Dermoscopy has been used for the non-invasive diagnosis of demodicosis. Several studies have evaluated the usefulness of this tool in the diagnosis, however, there are differences in the gold standard (SSSB or KOH test) and criteria of positivity used between studies. Added to this, is the lack of controls and objective quantification of the usefulness of dermoscopic signs in clinically observable and relevant ranges. To validate the usefulness of dermoscopy for the diagnosis of demodicosis by calculating the performance indicators for the different dermoscopic signs. Retrospective intrapatient case-control study, which included adults with suspicion of demodicosis. Dermoscopic photographs and scraping of healthy and lesional skin were obtained. Samples were analyzed microscopically by trained personnel. Photographs were evaluated by determining the presence of Demodex tails (DT), dilated follicular openings (DFO) and dilated blood vessels (DBV) in pre-defined ranges. 64 patients were included (total = 256 samples); the presence of demodex on skin scraping was seen in 69%. Under dermoscopy, the presence of DT in range 11-20/field had a positive likelihood ratio (LR) of 12.10 (95%CI 6.52-22.45) and negative LR 0.32 (95%CI 0.23-0.45). Combined and dichotomized performance for at least one positive sign under dermoscopy (DT > 10/field, DFO > 10/field or DBV > 50% of the field): positive LR 7.14 (95%CI 4.80-10.62) and negative LR 0.11 (95%CI 0.06-0.22). The presence of DT, DFO or DBV has a high correlation with a positive mite test, so the diagnosis of demodicosis could be made only through dermoscopy.

Demodex mite proliferation is frequently involved in the pathogenesis of rosacea. The gold standard for Demodex identification is microscopic examination on a standardized skin surface biopsy. However, this method of sampling can be distressing and painful, especially when performed on hairy sites. In this case-control study, we compared the sensitivity of PCR and microscopic examination in diagnosing a Demodex infestation. Moreover, we investigated the possible correlations between the presence of Demodex mites and clinical characteristics. In total, 20 patients affected by papulopustular rosacea and 10 controls were included. At both microscopic examination and PCR, patients with rosacea presented a greater prevalence of positive samples than controls at the scalp and at the face. Microscopy had sensitivity of 50% at the face and of 46.7% at the scalp. PCR had sensitivity of 93.75% at the face and of 86.7% at the scalp. The positivity of PCR was associated to a higher frequency of facial papules and pustules. Patients with positivity at the face had a more frequent positivity at the scalp. The scalp could represent a reservoir for the Demodex mites, and should be investigated by sensitive and painless methods. PCR performed on painlessly collected samples should be further investigated.

Objective: To explore the optimal regimen of standardized mite allergen immunotherapy for airway allergic diseases in children, and to observe the clinical efficacy, safety and compliance. Method: Use a retrospective real-world study, clinical data from 156 children aged 5-16 years who received subcutaneous immunotherapy (SCIT) with double mite allergen preparation in the pediatrics department of the Third Affiliated Hospital of Sun Yat sen University from June 2019 to September 2020 were selected for allergic rhinitis (AR) and/or allergic asthma (bronchial asthma, BA), including gender, age, total VAS(visual analogue scale) score and CSMS(combined symptom and medication scores) score at different time points (before treatment, 4-6 months, 1 year, and 2 years after initiation of desensitization), peripheral blood eosinophil counts (EOS), serum total IgE (tIgE), specific IgE (tIgE), and serum IgE (tIgE), specific IgE (sIgE), tIgG4, and incidence of local and systemic adverse reactions. All patients had a consistent regimen during the initial treatment phase (dose-escalation phase), which was performed as directed. Among them, 81 cases (observation group) continued to continue subcutaneous injection of 1 ml of vial No. 3 every 4-6 weeks during the dose maintenance phase, while 75 cases (control group) followed the old traditional regimen during the maintenance phase (i.e., change to a new vial to halve the amount of vial No. 3 by 0.5 