Subtype 6 - Rosacea Demodicidosis

[Brady Barrows]

Earlier this year I proposed a sixth subtype for rosacea:

Rosacea Demodicidosis

I thought I was the first one to come up with this subtype, but
apparently this has been known for some time. In doing a Google
search I found that this came up as far back as 1932 according
to an article published in California Medicine in 1963 by
Samuel Ayres, Jr., MD in Los Angeles.

Here is a small part of the article:

As early as 1932 Ayres and Anderson called attention
to a type of rosacea which they felt was
caused in large part by extraordinarily heavy infestation
by the mite, Demodex folliculorum, and it
was pointed out that the demodex type of rosacea
was a further development or complication of an entity
that had been described and named by the present
author two years previously under the title
"Pityriasis Folliculorum (Demodex) ."l Since that
time a number of publications have appeared on
the subject as well as an exhibit at the thirteenth
annual meeting of the American Academy of Dermatology
and Syphilology in 1954.

The most recent publication concerning the pathogenic
role of Demodex in the production of pityriasis
folliculorum (Demodex) and acne rosacea
was Ayres and Ayres' summary of 30 years' experience
with these two commonly unrecognized
entities. Both conditions were referred to as demodicidosis.
Inasmuch as the authors' attempts to
describe and segregate a particular type of acne
rosacea as being caused wholly or in large part by
Demodex has led to confusion and to the erroneous
statement that the authors have claimed that all
cases of rosacea are caused by Demodex, it was felt
that a new term should be coined and that rosacea
of the Demodex type should henceforth be referred
to as "rosacea-like demodicidosis."

source of article in pdf format >

http://www.pubmedcentral.nih.gov/picren ... obtype=pdf

html format >

http://www.pubmedcentral.nih.gov/articl ... id=1575759

If baffles me still that the NRS didn't include Rosacea Demodicidosis in
the subtype list, but hopefully this will be corrected in the future.

I have written an editorial on Demodex in Rosacea at this url >

http://www.rosaceans.com/html/demodex.html

[Walter]

Thanks Brady

Walter

[Brady Barrows]

You are welcome Walter. I sent you an email and got this back:

Could not deliver message to the following recipient(s):

Failed Recipient: [email protected]
Reason: The domain size limit has been exceeded

Maybe you should look into this?

Thanks Brady

Walter

[Brady Barrows]

It has been generally understood that "demodicoses are thought
to be rare, occurring mainly for patients with immunosuppression."
A study released in January 2005 had the objective "to demonstrate
the high frequency of demodicoses and the overlapping with
papulopustular rosacea (PPR) ." What did the study reveal?

"RESULTS: In all, 4372 diagnoses, in which 115 were demodicoses,
were collected among 3213 patients. Demodicosis was the 9th most
frequent diagnosis (13th new). Each dermatologist observed an average
of 2.4 demodicoses a week (1.2 new). The proportion of demodicoses
varied greatly according to the dermatologist. The general status was
good in 110 patients; only 3 had known immunodeficiency. The most
frequent symptoms were follicular scales (71%) and telangiectasia (63%).
The mean Dd was higher in pityriasis folliculorum (m = 61 D/cm 2 ) than
in PPR (m = 36 D/cm 2 ; P = .04); 42 patients with PPR had a high Dd,
6 had a low Dd. CONCLUSION: Demodicoses are frequent and occur
among patients who are immunocompetent. PPR with normal Dd are rare."

Journal of the American Academy of Dermatology

source of study can be found at this url >

http://www.rosaceans.com/html/demodex.html