Czepita Damian, Kuźna-Grygiel Wanda, Czepita Maciej, Grobelny Andrzej
Katedra i Klinika Okulistyki Pomorskiej Akademii Medycznej w Szczecinie al. Powstańców Wlkp. 72, 70-111 Szczecin.
Ann Acad Med Stetin. 2007;53(1):63-7; discussion 67.
Intensive long-term studies of Demodex spp. (D.) and its role in chronic blepharits have been carried out in recent years by scientists from the Pomeranian Medical University in Szczecin. It has resulted in numerous publications, spurring a lot of interest worldwide. A few of the papers have been cited in leading American medical journals. In recent years many papers dealing with demodicosis of the eyelids have been published worldwide. Based on the growing interest in the role of Demodex spp. in chronic blepharitis we decided to present and discuss the results of the latest experimental and clinical studies.
A review of the literature concerning the role of D. folliculorum and D. brevis in the pathogenesis of chronic blepharitis was done.
Demodex spp. are intradermal parasites, which thrive in follicles and sebaceous glands of humans and animals. D. is spread by direct contact and probably by dust containing eggs (figs. 1, 2, 3). Currently, it is thought that pathological changes in the course of demodicosis of the eyelids are consequences of: (1) blockage of follicles and leading out tubules of sebaceous glands by the mites and by reactive hyperkeratinization and epithelial hyperplasia; (2) a mechanical vector role of bacteria; (3) host's inflammatory reaction to the presence of parasite's chitine as a foreign body; and (4) stimulation of the host's humoral responses and cell-mediated immunological reactions under the influence of the mites and their waste products. It has been established that: (1) D. folliculorum and D. brevis are cosmopolitan in terms of their distribution; (2) Infection of Demodex spp. often occurs in the course of chronic blepharitis; (3) With the increase in age, the prevalence rate of eyelid demodicosis rises; (4) Demodicosis of the eyelids may be the effect of the decrease of immunity of some patients. Treatment of demodicosis of the eyelids as a general rule lasts a few months. The use of yellow mercurial ointment, sulphur ointment, camphorated oil, crotamiton, choline esterase inhibitors, sulfacetamide, steroids, antibiotics, as well as antimycotic drugs offers some improvement. A good response has been observed after oral application of ivermectin along with topical application of cream permethrin. However, the best results were obtained after 2% metronidazole gel or ointment treatment. Medical University in Szczecin. It has resulted in numerous publications, spurring a lot of interest worldwide. A few of the papers have been cited in leading American medical journals. In recent years many papers dealing with demodicosis of the eyelids have been published worldwide. Based on the growing interest in the role ofDemodex spp. in chronic blepharitis we decided to present and discuss the results of the latest experimental and clinical studies. Material and methods: A review of the literature concerning the role of D. folliculorum and D. brevis in the pathogenesis of chronic blepharitis was done. Results: Demodex spp. are intradermal parasites, which thrive in follicles and sebaceous glands of humans and animals. D. is spread by direct contact and probably by dust containing eggs (figs. 1, 2, 3). Currently, it is thought that pathological changes in the course of demodicosis of the eyelids are consequences of: (1) blockage of follicles and leading out tubules of sebaceous glands by the mites and by reactive hyperkeratinization and epithelial hyperplasia; (2) a mechanical vector role of bacteria; (3) host's inflammatory reaction to the presence of parasite's chitine as a foreign body; and (4) stimulation of the host's humoral responses and cell-mediated immunological reactions under the influence of the mites and their waste products. It has been established that: (1) D. folliculorum and D. brevis are cosmopolitan in terms of their distribution; (2) Infection ofDemodex spp. often occurs in the course of chronic blepharitis; (3) With the increase in age, the prevalence rate of eyelid demodicosis rises; (4) Demodicosis of the eyelids may be the effect of the decrease of immunity of some patients. Treatment of demodicosis of the eyelids as a general rule lasts a few months. The use of yellow mercurial ointment, sulphur ointment, camphorated oil, crotamiton, choline esterase inhibitors, sulfacetamide, steroids, antibiotics, as well as antimycotic drugs offers some improvement. A good response has been observed after oral application of ivermectin along with topical application of cream permethrin. However, the best results were obtained after 2% metronidazole gel or ointment treatment.
