Demodex Infestation in Discoid Lupus Erythematosus: A Histopathologic Study

Discoid lupus erythematosus (DLE) is a chronic form of cutaneous lupus that mainly affects the face, scalp, and neck. It presents as erythematous and infiltrated plaques that may lead to atrophy, scarring, and alopecia. Recent studies suggest a possible link between Demodex mite infestation and DLE pathogenesis. This study aims to evaluate the prevalence of Demodex mites in patients with DLE and their potential role in disease pathogenesis. A total of 85 histopathologically and clinically confirmed patients with DLE were assessed. Clinical and histopathologic data were collected, and hematoxylin-eosin-stained biopsy specimens were evaluated for Demodex infestation. Demodex mites were detected in 31 patients (36.5%). Infestation was more common in face localization (47.1%) than in scalp (16.7%) ( P = 0.006). No significant association was found between Demodex positivity and age, sex, or histopathologic findings of DLE. Although Demodex mites may not play a direct role in DLE pathogenesis, their increased prevalence in facial lesions suggests a secondary association because of immune dysregulation and autoimmune background. Further studies are needed to assess the impact of Demodex positivity on DLE progression, pathogenesis, and treatment response.