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Erythematotelangiectatic rosacea may be associated with a subclinical stage of demodicosis. A case control study.

Br J Dermatol. 2019 Feb 22;:

Authors: Forton F, De Maertelaer V

Abstract
BACKGROUND: Facial densities of Demodex mite 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 dermatoses.
METHODS: In this retrospective study, we recorded Demodex densities measured using two consecutive standardised skin 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 than did the healthy controls (mean ±SEM, SSSB1: 15.7±6.3 vs. 1.8±1.1 Demodex(D)/cm² [p=0.042]; SSSB2: 38.0±13.7 vs. 5.1±2.1 D/cm² [p=0.026]) and patients with other dermatoses (SSSB1: 0.4±0.1D/cm² [p=0.004]; SSSB2: 1.3±0.3 D/cm² [p=0.004]), but lower than patients with demodicosis (SSSB1: 82.7±4.2D/cm² [p=0.008]; SSSB2: 172.2±7.7 D/cm² [p=0.001]) or rosacea with papulopustules (SSSB1: 86.6±7.3 D/cm² [p=0.027]; SSSB2: 197.0±12.1 D/cm² [p=0.002]).
CONCLUSIONS: ETR may be associated with non-visible 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. This article is protected by copyright. All rights reserved.

PMID: 30801673 [PubMed - as supplied by publisher]

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