Demodex Species Frequency and Risk Factors in Patients With Rheumatoid Arthritis

Abstract

Objectives: This study aims to investigate the presence of Demodex species in rheumatoid arthritis (RA) patients, to identify the risk factors for developing Demodex infestation, and to determine the effect of immunosuppressant drugs on Demodex mite infestations. Patients and methods: The study included 93 RA patients (16 males, 77 females; mean age 53.3±11.3 years; range, 27 to 83 years) and 76 healthy controls (19 males, 57 females; mean age 50.3±13.9 years; range, 19 to 86 years). Specimens were collected from face skin by using standardized surface skin biopsy. Demodex infestation was considered for ≥5 living parasites/cm 2 of skin while Demodex mite presence was defined as any Demodex larvae, adults, or eggs found in the specimen. Results: The frequencies of Demodex mite presence were 44% for the RA patients and 15.7% for the healthy controls (p<0.001). The rates of Demodex infestation were similar between the two groups (18.3% versus 7.9%, p=0.054). There were no statistically significant differences between the groups regarding skin type, skin care, epilation, body washing, use of a moisturizer, personal towel use, the number of residents at home, or whether there were pets at home or in proximity. Itching in eyes was higher in RA patients, but the frequency of other skin symptoms was not different from healthy controls. Logistic regression analysis indicated that the diagnosis of RA was an independent risk factor for Demodex mite presence in this study population. Disease activity and duration, use of corticosteroids, conventional disease-modifying anti-rheumatic drugs (DMARDs) and biological DMARDs were not effective factors on Demodex mite presence in RA patients. Conclusion: Although Demodex mite presence was 3.5-fold higher in RA patients, the rate of Demodex infestation was similar to that of healthy controls.

Facial Erythema May Not Always Be a Manifestation of the Primary Condition in Connective Tissue Diseases: Keep Demodex in Mind!

“…In our study,Demodex infestation was significantly more frequent in CTD patients with facial erythema in comparison to healthy controls (58.1% vs 25.8%). Similar to our results, increased Demodex infestation has also been reported in rheumatoid arthritis patients when compared to healthy controls (44% vs 15.7%, p<0.001) 17 . Likewise, 50 % more Demodex infestation was observed in discoid lupus erythematosus patients 18 .…”

The Possible Relation of Demodex and Facial Erythema in Connective Tissue Diseases

“…In our study, Demodex infestation was significantly more frequent in CTD patients with facial erythema in comparison to healthy controls (58.1% vs 25.8%). Similar to our results, increased Demodex infestation has also been reported in rheumatoid arthritis patients when compared to healthy controls (44% vs 15.7%, P <0.001) ( 19 ). Likewise, 50% more Demodex infestation was observed in discoid lupus erythematosus patients ( 20 ).…”

Our life companions: the human follicular mite Demodex folliculorum

“…Iatrogenic induced immunosuppression for the treatment of autoimmune diseases, essential thrombocytosis, Crohn's disease, psoriasis, Cushing's syndrome and neoplasms, and for the support of organ transplantation support demodicosis/demodicidosis (Amitay-Laish et al, 2022). Autoimmune diseases themselves in the form of failure of the thyroid in humans and dogs or in rheumatoid arthritis can lead to breakdown of the host's regulation of Demodex density (Pinsenschaum et al, 2019;Yazisiz et al, 2020;Dursun et al, 2022). From alcoholism to heart failure, if homeostasis is compromised, Demodex increases (kokaçya et al, 2016;Yüksel and Yüksel, 2020;Pormann et al, 2021).…”