PURPOSE To evaluate facial Demodex densities in participants with varying severities of blepharitis secondary to Demodex folliculorum assessed by the highest number of cylindrical dandruff on one lid. METHODS This double masked cross-sectional study included 58 participants [19 control, 21 mild/moderate and 18 severe Demodex blepharitis] who underwent a standardized skin-surface biopsy and a lash epilation for each lid to obtain the forehead Demodex densities and the overall lash mite count, respectively. Also, facial photographs were taken to evaluate facial erythema and dermatological conditions. The Ocular Surface Disease Index [OSDI], non-invasive break-up time [NIBUT], tear meniscus height [TMH], bulbar conjunctival redness as well as additional questions on watery eyes, ocular itching and itching along the lids were assessed. RESULTS Both mild/moderate and severe Demodex blepharitis groups were over the cut-off value [≥ 5 mites/cm2] that confirms a facial demodicosis (mild/moderate: 5 ± 1; severe: 6 ± 1) while the control group was below it (2 ± 1). Thereby, group comparisons showed that an increased severity of Demodex blepharitis was associated with higher forehead mite densities (p = 0.002) and increased lash mite count (p < 0.001). The degree of facial erythema was also positively correlated with forehead mite densities (rs = 0.31, p = 0.02). When compared to the controls, the mild/moderate group had more watery eyes (X2 = 6.54, p = 0.02), a lower TMH (U = 100.5, p = 0.006) and the severe group had more itching along the lids (X2 = 4.94, p = 0.04). The other ocular signs and symptoms [NIBUT, bulbar conjunctival redness, OSDI] were not affected by the severity of Demodex blepharitis (p > 0.05). CONCLUSION Palpebral and facial Demodex infestation can co-exist, as the presence of blepharitis secondary to Demodex is associated with increased facial mite densities.

中文翻译：

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蠕形螨（Demodex folliculorum）对睑和面部皮肤的侵害。

目的评估具有严重程度的继发于毛囊蠕形螨的继发性睑缘炎的参与者的面部蠕形螨密度，通过一个盖上最大数量的头皮屑来评估。方法这项双掩膜横断面研究包括58位参与者（19位对照，21位轻度/中度和18位严重的Demodex睑缘炎），他们接受了标准化的皮肤表面活检，每个盖的睫毛脱毛，以获得前额的Demodex密度和整个睫毛螨计数。此外，还拍摄了面部照片以评估面部红斑和皮肤病状况。评估了眼表疾病指数[OSDI]，非侵入性破裂时间[NIBUT]，泪液半月板高度[TMH]，球结膜充血发红以及流水眼的其他问题，眼部瘙痒和眼睑瘙痒。结果轻度/中度和重度Demodex睑缘炎组均超过临界值[≥5螨/ cm2]，证实了面部蠕形螨病（轻度/中度：5±1；重度：6±1），而对照组则低于它（2±1）。因此，组间比较显示，蠕形螨眼睑缘炎的严重程度增加与前额螨密度较高（p = 0.002）和睫螨数量增加（p <0.001）有关。面部红斑的程度也与前额螨密度呈正相关（rs = 0.31，p = 0.02）。与对照组相比，轻度/中度组的眼睛水汪汪（X2 = 6.54，p = 0.02），TMH较低（U = 100.5，p = 0.006），重度组的眼睑瘙痒更多（X2 = 4.94，p = 0.04）。其他眼部症状和体征[NIBUT，球结膜发红，OSDI]不受蠕形眼睑睑球炎​​的严重性影响（p> 0.05）。结论睑裂和面部蠕形螨病可以共存，因为蠕形螨继发性睑缘炎的存在与面部螨密度的增加有关。