Relationship between Itching and the Presence of Demodex Species in the External Auditory Canal in Patients with Chronic Ear Itching

Abstract

Objective: The aim of this study was to investigate the relationship between ear itching and Demodex and to reveal the presence of Demodex in the aetiology of ear itching. Our study will contribute to this area, where there is a limited number of studies in the literature, and treatment planning can be provided by considering this aetiology in patients with chronic ear itching. Material and Methods: Fifty-two patients with chronic ear itching and 51 patients without itching were included in the study. The patients’ itching severity was assessed with the VAS (visual analog scale). A sample with the plug was taken from the external auditory canal. Demodex mites were investigated by examining the obtained samples using a light microscope. Results: There was no statistically significant difference between the groups with and without ear itching in the presence of Demodex mites (p=0.09). However, Demodex positivity was found to be higher in the patient group with itching (53.8%). There was no statistically significant relationship between the presence of Demodex and VAS scores measuring itching severity (p=0.89). Conclusion: In our study, the presence of Demodex mites was found to be numerically higher in patients with chronic ear itching. We believe that Demodex mites play a role in the aetiology of ear itching.

Keywords

• Demodex
• ear itchiness
• external auditory canal

References

1. 1. White RD, Ananthakrishnan G, McKean SA, Brunton JN, Hussain SS, Sudarshan TA. Masses and disease entities of the external auditory canal: radiological and clinical correlation. Clin Radiol 2012;67(2):172-81. google scholar
2. 2. Stroman DW, Roland PS, Dohar J, Burt W. Microbiology of normal external auditory canal. Laryngoscope 2001;111(11 Pt 1):2054-9. google scholar
3. 3. Pabla L, Jindal M, Latif K. The management of otitis externa in UK general practice. Eur Arch Otorhinolaryngol 2012;269(3):753-6. google scholar
4. 4. King WP. Allergic disorders in the otolaryngologic practice. Otolaryngol Clin North Am 1985;18(4):677-90. google scholar
5. 5. Li LY, Cruz PD Jr. Allergic contact dermatitis: pathophysiology applied to future therapy. Dermatol Ther 2004;17(3):219-23. google scholar
6. 6. Aycan OM, Otlu GH, Karaman U, Daldal N, Atambay M. Ceşitli hasta ve yaş gruplarinda Demodex sp. görülme sikliği [Frequency of the appearance of Demodex sp. in various patient and age groups]. Turkiye Parazitol Derg 2007;31(2):115-8. google scholar
7. 7. Aktaş Karabay E, Aksu Çerman A. Demodex folliculorum infestations in common facial dermatoses: acne vulgaris, rosacea, seborrheic dermatitis. An Bras Dermatol 2020;95(2):187-93. google scholar
8. 8. McCormack HM, Horne DJ, Sheather S. Clinical applications of visual analogue scales: a critical review. Psychol Med 1988;18(4):1007-19. google scholar

9. 9. Pena GP, Andrade Filho JS. Is Demodex really non-pathogenic? Rev Inst Med Trop Sao Paulo 2000;42(3):171-3. google scholar
10. 10. Ding Y, Huang X. [Investigation of external auditory meatus secretion Demodex folliculorum and Demodex breuis infection in college students]. Lin Chuang Er Bi Yan Hou Ke Za Zhi 2005;19(4):176-7. google scholar
11. 11. Liu J, Sheha H, Tseng SC. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol 2010;10(5):505-10. google scholar
12. 12. Wesolowska M, Knysz B, Reich A, Blazejewska D, Czarnecki M, Gladysz A, Pozowski A, Misiuk-Hojlo M. Prevalence of Demodex spp. in eyelash follicles in different populations. Arch Med Sci 2014;10(2):319-24. google scholar
13. 13. Bilal N, Kirişci Ö, Özkaya E. Demodex Species Infestation in Patients with Ear Itching and Its Relationship to Itch Severity. Turkiye Parazitol Derg 2017;41(2):87-91. google scholar
14. 14. Zhong J, Tan Y, Li S, Peng L, Wang B, Deng Y, Yuan J. The Prevalence of Demodex folliculorum and Demodex brevis in Cylindrical Dandruff Patients. J Ophthalmol 2019;2019:8949683. google scholar
15. 15. Aycan OM, Otlu GH, Karaman U, Daldal N, Atambay M. Frequency of the appearance of Demodex sp. in various patient and age groups. Turkiye Parazitol Derg 2007;31(2):115-8. google scholar
16. 16. Vargas-Arzola J, Reyes-Velasco L, Segura-Salvador A, Mârquez-Navarro A, D^az-Chiguer DL, Nogueda-Torres B. Prevalence of Demodex mites in eyelashes among people of Oaxaca, Mexico. Acta Microbiol Immunol Hung 2012;59(2):257-62. google scholar
17. 17. Cheng S, Zhang M, Chen H, Fan W, Huang Y. The correlation between the microstructure of meibomian glands and ocular Demodex infestation: A retrospective case-control study in a Chinese population. Medicine (Baltimore) 2019;98(19):e15595. google scholar
18. 18. Cevik C, Kaya OA, Akbay E, Yula E, Yengil E, Gulmez MI, Akoglu E. Investigation of Demodex species frequency in patients with a persistent itchy ear canal treated with a local steroid. J Laryngol Otol 2014;128(8):698-701. google scholar