Olt Serdar, Yalçın Gülter Gülter, Uysal Ozlem Sönmez, Karakeçe Engin, Ciftci Ihsan Hakkı
Department of Internal Medicine, Sakarya University Medical Faculty, Sakarya, Turkey.
Department of Oncology, Sakarya University Medical Faculty, Sakarya, Turkey.
Niger Med J. 2013 Sep;54(5):349-50. doi: 10.4103/0300-1652.122371.
Demodex folliculorum and Demodex brevis are obligatory parasites that live in sebaceous glands and follicles. When immune system becomes suppressed by any reason, patients become vulnerable to obligatory parasites like D. folliculorum and D. brevis. Immune system becomes suppressed in cancer patients who undergo chemotherapy, and as a result these patients become vulnerable to infestations. In our case, a 45 year-old female has been admitted to oncology clinic for a medical treatment of breast cancer. Her systematic physical examination was normal, except redness on her cheeks and forehead. There was no abnormality in biochemical and haematological laboratory values. We have decided to apply chemotherapy of Adriamycin, cyclophosphamide and 5-fluorouracil. Due to the itchy redness on her cheeks and forehead, we had performed an examination for demodex before chemotherapy; and we have identified 20 mites/cm(2) on her right and left cheeks, and 15 mites/cm(2) on her forehead. When our patient had came our clinic with increasing complaint of itchy rash, after the first course of chemotherapy we have reexamined demodex. The result of microscopic examination revealed large amount of demodex of 50 mites/cm(2) on her right and left cheeks and 30 mites/cm(2) on her forehead, which were nearly 2.5-times higher than the previous examination. This increase probably was associated with immune suppression of chemotherapy.
毛囊蠕形螨和皮脂蠕形螨是寄生于皮脂腺和毛囊的专性寄生虫。当免疫系统因任何原因受到抑制时,患者就容易受到毛囊蠕形螨和皮脂蠕形螨等专性寄生虫的侵害。接受化疗的癌症患者免疫系统会受到抑制,因此这些患者容易受到感染。在我们的病例中,一名45岁女性因乳腺癌入院接受治疗。除脸颊和额头发红外,她的全身体格检查正常。生化和血液学实验室检查值无异常。我们决定应用阿霉素、环磷酰胺和5-氟尿嘧啶进行化疗。由于她脸颊和额头瘙痒发红,我们在化疗前对蠕形螨进行了检查;我们在她的左右脸颊上发现每平方厘米有20只螨虫,额头上每平方厘米有15只螨虫。当我们的患者因皮疹瘙痒加重前来我们诊所时,在第一个化疗疗程后,我们再次检查了蠕形螨。显微镜检查结果显示,她的左右脸颊上每平方厘米有大量50只蠕形螨,额头上每平方厘米有30只蠕形螨,这几乎比之前的检查结果高出2.5倍。这种增加可能与化疗导致的免疫抑制有关。