Definition of videodermoscopic features of demodicosis

Diagnosis of demodicosis is usually confirmed by standardized skin surface biopsy. The skin of the patients with demodicosis is usually very sensitive. There is a need for new noninvasive tests. Videodermoscopic findings of demodicosis have not been validated yet. Our aim was to provide a noninvasive and easy method for diagnosis of demodicosis by using videodermoscopy.

This study included 26 patients with demodicosis which were confirmed with microscopy and responded well to anti-Demodex therapy Twenty-six age- and sex-matched individuals without demodicosis constituted the control group. Dermatologic evaluation included clinical observation along with microscopy. All photographs of the clinical and dermoscopic findings were taken with videodermoscope.

Demodex tails representing "Demodex mites" were a common feature in all patients. Gray dots were described as the second major videodermoscopic finding. Epidermal scale and red dots were also observed with higher prevalence than the other videodermoscopic features. We defined a new finding as follicular annular pigmentation corresponding to the facial pigmentation with demodicosis by videodermoscopy.

We concluded that it seems possible to confirm the clinical diagnosis of demodicosis by videodermoscopy, with similar results to handheld dermoscopy. Demodex tails should be considered as a sign of demodicosis, whereas detection of gray dots, epidermal scale, and red dots may raise the suspicion of demodicosis.