The clinical presentation and etiologic factors of demodicosis

Background: Demodicosis is a common cutaneous disease that is caused by demodex mites, which reside in me pilosebaceous follicles. However, any data of the clinical features and the factors that induce or aggravate demodicosis is lacking in the Korea literature. Objective: We aimed to demonstrate the clinical feature and determine the medical or personal history that influences demodicosis. Methods: We performed a retrospective study to review clinical features, the histopathologic findings and the past medical and personal history of Korean patients who suffer with demodicosis. Results: Thirty-four patients were diagnosed with demodicosis based on the clinical features, the potassium hydroxide examination and/or the skin biopsy specimen. There were 11 males and 23 female patients (mean age: 44.4 years). The mean duration of disease was 15.5 months. The clinical features were classified to acne rosacea-like (n=26), perioral dermatitis-like (n=3), granulomatous rosacea-like (n=2), pityriasis folliculorum (n=2) and demodex abscess (n=1). Skin biopsy was performed on 10 patients and the histopathologic findings showed demodex mites in the follicular infundibulum or sebaceous ducts with a perifollicular and perivascular inflammatory infiltrate in all case. According to me medical history, 17 patients had history of chronic use of topical steroid and calcineurin inhibitor and 5 patients didn't use the soap during washing their face. Conclusion: Our findings indicate that demodicosis demonstrates various clinical presentations. If patients with facial eruption chronically use topical steroid or calcineurin inhibitor or they do not use soap, demodicosis should be considered in the differential diagnosis and a potassium hydroxide examination or skin biopsy may be helpful to diagnose and treat the facial eruption.