Demodicosis as a Skin Complication in Organ Transplant Recipients: A Case Series

BACKGROUND Patients after organ transplantation are, due to chronic immunosuppression, prone to have many cutaneous adverse events, both infections and neoplasms. Studies show that some groups of patients under chronic immunosuppression are prone to develop demodicosis. The significance of demodicosis in the population of organ transplant recipients has not been established yet. CASE REPORT We present 4 cases of patients with multiply dermatological complications of immunosuppression, in which one of them is demodicosis. The presented symptoms were itch, pustules, papules, and/or telangiectasias. Age of patients varied from 64 to 79 years old. Time between transplantation and diagnosis of demodicosis varied from 6 to 10 years. Other dermatological problems that appeared were basal cell carcinoma, actinic keratosis, and seborrheic keratosis. Patients showed complete resolution after treatment with topical ivermectin 10 mg/g and topical permethrin 50 mg/g. However, the medications were prolonged to 16 weeks in 1 case to reduce persistent papules and telangiectasias. The therapy did not cause any complications or disruptions in function of transplanted kidneys in any of reported patients. CONCLUSIONS Demodicosis may have a significant role in the group of infections that organ transplant recipients are prone to, and may co-exist with other dermatological diseases, including neoplasms. However, larger studies in the field are needed.