Demodex folliculorum in rosacea based on a modified standardized skin surface biopsy

Introduction. Rosacea is a chronic disease characterized by (depending on the subtype) facial prolonged erythema, sometimes pustules or nodules. Rosacea affects all ages and sex with four subtypes. Pathophysiology aims to many different trigger factors like sun exposure, emotional stress or changed intestinal flora. Studies about Demodex mites according to different authors revealed that they may play a role in rosacea exacerbation in particular along with other triggers. Aim. An attempt to determine the role of Demodex mites among patients with rosacea. Material and methods. The study included patients with rosacea from 22 to 63 years of age. The patient status and content of hair follicles were assessed during two visits in our outpatient clinic. During the first visit, detailed medical history was taken, physical examination and hypoallergenic adhesive were applied (nose, chin, cheeks and forehead) in order to pursue the content of the sebaceous glands. During the second visit, patients qualified to the research were again examined while adhesives have been removed. By using stereoscopic microscope Stemi 2000, Demodex mites from hair follicles were analyzed. Results. Initially, contents from hair follicles of 38 patients with rosacea have been examined. The presence of Demodex was confirmed in 11 patients. Most cases of confirmed Demodex infestation concerned patients with papulopustular rosacea. Live subjects were collected only from the ales and the decrease in their motility was observed over the course of time after the removal of plasters from the skin. Conclusions. Obtained results confirming the infestation of 11 out of 38 patients with erythematotelangiectatic rosacea indicates Demodex folliculorum as a direct or indirect pathogen. Based on the results, we can state that among our patients Demodex mites were not a main trigger factor. Standardized skin surface biopsy is not a sufficient screening test.