Demodex Folliculorum
A February 2010 study in the British Journal of Dermatology that “many dermatologists do not include demodicosis in their differential diagnoses, or the diagnosis of demodicosis is frequently masked by other skin diseases such as papulopustular or erythematotelangiectatic rosacea, seborrhoeic dermatitis, perioral dermatitis and contact dermatitis.” I have been saying this since 2007 when I wrote my book on rosacea 101. I have been encouraging all rosaceans to insist that their dermatologist rule out demedectic rosacea by obtaining a skin biopsy. This same report concluded that the authors “recommend the use of SSSB for the measurement of Dd as more patients with demodicosis can be diagnosed with this method compared with the DME method.”
Another study also concluded what I wrote in my 2007 book that a skin biopsy should be done to determine demodex density to rule out Demodectic Rosacea. Here is the conclusion:
“Demodicosis should be considered in the differential diagnosis of recurrent or recalcitrant rosacea-like, granulomatous rosacea-like, and perioral dermatitis-like eruptions of the face. Potassium hydroxide examination, standardized skin surface biopsy, skin biopsy, or a combination of these are essential to establish the diagnosis.”
Source
Dr. Frank Powell wrote in his new book, Rosacea Diagnosis and Management, the following:
“There is no laboratory test or investigation that will confirm the diagnosis of PPR. Specific investigations may be required to rule out similar appearing conditions (many of which will be identified by listening carefully to the patient’s medical history and examining the skin lesions). These include skin swabs for bacterial culture, skin scrapings for the presence of demodex mites, scrapings for fungal KOH and fungal culture, skin biopsy for histologic examination, (and rarely culture) skin surface biopsy for demodex mite quantification, patch tests, photopatch tests, and very rarely systemic workup wih appropriate blood tests and radiological examinations.”
Did your dermatologist do any of the above tests including a skin biopsy to rule out Demodectic Rosacea?
“It is when the first diagnosis and treatment don’t work that dermatologists look deeper and often discover something called demodex.”
