Human Demodicosis: Revisit and a Proposed Classification

W. Chen; G. Plewig


The British Journal of Dermatology. 2014;170(6):1219-1225. 

In This Article

Clinical Manifestations of Primary Demodicosis

Primary human demodicosis is clinically characterized by (i) late onset, usually after age 40 years and especially in the elderly population; (ii) facial involvement, typically affecting periorificial areas (perioral, periorbital or periauricular); (iii) usually asymmetric distribution, grouped in an irregular shape with satellite lesions within one affected area; (iv) being follicle bound; and (v) being asymptomatic or mildly pruritic. The affected patients usually lack classical manifestations of rosacea, such as erythema, transient flushing or telangiectasias.[32] In contrast, secondary demodicosis can occur early in life and show a more diffuse facial distribution or truncal involvement with more extensive inflammation. Past history and features of the underlying diseases, such as perioral dermatitis or rosacea, are usually obvious.