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Archive

Spring 2018, Vol. 26 No. 1

Hong Kong J. Dermatol. Venereol. (2018) 26, 10-17


Review Article

Human demodicidosis and the current treatment options

人類蠕形蟎病和目前的治療方案

NS Lam 林兆麒, X Long 龍鑫鑫, RC Griffin, JCG Doery, F Lu 呂芳麗

Abstract

Demodex folliculorum and D. brevis live and reproduce in the pilosebaceous unit, including hair follicles and sebaceous glands. Various treatments have been found to be effective in managing Demodex-related diseases. The possible effects of the treatments are to decrease the mite counts, relieve the related symptoms, and to modulate the immune system. Metronidazole, ivermectin, and permethrin are effective drugs for treating Demodex infections. A combination of different treatments is needed occasionally for refractory cases, especially those with genetic susceptibility or immuno-compromised conditions. Although the current treatments are effective in controlling Demodex mite population and the related symptoms, more investigations are needed to enhance efficacy by improved drug delivery technologies and alternative treatments with less toxicity, a lower risk of resistance, and better side-effects profile. This review summarises the current oral and topical treatments on human demodicidosis, their possible mechanisms of action, and side effects.

毛囊蠕形蟎和脂蠕形蟎在毛囊皮脂腺單位包括毛囊和皮脂腺中生活和繁殖。現有的各種治療在控制與蠕形蟎有關的疾病方面皆有成效。治療的效果可能是通過減少蟎蟲數量、緩解相關症狀或調節免疫系統。甲硝唑、伊維菌素和氯菊酯是治療蠕形蟎感染的有效藥物。偶爾需要結合應用不同的治療方案來治療難治的病例,尤其是那些具有潛在遺傳易感性或免疫功能受損的患者。儘管目前的治療方法在控制蠕形蟎數量及相關症狀方面是有效的,但仍需要進行更多的調查,改善藥物輸送技術以及採用毒性低、抗藥風險小和副作用輕的替代治療。本綜述總結了目前口服和局部用藥治療人蠕形蟎病的方案及其可能的作用機制和副作用。

Keywords: Crotamiton, demodicidosis, ivermectin, lindane, metronidazole, permethrin

關鍵詞: 丁烯醯苯胺、蠕形蟎病、伊維菌素、林丹、甲硝唑、氯菊酯