Vol 2, No 1 (2017)
Review paper
Published online: 2017-03-22
Blepharitis and Demodex spp. infection
DOI: 10.5603/OJ.2017.0006
Ophthalmol J 2017;2(1):22-27.
Abstract
According to the latest reports Demodex mites appear to play an important role in the pathogenesis of chronic blepharitis. Demodex mites are cosmopolitan and are present in many species of mammals. In this paper we describe two species that are found in humans: Demodex folliculorum and D. brevis. Infection occurs during direct contact with an affected person and also through contact with dust containing eggs of the parasite, through contact with bed linen, as well as cosmetics used together with an affected person. Treatment of chronic blepharitis caused by D. folliculorum and D. brevis is difficult and time consuming. Some improvement can be achieved after topical application of yellow mercury ointment, sulphuric ointment, camphor oil, crotamiton, cholinesterase inhibitors, sulfacetamide, steroids, antibiotics and antifungal drugs. Good results have been achieved with oral ivermectin and permethrin cream. However, the best results were observed after treatment with metronidazole.
Keywords: pathogenesisinfectionocular demodicosistreatment
References
- Rodolfo L, Rodriguez OD, Blepharitis disease and its management. American Optometric Association, Paraoptometric Section. http://www.aoa.org/documents/optometricstaff/blepharitis_disease_and_its_management. pdf.
- Rather PA, Hassan I. Human demodex mite: the versatile mite of dermatological importance. Indian J Dermatol. 2014; 59(1): 60–66.
- Yagdiran Düzgün O, Aytekin S. Comparison of Demodex folliculorum density in haemodialysis patients with a control group. J Eur Acad Dermatol Venereol. 2007; 21(4): 480–483.
- Elston DM. Demodex mites: facts and controversies. Clin Dermatol. 2010; 28(5): 502–504.
- Bhandari V, Reddy JK. Blepharitis: always remember demodex. Middle East Afr J Ophthalmol. 2014; 21(4): 317–320.
- Gunnarsdottir S, Kristmundsson A, Freeman MA, et al. [Demodex folliculorum a hidden cause of blepharitis]. Laeknabladid. 2016; 102(5): 231–235.
- Izdebska JN. Roztocze skórne człowieka i zwierząt domowych. In: Majkowska-Wojciechowska B. ed. Alergologia w praktyce. Alergia na roztocze. Mediton, Łódź 2005: 95–105.
- Zhang XY, Sun XG. [Progress of study on the demodex blepharitis]. Zhonghua Yan Ke Za Zhi. 2016; 52(4): 315–320.
- Buczek A. Choroby pasożytnicze, epidemiologia, diagnostyka, objawy. Koliber, Lublin 2005.
- Zhao Y, Guo N, Zeng X, et al. Morphology and Demodex mites survival temperature range of observation and research. Entomological J. 2005; 48: 754–758.
- Marcinowska Z, Kosik-Bogacka D, Lanocha-Arendarczyk N, et al. [Demodex folliculorum and demodex brevis]. Pomeranian J Life Sci. 2015; 61(1): 108–114.
- Cheng AMS, Sheha H, Tseng SCG. Recent advances on ocular Demodex infestation. Curr Opin Ophthalmol. 2015; 26(4): 295–300.
- Garbacewicz A, Udziela M, Grytner-Ziecina B, et al. Demodex infections in general Polish population, in patients suffering from blepharitis, and among people who work with microscopes. Klin Oczna. 2010; 112(10-12): 307–310.
- Kuźna-Grygiel W, Kosik-Bogacka D, Czepita D, et al. Objawowe i bezobjawowe inwazje Demodex spp. powiek u osób w różnych grupach wiekowych. Wiad Parazytol. 2004; 50: 55–61.
- Buczek A. Choroby pasożytnicze. Koliber, Lublin 2010.
- Wesolowska M, Knysz B, Reich A, et al. Prevalence of Demodex spp. in eyelash follicles in different populations. Arch Med Sci. 2014; 10(2): 319–324.
- Liu J, Sheha H, Tseng SCG. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010; 10(5): 505–510.
