A PERSONALIZED APPROACH TO DIAGNOSIS OF DEMODECOSIS

Abstract

Purpose. Improving the diagnosis of demodicosis based on a personalized approach to choosing a method for collecting material, clinical manifestations for extracting ticks and assessing the degree of tick infestation. Materials and methods. The results of an examination of 57 patients with clinically and laboratory confirmed demodicosis are presented. The exclusion criteria were patients with acne, rosacea, perioral dermatitis. Clinical manifestations were assessed by dermatoscopy. The material was collected for microscopic detection of mites using 2 traditional and 3 proprietary methods. Microscopy was also used to identify bacterial flora in pustules and yeast flora in scrapings of the epidermis. Results. A comparative analysis of the effectiveness of 4 diagnostic methods showed the priority of comedone extraction: 5 or more mites were found from an area of 0.5 cm2 in 96.5% of patients. The occurrence and abundance of mites were highest in the material from follicular papules with “spikes” (74.5%, 4.9±1.1 specimens) and typical follicular papules (56.3% and 6.1±1.7). When the disease duration was more than 6 months, the phenomenon of “strands of vellus hair“ was detected in the contents of follicles at the same time with mites (5–17 specimens). Analysis of the contents of the pustules made it possible to prove the antagonism between the pyogenic flora and mites of the genus Demodex.