近年来，什切青的波美拉尼亚医科大学的科学家们对蠕形螨属及其在慢性睑缘炎中的作用进行了深入的长期研究。这一研究成果丰硕，发表了众多论文，在全球范围内引起了广泛关注。其中一些论文被美国顶尖医学期刊引用。近年来，全球范围内发表了许多关于眼睑蠕形螨病的论文。基于对蠕形螨属在慢性睑缘炎中作用的兴趣日益浓厚，我们决定展示并讨论最新的实验和临床研究结果。
对有关毛囊蠕形螨和皮脂蠕形螨在慢性睑缘炎发病机制中作用的文献进行了综述。
蠕形螨属是皮内寄生虫，在人和动物的毛囊及皮脂腺中大量繁殖。蠕形螨通过直接接触传播，也可能通过含有虫卵的灰尘传播（图1、2、3）。目前认为，眼睑蠕形螨病病程中的病理变化是由以下原因导致的：（1）螨虫以及反应性角化过度和上皮增生导致毛囊和皮脂腺排泄管堵塞；（2）细菌的机械载体作用；（3）宿主对寄生虫几丁质作为异物存在的炎症反应；（4）在螨虫及其排泄物的影响下，宿主的体液免疫反应和细胞介导的免疫反应受到刺激。现已确定：（1）毛囊蠕形螨和皮脂蠕形螨在分布上具有世界性；（2）蠕形螨属感染常发生在慢性睑缘炎病程中；（3）随着年龄增长，眼睑蠕形螨病的患病率上升；（4）眼睑蠕形螨病可能是一些患者免疫力下降的结果。眼睑蠕形螨病的治疗通常持续数月。使用黄降汞软膏、硫磺软膏、樟脑油、克罗米通、胆碱酯酶抑制剂、磺胺醋酰、类固醇、抗生素以及抗真菌药物可带来一定改善。口服伊维菌素并外用氯菊酯乳膏后观察到良好反应。然而，2%甲硝唑凝胶或软膏治疗后效果最佳。什切青医科大学。这一研究成果丰硕，发表了众多论文，在全球范围内引起了广泛关注。其中一些论文被美国顶尖医学期刊引用。近年来，全球范围内发表了许多关于眼睑蠕形螨病的论文。基于对蠕形螨属在慢性睑缘炎中作用的兴趣日益浓厚，我们决定展示并讨论最新的实验和临床研究结果。材料与方法：对有关毛囊蠕形螨和皮脂蠕形螨在慢性睑缘炎发病机制中作用的文献进行了综述。结果：蠕形螨属是皮内寄生虫，在人和动物的毛囊及皮脂腺中大量繁殖。蠕形螨通过直接接触传播，也可能通过含有虫卵的灰尘传播（图1、2、3）。目前认为，眼睑蠕形螨病病程中的病理变化是由以下原因导致的：（1）螨虫以及反应性角化过度和上皮增生导致毛囊和皮脂腺排泄管堵塞；（2）细菌的机械载体作用；（3）宿主对寄生虫几丁质作为异物存在的炎症反应；（4）在螨虫及其排泄物的影响下，宿主的体液免疫反应和细胞介导的免疫反应受到刺激。现已确定：（1）毛囊蠕形螨和皮脂蠕形螨在分布上具有世界性；（2）蠕形螨属感染常发生在慢性睑缘炎病程中；（3）随着年龄增长，眼睑蠕形螨病的患病率上升；（4）眼睑蠕形螨病可能是一些患者免疫力下降的结果。眼睑蠕形螨病的治疗通常持续数月。使用黄降汞软膏、硫磺软膏、樟脑油、克罗米通、胆碱酯酶抑制剂、磺胺醋酰、类固醇、抗生素以及抗真菌药物可带来一定改善。口服伊维菌素并外用氯菊酯乳膏后观察到良好反应。然而，2%甲硝唑凝胶或软膏治疗后效果最佳。
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