title: Potential role of Demodex mites and bacteria in the induction of rosacea.
abstract: Rosacea is a common dermatological condition that predominantly affects the central regions of the face. Rosacea affects up to 3 % of the world's population and a number of subtypes are recognized. Rosacea can be treated with a variety of antibiotics (e.g. tetracycline or metronidazole) yet no role for bacteria or microbes in its aetiology has been conclusively established. The density of Demodex mites in the skin of rosacea patients is higher than in controls, suggesting a possible role for these mites in the induction of this condition. In addition, Bacillus oleronius, known to be sensitive to the antibiotics used to treat rosacea, has been isolated from a Demodex mite from a patient with papulopustular rosacea and a potential role for this bacterium in the induction of rosacea has been proposed. Staphylococcus epidermidis has been isolated predominantly from the pustules of rosacea patients but not from unaffected skin and may be transported around the face by Demodex mites. These findings raise the possibility that rosacea is fundamentally a bacterial disease resulting from the over-proliferation of Demodex mites living in skin damaged as a result of adverse weathering, age or the production of sebum with an altered fatty acid content. This review surveys the literature relating to the role of Demodex mites and their associated bacteria in the induction and persistence of rosacea and highlights possible therapeutic options.
authors.affiliation: Department and Clinic of Dermatology, University of Medical Sciences, Poznań, Poland.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Jarmuda
authors.affiliation: Department of Biology, National University of Ireland Maynooth, Co. Kildare, Ireland.
authors.forename: Niamh
authors.initials: N
authors.lastname: O'Reilly
authors.affiliation: Department and Clinic of Dermatology, University of Medical Sciences, Poznań, Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Żaba
authors.affiliation: Department and Clinic of Dermatology, University of Medical Sciences, Poznań, Poland.
authors.forename: Oliwia
authors.initials: O
authors.lastname: Jakubowicz
authors.affiliation: Department of Medical Microbiology, University of Medical Sciences, Poznań, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Szkaradkiewicz
authors.affiliation: Department of Biology, National University of Ireland Maynooth, Co. Kildare, Ireland.
authors.forename: Kevin
authors.initials: K
authors.lastname: Kavanagh
mesh_terms: D000818:Animals; D016863:Bacillaceae Infections / Q000150:complications* / Q000382:microbiology; D001407:Bacillus / Q000145:classification / Q000502:physiology*; D006801:Humans; D008924:Mite Infestations / Q000150:complications* / Q000469:parasitology; D008925:Mites / Q000145:classification / Q000382:microbiology / Q000502:physiology; D012393:Rosacea / Q000209:etiology* / Q000382:microbiology / Q000469:parasitology; D013203:Staphylococcal Infections / Q000150:complications* / Q000382:microbiology; D013212:Staphylococcus epidermidis / Q000502:physiology*