Yazisiz Hatice, Çekİn Yeşim, Sezer İlhan, Bostan Feyzi, KoÇlar Fatma Gülsüm
Department of Medical Microbiology, Division of Parasitology, Akdeniz University Faculty of Medicine, Antalya, Turkey.
Department of Medical Microbiology, University of Health Sciences, Antalya Training and Research Hospital, Antalya, Turkey.
Arch Rheumatol. 2020 Feb 7;35(3):376-384. doi: 10.46497/ArchRheumatol.2020.7699. eCollection 2020 Sep.
This study aims to investigate the presence of Demodex species in rheumatoid arthritis (RA) patients, to identify the risk factors for developing Demodex infestation, and to determine the effect of immunosuppressant drugs on Demodex mite infestations.
The study included 93 RA patients (16 males, 77 females; mean age 53.3±11.3 years; range, 27 to 83 years) and 76 healthy controls (19 males, 57 females; mean age 50.3±13.9 years; range, 19 to 86 years). Specimens were collected from face skin by using standardized sur- face skin biopsy. Demodex infestation was considered for ≥5 living parasites/cm2 of skin while Demodex mite presence was defined as any Demodex larvae, adults, or eggs found in the specimen.
The frequencies of Demodex mite presence were 44% for the RA patients and 15.7% for the healthy controls (p<0.001). The rates of Demodex infestation were similar between the two groups (18.3% versus 7.9%, p=0.054). There were no statistically significant differences between the groups regarding skin type, skin care, epilation, body washing, use of a moisturizer, personal towel use, the number of residents at home, or whether there were pets at home or in proximity. Itching in eyes was higher in RA patients, but the frequency of other skin symptoms was not differ- ent from healthy controls. Logistic regression analysis indicated that the diagnosis of RA was an independent risk factor for Demodex mite presence in this study population. Disease activity and duration, use of corticosteroids, conventional disease-modifying anti-rheumatic drugs (DMARDs) and biological DMARDs were not effective factors on Demodex mite presence in RA patients.
Although Demodex mite presence was 3.5-fold higher in RA patients, the rate of Demodex infestation was similar to that of healthy controls.
本研究旨在调查类风湿关节炎（RA）患者中蠕形螨属物种的存在情况，确定发生蠕形螨感染的危险因素，并确定免疫抑制药物对蠕形螨感染的影响。
本研究纳入93例RA患者（16例男性，77例女性；平均年龄53.3±11.3岁；范围27至83岁）和76例健康对照者（19例男性，57例女性；平均年龄50.3±13.9岁；范围19至86岁）。通过标准化的面部皮肤活检从面部皮肤采集标本。当皮肤每平方厘米有≥5条活寄生虫时考虑为蠕形螨感染，而蠕形螨的存在定义为在标本中发现任何蠕形螨幼虫、成虫或虫卵。
RA患者中蠕形螨存在的频率为44%，健康对照者为15.7%（p<0.001）。两组的蠕形螨感染率相似（18.3%对7.9%，p=0.054）。两组在皮肤类型、皮肤护理、脱毛、沐浴、使用保湿剂、个人毛巾使用、家中居住人数或家中及附近是否有宠物方面无统计学显著差异。RA患者眼部瘙痒较高，但其他皮肤症状的频率与健康对照者无差异。逻辑回归分析表明，在本研究人群中，RA诊断是蠕形螨存在的独立危险因素。疾病活动度和病程、使用皮质类固醇、传统改善病情抗风湿药物（DMARDs）和生物DMARDs对RA患者蠕形螨的存在不是有效因素。
虽然RA患者中蠕形螨的存在率高3.5倍，但蠕形螨感染率与健康对照者相似。
