August 14, 2015
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Demodex found in meibomian glands of rosacea patients

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Dermatologists participated in a roundtable discussion that focused on research that links rosacea and Demodex at the annual American Academy of Dermatology meeting, according to a press release issued by the National Rosacea Society.

“Researchers have more recently discovered that while Demodex folliculorum and Demodex brevis live in the hair follicles and sebaceous glands of the facial skin, D. folliculorum is also found in the meibomian glands of ocular rosacea patients,” Frank Powell, MD, consultant dermatologist at Mater Misericordiae Hospital in Dublin and former president of the European Academy of Dermatology and Venereology, said. “In the mites’ brief life span of 14 days, they live and reproduce in the pilosebaceous units, subsisting on sebum and cellular contents, and emerge from the follicles primarily at night.”

Other dermatologists noted that while the relationship between rosacea and Demodex has been controversial for decades, recent research has shown that even the degree of a Demodex infestation is a significant factor for rosacea, and Demodex may influence specific rosacea types, according to the release.

“The classic ‘subtypes’ of rosacea appear to reflect variations in inflammatory and immunologic responses, which, in some cases, may be induced by Demodex mites,” James Del Rosso, MD, adjunct clinical professor of dermatology at Touro University College of Osteopathic Medicine in Henderson, Nevada, and a consultant to Galderma, said. “For example, in one study, individuals with erythematotelangiectatic rosacea (subtype 1) were found to have higher facial counts of Demodex mites than those with papulopustular rosacea (subtype 2).

“It has been suggested that the higher Demodex counts lead to degradation of the follicular wall as the mites attempt to improve their survival,” Del Rosso said in the press release. “This loss of follicular wall integrity then triggers an immunologic response that reduces the number of Demodex mites, with papules and pustules subsequently emerging from the augmented perifollicular inflammation that occurs.”

Experts concluded that more research was necessary to improve Demodex understanding and targeted treatment.

As detailed in the release, the discussion was sponsored by the National Rosacea Society and also received funding from Galderma Laboratories.