
oa Potential role of Demodex mites and bacteria in the induction of rosacea
- Authors: Stanisław Jarmuda1 , Niamh O’Reilly2 , Ryszard Żaba1 , Oliwia Jakubowicz1 , Andrzej Szkaradkiewicz3 , Kevin Kavanagh2
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1 1Department and Clinic of Dermatology, University of Medical Sciences, Poznań, Poland 2 2Department of Biology, National University of Ireland Maynooth, Co. Kildare, Ireland 3 3Department of Medical Microbiology, University of Medical Sciences, Poznań, Poland
- Correspondence Kevin Kavanagh [email protected]
- First Published Online: 01 November 2012, Journal of Medical Microbiology 61: 1504-1510, doi: 10.1099/jmm.0.048090-0
- Subject: Reviews
- Cover date:
- This is an open access article published by the Microbiology Society under the Creative Commons Attribution License




Potential role of Demodex mites and bacteria in the induction of rosacea, Page 1 of 1
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Rosacea is a common dermatological condition that predominantly affects the central regions of the face. Rosacea affects up to 3 % of the world’s population and a number of subtypes are recognized. Rosacea can be treated with a variety of antibiotics (e.g. tetracycline or metronidazole) yet no role for bacteria or microbes in its aetiology has been conclusively established. The density of Demodex mites in the skin of rosacea patients is higher than in controls, suggesting a possible role for these mites in the induction of this condition. In addition, Bacillus oleronius, known to be sensitive to the antibiotics used to treat rosacea, has been isolated from a Demodex mite from a patient with papulopustular rosacea and a potential role for this bacterium in the induction of rosacea has been proposed. Staphylococcus epidermidis has been isolated predominantly from the pustules of rosacea patients but not from unaffected skin and may be transported around the face by Demodex mites. These findings raise the possibility that rosacea is fundamentally a bacterial disease resulting from the over‐proliferation of Demodex mites living in skin damaged as a result of adverse weathering, age or the production of sebum with an altered fatty acid content. This review surveys the literature relating to the role of Demodex mites and their associated bacteria in the induction and persistence of rosacea and highlights possible therapeutic options.
© 2012 SGM | Published by the Microbiology Society
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Akilov O. E. , Mumcuoglu K. Y. . ( 2003; ). Association between human demodicosis and HLA class I. . Clin Exp Dermatol 28:, 70––73. [CrossRef] [PubMed]
-
Akilov O. E. , Mumcuoglu K. Y. . ( 2004; ). Immune response in demodicosis. . J Eur Acad Dermatol Venereol 18:, 440––444. [CrossRef] [PubMed]
-
Akilov O. E. , Butov Y. S. , Mumcuoglu K. Y. . ( 2005; ). A clinico-pathological approach to the classification of human demodicosis. . J Dtsch Dermatol Ges 3:, 607––614. [CrossRef] [PubMed]
-
Antille C. , Saurat J. H. , Lübbe J. . ( 2004; ). Induction of rosaceiform dermatitis during treatment of facial inflammatory dermatoses with tacrolimus ointment. . Arch Dermatol 140:, 457––460. [CrossRef] [PubMed]
-
Aquilina C. , Viraben R. , Sire S. . ( 2002; ). Ivermectin-responsive Demodex infestation during human immunodeficiency virus infection. A case report and literature review. . Dermatology 205:, 394––397. [CrossRef] [PubMed]
-
Aylesworth R. , Vance J. C. . ( 1982; ). Demodex folliculorum and Demodex brevis in cutaneous biopsies. . J Am Acad Dermatol 7:, 583––589. [CrossRef] [PubMed]
-
Ayres S. . ( 1930; ). Pityriasis folliculorum (Demodex). . Arch Derm Syphilol 21:, 19––24. [CrossRef]
-
Ayres S. Jr , Anderson N. P. . ( 1932; ). Demodex folliculorum: its role in the etiology of acne rosacea. . Arch Dermatol 25:, 89––98.[CrossRef]
-
Ayres S. Jr , Ayres S. III . ( 1961; ). Demodectic eruptions (demodicidosis) in the human. 30 years’ experience with 2 commonly unrecognized entities: pityriasis folliculorum (Demodex) and acne rosacea (Demodex type). . Arch Dermatol 83:, 816––827. [CrossRef] [PubMed]
-
Bevins C. L. , Liu F. T. . ( 2007; ). Rosacea: skin innate immunity gone awry?. Nat Med 13:, 904––906. [CrossRef] [PubMed]
-
Bohdanowicz D. , Raszeja-Kotelba B. . ( 2001; ). Demodex in the pathogenesis of certain skin diseases. . Post Dermatol Alergol 18:, 51––53 (in Polish).
