Steroid-withdrawal rosacea-like dermatitis

A patient with malignant lymphoma repeatedly developed transient rosacea-like dermatitis several days after each interruption of continuous oral prednisone intake. We thought that the eruption was provoked by withdrawal of orally administered steroid, and thus we diagnosed the patient as having steroid-withdrawal rosacea-like dermatitis, one manifestation of steroid-withdrawal syndrome.     

Lupoid form of rosacea-like dermatitis

In a 9-year-old girl, a lupoid variant of rosacea-like dermatitis was observed following the topical application of potent glucocorticosteroids. In addition to the micro- and macro-papulopustular forms, this is a third clinical variant of the disease, which has to date only been described in children.     

Rosacea-like demodicidosis in an immunocompromised child

Demodex folliculorum is a saprophytic mite of the human pilosebaceous unit. It is rarely found in children. It has been implicated in the development of follicular pityriasis, rosacea-like demodicidosis, pustular folliculitis, blepharitis, and granulomatous rosacea. We describe a 4-year-old boy who developed asymptomatic facial lesions that histologically corresponded to demodicidosis. He was in clinical remission of acute lymphoblastic leukemia and currently receiving maintenance chemotherapy. Exanthems related to D. folliculorum are rare in children. Most cases occur in immunocompromised patients and the clinical and histologic findings are diverse. A differential diagnosis should be established with rosacea and perioral dermatitis. The role of Demodex in the pathogenesis of these disorders is controversial. Immunosuppression might increase the number of mites, favoring an inflammatory reaction, or there could exist an impaired cutaneous immunologic response to the parasites.     

Rosacea-like demodicidosis and chronic blepharitis

Demodicidosis is a parasitic skin disease caused by the follicle mites Demodex sp. In this article, we present a case of rosacea-like demodicidosis, discuss the clinical features of Demodex infestation in man and review their diagnosis and therapeutic modalities. A 37-year-old woman presented in our department with chronic blepharitis present for one year. On physical examination, the patient presented blepharitis and papulovesicles with fine scaling limited to the face. There was no telangectasia. The patient did not report flushing episodes or any kind of photosensitivity. A diagnosis of rosacea-like demodicidosis and Demodex blepharitis was based on the presence of numerous Demodex folliculorum in the eyelashes and scrapings of skin lesions. The patient was put on topic and oral metronidazole for 2?months and on yellow mercury ointment for 15?days. The course involved disappearance of the facial mites and complete remission without recurrence. Screening for Demodex sp is essential to establish the correct diagnosis and ensure suitable treatment.     

人蠕形螨病的流行病学调查

蠕形螨广布全世界,人蠕形蜗病的调查国内尚无报告.对山东荷泽地区3067名人群作蠕形蜻的检查,感染率为60.58%,患病率为10.04%.此两率随年龄增大而升高,在青春期前两性无差异.青春期后,男高于女.全部15.例婴儿均来见感染.这说明人类的感染发生于后天性家庭内感染,特别是由于母亲和孩子间的接触传染.皮脂腺分泌率对蠕形瞒有影响.早期临床表现多梓.且很轻,微厂以致医生和病人都不认为是有病.应加强对该病的认识以达到早期防治的目的.     

Nosologic position of demodicidosis in humans

In 20 patients with rosacea and rosacea-like eruptions Demodex folliculorum mites were found in high numbers within lesional skin. In one patient Demodex folliculorum could be demonstrated in pits and burrows in the epidermis of the scalp. In other instances the mouth parts of the mites were closely related to the follicular epithelium. Recent parasitologic findings showed that in spite of their name (Demodex = "sebaceous worm") the mites derive their nutritive requirements from cellular proteins obtained by epithelial destruction. To clarify the pathogenetic significance of hair follicle mites in man as suggested by these histological findings as well as their known ability to form organisational centers of foreign body granulomas, further epidemiologic and immunologic studies are needed. Topical antiparasitic agents did not offer any therapeutic advantage over traditional preparations used for rosacea and seborrheic dermatitis.     

Rosacea-like demodicidosis associated with acquired immunodeficiency syndrome

We present a 35-year-old patient with acquired immunodeficiency syndrome who had demodicidosis on his face, characterized by multiple papules and papulopustules, associated pruritus, numerous mites on skin-surface biopsy and in biopsy specimens, and rapid response to topical treatment with permethrin. It seems likely that Demodex infestation does not manifest unless local or systemic immune function is altered, leading to the proliferation of the organism and subsequent disease.     

Spinulosis of the face as a manifestation of demodicidosis

We describe a 78-year-old woman with polycythaemia rubra vera who had multiple tiny follicular hyperkeratotic spicules on the cheeks. She was receiving treatment with oral hydroxyurea, but no topical agents had been applied to her face. Histopathological study demonstrated numerous Demodex folliculorum mites within dilated follicular infundibula, and we consider that the mites were playing a part in the aetiology of the skin lesions.     

