Demodex

Demodex"
Scientific classification
Kingdom: Animalia
Phylum: Arthropoda
Class: Arachnida
Subclass: Acari
Order: Trombidiformes
Family: Demodicidae
Nicolet, 1855
Genus: Demodex
Owen, 1843
Species

Demodex is a genus of tiny parasitic mites that live in or near hair follicles of mammals.

Around 65 species of Demodex are known.[1] Two species living on humans have been identified: Demodex folliculorum and Demodex brevis, both frequently referred to as eyelash mites. Different species of animals host different species of Demodex. Demodex canis lives on the domestic dog. Infestation with Demodex is common and usually does not cause any symptoms, although occasionally some skin diseases can be caused by the mites. 'Demodex' is derived from Greek 'dēmos' fat + 'dēx', a wood worm.[2]

D. folliculorum and D. brevis

Demodex folliculorum and Demodex brevis are typically found on humans. D. folliculorum was first described in 1842 by Simon; D. brevis was identified as separate in 1963 by Akbulatova. D. folliculorum is found in hair follicles, while D. brevis lives in sebaceous glands connected to hair follicles. Both species are primarily found in the face, near the nose, the eyelashes and eyebrows, but also occur elsewhere on the body.

The adult mites are only 0.3–0.4 millimetres (0.012–0.016 in) long, with D. brevis slightly shorter than D. folliculorum.[3] Each has a semitransparent, elongated body that consists of two fused segments. Eight short, segmented legs are attached to the first body segment. The body is covered with scales for anchoring itself in the hair follicle, and the mite has pin-like mouth-parts for eating skin cells and oils (sebum) which accumulate in the hair follicles. The mites can leave the hair follicles and slowly walk around on the skin, at a speed of 8–16 mm per hour, especially at night, as they try to avoid light.[3] The mites are transferred between hosts through contact with hair, eyebrows and the sebaceous glands of the face.

Females of Demodex folliculorum are larger and rounder than males. Both male and female Demodex mites have a genital opening, and fertilization is internal.[4] Mating takes place in the follicle opening, and eggs are laid inside the hair follicles or sebaceous glands. The six-legged larvae hatch after three to four days, and the larvae develop into adults in about seven days. The total lifespan of a Demodex mite is several weeks. Demodex mites live inside the sebaceous glands and hair follicles. Research about human infection by Demodex mites is ongoing,[5][6][7][8] with several preliminary studies suggested an association between mite infection and rosacea.[9][10]

Older people are much more likely to carry the mites: one study found that about a third of children and young adults, half of adults, and two-thirds of elderly people carried the mites.[11] The lower rate in children may be because children produce less sebum. Recently, a study of twenty-nine adults (eighteen and over) in North Carolina, USA, found that 70% of those eighteen years of age carried mites, and that all adults over eighteen (n = 19) carried them.[12] This study (using a DNA detection method, more sensitive than traditional sampling and observation by microscope), along with several studies of cadavers, suggests that previous work may have underestimated the mites' prevalence. However, the small sample size and small geographical area involved prevent drawing broad conclusions from this data.

One may observe one's own Demodex mites by removing an eyelash or eyebrow hair and placing it under a standard compound microscope. They may also be collected with a dull scraper such as a butter knife.[13] Hold the skin of the forehead taut with one hand and scrape in the opposite direction, extracting material from the sebaceous glands. Scrape the oily material from the blade with the edge of a microscope cover slip and transfer it to a drop of immersion oil on a microscope slide, then cover with the cover slip and view with a compound microscope.

In the vast majority of cases, the mites go unobserved, without any adverse symptoms, but in certain cases (usually related to a suppressed immune system, caused by stress or illness) mite populations can dramatically increase, resulting in a condition known as demodicosis or Demodex mite bite, characterised by itching, inflammation and other skin disorders. Blepharitis (inflammation of the eyelids) can also be caused by Demodex mites.[14] Evidence of a correlation between Demodex infection and acne vulgaris exists suggesting it may play a role in promoting acne.[7] Only one zoonosis of Demodex is known.

Demodex canis

Demodex canis

The species Demodex canis lives predominantly on the domestic dog, but can occasionally infest humans. Although the majority of infestations are commensal and therefore subclinical, they can develop into a condition called demodectic mange.

Due to the mites' habitat being deep in the dermis, transmission usually occurs only via prolonged direct contact, such as mother-to-pup transmission during suckling. As a result, the most common sites for early appearance of demodicodic lesions are the face, muzzle, forelimbs and periorbital regions. Demodicosis can manifest as lesions of two types: squamous, which causes dry alopecia and thickening of the skin, and pustular, which is the more severe form, causing secondary infection (usually by Staphylococcus) resulting in the characteristic numerous red pustules and wrinkling of the skin.

