Evaluation of the incidence of Demodex in eyelashes in rosacea patients with ocular involvement

Background and Design: Demodex, a mite, is known to influence the etiopathogenesis of rosacea, pityriasis folliculorum, pustular folliculitis, perioral granulomatous dermatitis, hyperpigmented patch, and chronic blepharitis. This study aimed to investigate the relationship between Demodex, which is increasingly important in the pathogenesis of rosacea, and ocular rosacea. Materials and Methods: A total of 103 rosacea patients with ocular involvement (ocular rosacea) and 140 volunteers without facial dermatosis were included in the study as the control group. Written and verbal consent was obtained from the participants. A total of five eyelashes were pulled from the upper and lower eyelids of one or both eyes of the patient group and control group, using forceps, and the presence of Demodex was examined by the epilation method and standard superficial skin biopsy method from the face. Under a light microscope, ≥1 and ≥5 Demodex per cm2 in the eyelashes and face were evaluated as positive, respectively.
Results: Of the 103 patients, 27 (26.2%) had conjunctivitis, 77 (74.8%) had blepharitis, 1 (1%) had hordeolum, and 24 (23.3%) had meibomian gland dysfunction. The eye examination findings of the control group were normal. The Demodex incidence rates were 84.5% and 29.3% in the patient group and control group, respectively. Of the 103 patients with rosacea accompanied by ocular rosacea, Demodex mites were present in the eyelashes and face of 51 patients (49.6%), only in the eyelashes in 26 (25.2%), and only in the face in 10 (9.7%). No Demodex mites were present on both eyelashes and face in 16 (15.5%) patients.
Conclusion: The results of this study show that Demodex positivity was detected at a higher rate in the eyelashes and face in patients with rosacea compared with the controls. Demodex may play an important role in the pathogenesis of rosacea and ocular rosacea.

Oküler tutulumu olan rozase hastalarýnda kirpikte Demodeks insidansýnýn deðerlendirilmesi

Amaç: Bir akar olan Demodeks’in rozase, pitiriyazis folikülorum, püstüler folikülit, perioral granülomatöz dermatit, hiperpigmente yama ve kronik blefaritin etiyopatogenezinde rolü olduðu bilinmektedir. Bu çalýþmada rozase patogenezinde gün geçtikçe önemi artan Demodeks’in oküler tutulum ile iliþkisini araþtýrmak amaçlanmýþtýr.
Gereç ve Yöntem: Oküler tutulumu olan 103 rozase tanýlý hasta ve herhangi fasiyal dermatozu olmayan 140 gönüllü birey kontrol grubu olarak çalýþmaya dahil edildi. Katýlýmcýlarýn yazýlý ve sözlü onamý alýndý. Hasta ve kontrol grubunun tek veya her iki gözünün üst ve alt göz kapaðýndan toplamda 5 adet kirpik pens yardýmý ile çekilerek epilasyon yöntemiyle, yüz bölgesinden ise standart yüzeysel deri biyopsi yöntemiyle Demodeks varlýðýna bakýldý. Iþýk mikroskobunda, kirpikte cm2’de 1 ve daha fazla, yüzde cm2’de 5 ve daha fazla Demodeks görülmesi pozitif olarak deðerlendirildi.
Bulgular: Yüz üç hastanýn 27’sinde (%26,2) konjonktivit, 77’sinde (%74,8) blefarit, 1’inde (%1) hordeolum, 24’ünde (%23,3) meibomian bez disfonksiyonu bulunmaktaydý. Kontrol grubundaki bireylerin hepsinin göz muayene bulgularý normaldi. Hasta grubunda Demodeks görülme oraný %84,5 iken, kontrol grubunda bu oran %29,3 idi. Oküler tutulumun eþlik ettiði rozasesi olan 103 hastanýn 51’inde (%49,6) kirpik ve yüzde, 26’sýnda (%25,2) sadece kirpikte, 10’unda (%9,7) sadece yüzde Demodeks akarý mevcutken 16 (%15,5) kiþide hem kirpikte hem yüzde Demodeks akarý görülmedi.
Sonuç: Bu çalýþmadan elde edilen bulgular, kontrol grubuna göre rozaseli hastalarda göz tutulumunda kirpikte ve yüzde yüksek oranda Demodeks pozitifliði saptandýðýný, rozase ve oküler rozase patogenezinde Demodeks’in önemli rol oynayabileceðini göstermektedir.