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KMID : 0363219760140010005
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Korean Journal of Dermatology
1976 Volume.14 No. 1 p.5 ~ p.16
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The Studies of the Pathogenicity of Demodex Folliculorum and the Treatment of Demodicidosis
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金永杓/Kim, Young Pio
田寅淇/申珍榮/Chun, Inn Ki/Shin, Jin Young
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Abstract
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The pathogenicity of Demodex folliculorum (DF) is not well established, because this cutaneous parasite can be found very often not only from acneic skin lesions but also on healthy human skin surface, particularly on sebaceous gland-rich and functionally active areas of the skin, i.e. on face, and therefore, the mite has been gene-rally considered as normal inhabitant of human skin. However, as is the case with candidiasis, the parasite could also be pathogenic in the state of disturbed host-parasite relationship.
To find out the pathogenicity of the mite, the authors studied the incidence of finding DF from different sites of face in several groups of 60 acneic patients (various types of acne vulgaris and rosacea.) and 30 normal subjects as control. And the-results obtained were as follows: the mite was found in 33 cases out of the acneic patients (55%), in male patients 67% (12 out of 18) were positive and in females 50 % (21 out of 42). In the control group of 30 (15 each sex), 17 cases (9 males. and 8 females) had the mite, the incidence rate being 57%. The incidence rate of DF in various types of acneic skin lesions were: 85% in rosacea, 80% in pustular acne, 71% in cystic acne and 32% in pa.pular acne.
The distribution of the mite in various sites of the face differed markedly in the acneic and normal groups. In the control group 17 (57%.) were positive on nose, 3 (10%) on cheek, 2 (7%) on chin, and none on the forehead. Among 60 acneic patients, however, 18 (30%) were positive on cheek, 17 (28%) on nose, 15 (25%) on chin 12 (20%) on forehead.
In addition, the acuthors observed two cases of demodicidosis in the dogs. These two dogs were siblings and lived together with other dogs of the same lineage, but the other dogs were not affected. In spite of vigorous treatment with 15% benzyl benzoate aqueous emulsion and 10% crotamiton ointment applied topically for two to three weeks, the dogs died within one to two months. Slight improvement only was noted in the first week of the treatment, but the dogs were gradually emaciated. leading to death. At the onset of the disease, both dogs were two to three months old.
Histopathological studies of the affected skin revealed dense patchy lymphocytic infiltration predominantly in perifollicular area, follicular keratotic plugging and egg-like materials in the lumen of hair follicle. Histopathology of the affected canine skin appeared similar to that of human demodicidosis except that the mitelike material was observed lodged in the lumen of hair follicle.
The morphology of demodex folliculorum canis seemed slightly different from that of the human strain (DF hominis). It is generally smaller in size and has narrower and shorter stunted abdomen than human strain, otherwise it is almost alike.
The human demodicidosis can be effectively treated with 15 % benzyl benzoate aqueous emulsion, 1 % gamma benzene hexachlrode cream and 10 % crotamiton ointment, and it seems to be most effective agent being crotamiton ointment among them. It is suggested that demodex folliculorum, which has been hitherto thought to be harmless, can be pathogenic in certain individuals and that some immunologic factors might be implicated in the process of the demodicidosis.
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