Original Article

The Incidence of Demodex folliculorum in the Combination of Allergic Rhinitis and Diabetes Mellitus


Background: Demodex mites are permanent ectoparasites of human pilosebaceous unit. They mainly infect skin of the face and scalp. Many studies have shown higher density of the ectoparasites in diseased inflammatory skin than in normal skin. The aim of this study was to determine the frequency of Demodex folliculorum (DF) in treatment-resistant patients with the combination of allergic rhinitis (AR) and diabetes mellitus (DM).

Method: This study was conducted in 2014-2017. It included 92 patients aged 18-70 years who presented at the Ear, Nose and Throat (ENT) and Endocrinology Polyclinics of Mustafa Kemal University Medical Faculty Hospital, Turkey. An age and gender matched control group was formed of 30 healthy individuals. To determine the presence of DF, a few eyelashes were taken from eyelids in both groups. Then samples were examined under a light microscope.

Results: DF positivity was determined in 44 (47.8%) of the 92 patients and in 1 (3.3%) of the 30 control group subjects. In the patient group, DF positivity was evaluated as present in 14 (43.7%) of the DM patients, in 12 (40%) of the AR patients and in 18 (60%) of the AR+DM patients. Statistically significant DF incidence was found in all three patient groups compared to the control group (P=0.001). The incidence in AR + DM group was not different from other patient groups.

Conclusion: DM, AR, advanced age and obesity had prepared the environment for Demodex infestations. This issue should be considered especially in treatment of patients with AR+DM.

1. Bousquet J, Dahl R, Khaltaev N. Global alliance against chronic respiratory diseas-es. Allergy.2007; 62:216-23.
2. Rydzewski B, Pruszewicz A, Sulkowski WJ. Assessment of smell and taste in patients with allergic rhinitis. Acta Otolaryngol. 2000; 120:323–6.
3. Delamaire M, Maugendre D, Moreno M, Le Goff MC, Allannic H, Genetet B. Impaired leucocyte functions in diabetic patients. Diabet Med. 1997; 14:29–34.
4. Yula E, Aycan-Kaya OM, Atambay M, Doğanay S, Daldal N, Tuzcu EA. What is the importance of Demodex folliculorum and D. brevis in the etiology of blepharitis? Turkiye Klinikleri J Med Sci. 2013; 33:420–4.
5. Rufli T, Mumcuoglu Y. The hair follicle mites Demodex folliculorum and Demodex brevis: biology and medical importance. A review. Dermatologica. 1981; 162:1–11.
6. Borda LJ, Wikramanayake TC. Seborrheic dermatitis and dandruff: A comprehensive review. J Clin Investig Dermatol. 2015;3(2).
7. Ozcelik S, Sumer Z, Degerli S, et al. The incidence of Demodex folliculorum in patients with chronic kidney deficiency. Turkiye Parazitol Derg.2007; 31:66–8.
8. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2013; 36(Suppl 1): S62–S69.
9. Humiczewska M, Kuźna W, Hermach U. [Frequency of occurrence of symptomatic and asymptomatic eyelid mite infestations among inhabitants of Szczecin]. Wiad Parazytol. 1994; 40(1): 69-71.
10. Türk M, Oztürk I, Sener AG, Küçükbay S, Afşar I, Maden A. Comparison of incidence of Demodex folliculorum on the eyelash follicule in normal people and blepharitis patients. Turkiye Parazitol Derg. 2007; 31:296-7.
11. Yengil E, Cevik C, Kaya OA, Taner M, Akkoca AN, Ozer C. Relationship between Demodex folliculorum and allergic rhinitis in adults. Acta Med Mediterr. 2014; 30:27-31.
12. Gokce C, Aycan-Kaya O, Yula E, et al. The effect of blood glucose regulation on the presence of opportunistic Demodex folliculorum mites in patients with type 2 diabetes mellitus. J Int Med Res. 2013; 41:1752–8.
13. Yamashita LS, Cariello AJ, Geha NM, Yu MC, Hofling-Lima AL. Demodex folliculorum on the eyelash follicule of diabetic patients. Arq Bras Oftalmol. 2011; 74:422–4.
14. Keskin Kurt R, Kaya OA, Karateke A, et al. Increased density of Demodex folliculorummites in pregnancies with gestational diabetes. Med Princ Pract. 2014; 23:369–72.
15. Mowat A, Baum J. Chemotaxis of polymorphonuclear leukocytes from patients with diabetes mellitus. N Engl J Med. 1971; 284:621-7.
16. Bagdade JD, Nielson KL, Bulger RJ. Reversible abnormalities in phagocytic function in poorly controlled diabetic patients. Am J Med Sci. 1972; 263:451-6.
17. Sannomiya P, Oliveira MA, Fortes ZB. Aminoguanidine and the prevention of leukocyte dysfunction in diabetes mellitus: a direct vital microscopic study. Br J Pharmacol. 1997; 122:894-8.
18. Karincaoglu Y, Esrefoglu Seyhan M, Bayram N, et al. Incidence of Demodex folliculorum in patients with end stage chronic renal failure.Ren Fail. 2005; 27:495-9.
19. Roihu T, Kariniemi AL.Demodex mites in acne rosacea. J Cutan Pathol. 1998; 25:550-2.
20. Aycan OM, Otlu GH, Karaman U, Daldal N, Atambay M. Frequency of the appearance of Demodexspp. in various patient and age groups. Turkiye Parazitol Derg. 2007; 31:115-8.
21. Inceboz T, Yaman A, Over L, Ozturk AT, Akisu C. Diagnosis and treatment of demodectic blepharitis. Turkiye Parazitol Derg. 2009; 33:32-6.
IssueVol 14 No 3 (2019) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijpa.v14i3.1486
Demodex folliculorum Diabetes mellitus Allergic rhinitis Obesity

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How to Cite
ARLİ C, OZSAN M, GURKAN E, AYCAN KAYA O, KOKACYA S. The Incidence of Demodex folliculorum in the Combination of Allergic Rhinitis and Diabetes Mellitus. Iran J Parasitol. 2019;14(3):459-464.