Demographic Patterns and Clinical Presentations of Demodicosis in a Longitudinal Study From Khuzestan Province,...

Demodicosis is a significant dermatological condition caused by Demodex mites, with a wide range of clinical manifestations. Despite its prevalence, population-based studies on the epidemiology, co-infections, and atypical presentations of demodicosis remain limited globally. This study aimed to investigate the demographic patterns, clinical characteristics, and associated co-infections of demodicosis over a 22-year period in southwest Iran.

A total of 382 patients with confirmed demodicosis were retrospectively analyzed. Data were collected from records of Iran Zamin Medical Diagnostic Laboratory (2002-2024). Demographic characteristics, clinical presentations, co-infections, and atypical manifestations were documented. Skin scrapings were examined microscopically to confirm Demodex infestation, and statistical analyses were conducted to identify significant patterns.

The mean patient age was 36.6 ± 12.8 years, with a marked female predominance (77.7%). The age distribution showed that the 21-35 age group accounted for the largest proportion of cases (45.3%), while pediatric (≤ 20 years) and geriatric (> 65 years) groups showed no significant gender disparity. Co-infections were identified in 6.8% of cases, predominantly involving dermatophyte infections, such as Tinea facei (46.1% of co-infections). This study also highlights novel co-infections and atypical presentations, including involvement of the trunk, sinus, ear, and thigh.

This is the first large-scale study of demodicosis in the general population of Iran, covering a 22-year period. It is also among the first worldwide to explore co-infections systematically. The findings emphasize significant demographic and clinical patterns, particularly age- and gender-specific susceptibility and the complex interplay of co-infections. These insights expand the understanding of demodicosis and highlight the importance of considering its atypical manifestations and associated infections in clinical practice.