ml, and then 0.75 ml after 1-2 weeks, and 1 ml in a further interval of 1-2 weeks). The clinical efficacy, safety and adherence to the treatment were compared between the two groups. Results: A total of 81 cases of 156 children were included in the observation group, of which 58 children with AR, 15 children with BA, and 8 children with AR combined with BA; 75 cases were included in the conventional control group, of which 52 children with AR, 16 children with BA, and 7 children with AR combined with BA. In terms of safety, the difference in the incidence of local and systemic adverse reactions between the two groups was not statistically significant (χ2=1.541 for local adverse reactions in the control group, χ2=0.718 for the observation group; χ2=0.483 for systemic adverse reactions in the control group, χ2=0.179 for the observation group, P value >0.05 for all of these), and there were no grade Ⅱ or higher systemic adverse reactions in any of them. In the control group, there were 15 cases of dropout at 2 years of follow-up, with a dropout rate of 20.0%; in the observation group, there were 7 cases of dropout at 2 years of follow-up, with a dropout rate of 8.6%, and there was a statistically significant difference in the dropout rates of the patients in the two groups (χ2=4.147, P<0.05). Comparison of serological indexes and efficacy (compared with baseline at 3 different time points after treatment, i.e., 4-6 months, 1 year and 2 years after treatment), CSMS scores of the observation group and the conventional control group at 4-6 months, 1 year and 2 years after treatment were significantly decreased compared with the baseline status (t-values of the conventional group were 13.783, 20.086 and 20.384, respectively, all P-values <0.001, and t-values of the observation group were 15.480, 27.087, 28.938, all P-values <0.001), and VAS scores also decreased significantly from baseline status in both groups at 4-6 months, 1 year, and 2 years of treatment (t-values of 14.008, 17.963, and 27.512 in the conventional control group, respectively, with all P-values <0.001, and t-values of 9.436, 13.184, and 22.377 in the observation group, respectively; all P-values <0.001). Intergroup comparisons showed no statistically significant differences in CSMS at baseline status, 4-6 months, 1 year and 2 years (t-values 0.621, 0.473, 1.825, and 0.342, respectively, and P-values 0.536, 0.637, 0.070, and 0.733, respectively), and VAS was no statistically significant difference in comparison between groups at different time points (t-values of 1.663, 0.095, 0.305, 0.951, P-values of 0.099, 0.925, 0.761, 0.343, respectively); suggesting that the treatment regimens of the observation group and the conventional control group were clinically effective, and that the two regimens were comparable in terms of efficacy. The peripheral blood eosinophil counts of the observation group and the conventional control group decreased significantly from the baseline status at 4-6 months, 1 year and 2 years of treatment (t-values of the conventional group were 3.453, 5.469, 6.273, P-values <0.05, and the t-values of the observation group were 2.900, 4.575, 5.988, P-values <0.05, respectively). 4-6 months, 1 year and 2 years compared with the baseline status tIgE showed a trend of increasing and then decreasing (t-value in the conventional group was -5.328, -4.254, -0.690, P-value was 0.000, 0.000, 0.492, respectively, and t-value in the observation group was -6.087, -5.087, -0.324, P-value was 0.000, 0.000, 0.745, respectively). However, the results of intergroup comparisons showed no statistically significant differences in serological indices and efficacy between the two groups in terms of peripheral blood eosinophil counts at baseline status, 4-6 months, 1 year and 2 years (t-values of 0.723, 1.553, 0.766, and 0.234, respectively; P-values of 0.471, 0.122, 0.445, and 0.815, respectively), tIgE (t-values of 0.170, -0.166, -0.449, 0.839, P-values 0.865, 0.868, 0.654, 0.403, respectively), tIgG4 (t-values 1.507, 1.467, -0.337, 0.804, P-values 0.134, 0.145, 0.737, 0.422, respectively). Conclusion: Both immunotherapy regimens for airway allergic diseases with double mite allergen subcutaneous immunotherapy have significant clinical efficacy, low incidence of adverse reactions, and the observation group has better patient compliance than the control group.