-
Bonnar E. , Eustace P. , Powell F. C. . ( 1993; ). The Demodex mite population in rosacea. . J Am Acad Dermatol 28:, 443––448. [CrossRef] [PubMed]
-
Borgo S. N. , Sattler E. C. , Hogardt M. , Adler K. , Plewig G. . ( 2009; ). PCR analysis for Wolbachia in human and canine Demodex mites. . Arch Dermatol Res 301:, 747––752. [CrossRef] [PubMed]
-
Butterwick K. J. , Butterwick L. S. , Han A. . ( 2006; ). Laser and light therapies for acne rosacea. . J Drugs Dermatol 5:, 35––39.[PubMed]
-
Crawford G. H. , Pelle M. T. , James W. D. . ( 2004; ). Rosacea: I. Etiology, pathogenesis, and subtype classification. . J Am Acad Dermatol 51:, 327––341, quiz 342–344. [CrossRef] [PubMed]
-
Czepita D. , Kuźna-Grygiel W. , Czepita M. , Grobelny A. . ( 2007; ). Demodex folliculorum and Demodex brevis as a cause of chronic marginal blepharitis. . Ann Acad Med Stetin 53:, 63––67, discussion 67.[PubMed]
-
Dahl M. V. , Ross A. J. , Schlievert P. M. . ( 2004; ). Temperature regulates bacterial protein production: possible role in rosacea. . J Am Acad Dermatol 50:, 266––272. [CrossRef] [PubMed]
-
Del Rosso J. Q. . ( 2006; ). Update on rosacea pathogenesis and correlation with medical therapeutic agents. . Cutis 78:, 97––100.[PubMed]
-
Deleuran M. , Ellingsen A. R. , Paludan K. , Schou C. , Thestrup-Pedersen K. . ( 1998; ). Purified Der p1 and p2 patch tests in patients with atopic dermatitis: evidence for both allergenicity and proteolytic irritancy. . Acta Derm Venereol 78:, 241––243. [CrossRef] [PubMed]
-
Desch C. , Nutting W. B. . ( 1972; ). Demodex folliculorum (Simon) and D. brevis akbulatova of man: redescription and reevaluation. . J Parasitol 58:, 169––177. [CrossRef] [PubMed]
-
Dominey A. , Rosen T. , Tschen J. . ( 1989; ). Papulonodular demodicidosis associated with acquired immunodeficiency syndrome. . J Am Acad Dermatol 20:, 197––201. [CrossRef] [PubMed]
-
Elston D. M. . ( 2010; ). Demodex mites: facts and controversies. . Clin Dermatol 28:, 502––504. [CrossRef] [PubMed]
-
Erbağci Z. , Ozgöztaşi O. . ( 1998; ). The significance of Demodex folliculorum density in rosacea. . Int J Dermatol 37:, 421––425. [CrossRef] [PubMed]
-
Forton F. M. . ( 2012; ). Papulopustular rosacea, skin immunity and Demodex: pityriasis folliculorum as a missing link. . J Eur Acad Dermatol Venereol 26:, 19––28. [CrossRef] [PubMed]
-
Forton F. , Seys B. . ( 1993; ). Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. . Br J Dermatol 128:, 650––659. [CrossRef] [PubMed]
-
Forton F. , Germaux M. A. , Brasseur T. , De Liever A. , Laporte M. , Mathys C. , Sass U. , Stene J. J. , Thibaut S. . & other authors ( 2005; ). Demodicosis and rosacea: epidemiology and significance in daily dermatologic practice. . J Am Acad Dermatol 52:, 74––87. [CrossRef] [PubMed]
-
Fujiwara S. , Okubo Y. , Irisawa R. , Tsuboi R. . ( 2010; ). Rosaceiform dermatitis associated with topical tacrolimus treatment. . J Am Acad Dermatol 62:, 1050––1052. [CrossRef] [PubMed]
-
