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Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis: a case-control study.
Br J Dermatol. 2019 10; 181(4):818-825.BJ

Abstract

BACKGROUND

Facial densities of Demodex mites have been observed to be greater in patients with demodicosis and papulopustular rosacea than in healthy control patients. In patients with erythematotelangiectatic rosacea (ETR), this density has been observed to be similar to or greater than that of healthy controls. Erythema and telangiectasia, characteristics of ETR, are often observed among patients with pityriasis folliculorum, a discreet demodicosis, suggesting a possible link between these conditions.

OBJECTIVES

To compare the facial Demodex densities of patients with clinical ETR and patients with healthy skin, demodicosis, rosacea with papulopustules, and other facial dermatoses.

METHODS

In this retrospective study, we recorded Demodex densities measured using two consecutive standardized skin surface biopsies (SSSB1 and SSSB2) in 23 patients with ETR, 20 healthy control patients, 590 patients with demodicosis, 254 with rosacea with papulopustules and 180 with other facial dermatoses.

RESULTS

Patients with ETR had higher Demodex densities (D cm-2) than did the healthy controls (mean ± SEM; SSSB1: 15·7 ± 6·3 vs. 1·8 ± 1·1 D cm-2 , P = 0·042; SSSB2: 38·0 ± 13·7 vs. 5·1 ± 2·1 D cm-2 , P = 0·026) and patients with other dermatoses (SSSB1: 0·4 ± 0·1 D cm-2 , P = 0·004; SSSB2: 1·3 ± 0·3 D cm-2 , P = 0·004), but lower densities than patients with demodicosis (SSSB1: 82·7 ± 4·2 D cm-2 , P = 0·008; SSSB2: 172·2 ± 7·7 D cm-2 , P = 0·001) or rosacea with papulopustules (SSSB1: 86·6 ± 7·3 D cm-2 , P = 0·027; SSSB2: 197·0 ± 12·1 D cm-2 , P = 0·002).

CONCLUSIONS

ETR may be associated with nonvisible Demodex proliferation, possibly corresponding to a subclinical stage of demodicosis. Dermatologists should be aware of this potential association and look for subclinical demodicosis in patients with ETR, so that topical acaricidal treatment can be offered if Demodex density is high.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Forton F
Dermatologist, rue Frans Binjé 8, 1030, Brussels, Belgium.
De Maertelaer V
Free University of Brussels (ULB), Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM) and Service de Biostatistique et Informatique Médicale (SBIM), Route de Lennik 808/CP602, 1070, Brussels, Belgium.

MeSH

AcaricidesAdolescentAdultAgedAged, 80 and overAnimalsCase-Control StudiesChildFacial DermatosesFemaleHealthy VolunteersHumansMaleMiddle AgedMite InfestationsMitesPityriasis RoseaRetrospective StudiesRosaceaSeverity of Illness IndexSkinYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30801673

Citation

Forton, F, and V De Maertelaer. "Erythematotelangiectatic Rosacea May Be Associated With a Subclinical Stage of Demodicosis: a Case-control Study." The British Journal of Dermatology, vol. 181, no. 4, 2019, pp. 818-825.
Forton F, De Maertelaer V. Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis: a case-control study. Br J Dermatol. 2019;181(4):818-825.
Forton, F., & De Maertelaer, V. (2019). Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis: a case-control study. The British Journal of Dermatology, 181(4), 818-825. https://doi.org/10.1111/bjd.17817
Forton F, De Maertelaer V. Erythematotelangiectatic Rosacea May Be Associated With a Subclinical Stage of Demodicosis: a Case-control Study. Br J Dermatol. 2019;181(4):818-825. PubMed PMID: 30801673.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis: a case-control study. AU - Forton,F, AU - De Maertelaer,V, Y1 - 2019/03/29/ PY - 2019/02/19/accepted PY - 2019/2/26/pubmed PY - 2020/10/21/medline PY - 2019/2/26/entrez SP - 818 EP - 825 JF - The British journal of dermatology JO - Br J Dermatol VL - 181 IS - 4 N2 - BACKGROUND: Facial densities of Demodex mites have been observed to be greater in patients with demodicosis and papulopustular rosacea than in healthy control patients. In patients with erythematotelangiectatic rosacea (ETR), this density has been observed to be similar to or greater than that of healthy controls. Erythema and telangiectasia, characteristics of ETR, are often observed among patients with pityriasis folliculorum, a discreet demodicosis, suggesting a possible link between these conditions. OBJECTIVES: To compare the facial Demodex densities of patients with clinical ETR and patients with healthy skin, demodicosis, rosacea with papulopustules, and other facial dermatoses. METHODS: In this retrospective study, we recorded Demodex densities measured using two consecutive standardized skin surface biopsies (SSSB1 and SSSB2) in 23 patients with ETR, 20 healthy control patients, 590 patients with demodicosis, 254 with rosacea with papulopustules and 180 with other facial dermatoses. RESULTS: Patients with ETR had higher Demodex densities (D cm-2) than did the healthy controls (mean ± SEM; SSSB1: 15·7 ± 6·3 vs. 1·8 ± 1·1 D cm-2 , P = 0·042; SSSB2: 38·0 ± 13·7 vs. 5·1 ± 2·1 D cm-2 , P = 0·026) and patients with other dermatoses (SSSB1: 0·4 ± 0·1 D cm-2 , P = 0·004; SSSB2: 1·3 ± 0·3 D cm-2 , P = 0·004), but lower densities than patients with demodicosis (SSSB1: 82·7 ± 4·2 D cm-2 , P = 0·008; SSSB2: 172·2 ± 7·7 D cm-2 , P = 0·001) or rosacea with papulopustules (SSSB1: 86·6 ± 7·3 D cm-2 , P = 0·027; SSSB2: 197·0 ± 12·1 D cm-2 , P = 0·002). CONCLUSIONS: ETR may be associated with nonvisible Demodex proliferation, possibly corresponding to a subclinical stage of demodicosis. Dermatologists should be aware of this potential association and look for subclinical demodicosis in patients with ETR, so that topical acaricidal treatment can be offered if Demodex density is high. SN - 1365-2133 UR - https://www.unboundmedicine.com/medline/citation/30801673/Erythematotelangiectatic_rosacea_may_be_associated_with_a_subclinical_stage_of_demodicosis:_a_case_control_study_ DB - PRIME DP - Unbound Medicine ER -