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In Vivo Confocal Microscopy: A Standard Operating Procedure for the Detection of Demodex Mites at the Eyelid Margin
Published on: July 3, 2025
Is Demodex hiding in lichen planopilaris pathogenesis? The trichoscopy-blind zone
Kambiz Kamyab Hesari1, Alireza Ghanadan1, Vahidehsadat Azhari1
1Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
None:
The pathogenic role of commensal Demodex mites in lichen planopilaris remains hypothetical. We propose a multifactorial model where mite lipases and antigens disrupt follicular peroxisome proliferator-activated receptor gamma (PPAR-γ) signalling and trigger a lymphocytic response that may progress to autoimmunity. A therapeutic paradox exists, as immunomodulatory treatments may reduce inflammation but also promote mite proliferation, underscoring the need for controlled trials.
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