Potential role of Demodex mites and bacteria in the induction of rosacea

Abstract

Rosacea is a common dermatological condition that predominantly affects the central regions of the face. Rosacea affects up to 3 % of the world's population and a number of subtypes are recognized. Rosacea can be treated with a variety of antibiotics (e.g. tetracycline or metronidazole) yet no role for bacteria or microbes in its aetiology has been conclusively established. The density of Demodex mites in the skin of rosacea patients is higher than in controls, suggesting a possible role for these mites in the induction of this condition. In addition, Bacillus oleronius, known to be sensitive to the antibiotics used to treat rosacea, has been isolated from a Demodex mite from a patient with papulopustular rosacea and a potential role for this bacterium in the induction of rosacea has been proposed. Staphylococcus epidermidis has been isolated predominantly from the pustules of rosacea patients but not from unaffected skin and may be transported around the face by Demodex mites. These findings raise the possibility that rosacea is fundamentally a bacterial disease resulting from the over-proliferation of Demodex mites living in skin damaged as a result of adverse weathering, age or the production of sebum with an altered fatty acid content. This review surveys the literature relating to the role of Demodex mites and their associated bacteria in the induction and persistence of rosacea and highlights possible therapeutic options.

Demodex – An Old Pathogen or a New One?

“…and Bacteroides spp. [3,18,19]. along with the presence of Demodex, immunohistological tests show proliferations of accessory T lymphocytes, plasmocytes, histocytes and giant cells.…”

Demodex spp. Infestation Associated with Treatment-Resistant Chalazia and Folliculitis

“…bireyde bulunsa da hastalık oluşturması için bazı genetik ve çevresel faktörlerin (4). Rozasealı hastalar ile yapılan araştırmalarda, bu hastaların B. olerinus proteinlerine karşı aşırı duyarlılık geliş-tirdiği ve bu nedenle hastalığın ortaya çıktığı düşünülmektedir (3,4). Bazı yazarlar, yüzde gelişen Demodex spp.…”

“…Güncel çalışmalarda rosasea, akne vulgaris, blefarit, perioral dermatit, püstüler folikülit, saclı derinin papülo püstüler lezyonları, pitriazis folikülorum, bazal hücreli karsinom ve akkiz immun yetmezlik sendromundaki pustuler lezyonlar, ayrıca blefarit, keratokonjoktivit, tekrarlayan şalaz-yon ve meiboimian bez disfonksiyonlarının etyopatogenezinde Demodex spp. 'lerin rolünün olabileceği saptanmıştır (1)(2)(3)(4)(5)(6). Burada Demodex folliculorum' a bağlı geliştiğini düşündüğü-müz üç ayrı klinik tabloyu barındıran olguyu sunduk.…”

Clinical aspects of demodecosis in veterinary and human medicine

“…All 3 species of the genus Demodex that parasitize canine skin have been found in Poland (29). Moreover, D. cornei has also been found among dogs in China, Greece and India (11,50,53).…”