接受光疗患者中毛囊蠕形螨的临床重要性。

Clinical importance of Demodex folliculorum in patients receiving phototherapy.

作者信息

Kulac Mustafa, Ciftci Ihsan Hakki, Karaca Semsettin, Cetinkaya Zafer

机构信息

Departments of Dermatology and Microbiology, Faculty of Medicine, Afyon Kocatepe University, Afyon, Turkey.

出版信息

Int J Dermatol. 2008 Jan;47(1):72-7. doi: 10.1111/j.1365-4632.2007.03336.x.

DOI:10.1111/j.1365-4632.2007.03336.x

PMID:18173609

Abstract

BACKGROUND

Patients with immunodeficiency are prone to infestation with Demodex folliculorum mites. Ultraviolet (UV) radiation can lead to immunosuppression and sebaceous gland hyperplasia. Although some cases of demodicidosis related to UV radiation exposure have been reported, no studies have been performed on the incidence of D. folliculorum and its clinical characteristics in patients receiving phototherapy. Objective To investigate the effects of phototherapy on the density of D. folliculorum infestation and its clinical characteristics.

METHODS

This was a cross-sectional study. Forty-five patients receiving phototherapy and 43 age- and sex-matched healthy controls were enrolled to the study. The sociodemographic characteristics, occupational information, and skin types (2, 3, 4, or 5) of both patients and controls were carefully recorded. The dermatologic diseases requiring phototherapy, type and number of phototherapy treatments, and cumulative UV doses of all patients were noted. The clinical findings that may relate to demodicidosis were recorded. Standardized skin surface biopsies were taken from three anatomic regions (forehead, cheek, and nasal dorsum) and suspected lesions; five or more D. folliculorum mites per square centimeter of skin was defined as demodicidosis.

RESULTS

Twelve (26.7%) patients received psoralen plus UV-A (PUVA) and 33 (73.3%) received narrow-band UV-B. Demodicidosis was detected in 13 (28.9%) patients and three (7%) controls. The difference in the demodicidosis rate between patients and controls was statistically significant (P = 0.01). In eight of the 13 patients (61.5%) with demodicidosis, clinical demodicidosis was present. Demodicidosis was present in seven of the 12 patients (58.3%) receiving PUVA and in six of the 33 patients (18.2%) receiving narrow-band UV-B. The difference in demodicidosis rates between patients receiving PUVA and those receiving narrow-band UV-B was statistically significant (P = 0.02). A statistically significant difference was also found between the mean D. folliculorum densities of patients and controls in all anatomic regions.

CONCLUSION

Demodicidosis should be included in the differential diagnosis of facial eruptions in patients receiving phototherapy.

摘要

背景

免疫缺陷患者容易感染毛囊蠕形螨。紫外线（UV）辐射可导致免疫抑制和皮脂腺增生。虽然已有一些与紫外线辐射暴露相关的蠕形螨病病例报道，但尚未对接受光疗的患者中毛囊蠕形螨的发病率及其临床特征进行研究。目的：探讨光疗对毛囊蠕形螨感染密度及其临床特征的影响。

方法

这是一项横断面研究。45例接受光疗的患者和43例年龄及性别匹配的健康对照者纳入研究。仔细记录患者和对照者的社会人口学特征、职业信息及皮肤类型（2、3、4或5型）。记录所有患者需要光疗的皮肤病、光疗治疗的类型和次数以及累积紫外线剂量。记录可能与蠕形螨病相关的临床发现。从三个解剖部位（前额、脸颊和鼻背）及可疑皮损处进行标准化皮肤表面活检；每平方厘米皮肤有五只或更多毛囊蠕形螨被定义为蠕形螨病。

结果

12例（26.7%）患者接受了补骨脂素加紫外线A（PUVA）治疗，33例（73.3%）接受了窄谱紫外线B治疗。13例（28.9%）患者和3例（7%）对照者检测到蠕形螨病。患者和对照者的蠕形螨病发病率差异有统计学意义（P = 0.01）。13例蠕形螨病患者中有8例（61.5%）存在临床蠕形螨病。接受PUVA治疗的12例患者中有7例（58.3%）存在蠕形螨病，接受窄谱紫外线B治疗的33例患者中有6例（18.