目的： 探讨儿童气道过敏性疾病标准化螨变应原免疫治疗的优化方案，观察其临床疗效、安全性和依从性。 方法： 采用回顾性真实世界研究，选取2019年6月至2020年9月在中山大学附属第三医院儿科接受双螨变应原制剂皮下免疫治疗（Subcutaneous immunotherapy，SCIT）的变应性鼻炎（allergic rhinitis，AR）和（或）过敏性哮喘（支气管哮喘，bronchial asthma，BA）的5~16岁共156例患儿的临床资料，包括性别、年龄、不同时间节点（治疗前，启动脱敏治疗后4~6个月、1年、2年时）总VAS（视觉模拟量表）评分和CSMS（综合症状和用药评分）评分、外周血中嗜酸性粒细胞计数（EOS）、血清总IgE（tIgE）、特异性IgE（sIgE）、tIgG4、局部及全身不良反应发生率。所有患者在初始治疗阶段（剂量递增阶段）的方案一致，均按说明书进行。其中，81例（观察组）在剂量维持阶段持续继续每4~6周皮下注射1次，每次注射3号瓶1 ml；75例（对照组）维持阶段按照旧的传统方案进行（即换新瓶减半量3号瓶0.5 ml，1~2周后0.75 ml，再间隔1~2周1 ml）。比较两组患者治疗的临床疗效、安全性及依从性。 结果： 156例患儿中观察组共纳入81例，其中AR患儿有58例，BA患儿15例，AR合并BA患儿有8例；常规对照组共纳入75例，AR患儿有52例，BA患儿16例，AR合并BA患儿有7例。在安全性方面，两组患者的局部和全身不良反应发生率差异均无统计学意义（局部不良反应对照组χ2=1.541，观察组χ2=0.718；全身不良反应对照组χ2=0.483，观察组χ2=0.179，P值均>0.05），且均无Ⅱ级以上全身不良反应发生。对照组随访2年脱漏15例，脱落率20.0%；观察组随访2年脱漏7例，脱落率8.6%，两组患者脱落率差异有统计学意义（χ2=4.147，P<0.05）。血清学指标及疗效对比（在治疗后3个不同的时间节点即治疗4~6个月、1年及2年时与基线进行比较），观察组和常规对照组治疗4~6个月、1年及2年时CSMS评分较基线状态明显下降（常规组t值分别为13.783，20.086，20.384，P值均<0.001；观察组t值分别为15.480，27.087，28.938，P值均<0.001）；两组患者治疗4~6个月、1年及2年时VAS评分也均较基线状态明显下降（常规组t值分别为14.008，17.963，27.512，P值均<0.001；观察组t值分别为9.436，13.184，22.377，P值均<0.001）；组间比较结果显示，基线状态、4~6个月、1年及2年时CSMS差异无统计学意义（t值分别为0.621，0.473，1.825，0.342；P值分别为0.536，0.637，0.070，0.733），VAS在不同时间点的组间比较差异也无统计学意义（t值分别为1.663，0.095，0.305，0.951；P值分别为0.099，0.925，0.761，0.343）；提示观察组和常规对照组的治疗方案均临床显效，且两种方案疗效相当。观察组和常规对照组治疗4~6个月、1年及2年时外周血嗜酸性粒细胞计数均较基线状态明显下降（常规组t值分别为3.453，5.469，6.273，P值均<0.05；观察组t值分别为2.900，4.575，5.988，P值均<0.05），两组患者在治疗4~6个月、1年及2年时较基线状态tIgE呈现先升高后降低的趋势（常规组t值分别为-5.328，-4.254，-0.690，P值分别为0.000，0.000，0.492；观察组t值分别为-6.087，-5.087，-0.324，P值分别为0.000，0.000，0.745）。但组间比较结果显示血清学指标及疗效在基线状态、4~6个月、1年及2年时外周血嗜酸性粒细胞计数在两组之间无明显统计学差异（t值分别为0.723，1.553，0.766，0.234；P值分别为0.471，0.122，0.445，0.815），tIgE（t值分别为0.170，-0.166，-0.449，0.839；P值分别为0.865，0.868，0.654，0.403），tIgG4（t值分别为1.507，1.467，-0.337，0.804；P值分别为0.134，0.145，0.737，0.422）。 结论： 针对气道过敏性疾病双螨变应原皮下免疫治疗的两种免疫治疗方案均有显著的临床疗效，不良反应发生率低，观察组较对照组患者依从性更好。.

