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Demodicidosis in immunocompetent young children: report of eight cases
A Patrizi1, I Neri, C Chieregato
1Department of Clinical and Experimental Medicine, University of Bologna, Italy.
Abstract:
Demodex folliculorum and Demodex brevis are obligate parasites of the human pilosebaceous unit. They are the most common permanent ectoparasites in adults, but their incidence on children's skin is rare. Only few cases of demodicidosis have been reported in children aged below 5 years and most of them were suffering from leukemia or HIV infection. The aim of this study is to describe demodicidosis in young immunocompetent children. The clinical details of 8 healthy children are given. There were 4 males and 4 females aged between 10 months and 5 years referred to us for evaluation of a facial eruption characterized by erythema, papulopustules and variable edema. In 7 of these patients, skin scrapings were performed and in 1 a 4-mm punch biopsy. Numerous D. folliculorum were found in skin scrapings of 7 cases and at a histologic examination of skin biopsy in 1 case. We employed topical metronidazole gel 1% in all patients and we obtained a 100% recovery without relapses after a 1- to 3-year follow-up. In 2 of our cases Demodex infestation had a mild form resembling pityriasis folliculorum and the other cases presented a rosacea-like form. The reason why these young immunocompetent children developed demodicidosis is still under evaluation and investigation.
Insights
Demodex mites can cause skin conditions in young children, even if they are healthy. Topical metronidazole gel effectively treated these cases of demodicidosis in children.
Area of Science:
- Dermatology
- Parasitology
- Pediatrics
Background:
- Demodex folliculorum and Demodex brevis are common human ectoparasites, typically found in adults.
- Demodicidosis (Demodex infestation) is rare in children, especially those under five years old, and often associated with underlying health issues like leukemia or HIV.
Observation:
- This study details eight immunocompetent children (4 male, 4 female, aged 10 months to 5 years) presenting with facial erythema, papulopustules, and edema.
- Skin scrapings or biopsies revealed numerous Demodex folliculorum in seven and one patient, respectively.
- Clinical presentations varied, with some resembling pityriasis folliculorum and others a rosacea-like form.
Findings:
- Topical 1% metronidazole gel achieved a 100% recovery rate in all treated children.
- No relapses were observed during a 1- to 3-year follow-up period.
Implications:
- This study highlights that demodicidosis can occur in young, healthy children.
- Topical metronidazole is an effective treatment for pediatric demodicidosis.
- Further research is needed to understand the factors contributing to demodicidosis in immunocompetent children.