García-Vargas A. , Mayorga-Rodríguez J. A. , Sandoval-Tress C. . ( 2007; ). Scalp demodicidosis mimicking favus in a 6-year-old boy. . J Am Acad Dermatol 57: (Suppl. 2), S19––S21. [CrossRef] [PubMed]
-
Georgala S. , Katoulis A. C. , Kylafis G. D. , Koumantaki-Mathioudaki E. , Georgala C. , Aroni K. . ( 2001; ). Increased density of Demodex folliculorum and evidence of delayed hypersensitivity reaction in subjects with papulopustular rosacea. . J Eur Acad Dermatol Venereol 15:, 441––444. [CrossRef] [PubMed]
-
Gortel K. . ( 2006; ). Update on canine demodicosis. . Vet Clin North Am Small Anim Pract 36:, 229––241, ix. [CrossRef] [PubMed]
-
Hsu C. K. , Hsu M. M.-L. , Lee J. Y. . ( 2009; ). Demodicosis: a clinicopathological study. . J Am Acad Dermatol 60:, 453––462. [CrossRef] [PubMed]
-
Ivy S. P. , Mackall C. L. , Gore L. , Gress R. E. , Hartley A. H. . ( 1995; ). Demodicidosis in childhood acute lymphoblastic leukemia; an opportunistic infection occurring with immunosuppression. . J Pediatr 127:, 751––754. [CrossRef] [PubMed]
-
Jing X. , Shuling G. , Ying L. . ( 2005; ). Environmental scanning electron microscopy observation of the ultrastructure of Demodex . . Microsc Res Tech 68:, 284––289. [CrossRef] [PubMed]
-
Karincaoglu Y. , Esrefoglu Seyhan M. , Bayram N. , Aycan O. , Taskapan H. . ( 2005; ). Incidence of Demodex folliculorum in patients with end stage chronic renal failure. . Ren Fail 27:, 495––499. [CrossRef] [PubMed]
-
Kuhnigk T. , Borst E. M. , Breunig A. , König H. , Collins M. D. , Hutson R. A. , Kämpfer P. . ( 1995; ). Bacillus oleronius sp.nov., a member of the hindgut flora of the termite Reticulitermes santonensis (Feytaud). . Can J Microbiol 41:, 699––706. [CrossRef] [PubMed]
-
Lacey N. , Delaney S. , Kavanagh K. , Powell F. C. . ( 2007; ). Mite-related bacterial antigens stimulate inflammatory cells in rosacea. . Br J Dermatol 157:, 474––481. [CrossRef] [PubMed]
-
Lacey N. , Kavanagh K. , Tseng S. C. . ( 2009; ). Under the lash: Demodex mites in human diseases. . Biochem (Lond) 31:, 2––6.[PubMed]
-
Lacey N. , Ní Raghallaigh S. , Powell F. C. . ( 2011; ). Demodex mites – commensals, parasites or mutualistic organisms?. Dermatology 222:, 128––130. [CrossRef] [PubMed]
-
Lazaridou E. , Giannopoulou C. , Fotiadou C. , Vakirlis E. , Trigoni A. , Ioannides D. . ( 2011; ). The potential role of microorganisms in the development of rosacea. . J Dtsch Dermatol Ges 9:, 21––25. [CrossRef] [PubMed]
-
Li J. , O’Reilly N. , Sheha H. , Katz R. , Raju V. K. , Kavanagh K. , Tseng S. C. . ( 2010; ). Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with facial rosacea. . Ophthalmology 117:, 870––877, e1. [CrossRef] [PubMed]
-
Ní Raghallaigh S. , Bender K. , Lacey N. , Brennan L. , Powell F. C. . ( 2012; ). The fatty acid profile of the skin surface lipid layer in papulopustular rosacea. . Br J Dermatol 166:, 279––287. [CrossRef] [PubMed]
-
O’Reilly N. , Bergin D. , Reeves E. P. , McElvaney N. G. , Kavanagh K. . ( 2012; ). Demodex-associated bacterial proteins induce neutrophil activation. . Br J Dermatol 166:, 753––760. [CrossRef] [PubMed]
