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Demodex blepharitis, a chronic lid margin disease, is caused by an infestation of Demodex mites, the most common ectoparasites in human skin and eyelids. Lotilaner ophthalmic solution, 0.25% (Xdemvy, Tarsus Pharmaceuticals), is the first therapy approved to treat Demodex blepharitis. This narrative review characterizes lotilaner ophthalmic solution, 0.25%, and describes its efficacy, safety, and tolerability. The safety and efficacy of lotilaner ophthalmic solution, 0.25%, for treating Demodex blepharitis was evaluated in four phase 2 and two phase 3 trials. The data of 980 patients included in these phase 2 and 3 clinical trials revealed that the proportion of eyes with a clinically meaningful reduction to 10 or fewer collarettes (the cylindrical, waxy debris found at the base of the eyelashes) ranged from 81 to 93%. The mite eradication rate confirmed by a microscopy of epilated lashes ranged from 52 to 78%. No serious treatment-related adverse events were reported in any of these clinical studies. As high as 92% of the patients receiving lotilaner eyedrops in the phase 3 trials found it to be neutral to very comfortable. Given the positive safety and efficacy outcomes, the drug is likely to become the standard of care in the treatment of Demodex blepharitis. [ABSTRACT FROM AUTHOR]

Demodex mites are acari, common ectoparasites of humans and other mammalian pilosebaceous units. Demodicosis occurs when mites overpopulate the skin, causing several skin disorders. Our aim was to investigate the prevalence of demodicosis in patients with suspicious clinical features, such as cheek redness, itching, and skin sensitivity, who presented at the outpatient clinic of the Andreas Syggros Dermatology Hospital in Greece. We studied 184 individuals aged between 18 and 97 years and analyzed the content of pilosebaceous units by microscopy to determine the density of Demodex mites. Samples were evaluated as positive when Demodex spp. densities equaled or exceeded 5 mites per square cm. Sixty-six percent of the examined subjects were positive for demodicosis. The age distribution was statistically normal (p = 0.2), and the median age was 51.29 years. Seventy percent of the patients were females, and 30% were males, while 64.46% of the demodicosis-positive individuals were females, and 35.54% were males. We observed a rise in the percentage of males as the age of the patients increased. Demodicosis can be a challenging disease because it presents apart from the typical symptoms, with a variety of nonspecific symptoms mimicking other dermatological skin conditions. Therefore, it is important to investigate Demodex spp. in patients who present with common facial dermatological diseases to improve treatment results. Further studies could contribute to a better understanding of the pathogenic role of Demodex mites and how this role is affected by mite density, host sex and age. [ABSTRACT FROM AUTHOR]

Simple Summary: A serosurvey study was conducted in southern Spain to assess the exposure and spatial distribution of Sarcoptes scabiei in Iberian ibexes (Capra pyrenaica) and domestic goats (Capra hircus). The study included sera from 411 Iberian ibexes (157 with skin lesions compatible with sarcoptic mange and 254 that were clinically healthy), skin samples from 88 affected animals, and 392 serum samples from domestic goats, collected between 2015 and 2021. Antibodies against S. scabiei were found in 3.1% of the clinically healthy ibexes and 66.2% of those with compatible skin lesions. Mites were confirmed in 64.8% of the skin samples, and 86.0% of these mite-positive individuals had antibodies. Seropositive animals were detected in population nuclei with previous records of sarcoptic mange, but not in historically free population nuclei. The non-detection of antibodies against S. scabiei in the domestic goats suggests an independent epidemiological cycle of sarcoptic mange in Iberian ibex populations in the study area. Integrated surveillance programs and control strategies in wildlife and livestock are essential to mitigating the risk of S. scabiei circulation in Iberian ibex populations. Sarcoptic mange is a highly contagious skin disease caused by Sarcoptes scabiei. Sera were collected from 411 Iberian ibexes, comprising 157 individuals with sarcoptic mange skin lesions and 254 clinically healthy animals, in 13 population nuclei across Andalusia (southern Spain) between 2015 and 2021. Skin samples from 88 of the 157 animals with mange-compatible lesions were also obtained. Moreover, 392 serum samples from domestic goats (Capra hircus) were collected in the same region and study period. Antibodies against S. scabiei were tested using an in-house indirect ELISA, while the presence of mites of S. scabiei was evaluated in the skin samples by potassium hydroxide digestion. Seropositivity was found in eight (3.1%) of the clinically healthy ibexes and in 104 (66.2%) of the animals with mange-compatible lesions. The presence of S. scabiei was confirmed in 57 (64.8%) out of the 88 skin samples analysed and anti-S. scabiei antibodies were found in 49 (86.0%) of these 57 mite-positive individuals. Seropositive animals were detected in population nuclei with previous records of sarcoptic mange, where S. scabiei mites were detected by potassium hydroxide digestion in individuals with sarcoptic mange-compatible external lesions. However, seropositivity was not observed in population nuclei that were historically free of this disease. None of the 392 domestic goats had antibodies against S. scabiei, suggesting an independent epidemiological cycle of sarcoptic mange in Iberian ibex populations in the study area, and a limited or null role of domestic goats in the transmission of the parasite to this wild species. Overall, our findings underscore the importance of maintaining and/or implementing integrated surveillance programs and control strategies in wildlife and livestock, to limit the risk of S. scabiei circulation in Iberian ibex populations. [ABSTRACT FROM AUTHOR]

