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Published in: Ophthalmology and Therapy 2/2017

Open Access 01-12-2017 | Case Report

Demodex Blepharitis Treated with a Novel Dilute Povidone-Iodine and DMSO System: A Case Report

Authors: Jesse S. Pelletier, Kara Capriotti, Kevin S. Stewart, Joseph A. Capriotti

Published in: Ophthalmology and Therapy | Issue 2/2017

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Abstract

Introduction

Povidone-iodine aqueous solution is an antiseptic commonly used in ophthalmology for treatment of the ocular surface. Dimethylsulfoxide (DMSO) is a well-known skin penetration enhancer that is scarcely utilized in ophthalmic drug formulations. We describe here a low-dose formulation of 0.25% PVP-I in a gel containing DMSO for the treatment of Demodex blepharitis.

Case Report

A 95-year-old female presented with chronic blepharitis involving both the anterior and posterior eyelid margins. The anterior eyelid margins demonstrated pathognomonic features consistent with Demodex infection, and this diagnosis was confirmed with microscopy. Previous traditional therapies had been ineffective at controlling her signs and symptoms.

Conclusion

The topical PVP-I/DMSO system was effective at treating the signs and symptoms of Demodex blepharitis. Further investigation of the novel agent is warranted.
Literature
2.
go back to reference Fulk GW, Clifford C. A case report of demodicosis. J Am Optom Assoc. 1990;61:637–9.PubMed Fulk GW, Clifford C. A case report of demodicosis. J Am Optom Assoc. 1990;61:637–9.PubMed
3.
4.
go back to reference Kamoun B, Fourati M, Feki J, et al. Blepharitis due to Demodex: myth or reality? J Fr Ophtalmol. 1999;22:525–7. Kamoun B, Fourati M, Feki J, et al. Blepharitis due to Demodex: myth or reality? J Fr Ophtalmol. 1999;22:525–7.
5.
go back to reference Rodriguez AE, Ferrer C, Alio JL. Chronic blepharitis and Demodex. Arch Soc Esp Oftalmol. 2005;80:635–42. Rodriguez AE, Ferrer C, Alio JL. Chronic blepharitis and Demodex. Arch Soc Esp Oftalmol. 2005;80:635–42.
6.
go back to reference Basta-Juzbasic A, Subic JS, Ljubojevic S. Demodex folliculorum in development of dermatitis rosaceiformis steroidica and rosacea-related diseases. Clin Dermatol. 2002;20:135–40.CrossRefPubMed Basta-Juzbasic A, Subic JS, Ljubojevic S. Demodex folliculorum in development of dermatitis rosaceiformis steroidica and rosacea-related diseases. Clin Dermatol. 2002;20:135–40.CrossRefPubMed
7.
go back to reference Erbagci Z, Ozgoztasi O. The significance of Demodex folliculorum density in rosacea. Int J Dermatol. 1998;37:421–5.CrossRefPubMed Erbagci Z, Ozgoztasi O. The significance of Demodex folliculorum density in rosacea. Int J Dermatol. 1998;37:421–5.CrossRefPubMed
8.
9.
go back to reference Koo H, Kim TH, Kim KW, Wee SW, Chun YS, Kim JC. Ocular surface discomfort and Demodex: effect of tea tree oil eyelid scrub in Demodex blepharitis. J Korean Med Sci. 2012;27(12):1574–9. Koo H, Kim TH, Kim KW, Wee SW, Chun YS, Kim JC. Ocular surface discomfort and Demodex: effect of tea tree oil eyelid scrub in Demodex blepharitis. J Korean Med Sci. 2012;27(12):1574–9.
10.
go back to reference Liu J, Sheha H, Tseng SC. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010;10:505–10. Liu J, Sheha H, Tseng SC. Pathogenic role of Demodex mites in blepharitis. Curr Opin Allergy Clin Immunol. 2010;10:505–10.
11.
go back to reference Liang L, Ding X, Tseng SC. High prevalence of Demodex brevis infestation in chalazia. Am J Ophthalmol. 2014;157:342–8. Liang L, Ding X, Tseng SC. High prevalence of Demodex brevis infestation in chalazia. Am J Ophthalmol. 2014;157:342–8.
12.
go back to reference English FP, Cohn D, Groeneveld ER. Demodectic mites and chalazion. Am J Ophthalmol. 1985;100:482–3.CrossRefPubMed English FP, Cohn D, Groeneveld ER. Demodectic mites and chalazion. Am J Ophthalmol. 1985;100:482–3.CrossRefPubMed
13.
