Oküler dandrufflu hastalarda Demodex folliculorum ve D. brevis (Acari: Demodicidae) yaygınlığı ve yoğunluğu

Yıl 2019, Cilt: 1 Sayı: 1, 23 - 43, 29.01.2019

Yasin Sarı Erhan Zeytun Salih Doğan Yücel Karakurt

Öz

Demodex akarlar (Acari) Demodicidae familyasına mensup mikro eklembacaklı mikroorganizmalardır. İnsanlarda parazitlenen iki türü tanımlanmıştır: Demodex folliculorum ve D. brevis. Günümüzde göz hastalıkları uzmanlarının da dikkatini çeken bu akarların oluşturdukları silindirik, sporadik ve diffüs dandruff gibi göz kapağı hastalıklarının patogenezinde önemi olduğu düşünülmektedir. D. brevis ve D. folliculorum’un ana besin kaynağı folikül içi epitel hücreleri ve sebumdur. Folikül içi epitel hücreleri delip sindirmek için birtakım enzimlere ve delici ağız uzuvlarına sahiptirler. Akarların beslenmesine bağlı olarak oluşan folikül içi hücre atıkları zamanla folikül yüzeyine doğru itilir. Sonuç olarak, bu atıklar kirpiklerin tabanında birikerek dandruff (kepek) oluşturur. Oküler dandrufflu hastalarda Demodex spp. yaygınlığı ve yoğunluğunu belirlemek amacı ile bu çalışma yapıldı. Tanısı göz hastalıkları polikliniğinde konulan dandrufflu 186 hasta ve 183 sağlıklı kontrol çalışmaya dâhil edildi. Bu katılımcıların kişisel bakım ve hijyen uygulamaları, demografik özellikleri, cilt biyofiziksel parametreleri kayıt altına alınıp yüz bölgelerinden (kirpik, kaş ve yanak) örnekler alındı. Çalışmada örnekleme yapılan yüz bölgelerinin tümü değerlendirildiğinde silindirik dandrufflu hastaların %90,9’unda (ortalama 38,39), kontrollerin %83,1’inde (ortalama 21,86) Demodex spp. pozitifliği tespit edildi. Katılımcıların cilt biyofiziksel özellikleri dikkate alındığında, Demodex yoğunluğunun ortalama nem ve sıcaklık değeri düşük, pH değeri yüksek olan hasta ve kontrollerde daha fazla olduğu tespit edildi. Demografik özelliklerde ise yaş artışı ile birlikte Demodex pozitifliği ve yoğunluğunun arttığı belirlendi. Sonuç olarak hastalarda en yaygın oküler şikâyetlerin kaşıntı ve yabancı cisim olduğu belirlenmiş olup oküler dandrufflu hastalarda Demodex spp.’nin çok yaygın ve yoğun olduğu tespit edildi. Bu hastaların klinik değerlendirme ve tedavisinde Demodex akarlarında dikkate alınmasının faydalı olabileceği düşünüldü.

Anahtar Kelimeler: Akar, Demodex, folikül, kaş, kepek, kirpik.

Anahtar Kelimeler

Akar, Demodex, folikül, kaş, kepek, kirpik

The prevalence and intensity of Demodex folliculorum and D. brevis (Acari: Demodicidae) in patients with ocular dandruff

Öz

Demodex mites (Acari) are micro-arthropods belonging to the
family Demodicidae. Two species of these mites have been identified in humans: Demodex folliculorum and D. brevis. It is believed that these
mites are important in the pathogenesis of eyelid symptoms such as cylindrical,
sporadic and diffuse dandruff. The follicular epithelial cells and sebum are
the main nutritional source of these mites. With the help of salivary enzymes
and their mouthparts, they permeate the follicular epithelial cells. The
follicular cell waste formed due to the feeding of the mites are moves towards
the follicle surface, and as a result of it accumulates at the base of the
lashes and form dandruff. This study was performed to determine the prevalence and
intensity of Demodex spp. in patients
with ocular dandruff. A total of 186 patients with ocular dandruff and 183
healthy controls were included in the study. Personal care and hygiene
practices, demographic characteristics and skin biophysical parameters of these
participants were recorded, and samples were taken from the facial areas
(eyelash, eyebrow and cheek). In the study, Demodex
positivity was detected in 90.9% of the cylindrical dandruff patients (mean
38.39) and 83.1% of the controls (mean 21.86). When the skin biophysical
properties were taken into consideration, the density of Demodex was higher in participants with low moisture and
temperature values and high pH values. On the other hand, Demodex positivity and density were increased with age of the
participants. The most common ocular complaints were itching and foreign body
sensation. Demodex mites were found
to be very common and intense in the patients with ocular dandruff.
Accordingly, Demodex mites should be
taken in to consideration during the clinical evaluation and treatment of these
patients.

Anahtar Kelimeler

Demodex, follicle mite, dandruff, eyebrow, eyelash

Kaynakça

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