tolerate relatively high concentrations of this agent. Other treatments that have been used are similar to those implemented for eosinophilic folliculitis including UV light and retinoids.
Mites
Gail Miriam Moraru, Jerome Goddard in The Goddard Guide to Arthropods of Medical Importance, Seventh Edition, 2019
Although numerous species of Demodex (family Demodecidae) infest wild and domestic animals, only two species of the mites are specific human-associated mites: follicle mites. These minute, wormlike mites live exclusively in hair follicles or sebaceous glands. They have no proven detrimental effect on humans, although some authors have attributed various pathological conditions of the skin to Demodex and a recent report described “demodectic frost” of the (human) ear from these mites24 in which a patient displayed a frosted appearance of the skin on the ear caused by follicular-based scale. Alexander6 provided a good review of this issue and concluded, “It should be emphasized that, in general, Demodex is a harmless saprophyte. It is only exceptionally that it appears to exercise a pathogenic influence, as, for example, when excessive amounts of cosmetics prepare the ground for its proliferation or when it escapes into the dermis.” Various estimates of the incidence of human Demodex infestation range from about 25–100%, and clinicians should be aware of mite appearance, as they may be seen during skin-scraping examination.
A LIFE ON THE SKIN
Rob Norman in The Woman Who Lost Her Skin, 2004
prime areas where the Pitrosporum ovale popluation can total half a million per square cm. Pityrosporum orbiculare - a round yeast of about 2 microns - can bring on problems when it turns into another form. Filaments called hyphae expand into a spreading mycelium or root-like growth of fungus. I have often seen patients with yeast infections following the chronic use of steroid creams and ointments. Steroids are helpful to calm the inflammation of diseases such as eczema, but they also can suppress the body's natural immune defenses, which sets up yeast for a sumptuous feast. Or what if Demodex folliculorum staged a revolution? What do you think of when you think of mites? The disease-filled Middle Ages? Demodex is as jovial and welladjusted, if I may be anthropomorphic: on clean hair as on dirty and craves blue blood as much as red. The parasites of the human body, in fact, have shown no respect for social order or class as they have evolved with us through the millennia. Demodex mites are part of normal human fauna. The mites are in the order Arachnida, along with mites, ticks, spiders, and scorpions. Demodex mites are common commensals of the pilosebaceous unit in mammals. However, there is no consensus to what degree the mites are causative of the skin pathology and how they might contribute to disease. Demodex, each a third of a millimeter long, is our constant miniature companion throughout life. Although the effect of their presence is still in dispute, as many as 25 mites have been found hanging on to one human eyelash root, which questions their benignity. Each of their individual movements, due to their size, is below the threshold to sensory perception. As Michael Andrew writes of Demodex in his 1976 book The Life That Lives on Man:
Therapeutic Effect of Intense Pulsed Light on Ocular Demodicosis
Published in Current Eye Research, 2019
XiaoZhao Zhang, Nan Song, Lan Gong
Blepharitis and blepharoconjunctivitis are characterized by inflammation of the outer eyelids and the conjunctiva that results in redness, swelling, prickle and stabbing pain, and also can lead to scarring of the eyelid and loss of proper eyelid function over time. Both of them are closely associated with Demodex infestation.1–3Demodex is a microscopic, elongated mite which is the common permanent ectoparasite of humans.4 The prevalence of Demodex infestation increases with age, reaching 84% of the population at age 60 years and 100% of those older than 70 years.5 Ocular manifestations of Demodex infestation include unexplained keratitis, superficial corneal vascularization, marginal infiltration, phlyctenule-like lesions, nodular corneal scarring, etc.6,7 It was proven that ocular demodicosis can be essentially diagnosed by the modified eyelash sampling and counting method and in vivo confocal microscopy (IVCM).8,9 However, there are only a few effective treatments at present.
In Vivo Confocal Microscopy in Blepharitis Patients with Ocular Demodex Infestation
Published in Ocular Immunology and Inflammation, 2022
Ayse Yildiz-Tas, Ceyhun Arici, Burak Mergen, Afsun Sahin
Demodex, a type of small parasite mites that affect mammals, was first described in 1841, attracting the attention of many clinicians, especially dermatologists and ophthalmologists, in recent years.3 Two different Demodex types are defined in the human body; D. folliculorum lives in the lash follicles and measures 0.35–0.4 mm in length and D. brevis lives deep in the meibomian glands and the sebaceous glands of the lash, measuring 0.15–0.2 mm in length.4 The rate of Demodex infestation increases with age, being observed in 84% of the general population at age 60 and 100% of this population aged above 70 years.5Demodex infestation related ocular pathologies involves causing direct damage, acting as a vector for bacteria, and inducing delayed hypersensitivity response in ocular immune system.2
Anti-Demodex Effect of Commercial Eyelid Hygiene Products
Published in Seminars in Ophthalmology, 2021
There are different brands and products in the market of many countries that can be obtained easily. This is because these products are not licensed for pharmaceuticals; rather, they are licensed under agricultural products, food supplements, medical devices. Therefore, a safety and efficacy audit, which requires a long process from phase 1–4, is not carried out in these products as in drug development stages. For this reason, most eyelid cleansers do not have a definitive proven dosage and ingredient for Demodex treatment. Many companies are trying to launch products with an effective content based on experiences gained in recent years and in information obtained from in vitro and in vivo studies. In our study, in vitro activity of three eyelid cleanser products of the market in Turkey was evaluated. In this way, this study could be a reference for products with similar content in other country markets.
Related Knowledge Centers
- Acne
- Demodex Brevis
- Demodex Folliculorum
- Demodicosis
- Eyebrow
- Eyelash
- Hair Follicle
- Skin
- Sebaceous Gland
- Scale