Potential Role and Significance of Ocular Demodicosis in Patients with Concomitant Refractory Herpetic Keratitis

Hung, Kuo-Hsuan; Lan, Yu-Hsiang; Lin, Jui-Yen; Kang, Eugene Yu-Chuan; Tan, Hsin-Yuan; Chen, Hung-Chi; Hsiao, Ching-Hsi; Yeh, Lung‐Kun

doi:10.2147/opth.s282059

Cited by 9 publications

(12 citation statements)

References 27 publications

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“…Differential diagnosis of inflammatory conditions, especially in the anterior compartment of the eye, is essential [ 8 ]. When diagnosing infectious agents such as Herpes virus, Demodex leads to misdiagnosis as viral keratitis or allergic conjunctivitis [ 19 ]. In cases of recurrent viral keratitis, comorbid ocular demodicosis should be considered to prevent the viral infection from entering the cornea [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Demodex Blepharitis: An Analysis of Nine Patients

2022

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Inflammatory eyelid symptoms are common in primary care and there have been several reports on Demodex blepharitis. In the present study, we evaluate the 9 patients with Demodex blepharitis, who showed inflammation of the eyelids, dry eye, and cylindrical dandruff at the base of the eyelashes. The causative species from all patients was Demodex folliculorum of either the adult or nymph stage. Two patients had recurrent chalazion and 3 patients had keratitis. Weekly lid scrubs with 50% tee tree oil were performed for 6 weeks. After treatment, the symptoms of blepharitis and keratitis had improved in all patients. This case report provides clinical reference source for the proper treatment of ocular demodicosis.

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Section: Discussionmentioning

confidence: 99%

Demodex Blepharitis: An Analysis of Nine Patients

2022

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“…It has been shown that in patients with demodicosis, the combination of anti-degenerative and antibacterial therapy often gave better results [ 39 ]. Moreover, it is indicated based on the clinical observations of Hung et al, 2021 [ 40 ] on coexisting infestation with Demodex sp. infestation in patients with herpetic keratitis [ 40 ].…”

Section: Demodicosis Etiology and Coinfectionsmentioning

confidence: 99%

“…Moreover, it is indicated based on the clinical observations of Hung et al, 2021 [ 40 ] on coexisting infestation with Demodex sp. infestation in patients with herpetic keratitis [ 40 ]. Due to the possibility of transmitting pathogenic microorganisms, inflammatory reactions may develop even after the elimination of demodicosis.…”

Section: Demodicosis Etiology and Coinfectionsmentioning

confidence: 99%

Demodicosis in Different Age Groups and Alternative Treatment Options—A Review

Chudzicka-Strugała

Gołębiewska

Brudecki³

et al. 2023

JCM

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Infestation with Demodex mites is a common occurrence, especially in adults and the elderly. More recent attention has been paid to the presence of Demodex spp. mites in children, even ones without comorbidities. It causes both dermatological and ophthalmological problems. The presence of Demodex spp. is often asymptomatic, thus it is suggested to include parasitological investigation tests in dermatological diagnostics, in addition to bacteriological analysis. Literature reports show that Demodex spp. are related to the pathogenesis of numerous dermatoses, including rosacea or demodicosis gravis, and common eye pathologies reported by patients such as dry eye syndrome or ocular surface inflammatory conditions, such as blepharitis, chalazia, Meibomian gland dysfunction, and keratitis. Treatment of patients is a challenge and is usually prolonged, therefore it is important to carefully diagnose and properly select the therapy regimen for the treatment to be successful, and with minimal side effects, especially for young patients. Apart from the use of essential oils, research is ongoing for new alternative preparations active against Demodex sp. Our review was focused on the analysis of the current literature data on the available agents in the treatment of demodicosis in adults and children.

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“…Although this report elaborates a role for acarians in the pathophysiology of AD, other diseases associated with IgE likely also involve acarians. Demodex have been implicated in the pathophysiology of recurrent herpetic keratitis [ 104 ]. Persons with recurrent herpetic keratitis present with cylindrical dandruff [ 105 ], a finding pathognomonic of demodicosis.…”

Section: Connecting Dotsmentioning

confidence: 99%

“…Persons with recurrent herpetic keratitis present with cylindrical dandruff [ 105 ], a finding pathognomonic of demodicosis. Importantly, treatment of ocular demodicosis resolves the keratitis [ 104 ]. Of note, persons suffering from recurrent herpetic infection have elevated IgE at the time of exacerbation [ 106 ].…”

Section: Connecting Dotsmentioning

confidence: 99%

The Acari Hypothesis, III: Atopic Dermatitis

Retzinger

2022

Pathogens

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Atopic dermatitis is a chronic relapsing dermatopathology involving IgE against allergenic materials present on mammalian epithelial surfaces. Allergens are as diverse as pet danders, and polypeptides expressed by microbes of the mammalian microbiome, e.g., Malassezia spp. The Acari Hypothesis posits that the mammalian innate immune system utilizes pathogen-bound acarian immune effectors to protect against the vectorial threat posed by mites and ticks. Per The Hypothesis, IgE-mediated allergic disease is a specious consequence of the pairing of acarian gastrointestinal materials, e.g., allergenic foodstuffs, with acarian innate immune effectors that have interspecies operability. In keeping with The Hypothesis, the IgE profile of atopic patients should include both anti-acarian antibodies and specious antibodies responsible for specific allergy. Further, the profile should inform on the diet and/or environment of the acarian vector. In this regard, the prevalence of Demodex and Dermatophagoides on the skin of persons suffering from atopic dermatitis is increased. Importantly, the diets of these mites correspond well with the allergens of affected patients. In this report, roles for these specific acarians in the pathogenesis of atopic dermatitis are proposed and elaborated.

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Potential Role and Significance of Ocular Demodicosis in Patients with Concomitant Refractory Herpetic Keratitis

Cited by 9 publications

References 27 publications

Demodex Blepharitis: An Analysis of Nine Patients

Demodex Blepharitis: An Analysis of Nine Patients

Demodicosis in Different Age Groups and Alternative Treatment Options—A Review

The Acari Hypothesis, III: Atopic Dermatitis

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