go back to reference Gao YY, Di Pascuale MA, Elizondo A, Tseng SC. Clinical treatment of ocular demodecosis by lid scrub with tea tree oil. Cornea. 2007;26:136–43.CrossRefPubMed Gao YY, Di Pascuale MA, Elizondo A, Tseng SC. Clinical treatment of ocular demodecosis by lid scrub with tea tree oil. Cornea. 2007;26:136–43.CrossRefPubMed
14.
go back to reference Gao YY, Di Pascuale MA, Li W, et al. In vitro and in vivo killing of ocular Demodex by tea tree oil. Br J Ophthalmol. 2005;89:1468–73. Gao YY, Di Pascuale MA, Li W, et al. In vitro and in vivo killing of ocular Demodex by tea tree oil. Br J Ophthalmol. 2005;89:1468–73.
15.
go back to reference Holzchuh FG, Hida RY, Moscovici BK, et al. Clinical treatment of ocular Demodex folliculorum by systemic ivermectin. Am J Ophthalmol. 2011;151(6):1030–4.CrossRefPubMed Holzchuh FG, Hida RY, Moscovici BK, et al. Clinical treatment of ocular Demodex folliculorum by systemic ivermectin. Am J Ophthalmol. 2011;151(6):1030–4.CrossRefPubMed
16.
go back to reference Salem DA, El-Shazly A, Nabih N, et al. Evaluation of the efficacy of oral ivermectin in comparison with ivermectin: metronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum. Int J Infect Dis. 2013;17(5):343–7.CrossRef Salem DA, El-Shazly A, Nabih N, et al. Evaluation of the efficacy of oral ivermectin in comparison with ivermectin: metronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum. Int J Infect Dis. 2013;17(5):343–7.CrossRef
17.
go back to reference Speaker MG, Menikoff JA. Prophylaxis of endophthalmitis with topical povidone-iodine. Ophthalmology. 1991;98(12):1769–75.CrossRefPubMed Speaker MG, Menikoff JA. Prophylaxis of endophthalmitis with topical povidone-iodine. Ophthalmology. 1991;98(12):1769–75.CrossRefPubMed
18.
go back to reference Trinavarat A, Atchaneeyasakul LO, Nopmaneejumruslers C, Inson K. Reduction of endophthalmitis rate after cataract surgery with preoperative 5% povidone-iodine. Dermatology. 2006;212(Suppl 1):35–40.CrossRefPubMed Trinavarat A, Atchaneeyasakul LO, Nopmaneejumruslers C, Inson K. Reduction of endophthalmitis rate after cataract surgery with preoperative 5% povidone-iodine. Dermatology. 2006;212(Suppl 1):35–40.CrossRefPubMed
19.
go back to reference Saedon H, Nosek J, Phillips J, Narendran N, Yang YC. Ocular surface effects of repeated application of povidone iodine in patients receiving frequent intravitreal injections. Cutan Ocul Toxicol. 2017;6:1–12. Saedon H, Nosek J, Phillips J, Narendran N, Yang YC. Ocular surface effects of repeated application of povidone iodine in patients receiving frequent intravitreal injections. Cutan Ocul Toxicol. 2017;6:1–12.
20.
go back to reference Cebra C, Anderson D, Tibary A, Van Saun R, Johnson LW. Llama and alpaca care: medicine, surgery, reproduction, nutrition and herd health. St. Louis: Elsevier; 2014. Cebra C, Anderson D, Tibary A, Van Saun R, Johnson LW. Llama and alpaca care: medicine, surgery, reproduction, nutrition and herd health. St. Louis: Elsevier; 2014.
21.
go back to reference Pelletier JS, Stewart KP, Capriotti K, Capriotti JA. Rosacea blepharoconjunctivitis treated with a novel preparation of dilute povidone iodine and dimethylsulfoxide: a case report and review of the literature. Ophthalmol Ther. 2015;4(2):143–50.CrossRefPubMedPubMedCentral Pelletier JS, Stewart KP, Capriotti K, Capriotti JA. Rosacea blepharoconjunctivitis treated with a novel preparation of dilute povidone iodine and dimethylsulfoxide: a case report and review of the literature. Ophthalmol Ther. 2015;4(2):143–50.CrossRefPubMedPubMedCentral
22.
go back to reference Kheirkhah A, Blanco G, Casas V, Tseng SC. Fluorescein dye improves microscopic evaluation and counting of Demodex in blepharitis with cylindrical dandruff. Cornea. 2007;26:697–700. Kheirkhah A, Blanco G, Casas V, Tseng SC. Fluorescein dye improves microscopic evaluation and counting of Demodex in blepharitis with cylindrical dandruff. Cornea. 2007;26:697–700.
23.
go back to reference Gao YY, Di Pascuale MA, Li W, et al. High prevalence of ocular Demodex in lashes with cylindrical dandruffs. Invest Ophthalmol Vis Sci. 2005;46:3089–94. Gao YY, Di Pascuale MA, Li W, et al. High prevalence of ocular Demodex in lashes with cylindrical dandruffs. Invest Ophthalmol Vis Sci. 2005;46:3089–94.