-
Ozdemir M. H. , Aksoy U. , Sönmez E. , Akisu C. , Yorulmaz C. , Hilal A. . ( 2005; ). Prevalence of Demodex in health personnel working in the autopsy room. . Am J Forensic Med Pathol 26:, 18––23. [CrossRef] [PubMed]
-
Powell F. C. . ( 2005; ). Clinical practice. Rosacea. . N Engl J Med 352:, 793––803. [CrossRef] [PubMed]
-
Raszeja-Kotelba B. , Jenerowicz D. , Izdebska J. N. , Bowszyc-Dmochowska M. , Tomczak M. , Dembińska M. . ( 2004; ). [ Some aspects of the skin infestation by Demodex folliculorum . ]. Wiad Parazytol 50:, 41––54 (in Polish).[PubMed]
-
Schauber J. , Gallo R. L. . ( 2008; ). Antimicrobial peptides and the skin immune defense system. . J Allergy Clin Immunol 122:, 261––266. [CrossRef] [PubMed]
-
Schauber J. , Dorschner R. A. , Coda A. B. , Büchau A. S. , Liu P. T. , Kiken D. , Helfrich Y. R. , Kang S. , Elalieh H. Z. . & other authors ( 2007; ). Injury enhances TLR2 function and antimicrobial peptide expression through a vitamin D-dependent mechanism. . J Clin Invest 117:, 803––811. [CrossRef] [PubMed]
-
Spickett S. G. . ( 1961; ). Studies on Demodex folliculorum Simon (1842). I. Life history. . Parasitology 51:, 181––192. [CrossRef]
-
Szkaradkiewicz A. , Chudzicka-Strugała I. , Karpiński T. M. , Goślińska-Pawłowska O. , Tułecka T. , Chudzicki W. , Szkaradkiewicz A. K. , Zaba R. . ( 2012; ). Bacillus oleronius and Demodex mite infestation in patients with chronic blepharitis. . Clin Microbiol Infect 18:, 1020––1025. [CrossRef] [PubMed]
-
Tsutsumi Y. . ( 2004; ). Deposition of IgD, α-1-antitrypsin and α-1-antichymotrypsin on Demodex folliculorum and D. brevis infesting the pilosebaceous unit. . Pathol Int 54:, 32––34. [CrossRef] [PubMed]
-
Vollmer R. T. . ( 1996; ). Demodex-associated folliculitis. . Am J Dermatopathol 18:, 589––591. [CrossRef] [PubMed]
-
Whitfeld M. , Gunasingam N. , Leow L. J. , Shirato K. , Preda V. . ( 2011; ). Staphylococcus epidermidis: a possible role in the pustules of rosacea. . J Am Acad Dermatol 64:, 49––52. [CrossRef] [PubMed]
-
Wilkin J. , Dahl M. , Detmar M. , Drake L. , Feinstein A. , Odom R. , Powell F. . ( 2002; ). Standard classification of rosacea: report of the national rosacea society expert committee on the classification and staging of rosacea. . J Am Acad Dermatol 46:, 584––587. [CrossRef] [PubMed]
-
Yamasaki K. , Gallo R. L. . ( 2009; ). The molecular pathology of rosacea. . J Dermatol Sci 55:, 77––81.[CrossRef]
-
Yamasaki K. , Di Nardo A. , Bardan A. , Murakami M. , Ohtake T. , Coda A. , Dorschner R. A. , Bonnart C. , Descargues P. . & other authors ( 2007; ). Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. . Nat Med 13:, 975––980. [CrossRef] [PubMed]
-
Yamasaki K. , Kanada K. , Macleod D. T. , Borkowski A. W. , Morizane S. , Nakatsuji T. , Cogen A. L. , Gallo R. L. . ( 2011; ). TLR2 expression is increased in rosacea and stimulates enhanced serine protease production by keratinocytes. . J Invest Dermatol 131:, 688––697. [CrossRef] [PubMed]

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