Prevalence of Demodex folliculorum and brevis in protein energy malnutrition and childhood malignancies

Background and aim: Demodicozis is a parasitic disease caused by D.folliculorum and D. brevis which are known hair follicle mites. It is transmitted fromperson to person by close contact. Demodicosis is common all over the world and itsfrequency increases with age. Demodex spp causes different clinical findings such asitching, redness, erythema, dermatitis and acne, blepharitis, hair loss, favus, etc. Despitefew studies related to the Demodex in children, D. follikulorum have been reported inlesions of rosacea of children with leukemia and immune deficiency. There is not any astudy researching the presence of Demodex spp in malnutrition. In this study we aimedto determine the prevalence of D. folliculorum and brevis in childhod maligniencies andprotein energy malnutrition and to determine the clinical findings, if exists, andcontributory factors to the presence of Demodex.Materials and methods: The study included 100 children with protein and energymalnutrition, 31 children with malingnancy and 63 children without immun deficiencymalnutrition or chronic diseases. History, physical examination, antropometricmeasures, and routine laboratory findings were recorded. Demodex spp was invastigatedwith the standard superficial skin biopsies.Results: Demodex was found in one patient (1.6%) in the control group, 25patients (25%) in the malnutrition group, and ten patients (%32.3) in the malignantgroup. In malnutrition group, Demodex was found on cheek, forehead and nose in 8%,3%, and 4%, respectively. In malignancy group Demodex was found on cheek, nose andforehead in 22.6%, 6.5%, and 3.2%, respectively. In malnutrition group Demodex wasfound only one region and in more than one region in 11% and 14%, respectively.İnmalignancy group Demodex was found only in one region and in more than one regionin 22.6% and 9.7%, respectively. Demodex positivity (p =0.001), region (p =0.001), andthe number of regions (p =0.001) were found between different the groups. D.foliculorum was found in one patient of the control group (1.6%), in 19 patients of themalnutrition group (19%) and at in eight patients of the malignancy group (25.8%) andD. folikülorum and D. brevis were found in six patients of the malnutrition group (6%)and two cases of the malignancy group (6.5%). The risk of Demodex was assessed bybinary multi logistic analysis. The incidence of Demodex was increased 17.37 fold inmalnutrition (p = 0.006), 27.29-fold in malignancy (p= 0.002) and 2.30-fold in the lowsocioeconomic status (p = 0.037).Conclusion: Compared to Demodex infestation, which is rather rare in childrencompared to adults, was detected in ¼ and 1/3 of children with malnutrition andmalinancy respectively. Although there are no skin findings, the studies in patients withkwashiorkor would be helpful in useful understanding Demodex pathogenesis.