This week's case is by our awesome dermatopathology fellow and former chief resident, Kabeer Shah. The following was seen in a scraping of a papule from a patient with rosacea. Identification?
Check out the way this little guy moves!
13 comments:
Bernardino Rocha
said...
These are follicle mites, Demodex sp. (probably D. folliculorum). They are elongated and vermiform, with 3 body divisions: gnathosoma (anterior end); podosoma (4 pairs of appendages); opisthosoma (posterior rounded end)
Quite sure is a Demodex folliculorum. D. brevis has a V like shape in his posterior part of the body. Living in the sebaceous glands D. brevis can be seen much less often than D. folliculorum which lives in the hair follicles.
So many people think they live immaculate lives but among their hair follicles another creature thrives you can shower and scrub to your heart's content but all that effort won't make a dent because the mite Demodex folliculorum continues to survive
I agree with the other bloggers. The critter is Demodex sp. And I will wait with Florida Fan for a more professional identification.
Demodex has long been considered a very common commensal of humans. We would find high percentages of our students providing a cozy living space for these tiny mites. Giving credence to the thought that it is probably living in just about everyone.
Recently it has been suggested that higher populations of this mite might have a role in developing Rosacea in human patients. One hypothesis is when elevated populations of Demodex die they release bacteria loads which initiate an inflammatory response. It is thought the bacteris is entirely responsible for the reaction not the mite. This might be why there are cases of Rosacea which are refractile to traditional treatment but do respond when Demodedic treatment is added.
Demodex from a veterinary prospective. There art 65 species of Demodex . All the common domestic animals have their own species. They are host specific capable of only transient cross infectivity.
We normally diagnose with skin scrapings, but have seen them in fecal flotations (along with their rhombus shaped eggs). The Greek derivation of the genus: Dermos = fat, dex= woodworm. I would be less impressed with the translation if it weren’t for the fact that we often see another mite that mimics Demodex and are common in fecals. These mites cause leaf galls in trees.
I have also seen Demodex in modified Knott’s preparations. A lucky blood draw, I guess.
Every week I will post a new Case, along with the answer to the previous case. Please feel free to write in with your answers, comments, and questions. Also check out my image archive website at http://parasitewonders.com. Enjoy!
The Fine Print: Please note that all opinions expressed here are mine and not my employer. Information provided is for educational purposes only. It is not intended as and does not substitute for medical advice. I do not accept medical consults from patients.
13 comments:
These are follicle mites, Demodex sp. (probably D. folliculorum). They are elongated and vermiform, with 3 body divisions: gnathosoma (anterior end); podosoma (4 pairs of appendages); opisthosoma (posterior rounded end)
Demodex folliculorum
Demodex brevis
-HLCM fan
Like my former colleague, I think it's about Demodex brevis.
Luis.
Demodex brevis
Demodex sp. (Follicle mite).
Demodex sp
For sure a classic case of Demodex sp. I would leave the species identification to a true entomologist.
Florida Fan
Quite sure is a Demodex folliculorum. D. brevis has a V like shape in his posterior part of the body. Living in the sebaceous glands D. brevis can be seen much less often than D. folliculorum which lives in the hair follicles.
Demodex
So many people think they live immaculate lives
but among their hair follicles another creature thrives
you can shower and scrub to your heart's content
but all that effort won't make a dent
because the mite Demodex folliculorum continues to survive
I agree with the other bloggers. The critter is Demodex sp. And I will wait with Florida Fan for a more professional identification.
Demodex has long been considered a very common commensal of humans. We would find high percentages of our students providing a cozy living space for these tiny mites. Giving credence to the thought that it is probably living in just about everyone.
Recently it has been suggested that higher populations of this mite might have a role in developing Rosacea in human patients. One hypothesis is when elevated populations of Demodex die they release bacteria loads which initiate an inflammatory response. It is thought the bacteris is entirely responsible for the reaction not the mite. This might be why there are cases of Rosacea which are refractile to traditional treatment but do respond when Demodedic treatment is added.
Demodex from a veterinary prospective.
There art 65 species of Demodex . All the common domestic animals have their own species. They are host specific capable of only transient cross infectivity.
We normally diagnose with skin scrapings, but have seen them in fecal flotations (along with their rhombus shaped eggs). The Greek derivation of the genus: Dermos = fat, dex= woodworm. I would be less impressed with the translation if it weren’t for the fact that we often see another mite that mimics Demodex and are common in fecals. These mites cause leaf galls in trees.
I have also seen Demodex in modified Knott’s preparations. A lucky blood draw, I guess.
demodex
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