- Arriaga C, Domingues M, Castela G, et al. Pediatric ocular rosacea, a misdiagnosed disease with high morbidity: Proposed diagnostic criteria. World Journal of Dermatologyy. 2016; 5(2): 109.
- Cao YS, You QX, Wang L, et al. [Facial Demodex infection among college students in Tangshan]. Zhongguo Ji Sheng Chong Xue Yu Ji Sheng Chong Bing Za Zhi. 2009; 27(3): 271–273.
- Raszeja-Kotelba B, Jenerowicz D, Izdebska JN, et al. [Some aspects of the skin infestation by Demodex folliculorum]. Wiad Parazytol. 2004; 50(1): 41–54.
- Forton F, Germaux MA, Brasseur T, et al. Demodicosis and rosacea: epidemiology and significance in daily dermatologic practice. J Am Acad Dermatol. 2005; 52(1): 74–87.
- Horváth A, Neubrandt DM, Ghidán Á, et al. Risk factors and prevalence of Demodex mites in young adults. Acta Microbiol Immunol Hung. 2011; 58(2): 145–155.
- Yamashita LS, Cariello AJ, Geha NM, et al. Demodex folliculorum on the eyelash follicle of diabetic patients. Arq Bras Oftalmol. 2011; 74(6): 422–424.
- Dokuyucu R, Kaya OA, Yula E, et al. The Presence of Demodex Folliculorum in Various Obese Groups According to BMI Levels. Arch Iran Med. 2016; 19(3): 210–214.
- Gökçe C, Aycan-Kaya Ö, Yula E, et al. The effect of blood glucose regulation on the presence of opportunistic Demodex folliculorum mites in patients with type 2 diabetes mellitus. J Int Med Res. 2013; 41(5): 1752–1758.
- Kosik-Bogacka DI, Lanocha N, Lanocha A, et al. Role of Demodex folliculorum in the pathogenesis of blepharitis. Acta Ophthalmol. 2012; 90(7): e579.
- Kosik-Bogacka DI, Łanocha N, Łanocha A, et al. Demodex folliculorum and Demodex brevis in healthy and immunocompromised patients. Ophthalmic Epidemiol. 2013; 20(3): 159–163.
- Kurt RK, Kaya OA, Karateke A, et al. Increased density of Demodex folliculorum mites in pregnancies with gestational diabetes. Med Princ Pract. 2014; 23(4): 369–372.
- Chen W, Plewig G. Human demodicosis: revisit and a proposed classification. Br J Dermatol. 2014; 170(6): 1219–1225.
- Karincaoglu Y, Esrefoglu Seyhan M, Bayram N, et al. Incidence of Demodex folliculorum in patients with end stage chronic renal failure. Ren Fail. 2005; 27(5): 495–499.
- Tian Y, Li CP. Demodex infection of the eyelids in patients with eyelid investigation. Chin J Parasitol Dis Control. 2004; 17: 236–237.
- Türk M, Oztürk I, Sener AG, et al. Comparison of incidence of Demodex folliculorum on the eyelash follicule in normal people and blepharitis patients. Turkiye Parazitol Derg. 2007; 31(4): 296–297.
- Kemal M, Sümer Z, Toker MI, et al. The Prevalence of Demodex folliculorum in blepharitis patients and the normal population. Ophthalmic Epidemiol. 2005; 12(4): 287–290.
- Bevins CL, Liu FT. Rosacea: skin innate immunity gone awry? Nat Med. 2007; 13(8): 904–906.
- Lacey N, Kavanagh K, Tseng SCG. Under the lash: Demodex mites in human diseases. Biochem (Lond). 2009; 31(4): 2–6.
- Köksal M, Kargi S, Tayşi BN, et al. A rare agent of chalazion: demodectic mites. Can J Ophthalmol. 2003; 38(7): 605–606.
- Liang L, Ding X, Tseng SCG. High prevalence of demodex brevis infestation in chalazia. Am J Ophthalmol. 2014; 157(2): 342–348.e1.
