Introduction: Demodex mites (DM) are the most common ectoparasites of humans. Demodex folliculorum and Demodex brevis are the two species we are hosts for. Through the years there have been more data proving DM to be a pathogenic parasite. To this date it has not clear which groups of patients are clearly prone to develop demodicosis. Aim: To present a literature review in order to analyse and establish whether immunosuppressed patients are prone to develop demodicosis. Material and methods: Data were collected mostly from the PubMed database and through citation searching of the articles. Results: A total amount of 23 case reports and 13 original works were included. Out of them, 4 original works deny the correlation between demodicosis and immunosuppression whereas 9 original works suggest that correlation. Conclusions: Demodicosis seems to be correlated with immunosuppression, but it requires more study in the future.

Case series Patients: Male, 79-year-old • Male, 64-year-old • Male, 70-year-old • Male, 68-year-old Final Diagnosis: Demodicosis Symptoms: Itch • papular skin lesion • telangiectasiae Medication: — Clinical Procedure: — Specialty: Dermatology • Transplantology Objective: Rare coexistence of disease or pathology Background: Patients after organ transplantation are, due to chronic immunosuppression, prone to have many cutaneous adverse events, both infections and neoplasms. Studies show that some groups of patients under chronic immunosuppression are prone to develop demodicosis. The significance of demodicosis in the population of organ transplant recipients has not been established yet. Case Reports: We present 4 cases of patients with multiply dermatological complications of immunosuppression, in which one of them is demodicosis. The presented symptoms were itch, pustules, papules, and/or telangiectasias. Age of patients varied from 64 to 79 years old. Time between transplantation and diagnosis of demodicosis varied from 6 to 10 years. Other dermatological problems that appeared were basal cell carcinoma, actinic keratosis, and seborrheic keratosis. Patients showed complete resolution after treatment with topical ivermectin 10 mg/g and topical permethrin 50 mg/g. However, the medications were prolonged to 16 weeks in 1 case to reduce persistent papules and telangiectasias. The therapy did not cause any complications or disruptions in function of transplanted kidneys in any of reported patients. Conclusions: Demodicosis may have a significant role in the group of infections that organ transplant recipients are prone to, and may co-exist with other dermatological diseases, including neoplasms. However, larger studies in the field are needed.

The occurrence of neoplasms is one of the most common complications and second most frequent cause of death in organ transplant recipients (OTRs). The most frequently occurring neoplasms are skin cancers, predominantly squamous cell carcinoma (SCC). However, the ratio between SCC and basal cell carcinoma (BCC) in OTRs differs in several studies depending on the follow-up time, country, environment and other factors. In this population SCC has a more aggressive course with the presence of metastases and tends to have multifocal growth. The clinical and histopathological picture of SCC in OTRs differs from that observed in immunocompetent patients, which implicates tumour treatment and prognosis. The clinical features and distinctness which pertain to SCC in post-transplantation patients are described in this paper.