Performance of the diagnostic test for Demodex spp. in the context of minimizing the risk of false negative results
DOI:
https://doi.org/10.17420/ap7004.537Keywords:
Demodex, demodicosis, diagnosis, eyelashes epilation, ocular symptoms, skin symptomsAbstract
Demodex species are permanent parasites of pilosebaceous units infesting humans worldwide. Of the two species associated with the human host, Demodex folliculorum is much more commonly detected and occurs more abundantly in hair follicles and Zeiss glands. Demodex brevis, on the other hand, is mainly associated with the sebaceous and meibomian glands, all over the body. The infestation is usually chronic, and the troublesome ocular and skin symptoms often make it difficult for patients to function in both a social and professional context. Despite this, diagnostics for Demodex spp. are still not routinely performed during ophthalmological and dermatological examinations. We aimed to compare preparations of eyebrow hair, eyelashes, and skin scrapings, and to investigate the correlation with false negative results in the laboratory diagnosis of demodicosis. Direct microscopic examination was applied on 100 patients (81 women and 19 men). The most common ocular and skin symptoms reported by the study participants were eyelid itching and erythema, respectively. Significant differences were found between infested and uninfested patients with regard to the following symptoms: eyelid itching which was more common in infested patients (35.8%) (p = 0.0343) and chalazion occurring only in infested patients (13.2%) (p = 0.0285). The collection of diagnostic material from more than one site e.g. nasolabial folds, eyebrow hairs or eyelashes has a significant effect on the test result. Taking a single type of a sample from a single face zone can lead to false negative results.
References
[1] Walter D.E., Proctor H.C. 2013. Mites: ecology, evolution and behaviour. Life at a microscale. 2nd ed. Springer; Dordrecht. https://doi.org/10.1007/978-94-007-7164-2
[2] Bogdanowicz W., Chudzicka E., Pilipiuk I., Skibińska E. (Eds.). 2008. Fauna Polski: charakterystyka i wykaz gatunków [Fauna of Poland: characteristics and checklist of species. vol. 3, Arthropoda pro parte (Chelicerata, Crustacea, Myriapoda), Acanthocephala, Bryozoa, Cnidaria, Entoprocta, Gastrotricha, Mollusca, Nematoda, Nematomorpha, Nemertea, Platyhelminthes, Porifera, Rotifera, Tardigrada). Muzeum i Instytut Zoologii PAN, Warsaw.
[3] Elston C.A., Elston D.M. 2014. Demodex mites. Clinics in Dermatology 32(6): 739–743. https://doi.org/10.1016/j.clindermatol.2014.02.012
[4] Coston T.O. 1987. Demodex folliculorum blepharitis. Transactions of the American Ophthalmological Society 65: 361–392.
[5] Enginyurt O., Karaman U., Cetin F., Ozer A. 2015. The prevalence of Demodex species and its relationship with the metabolic syndrome in women of Malatya Province, Turkey. Jundishapur Journal of Microbiology 8(10): e24322. https://doi.org/10.5812/jjm.24322
[6] Dzika E., Kubiak K., Korycińska J., Lepczyńska M., Szymańska H. 2020. Demodex spp. (Acari: Demodicidae) infection in healthy young adults in Poland – occurrence and risk factors. Polish Annals of Medicine 27(2): 122–127. https://doi.org/10.29089/2020.20.00109
[7] Cheng A.M., Hwang J., Dermer H., Galor A. 2021. Prevalence of ocular demodicosis in an older population and its association with symptoms and signs of dry eye. Cornea 40(8): 995–1001. https://doi.org/10.1097/ICO.0000000000002542
[8] Bikowski J.B., Del Rosso J.Q. Demodex dermatitis: a retrospective analysis of clinical diagnosis and successful treatment with topical crotamiton. The Journal of Clinical and Aesthetic Dermatology 2(1): 20–25.
[9] Desch C., Nutting W.B. 1972. Demodex folliculorum (Simon) and D. brevis Akbulatova of man: redescription and reevaluation. The Journal of Parasitology 58(1): 169–177.
[10] Yun C.H., Yun J.H., Baek J.O., Roh J.Y., Lee J.R. 2017. Demodex mite density determinations by standardized skin surface biopsy and direct microscopic examination and their relations with clinical types and distribution patterns. Annals of Dermatology 29(2): 137–142. https://doi.org/10.5021/ad.2017.29.2.137
[11] Hsu C.K., Hsu M.M, Lee J.Y. 2009. Demodicosis: a clinicopathological study. Journal of the American Academy of Dermatology 60(3): 453–462. https://doi.org/10.1016/j.jaad.2008.10.058
[12] Sędzikowska A., Osęka M., Grytner-Zięcina B. 2016. Ocular symptoms reported by patients infested with Demodex mites. Acta Parasitologica 61(4): 808–814. https://doi.org/10.1515/ap-2016-0112
[13] Przydatek-Tyrajska R., Sędzikowska A., Bartosik K. 2021. Primary facial demodicosis as a health problem and aesthetic challenge: a case report. Journal of Cosmetic Dermatology 20(2): 420–424. https://doi.org/10.1111/jocd.13542
[14] Aşkin U., Seçkin D. 2010. Comparison of the two techniques for measurement of the density of Demodex folliculorum: standardized skin surface biopsy and direct microscopic examination. The British Journal of Dermatology 162(5): 1124–1126. https://doi.org/10.1111/j.1365-2133.2010.09645.x
[15] Cielecka D., Salamatin R., Garbacewicz A. 2009. Usage of the Hoyer’s medium for diagnostics and morphological studies of some parasites. Annals of Parasitology 55(3): 265–270.
[16] Tarkowski W., Owczyńska M., Błaszczyk-Tyszka A., Młocicki D. 2015. Demodex mites as potential etiological factor in chalazion – a study in Poland. Acta Parasitologica 60(4): 777–783. https://doi.org/10.1515/ap-2015-0110
[17] Diener-Kudisch S., Ramírez-Barajas L., Perezpeña- Diazconti J.M., Nava-Castañeda Á. 2024. Correlation between Demodex species in primary and recurrent chalazia. Archivos de la Sociedad Espanola de Oftalmologia (Engl Ed) 99(2): 49–55. https://doi.org/10.1016/j.oftale.2023.11.009
[18] Erdal B., Albayrak H. 2022. Investigation of the prevalence of Demodex spp. in dermatological diseases. Turkiye Parazitolojii Dergisi 46(1): 54–59. https://doi.org/10.4274/tpd.galenos.2021.93685
[19] Paichitrojjana A., Chalermchai T. 2024. The association between acne vulgaris, acne vulgaris with nonspecific facial dermatitis, and Demodex mite presence. Clinical, Cosmetic and Investigational dermatology 17: 137–146. https://doi.org/10.2147/CCID.S450540
[20] Fernandez-Gonzalez P., Truchuelo-Díez M.T., Gómez-Sánchez M.J. 2024. Open clinical trial evaluating the efficacy of a novel eyelash growth enhancer with peptides and glycosaminoglycans. Journal of Cosmetic Dermatology 23(6): 2170–2180. https://doi.org/10.1111/jocd.16265