- Yam JCS, Tang BSF, Chan TM, et al. Ocular demodicidosis as a risk factor of adult recurrent chalazion. Eur J Ophthalmol. 2014; 24(2): 159–163.
- Kim JH, Chun YS, Kim JC. Clinical and immunological responses in ocular demodecosis. J Korean Med Sci. 2011; 26(9): 1231–1237.
- Koo H, Kim TH, Kim KW, et al. Ocular surface discomfort and Demodex: effect of tea tree oil eyelid scrub in Demodex blepharitis. J Korean Med Sci. 2012; 27(12): 1574–1579.
- Akilov OE, Mumcuoglu KY. Immune response in demodicosis. J Eur Acad Dermatol Venereol. 2004; 18(4): 440–444.
- Gao YY, Di Pascuale MA, Elizondo A, et al. Clinical treatment of ocular demodecosis by lid scrub with tea tree oil. Cornea. 2007; 26(2): 136–143.
- Kheirkhah A, Casas V, Li W, et al. Corneal manifestations of ocular demodex infestation. Am J Ophthalmol. 2007; 143(5): 743–749.
- Inceboz T, Yaman A, Over L, et al. Diagnosis and treatment of demodectic blepharitis. Turkiye Parazitol Derg. 2009; 33(1): 32–36.
- Rufli T, Mumcuoglu Y. The hair follicle mites Demodex folliculorum and Demodex brevis: biology and medical importance. A review. Dermatologica. 1981; 162(1): 1–11.
- Diaz-Perez JL. Demodex mites in rosacea. J Am Acad Dermatol. 1994; 30(5 Pt 1): 812–813.
- Spickett SG. A preliminary note on Demodex folliculorum Simon (1842), as a possible vector of leprosy. Lepr Rev. 1961; 32: 263–268.
- Lacey N, Delaney S, Kavanagh K, et al. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007; 157(3): 474–481.
- Szkaradkiewicz A, Chudzicka-Strugała I, Karpiński TM, et al. Bacillus oleronius and Demodex mite infestation in patients with chronic blepharitis. Clin Microbiol Infect. 2012; 18(10): 1020–1025.
- Clifford CW, Fulk GW. Association of diabetes, lash loss, and Staphylococcus aureus with infestation of eyelids by Demodex folliculorum (Acari: Demodicidae). J Med Entomol. 1990; 27(4): 467–470.
- Lee SH, Chun YS, Kim JH, et al. The relationship between demodex and ocular discomfort. Invest Ophthalmol Vis Sci. 2010; 51(6): 2906–2911.
- Wolf R, Ophir J, Avigad J, et al. The hair follicle mites (Demodex spp.). Could they be vectors of pathogenic microorganisms? Acta Derm Venereol. 1988; 68(6): 535–537.
- Hallur V, Singh G, Rudramurthy SM, et al. Demodex mite infestation of unknown significance in a patient with rhinocerebral mucormycosis due to Apophysomyces elegans species complex. J Med Microbiol. 2013; 62(Pt 6): 926–928.
- Schmidt P, Kocięcki J, Dalz M, et al. Chronic Demodex related blepharitis: new aspects of treatment. Farm Współ. 2010; 3: 210–213.
- Chovatiya RJ, Colegio OR. Demodicosis in Renal Transplant Recipients. Am J Transplant. 2016; 16(2): 712–716.
- Filho PA, Hazarbassanov RM, Grisolia AB, et al. The efficacy of oral ivermectin for the treatment of chronic blepharitis in patients tested positive for Demodex spp. Br J Ophthalmol. 2011; 95(6): 893–895.
- Brown M, Hernández-Martín A, Clement A, et al. Severe demodexfolliculorum-associated oculocutaneous rosacea in a girl successfully treated with ivermectin. JAMA Dermatol. 2014; 150(1): 61–63.
- Czepita D, Kosik-Bogacka D. Eyelid demodicosis. Russ Ophthalmol J. 2014; 7: 107–110.
- Nicholls SG, Oakley CL, Tan A, et al. Demodex species in human ocular disease: new clinicopathological aspects. Int Ophthalmol. 2017; 37(1): 303–312.