High incidence of demodicidosis in eyelid basal cell carcinomas

BACKGROUND: Although UV radiation is the major cause of basal cell carcinoma (BCC), local factors, such as chronic trauma, irritation, or inflammation, may also have some role in its etiopathogenesis. The pilosebaceous follicle mites, Demodex folliculorum and D. brevis, inhabit most commonly and densely certain facial skin areas, including the nose and periorbital regions, where BCC also develops most frequently. AIM: To investigate, in a retrospective histopathologic study, whether a possible etiopathogenetic relationship exists between demodicidosis and eyelid BCCs. METHODS: We examined 32 eyelid BCC specimens that contained at least five eyelashes or five hair follicles with respect to the presence and density of Demodex mites. As controls, we evaluated 34 matched specimens consisting of benign eyelid skin lesions. RESULTS: Twenty-one of 32 BCC cases (65.6%) and eight of 34 control cases (23.33%) had demodicidosis. Mean mite counts were 1.31 +/- 1.57 and 0.47 +/- 0.99 in BCC cases and controls, respectively. The differences were significant for both prevalence (P < 0.001) and density (P = 0.0052). Although there was a significant positive correlation between increasing mite number and patient age in the control group (r = 0.47, P < 0.05), no significant correlation was found between these two factors in BCC cases (r = -0.102, P > 0.05). CONCLUSIONS: Demodicidosis may be one of the triggering factors of carcinogenesis in eyelid BCCs in otherwise predisposed people due to its traumatic/irritating effect or chronic inflammation.     

青蒿琥酯对小鼠玫瑰痤疮样炎症的作用观察

目的 观察青蒿琥酯对小鼠玫瑰痤疮样炎症的影响.方法 在25只7周龄BALB/c雄鼠背部皮下注射40μl抗菌肽LL-37,每12小时1次,共4次,制备玫瑰痤疮样小鼠模型,并将其随机等分为5组,每次注射LL-37后模型组给予生理氯化钠溶液灌胃,治疗组分别给予25、50、100 mg/kg青蒿琥酯溶液灌胃,阳性对照组给予30 mg/kg盐酸多西环素溶液灌胃;另取5只小鼠作为空白对照组,仅背部皮下注射4次纯水.首次注射LL-37后48 h观察各组皮损和红斑评分,取背部注射部位皮肤行HE染色,观察组织结构并计数炎症细胞数量,ELISA法检测皮损髓过氧化物酶(MPO)活性.结果 模型组皮损炎症反应明显,红斑评分(3.20±0.84)、炎症细胞计数(517.27±99.43)和MPO活性(0.57±0.08)均显著高于空白对照组(均P＜0.01),阳性对照组红斑评分(1.60±0.89)、炎症细胞计数(270.93±124.63)和MPO活性(0.40±0.05)均显著低于模型组,差异有统计学意义(P＜0.05、0.01、0.01).50和100 mg/kg青蒿琥酯组红斑评分分别是1.80±0.84和1.40±0.55,显著低于模型组(P＜0.05、0.01),炎症细胞计数分别为286.00±33.72和258.00±36.44,显著低于模型组(均P＜0.01),MPO活性分别是0.43±0.05和0.40±0.06,亦明显低于模型组(P＜ 0.05、0.01).50 mg/kg和100 mg/kg青蒿琥酯组红斑评分、炎症细胞计数和MPO活性与阳性对照组差异均无统计学意义.结论 青蒿琥酯能抑制小鼠玫瑰痤疮样炎症反应,以中、高剂量最为明显.     

Granulomatous cheilitis

A 54-year-old man presented with lip swelling, which was not altered by a trial of medication discontinuation. Patch tests showed reactions to bromonitropropane and gold, which were not clinically relevant. Treatment included topical and intralesional glucorticoids as well as tacrolimus ointment. Granulomatous chelitis an idiopathic disorder that is characterized by painless lip edema. It may be found as part of the triad of Melkersson-Rosenthal syndrome. Treatment includes intralesional glucocorticoids as well as systemic therapies.     

肉芽肿性唇炎

患者男,45岁。 主诉：下唇肿胀1年。 现病史：患者自2002年12月起无明显原因出现下唇左侧肿胀,无痒痛,偶有麻木感,未引起重视。肿胀持续不退．并逐渐向下唇右侧发展。曾在当地医院多次就诊,诊断为“血管神经性水肿”、“唇炎”等,口服多种抗组胺药物及抗生素,均未见疗效。自发病以来口唇无糜烂渗出,面部皮肤未出现异常。