The escalation of a commensal D. canis infestation into one requiring clinical attention usually involves complex immune factors. Demodicosis can follow immunosuppressive conditions or treatments, or may be related to a genetic immune deficiency. This is complicated because Demodex is thought to suppress the normal T-lymphocyte response. Also, certain breeds—such as the Dalmatian, the American Bulldog and the American Pit Bull Terrier—appear to be more susceptible.[15]

While direct treatment for severe cases is possible by oral administration of 1% Ivermectin in Ivermectin-tolerant breeds (the general dosage is 0.3–0.6 mg/kg, PO, SID until 2 negative skin scrapings 1 month apart),[16] other breeds can be successfully treated by applying the antiparasitic drug amitraz to the skin, concomitant with improved nutrition and addressing any possible underlying immune system-suppressing diseases. Commercial preparations including fipronil, amitraz, and (S)-methoprene are efficient.[17] The secondary bacterial infection associated with pustular demodicosis may require treatment with antibiotics.

References

  1. ↑ Yong, Ed (August 31, 2012). "Everything you never wanted to know about the mites that eat, crawl, and have sex on your face". Not Exactly Rocket Science. Discover. Retrieved April 24, 2013.
  2. ↑ "Demodex". Medical Dictionary (medicine.academic.ru).
  3. ↑ 3.0 3.1 Rufli, T.; Mumcuoglu, Y. (1981). "The hair follicle mites Demodex folliculorum and Demodex brevis: biology and medical importance. A review". Dermatologica 162 (1): 1–11. doi:10.1159/000250228. PMID 6453029.
  4. ↑ Rush, Aisha (2000). "Demodex folliculorum". Animal Diversity Web. University of Michigan. Retrieved 2 April 2015.
  5. ↑ Liu, Jingbo; Sheha, Hosam; Tseng, Scheffer C. G. (October 2010). "Pathogenic role of Demodex mites in blepharitis". Current Opinion in Allergy and Clinical Immunology 10 (5): 505–510. doi:10.1097/ACI.0b013e32833df9f4. PMC 2946818. PMID 20689407.
  6. ↑ Zhao, Ya-e; Peng, Yan; Wang, Xiang-lan; Wu, Li-ping; Wang, Mei; Yan, Hu-ling; Xiao, Sheng-xiang (December 2011). "Facial dermatosis associated with Demodex: a case-control study". Journal of Zhejiang University-SCIENCE B 12 (8): 1008–1015. doi:10.1631/jzus.B1100179. PMC 3232434. PMID 22135150.
  7. ↑ 7.0 7.1 Zhao, Ya-e; Hu, Li; Wu, Li-ping; Ma, Jun-xian (March 2012). "A meta-analysis of association between acne ulgaris and Demodex infestation". Journal of Zhejiang University-SCIENCE B 13 (3): 192–202. doi:10.1631/jzus.B1100285. PMC 3296070. PMID 22374611.
  8. ↑ "2011-2012 Annual Evidence Update on Acne vulgaris" (PDF). University of Nottingham Centre of Evidence Based Dermatology. 2012. p. 10. Retrieved 23 September 2013.
  9. ↑ MacKenzie, Debora (August 30, 2012). "Rosacea may be caused by mite faeces in your pores". New Scientist. Retrieved August 30, 2012.
  10. ↑ Jarmuda, Stanisław; O'Reilly, Niamh; Żaba, Ryszard; Jakubowicz, Oliwia; Szkaradkiewicz, Andrzej; Kavanagh, Kevin (August 2012). "The potential role of Demodex folliculorum mites and bacteria in the induction of rosacea". Journal of Medical Microbiology. doi:10.1099/jmm.0.048090-0. PMID 22933353.
  11. ↑ Sengbusch, H. G.; Hauswirth, J. W. (1986). "Prevalence of hair follicle mites, Demodex folliculorum and D. brevis (Acari: Demodicidae), in a selected human population in western New York, USA". Journal of Medical Entomology 23 (4): 384–388. PMID 3735343.
  12. ↑ Thoemmes, Megan S.; Fergus, Daniel J.; Urban, Julie; Trautwein, Michelle; Dunn, Robert R.; Kolokotronis, Sergios-Orestis (27 August 2014). "Ubiquity and Diversity of Human-Associated Demodex Mites". PLoS ONE 9 (8): e106265. doi:10.1371/journal.pone.0106265.
  13. ↑ Wilson, Edward O. (1992). The Diversity of Life. Cambridge, Massachusetts: Belknap. p. 177. ISBN 0674212983.
  14. ↑ Lindsey, Kristina; Matsumara, Sueko; Hatel, Elham; Akpek, Esen K. (16 May 2012). "Interventions for chronic blepharitis". Cochrane Database of Systematic Reviews 5: CD00556. doi:10.1002/14651858.CD005556.pub2. PMID 22592706.
  15. ↑ Urquhart, G. M. (1996). Veterinary Parasitology (2nd ed.). Blackwell Publishing. ISBN 0-632-04051-3.
  16. ↑ "Antiparasitics for Integumentary Disease". The Merck Veterinary Manual. September 2014.
  17. ↑ Fourie, J.; Dumont, P.; Halos, L.; Beugnet, F.; Pollmeier, M. (21 November 2013). "Efficacy of a topical application of Certifect(®) (fipronil 6.26% w/v, amitraz 7.48% w/v, (S)-methoprene 5.63% w/v) for the treatment of canine generalized demodicosis". Parasite 20: 46. doi:10.1051/parasite/2013046. PMID 24256940.

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