Retrospective analysis of the association between Demodex infestation and rosacea.
OBJECTIVE
To explore the association between Demodex infestation and rosacea and the pathogenesis of demodicosis rosacea by means of a meta-analysis.


METHODS
Electronic searches of the ISI Web of Knowledge (Science Citation Index, ISTP [Index to Scientific & Technical Proceedings], Journal Citation Reports, BP [BIOSIS Preview], INSPEC [Ination Service in Physics, Electronics Technology, and Computer and Control], and DII [Derwent Innovation Index]), MEDLINE, and CNKI (China National Knowledge Infrastructure) databases (January 1, 1950, to December 31, 2009). We also performed hand searches of reference lists and conference proceedings.


METHODS
Predefined selection criteria were applied to all published case-control studies that analyzed the association between Demodex infestation and rosacea.


METHODS
Two of us independently extracted data from the included studies. For disputed articles, a third party mediated whether to include the study.


RESULTS
Forty-eight English- and Chinese-language articles, which covered 10 different countries and 28 527 participants, were eligible. The pooled odds ratio in random-effects models is 7.57 (95% confidence interval, 5.39-10.62). Stability is good according to sensitivity analysis. The fail-safe number is 18 456 in the quantitative analysis of publication bias.


CONCLUSIONS
A significant association exists between Demodex infestation and the development of rosacea. Demodex infestation is a vital risk factor for rosacea according to the time-to-event relationship, and the degree of infestation played a more important role than did the mite infestation rate in the development of rosacea.
Zhao
Ya E
YE
Department of Immunology and Pathogen Biology, Medical School of Xi'an Jiaotong University, No. 76 Yanta W. Road, Xi'an, China. zhaoyae@sina.com
Wu
Li Ping
LP
Peng
Yan
Y
Cheng
Hui
H
D000818:Animals; D016022:Case-Control Studies; D016208:Databases, Factual; D006801:Humans; D008924:Mite Infestations / Q000150:complications* / Q000453:epidemiology; D015233:Models, Statistical; D017594:Publication Bias; D012189:Retrospective Studies; D012307:Risk Factors; D012393:Rosacea / Q000453:epidemiology / Q000469:parasitology*; D013997:Time Factors