Bory Tucholskie National Park, founded in 1996, is one of the most recently established national parks in Poland, and therefore, has not been thoroughly examined yet. The authors of the current study present results of their research concerning communities of mites from the suborder Uropodina (Acari: Mesostigmata), inhabiting bird nesting boxes within the area of Bory Tucholskie National Park. The mite community comprises two nidicolous species, i.e. Leiodinychus orbicularis (C.L. Koch, 1839) and Chiropturopoda nidiphila (Wiśniewski and Hirschmann 1993). The former is a species characteristic of various types of nests, as well as nesting boxes, where it is usually the eudominant species. The latter is an extremely rare and scarce species of Uropodina, known thus far from woodpeckers\' hollows. The population of L. orbicularis in the analysed communities in the realm of Bory Tucholskie National Park has been estimated to be over 6,000 specimens, and in the case of Ch. nidiphila - over 400 specimens.

In order to speculate the three-dimensional structure of the potential binding pocket of the chitin synthase inhibitor, a series of 2,4-diphenyloxazoline derivatives with different lengths of alkyl chains and heteroatoms were designed and synthesized by a homologous strategy. The bioassay results indicate that both the length of the alkyl chains and the type of substituents can affect the acaricidal activity against mite eggs. Compounds containing chloropropyl, alkoxyalkyl, and para-substituted phenoxyalkyl or phenylthioalkyl groups exhibit good activity, while those containing steric hindrance substituents or carbonyl substituents on the benzene ring exhibit reduced activity. Three-dimensional quantitative structure-activity relationship (3D-QSAR) study showed that there may be a narrow hydrophobic region deep in the pocket, and the steric effect plays a more important role than the electrostatic effect. The current work will provide assistance for future molecular design and target binding research.

UNASSIGNED: Human Demodex mites are parasites that live in the pilosebaceous unit and can cause demodicosis. While demodicosis may occur as a primary skin disease, it may also result from immunosuppression and topical or systemic immunosuppressive therapies. Surgical rhinoplasty is one of the most commonly performed cosmetic procedures, and it is the cause of a variety of cutaneous complications, particularly acne, as it affects the skin\'s adnexal structures. Thus, this study aimed to investigate whether the cutaneous changes in surgical rhinoplasty patients render them vulnerable to Demodex infestation.
UNASSIGNED: Individuals who had undergone rhinoplasty (patients) and age- and sex-matched healthy volunteers (controls) were included in this prospective case-control study. To determine the Demodex density, samples were collected from the malar and nasal regions of both the patients and controls using the standard superficial skin biopsy method.
UNASSIGNED: A total of 50 rhinoplasty patients and 50 healthy controls were enrolled in the study. The Demodex density on the nose was significantly higher in the rhinoplasty patients (p = 0.0001). Furthermore, the frequency of xerosis and pustules was significantly higher in the rhinoplasty patients compared to the control group (p = 0.046 and p = 0.001, respectively).
UNASSIGNED: Surgical rhinoplasty may be a risk factor for demodicosis, and patients will recover faster after surgery with proper diagnosis and treatment.

OBJECTIVE: This study aimed to identify by in silico methods tropomyosin consensus B and T epitopes of shrimp species, house dust mites, insects, and nematodes associated with allergic diseases in tropical countries.
METHODS: In silico analysis included tropomyosin from mites (Der p 10, Der f 10, Blo t 10), insects (Aed a 10, Per a 7, Bla g 7), shrimp (Lit v 1, Pen m 1, Pen a 1), and nematode (Asc l 3) all sequences were taken from the UniProt database. Linear IgE epitopes were predicted with AlgPred 2.0 and validated with BepiPred 3.0. MHC-II binding T cell epitopes were predicted using the IEDB server, which implements nine predictive methods (consensus method, combinatorial library, NN-align-2.3, NN- align-2.2, SMM-align, Sturniolo, NetMHCIIpan 3.1, and NetMHCIIpan 3.2) these predictions focused on 10 HLA-DR and 2 HLA-DQ alleles associated with allergic diseases. Subsequently, consensus B and T epitopes present in all species were identified.
