Demodicosis
Description:
Demodicosis (Latin Demodecosis oculi) — a ciliary tick, in a popular speech — демодекс) — the disease from group of akariaz caused by parasitizing of an opportunistic tick — an iron woundwort acne (Demodex folliculorum and Demodex brevis). The tick the sizes of 0,2-0,5 mm lives in channels of sebaceous and meibomian glands, in mouths of hair follicles of the person and mammals.
Demodicosis symptoms:
The diagnosis is confirmed microscopically: detection of a tick and his eggs in scraping from face skin or a secret of sebaceous glands.
Favourite localization of a tick — eyelids, face skin, area of superciliary arches, a forehead, nasolabial folds and a chin, outside acoustical pass. More rare — a breast and it is very rare — a back. Waste products of a tick promote organism allergization, development of pink eels (Acne rosacea) on a face, seborrheas; cause specific damage of eyes — a demodekozny blepharitis and blefarokonjyunktivit. The disease has chronic character with seasonal aggravations in the spring and in the fall.
Often the inflammatory skin disease a rhinophyma happens a consequence of a demodicosis.
The clinical picture of a demodicosis preferential is registered at persons with the weakened immune system, ametropias and disbolism, is frequent — at advanced age. Often occurs at people with a disease on a trichomoniasis. Occurs at children with chronic diseases of digestive tract and lungs, nekorrigirovanny refraction pathology (far-sightedness).
The fatigue of eyes, itch, hypostasis, hyperemia of edges a century, emergence of scales in roots of eyelashes for a long time and high degree of invasiveness (transmissibility of people around) allow to find a demodicosis already at visual survey. The type of the struck century is characteristic: a plaque on edge the century, cilia bound together, are surrounded with crusts in the form of the coupling. In the anamnesis: frequent barley, loss of eyelashes, recurrent acne rash, psoriasis. The laboratory research extremely simple, does not demand special preparation and it is possible in the presence of the patient directly in an office. From each eye about 8 eyelashes undertake: four from an upper eyelid, four from lower. They are located on a slide plate in a drop of alkaline solution or mix from 1 ml of glycerin and 9 ml of physical solution; are covered with cover glass and are considered under a microscope. The similar research gives the chance of bystry diagnosis.
Oftalmodemodekoz (demodicosis of eyes) — акариаз organs of sight.
Demodex folliculorum activators D. brevisв glands, grease meibomian and Tseysa lives in hair follicles. D.folliculorum has the extended body, the size 0,27-048kh0,048-0,064mm, D.brevis is twice less (0,16-0,176kh0,048mm). In ciliary follicles the century of D.folliculorum meets less often (39%), than on face skin.
The demodekozny blepharitis develops, blefarokonjyunktivit, halyaziona, episclerites and a regional keratitis.
Cavities of hair follicles of skin become a century stretched, there is a hyperplasia and a hyperkeratosis, an easy chronic perifolliculitis. At a chronic proliferative inflammation of meibomian gland (халязион), an internal wall of a granuloma is dilapidated a tick the epithelial vystilka, outside the connective tissue capsule, infiltrirovanny eosinophils, histiocytes and macrophages.
Often the disease can be characterized to proceed as an asymptomatic carriage, the erased forms, a demodekozny blefarokonjyunktivit (uncomplicated, complicated), an episcleritis, a keratitis, an iridocyclitis. The eye demodicosis can proceed as it is isolated, and in combination with a demodicosis of face skin and other body parts. Gradually there is an organism sensitization to waste products and disintegration of mites. Development of an inflammation at a demodicosis is referred to a hyper sensitization of the IV type.
Action of a parasite on a conjunctiva, a cornea and other covers of an eye toksiko-allergic. There can be a scanty mucous discharge from a conjunctival cavity, an easy hyperemia and a roughness of a conjunctiva a century, a razrykhlennost of the lower transitional folds, a weak follicular or papillary hypertrophy, heart attacks and concrements of meibomian glands. The demodekozny episcleritis is seldom observed. As a result of disturbance of secretory function of meibomian glands the lipidic layer of a precorneal lacrimal film decreases, its evaporability amplifies that leads to development of a syndrome of a dry eye at which trophic disturbances in cornea blankets prevail, there is a decrease in its sensitivity. Sometimes the choroid is at the same time involved in process. The demodicosis burdens a current of a keratitis of any etiology.
Demodicosis reasons:
Infestant - an iron woundwort acne (Demodex folliculorum and Demodex brevis). The tick the sizes of 0,2-0,5 mm lives in channels of sebaceous and meibomian glands, in mouths of hair follicles of the person and mammals.
Treatment of the Demodicosis:
Inside: Metronidazole Outwardly: topical treatment by acaricidal means: 20% water and soap emulsion of benzyl benzoate, metronidazole gel, trikhopolovy ointment, Vilkinson's ointment, ointment of "Holes", 5-10% Unguentum sulfuratum.
