Demodicosis in Pediatric Cancer

Abstract

Demodicosis is a rare condition that most often occurs in immunocompromised patients. We here describe a boy with T-cell non-Hodgkin lymphoma who developed a facial papulopustular eruption just before finalizing T-cell non-Hodgkin lymphoma treatment. He was treated for several infectious diseases without improvement. Demodicosis was considered and complete resolution was finally reached with topical metronidazole. We conducted a systematic search of all previously described cases of this condition in children with cancer, which showed that almost all demodicosis cases occurred in patients with lymphoreticular malignancies during maintenance chemotherapy. Hence, demodicosis may be seriously considered in antibiotic-resistant facial papulopustular eruptions in this group of patients to prevent delay of adequate treatment.

A case series of demodicosis in children

“…In children, demodicosis was first reported with immunosuppression, especially HIV and leukemia. It has also been linked to Langerhans cell histiocytosis, as seen in two of our patients, acute lymphoblastic leukemia, and T‐cell non‐Hodgkin lymphoma . T‐cell suppression, either viral induced or due to chemotherapy, is implicated in pathogenesis.…”

“…T‐cell suppression, either viral induced or due to chemotherapy, is implicated in pathogenesis. However, many healthy children have now been reported …”

“…Demodex mites rarely cause clinical manifestations, even with their high prevalence in the elderly. [1][2][3][4] The mites are believed to play a pathogenic role when they penetrate the dermis and multiply, thus causing inflammation. 5 Demodex folliculorum is thought to trigger a humoral response, and D brevis, a cellular response.…”

“…It has also been linked to Langerhans cell histiocytosis, as seen in two of our patients, acute lymphoblastic leukemia, and T-cell non-Hodgkin lymphoma. 2,9,10 T-cell suppression, either viral induced or due to chemotherapy, is implicated in pathogenesis. However, many healthy children have now been reported.…”

“…However, many healthy children have now been reported. [1][2][3]6,9,11 Human primary demodicosis presents similarly to other diseases, or can secondarily exacerbate existing disorders, and is therfore lesions. Increased number of the mites-more than five individuals on 1 cm 2 of skin-is closely associated with pathogenic activity and has been accepted as a positive test.…”