RESULTS: We identified 12 sequences that behaved as IgE-epitopes and B-cell epitopes, three of them: 160RKYDEVARKLAMVEA174, 192ELEEELRVVGNNLKSLEVSEEKAN215, 251KEVDRLEDELV261 were consensus in all species. Eleven peptides (T-epitopes) showed strong binding (percentile rank ≤ 2.0) to HLA-DRB1*0301, *0402, *0411, *0701, *1101, *1401, HLA-DQA1*03:01/DQB1*03:02, and HLA- DQA1*05:01/DQB1*02:01. Only two T-epitopes were consensus in all species: 167RKLAMVEADLERAEERAEt GEsKIVELEEELRV199, and 218EEeY KQQIKT LTaKLKEAEARAEFAERSV246. Subsequently, we identified 2 B and T epitope sequences and reached a consensus between species 167RKLAMVEA174 and 192ELEEELRV199.
CONCLUSIONS: These data describe three sequences that may explain the IgE cross-reactivity between the analyzed species. In addition, the consensus B and T epitopes can be used for further in vitro investigations and may help to design multiple-epitope protein-based immunotherapy for tropomyosin-related allergic diseases.
OBJECTIVE: Este estudio tuvo como objetivo identificar mediante métodos in silico epítopes B y T consenso de tropomiosina de especies de camarón, ácaros del polvo doméstico, insectos y nematodos asociados a enfermedades alérgicas en países tropicales.
UNASSIGNED: El análisis in silico incluyó tropomiosina de ácaros (Der p 10, Der f 10, Blo t 10), insectos (Aed a 10, Per a 7, Bla g 7), camarones (Lit v 1, Pen m 1, Pen a 1), y nematodo (Asc l 3). Todas las secuencias se tomaron de la base de datos UniProt. Los epítopes IgE lineales se predijeron con AlgPred 2.0 y se validaron con BepiPred 3.0. Los epítopes de células T de unión a MHC-II se predijeron utilizando el servidor IEDB, que implementa nueve métodos predictivos (método de consenso, biblioteca combinatoria, NN-align-2.3, NN-align-2.2, SMM-align, Sturniolo, NetMHCIIpan 3.1 y NetMHCIIpan 3.2). Estas predicciones se centraron en diez alelos HLA-DR y 2 HLA-DQ asociados con enfermedades alérgicas. Posteriormente, se identificaron epítopes consenso B y T presentes en todas las especies.
RESULTS: Se identificaron 12 secuencias que se comportaron como epítopes de IgE y, también, como epítopes de células B. Tres de ellas: 160RKYDEVARKLAMVEA174, 192ELEEELRVVGNNLKSLEVSEEKAN213 y 251KEVDRLEDELV261, fueron consenso en todas las especies. Once péptidos mostraron una fuerte unión (rango percentil ≤ 2,0) a HLA-DRB1*0301, *0402, *0411, *0701, *1101, *1401 y a HLA HLA-DQA1*03:01/DQB1*03:02, o HLA-DQA1*05:01/DQB1*02:01. Solo se encontraron dos secuencias: 167RKLAMVEADLERAEERAEtGEsKIVELEEELRV199 con fuerte afinidad por HLA-DQA1*03:01/DQB1*03:02, y HLA-DQA1*05:01/DQB1*02:01. Se identificaron dos secuencias que son epítopos B y T, y son consenso entre especies: 167RKLAMVEA174 y 192ELEEELRV199.
CONCLUSIONS: Estos datos describen tres secuencias que pueden explicar la reactividad cruzada de IgE entre las especies analizadas. Además, los epítopos B y T consenso se pueden usar para investigaciones in vitro adicionales, y pueden ayudar a diseñar inmunoterapia basada en proteínas de múltiepítopes para enfermedades alérgicas relacionadas con la tropomiosina.

BACKGROUND: Chronic blepharitis is a common cause of eye irritation and dryness. They are often treated without regard to causal factors such as parasites which are rarely mentioned.
OBJECTIVE: To describe the role of Demodex in the pathogenesis of chronic blepharitis, to analyze the epidemiological, clinical, diagnostic and therapeutic particularities.
METHODS: This is a prospective, case-control study conducted in the mycology parasitology department at the Habib Bourguiba university hospital in Sfax covering 100 cases with chronic blepharitis and 87 control cases. Clinical examination and eyelash removal were performed with direct examination for qualitative and quantitative analysis, before and after treatment.
