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    The clinical importance of Demodex folliculorum presenting with nonspecific facial signs and symptoms
    (Japanese Dermatolgical Assoc, 2004) Karincaoglu, Y; Bayram, N; Aycan, O; Esrefoglu, M
    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, rosacca-like demodicidosis, and granulomatous rosacca-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 cm(2), 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%), granulomatons rosacea-like in 1 (3.1%), and perioral dermatitis-like symptoms in 1 (3.3%), D. folliculorum density was determined as 5>D/cm(2) in all clinical lesions. A significant clinical healing and density of D. folliculorum at <=5 D/cm(2) 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.
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    Incidence of Demodex folliculorum in patients with end stage chronic renal failure
    (Taylor & Francis Inc, 2005) Karincaoglu, Y; Seyhan, ME; Bayram, N; Aycan, O; Taskapan, H
    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/cm(2) area was diagnosed as infestation. Results. The mean mite count in the ESRF group, 6.12/cm(2), was significantly higher than that in controls, 0.31/cm(2), (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.