Demodicosis is a infestation caused by mite from Demodex species, belongs to class arachnida called Demodex folliculorum or Demodicid, It is a tiny mite that lives in the pores of hair follicle. Demodex folliculorum is commonly found on the nose, forehead, scalp, cheek, chin, and eyelashes of adult and itâ€™s number continue to increase with the increasing age of an individual and is often associated with blackheads, acne , rosacea, and skin irritations.
Adult Demodex folliculorum has an appearance of worm with four pair of short legs. Itâ€™s size ranges from 0.1mm to 0.4 mm; has a needle like mouth. The body is covered with layer of scales which helps the mite to anchor itself in to the hair follicle. The mite doesn’t have the excretory system. The mite copulates outside the hair follicle then female mite moves to a new hair follicle and lays up to 25 eggs in the hair follicle. The larva grows in to a adult mite in the hair follicle. During the day the mite stays in the hair follicle and feed on sebaceous secretion, and at night, it come out of the hair follicle onto the surface to the skin to mate and female mite moves to a new follicle and lays eggs over there. The whole cycle takes about14 to 18 days.
The mite stay in the hair follicle with head-down. When too many mites get buried into the same follicle, it may cause the hair fall and induce inflammation around the hair follicle.
The infection by demodex mite depends on the ability of individuals gene to induce immune response against the mite. The body reacts to the existence mites and induces an inflammatory response as it tries to rebuff the mites.
It has been observed that eighty-eight percent of individuals with thin hair have Demodex Folliculorum in their body, in contrast to 9% in individuals with normal hair density. The incidence of demodex in the hair follicle of a individual varies with age , it has been reported that about 25% of demodex is seen in about 20 years of age, 30% in 50 years , and up 50% in 80 years age.
Demodicids are mostly present in adults and they are usually harmless; they do not transmit diseases to others by close contact but infection occurs when large number of these mites congregate in a single follicle. It produces itching and inflammatory lesion at the site of hair follicle, as it is commonly found on the face, itâ€™s often regarded as the ‘face miteâ€™.Infection is commonly noticed in adults with oily skin; persons using heavy cosmetics, and those who don’t wash off cosmetics thoroughly.
The demodex infection is characterized by itchy erythematous edematous papules, pustules on the face and scalp. The infestation may be frequently free of symptoms. However, Demodicidosis is characterized by the presence of an erythematous papulo- pustular rash on the face. The inflammation is either acute and chronic in nature. Our observation was also similar but our patients had extensive areas of involvement face, scalp, back, â€˜Vâ€™ area of the chest, axilla and forearm.
Treatment with topical Permethrine5% for 5-7 consecutive days, and the other drugs which have been used effectively are Gamma benzinehexachliride, Oral Ivermectin, Metronidazole 2% cream and oral. In our personal cases we had used Permethrine 5% topical cream effectively with rapid clearance of symptoms and lesions.
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