24.
go back to reference Nicholls SG, Oakley CL, Tan A, Vote BJ. Demodex species in human ocular disease: new clinicopathological aspects. Int Ophthalmol. 2017;37(1):303–12. Nicholls SG, Oakley CL, Tan A, Vote BJ. Demodex species in human ocular disease: new clinicopathological aspects. Int Ophthalmol. 2017;37(1):303–12.
25.
go back to reference Cheng AM, Sheha H, Tseng SC. Recent advances on ocular Demodex infestation. Curr Opin Ophthalmol. 2015;26(4):295–300. Cheng AM, Sheha H, Tseng SC. Recent advances on ocular Demodex infestation. Curr Opin Ophthalmol. 2015;26(4):295–300.
26.
go back to reference Larson D, Jacob SE. Tea tree oil. Dermatitis. 2012;23(1):48–9. Larson D, Jacob SE. Tea tree oil. Dermatitis. 2012;23(1):48–9.
27.
go back to reference Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol. 1993;128:650–9.CrossRefPubMed Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol. 1993;128:650–9.CrossRefPubMed
28.
go back to reference Forton F, Germaux MA, Brasseur T, et al. Demodicosis and rosacea: epidemiology and significance in daily dermatologic practice. J Am Acad Dermatol. 2005;52:74–87.CrossRefPubMed Forton F, Germaux MA, Brasseur T, et al. Demodicosis and rosacea: epidemiology and significance in daily dermatologic practice. J Am Acad Dermatol. 2005;52:74–87.CrossRefPubMed
29.
go back to reference Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007;157:474–81.CrossRefPubMed Lacey N, Delaney S, Kavanagh K, Powell FC. Mite-related bacterial antigens stimulate inflammatory cells in rosacea. Br J Dermatol. 2007;157:474–81.CrossRefPubMed
30.
go back to reference Li J, O’Reilly N, Sheha H, et al. Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with facial rosacea. Ophthalmology. 2010;117:870–7. Li J, O’Reilly N, Sheha H, et al. Correlation between ocular Demodex infestation and serum immunoreactivity to Bacillus proteins in patients with facial rosacea. Ophthalmology. 2010;117:870–7.
31.
go back to reference Wolf R, Ophir J, Avigad J, et al. The hair follicle mites (Demodex spp.). Could they be vectors of pathogenic microorganisms? Acta Derm Venereol. 1988;68:535–7.PubMed Wolf R, Ophir J, Avigad J, et al. The hair follicle mites (Demodex spp.). Could they be vectors of pathogenic microorganisms? Acta Derm Venereol. 1988;68:535–7.PubMed
32.
go back to reference Berkelman RL, Holland BW, Anderson RL. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J Clin Microbiol. 1982;15(4):635–9.PubMedPubMedCentral Berkelman RL, Holland BW, Anderson RL. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J Clin Microbiol. 1982;15(4):635–9.PubMedPubMedCentral
33.
go back to reference Beukelman CJ, van den Berg AJ, Hoekstra MJ, Uhl R, Reimer K, Mueller S. Anti-inflammatory properties of a liposomal hydrogel with povidone-iodine (Repithel) for wound healing in vitro. Burns. 2008;34(6):845–55. Beukelman CJ, van den Berg AJ, Hoekstra MJ, Uhl R, Reimer K, Mueller S. Anti-inflammatory properties of a liposomal hydrogel with povidone-iodine (Repithel) for wound healing in vitro. Burns. 2008;34(6):845–55.
34.
go back to reference Notman R, Noro M, O’Malley B, Anwar J. Molecular basis for dimethylsulfoxide (DMSO) action on lipid membranes. J Am Chem Soc. 2006;128(43):13982–3.CrossRefPubMed Notman R, Noro M, O’Malley B, Anwar J. Molecular basis for dimethylsulfoxide (DMSO) action on lipid membranes. J Am Chem Soc. 2006;128(43):13982–3.CrossRefPubMed
Metadata
Title
Demodex Blepharitis Treated with a Novel Dilute Povidone-Iodine and DMSO System: A Case Report
Authors
Jesse S. Pelletier
Kara Capriotti
Kevin S. Stewart
Joseph A. Capriotti
Publication date
01-12-2017
Publisher
Springer Healthcare
Published in
Ophthalmology and Therapy / Issue 2/2017
Print ISSN: 2193-8245
Electronic ISSN: 2193-6528
DOI
https://doi.org/10.1007/s40123-017-0097-3

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