Aycan Om

The clinical importance of Demodex folliculorum presenting with nonspecific facial signs and symptoms

Demodex folliculorum (D. folliculorum), found in the pilosebaceous unit, is the most common ectoparasite of humans. Various clinical forms such as pustular folliculitis, papulopustular scalp eruptions, perioral dermatitis, and blepharitis have been defined, although in general, the disease has been classified into three main groups as “pityriasis folliculitis”, “rosacea‐like demodicidosis”, and granulomatous rosacea‐like“demodicidosis gravis”. Our aim was to test for the presence of D. folliculorum in pathogenic numbers in patients who came to our clinic with non‐specific symptoms such as facial itching with or without erythema, seborrheic dermatitis‐like or perioral dermatitis‐like lesions, papulopustular lesions, and an acneiform clinical appearance without telengiectasia or flushing. Twenty‐eight (87.5%) female and 4 male (12.5%), patients and 33 age‐and‐sex matched healthy subjects enrolled in this study. D. folliculorum was sought in the lesion sites using the noninvasive method known as the Standardised Skin Surface Biopsy (SSSB). The discovery of more than five parasites in an area of 1 cm2, was evaluated as pathogenic. For treatment, 5% permethrine cream was applied twice daily for 15 to 30 days. The clinical symptoms of the patients were classified into clinical groups and evaluated as facial itching in 2 (6.3%), nonspecific erythema and itching in 21 (65.6%), erythema and pityriasiform squamous lesions in 3 (9.4%), acneiform in 3 (9.4%), papulopustular lesions in 1 (3.1%), granulomatous rosacea‐like in 1 (3.1%), and perioral dermatitis‐like symptoms in 1 (3.3%), D. folliculorum density was determined as 5>D/cm2 in all clinical lesions. A significant clinical healing and density of D. folliculorum at <=5 D/cm2 was determined in all but two patients after treatment. We consider that D. folliculorum presentation with different symptoms and signs than classical forms is not rare. For this reason, we suggest that it is useful to test for D. folliculorum in patients with non‐classical presentations like facial itching, itching accompanied by non‐specific erythema, itching and non‐specific pityriasiform squamous lesions, and acneiform lesions.

Density of Demodex folliculorum in haematological malignancies.

We aimed to investigate the incidence and density of Demodex folliculorum in adults with leukaemia or lymphoma. Fifty patients with haematological malignancy and 50 healthy controls were studied. Patients had been diagnosed with acute lymphocytic leukaemia (12%), acute myelocytic leukaemia (32%), chronic lymphocytic leukaemia (4%), chronic myelocytic leukaemia (10%), Hodgkins lymphoma (4%) or non-Hodgkins lymphoma (38%). Standardized skin surface biopsies were taken and ≥ 5 living parasites/cm2 of skin was defined as an infestation. The difference in infestation rates between patients and controls was statistically significant. The highest incidences of D. folliculorum were found in patients with acute myelocytic leukaemia (10%), non-Hodgkins lymphoma (6%), acute lymphocytic leukaemia (4%), chronic lymphocytic leukaemia (4%) and chronic myelocytic leukaemia (4%). Demodicidosis should be included in the differential diagnosis of facial eruptions in patients with haematological malignancies who are receiving chemotherapy, and a standardized skin surface biopsy should be performed.

Incidence of Demodex Folliculorum in Patients with End Stage Chronic Renal Failure

Background. Demodex folliculorum (DF), found in the pilosebaceous unit, is the most common ectoparasite in humans. It has been implicated in various clinical lesions such as pustular folliculitis, papulopustular scalp eruption, perioral dermatitis, and skin lesions of immunosuppressed patients on chemotherapy or with acquired immunodeficiency syndrome (AIDS). Objective. We aimed to determine DF carriers and location of DF among patients on chronic dialysis because of end stage renal failure (ESRF), to compare them with healthy controls, and to examine the relationship between DF incidence and dialysis method and symptoms. Methods. Sixty-seven patients on dialysis and 67 healthy controls were taken into the study. The patient groups were classified according to the diseases causing ESRF [diabetes mellitus (DM), polycystic disease (PCD), glomerulonephritis (GN), hypertensive nephrosclerosis (HTNS), others (OT), unknown etiology (UE)], and mode of dialysis. Five standardized skin surface biopsies (SSSB) were taken. The determination of five and more living parasites/cm2 area was diagnosed as infestation. Results. The mean mite count in the ESRF group, 6.12/cm2, was significantly higher than that in controls, 0.31/cm2, (Independent Samples Test, p = 0.000). The DF positivity according to primary disease causing ESRF revealed that it was most frequent in DM with 12 patients (44.4%), followed by UE with nine patients (33.4%). Conclusions. Our findings indicate that the DF number is increased in ESRF patients on dialysis treatment. We recommend that demodicidosis should be included in the differential diagnosis of facial eruptions in patients with ESRF.

Correlation of environmental mite levels & the symptoms of allergic rhinitis regarding the efficacy of preventive education

Allergic rhinitis is still a commonly investigated disease all over the world. Allergens are usually in the nature of glycoprotein or protein which interact with antibodies resulting in the formation of specific Ig E in the body 1. It is presumed that some environmental factors play an important role in their clinics. In allergic rhinitis, symptoms usually occur after the interaction of nasal mucosa with allergens. Allergens may be indoors, outdoors or in both environments. House-dust contains most of the indoor allergens. Mites are the most egregious allergen in house dust. D. pteronyssinus is commonly seen in European countries, D. farinae is mostly seen in North America. House-dust mites play an important role in allergic sensitization of individuals in Turkey. Perennial allergic rhinitis is a common chronic disorder that results most frequently from sensitivity to house-dust mites. National and international guidelines for the management of allergic rhinitis recommend that house and dust mite avoidance measures be considered for all patients with house-dust mite provoked rhinitis. Symptoms of allergic rhinitis are related to the environmental mite level in which patients live. The aim of this study is to show the relationship between mite levels and symptoms of allergic rhinitis diagnosed patients and the change of mite levels in the environment after appropriate education.

Assessment of the levels of nitric oxide (NO) in chronic diarrhea patients infected with Giardia intestinalis

Department of Parasitology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Department of Parasitology, Faculty of Medicine, Inonu University, Malatya, Turkey. Department of Microbiology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Department of Biochemistry, Faculty of Medicine, Inonu University, Malatya, Turkey. Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Department of Biochemistry, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. Department of Internal Medicine, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.