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Thread: Demodex mites

  1. #1
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    Default Demodex mites

    Does anyone know in particular how mite induced rosacea looks different from "normal" rosacea?
    I've noticed in the past few weeks the redness on my right cheek(my worst zone for blushes and random red marks) has increased, and a horseshoe shaped line of small red bumps have appeared and not even started to fade.
    I had a really awful lice infestation a couple years ago.. could it be a possibility that my rosacea has started from that? It's only been noticible this past year.

  2. #2
    Senior Member Brady Barrows's Avatar
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    Default Diagnosis of Demodectic Rosacea

    Demodectic Rosacea looks similar to rosacea and a plethora of rosacea mimics or co-existing conditions.

    “There is no laboratory test or investigation that will confirm the diagnosis of PPR. Specific investigations may be required to rule out similar appearing conditions (many of which will be identified by listening carefully to the patient’s medical history and examining the skin lesions). These include skin swabs for bacterial culture, skin scrapings for the presence of demodex mites, scrapings for fungal KOH and fungal culture, skin biopsy for histologic examination, (and rarely culture) skin surface biopsy for demodex mite quantification, patch tests, photopatch tests, and very rarely systemic workup wih appropriate blood tests and radiological examinations.” Rosacea Diagnosis and Management, page 82 by Frank C. Powell, Informa Healthcare, 2008

    Did you physician do any of the above?

    For a comprehensive article on Demodectic Rosacea click here.
    Brady Barrows
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  3. #3
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    Is it compulsory to have active papules and/or pustules to perform the skin surface biopsy for demodex? The dermatologist refused to do it, because I have none nowadays, I have only red trails.

  4. #4
    Senior Member Brady Barrows's Avatar
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    Default Skin Scraping for Demodex Density Count

    Quote Originally Posted by MariaSt View Post
    Is it compulsory to have active papules and/or pustules to perform the skin surface biopsy for demodex? The dermatologist refused to do it, because I have none nowadays, I have only red trails.
    No. A skin scraping and demodex density count can be done on anyone whether they have rosacea, pimples, or not.

    Demodectic Rosacea has long been a controversy, and some docs still are old school and believe that the demodex plays a minor role in rosacea. The RRDi is the only non profit organization for rosacea that lists Demodectic Rosacea as a rosacea variant. There are other names for this condition, such as Demodicidosis, Demodex folliculorum, rosacea-like demodicidosis, Demodex Dermatitis, pityriasis folliculorum etc.

    Dr. Powell, in his book on rosacea states, ""The diagnosis of pityriasis folliculorum is facilitated by the use of dermatoscopy, which shows a distinctive picture of the presence of multiple white keratotic material consisting of keratin encrusted demodex mites protruding upwards from the follicular orifices. Scraping the skin surface with the blunt side of a scalpel blade and spreading the scrapings on a glass slide reveals the presence of multiple dead and living D. folliculorum mites. The condition appears to be caused by an overpopulation of mites facilitated by the frequent use of creams and the lack of face washing with soap and water."

    Rosacea: Diagnosis and Management, pages 81-82
    Frank Powell, MD, Informa Healthcare, 2008

    "With the help of CLSM it is possible to non-invasively detect, image and quantify Demodex mites in facial skin of patients with rosacea."
    Non-invasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy.
    Sattler EC, Maier T, Hoffmann VS, Hegyi J, Ruzicka T, Berking C.
    Br J Dermatol. 2012 Jun 20. doi: 10.1111/j.1365-2133.2012.11096.x.

    "The features of demodecidosis are often similar to those of rosacea."
    Demodecidosis in a patient infected by HIV: successful treatment with ivermectin
    Clyti E, Sayavong K, Chanthavisouk K.
    Ann Dermatol Venereol. 2005 May;132(5):459-61
    Brady Barrows
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  5. #5
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    Thank you,Brady. I had high expectations of this appointment in the biggest dermatology hospital in my country and all I got was the gel Zelogent, even though I told them I have demodex blefaritis. Unbelievable.

  6. #6
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    Brady, do you happen to have any articles about the use of oral Bactrim against demodex?

  7. #7
    Senior Member Brady Barrows's Avatar
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    Default

    Quote Originally Posted by MariaSt View Post
    Brady, do you happen to have any articles about the use of oral Bactrim against demodex?
    No. If you find any please post.
    Brady Barrows
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