Increased frequency of Demodex blepharitis in rosacea and facial demodicosis patients

Abstract

Background Rosacea is an inflammatory disease with 50% of ocular involvement rate. Primary demodicosis is an eruption caused by Demodex mites, and there is no data about the rate of ocular involvement in primary demodicosis. Aims In this cross‐sectional study, it is aimed to reveal the frequency of Demodex blepharitis in rosacea and primary demodicosis patients. Methods In total, 58 rosacea, 33 primary demodicosis patients, and 31 healthy volunteers were included in the study. Four samples were obtained from eyelashes with a forceps and from facial skin by standardized skin surface biopsy. A positive result is described as detecting at least one Demodex mite on an eyelash or at five mites in the face. The patients were also examined by an ophthalmologist in terms of ocular involvement. Results Both rosacea and primary demodicosis patients had significantly more complaints like burning and stinging in the eyes compared to the control patients (P = .001). Primary demodicosis and papulopustular rosacea patients had the highest numbers of eyelash mites, respectively, and significantly a higher rate of blepharitis than the control group. Conclusion As a result, the Demodex count was significantly higher in the primary demodicosis and rosacea patients than the control group. We think that every Demodex‐positive patients should be evaluated for also eyelash mites to prevent a possible chronic blepharitis.

Ocular Manifestations of Patients With Cutaneous Rosacea With and Without Demodex Infection

“…One study compared patients with primary demodicosis and patients with rosacea with Demodex-induced blepharitis to healthy controls and found that patients with primary demodicosis and patients with rosacea did not have significantly different ocular findings. 23 In contrast, Forton and De Maertelaer 24 reported that patients with PPR had significantly more severe ocular manifestations compared with patients with demodicosis (P=.004).…”

Murine models of rosacea: a review

“…14 Standardized protocols are also needed in further research, considering the heterogeneity of product manufacturer, dosage or concentration, administration frequency, and duration. 14 Besides, D. folliculorum, Helicobacter pylori, and genetics contribute to the pathogenesis of rosacea, [47][48][49][50][51] but are not shown in these models. Animal models each can only reflect limited aspects of human rosacea.…”

Update on the Management of Demodex Blepharitis

“…44 Thus, it is not surprising that a 2019 study found that patients presenting with papulopustular rosacea had significantly higher odds of developing Demodex blepharitis than in control patients. 46 Evidently, we always need to examine the patients' face because rosacea and Demodex blepharitis are often seen together in a clinical setting. This is especially true of childhood Rosacea.…”