RESULTS: Demodex was significantly more found in patients than in controls (48% vs 13.8%). The quantitative analysis showed a significant difference between the two groups with 52.1% of Demodex (+++) for patients versus 8.3% for controls. Demodex blepharitis were treated with yellow oxid mercure ophthalmic ointment with a good outcome in 81,3%.
CONCLUSIONS: Although it is admitted to be a saprophyte of the skin, a large number of arguments argues for the incrimination of Demodex in the etiopathogenesis of chronic blepharitis, hence the interest of eyelashes examination and a parasitic research in front of any chronic blepharitis resistant to usual treatments. In case of positive research, a specific treatment should be prescribed. Its effectiveness is another argument for the etiological diagnosis.

OBJECTIVE: To study the demographic, clinical, and microbiological profile of Demodex-related blepharokeratoconjunctivitis (BKC) at a tertiary eye care hospital.
METHODS: This retrospective observational study was conducted from January 2016 to September 2022. It included 83 patients with microbiologically proven Demodex BKC who presented to the cornea department of our tertiary care eye center. The clinical, microbiological, and demographic data of the 83 cases were analyzed.
RESULTS: Of the 83 cases, 57 (68.67%) were younger than 40 years, and 25 (30.12%) were below 20. Most patients presented with a good visual acuity of 20/40 or better (93 eyes; 84.55%). The disease was unilateral in 55 patients and bilateral in 28. Cylindrical dandruff was the predominant presentation noted in 61 eyes (54.95%), followed by corneal scarring in 47 eyes (42.34%) and corneal vascularization in 40 eyes (36.04%). On light microscopy, 87.95% of the positive samples were identified as Demodex folliculorum , 7.23% as Demodex brevis , and 6.02% remained unidentified. Tea tree oil and lid scrubs eradicated the disease in most patients clinically (75/83, 90.36%).
CONCLUSIONS: The spectrum of BKC includes both lid signs and corneal involvement. It can be a cause of recurrent BKC and detection of the mite by microscopic evaluation of the lashes can confirm the diagnosis. In most cases, the tea tree oil can effectively manage this condition. However, low doses of topical steroids are needed to control the inflammation in patients with corneal involvement.

Allergic Rhinitis (AR) is rising in incidence in both developed and developing countries. Genetics and epigenetics have a potential role to play. The pattern and severity of AR have implications with regard to choice of treatment, which itself could be related to patient specific genetic and epigenetic factors. Hence, the present study was undertaken to correlate the patient characteristics with AR pattern and severity, in order to understand the pathophysiology of AR. The study also aimed to find out the allergen sensitivity pattern among patients attending a tertiary care centre of rural central India, where climatic variations make it a high prevalence zone. Prospective Observational study on 90 patients with clinically diagnosed Allergic Rhinitis confirmed by Skin Prick Tests. Patient characteristics like demographic data, data relevant to allergen exposure, occupation, family history of atopy and gender; and Disease characteristics like severity (mild, mod-severe), pattern (continuous/ intermittent), type of disease (seasonal/perennial) were noted, analysed and correlation studied. Majority of the patients with AR were in the age group of 15-40 years. Medical students (52%) suffered from moderate to severe type of Allergic Rhinitis, with Persistent disease in approximately 80%. Similarly, 70.59% of farmers had moderate to severe type of the disease, with persistent disease in 70%. In the present study, in clinically diagnosed allergic rhinitis patients, Mite was the commonest allergen found on Skin Prick Test overall and in Medical students, whereas Pollen sensitivity was more common among farmers. 56.66% of the patients had negative family history of atopy. Severity and type of AR depend on allergen exposure. In farmers and medical professionals, persistent and moderate to severe type of disease was more common, as they were persistently exposed to different type of allergens, mites in case of medical professionals and pollens in farmers. Hence, the Disease characteristics, as defined by ARIA guidelines, should not be taken in isolation and management should consider the Patient characteristics for deciding and devising protocols. In the present study, more than 50% patients were without family history of atopy. Hence, the role of various environmental factors, leading to epigenetic changes could be a major contributor in the increase in incidence of allergic rhinitis in recent times. Occurrence of perennial moderate to severe form of disease, in majority of farmers, defies the phenomenon of \"Hygiene Hypothesis\", focusing on the role of epigenetic changes and various outdoor allergens in the development of allergic rhinitis in them.