Mites are highly prevalent arthropods that infest diverse ecological niches globally. Approximately 55,000 species of mites have been identified but many more are yet to be discovered. Of the ones we do know about, most go unnoticed by humans and animals. However, there are several species from the Acariformes superorder that exert a significant impact on global human health. House dust mites are a major source of inhaled allergens, affecting 10–20% of the world's population; storage mites also cause a significant allergy in susceptible individuals; chiggers are the sole vectors for the bacterium that causes scrub typhus; Demodex mites are part of the normal microfauna of humans and their pets, but under certain conditions populations grow out of control and affect the integrity of the integumentary system; and scabies mites cause one of the most common dermatological diseases worldwide. On the other hand, recent genome sequences of mites provide novel tools for mite control and the development of new biomaterial with applications in biomedicine. Despite the palpable disease burden, mites remain understudied in parasitological research. By better understanding mite biology and disease processes, researchers can identify new ways to diagnose, manage, and prevent common mite-induced afflictions. This knowledge can lead to improved clinical outcomes and reduced disease burden from these remarkably widespread yet understudied creatures. [ABSTRACT FROM AUTHOR]

Denture prostheses are an ideal and extensive reservoir for microorganisms to attach to their surfaces. The aim of the study was to elucidate interactions between materials for the fabrication of denture bases and the attachment of microorganisms, focusing on respiratory pathogens and Candida species. Specimens (6 mm × 1 mm) with a standardized surface roughness (Sa = 0.1 µm) were prepared from heat-pressed polymethyl methacrylate (PMMA), CAD/CAM-processed PMMA, and CAD/CAM-processed polyether ether ketone (PEEK). The specimens were randomly placed in the vestibular areas of complete upper dentures in seven patients and were removed either after 24 h without any oral hygiene measures or after a period of four weeks. The microorganisms adherent to the surface of the specimens were cultivated and subsequently analyzed using mass spectrometry (MALDI-TOF). The means and standard deviations were calculated, and the data were analyzed using a two-way analysis of variance (ANOVA) and Tukey post-hoc test where appropriate (α = 0.05). There was a significant increase (p ≤ 0.004) in the total bacterial counts (CFU/mL) between the first (24 h) and the second (four weeks) measurements. Regarding quantitative microbiological analyses, no significant differences between the various materials were identified. Respiratory microorganisms were detected in all samples at both measurement time points, with a large variance between different patients. Only after four weeks, Candida species were identified on all materials but not in all participants. Candida species and respiratory microorganisms accumulate on various denture base resins. While no significant differences were identified between the materials, there was a tendency towards a more pronounced accumulation of microorganisms on conventionally processed PMMA. [ABSTRACT FROM AUTHOR]

We aimed to determine the prevalence of Demodex spp. and bacterial infection in patients with blepharitis and also to investigate the relationship between culturable microorganisms and Demodex spp. in this study. The study included patients diagnosed with blepharitis (n = 128) and volunteers without ocular problems (n = 113). Eyelash sampling was performed by epilating eight lashes, which were then tested for Demodex spp. using a light microscope. The examination consisted of assessing the patient's vision with and without ocular correction and tonus in both eyes and a careful examination of the anterior segment of both eyes. Bacterial identification was performed based on morphological, physiological, and biochemical methods. The prevalence of Demodex spp. was 8.0% in patients from the control group and all patients with blepharitis. Isolated forms of Demodex spp. were detected in all infested patients in the control group and in 58% of patients with blepharitis. A total of 35% of patients with blepharitis had from three to nine forms of Demodex spp., and 7% of patients with blepharitis had more than 10 mites in every field of vision. We found a statistically significant relationship between Demodex spp. infestation and the occurrence of eye dryness and sensations of burning and tearing, redness of the conjunctiva, feeling of a foreign body, loss of eyelashes, Meibomian gland dysfunction, and cylindrical dandruff. There were statistically significant relationships between Demodex sp. infestation and the presence of hyperopia, Meibomian cysts, chronic eyelid inflammation, and the use of eyeglasses. There was also a statistically significant relationship between the occurrence of Demodex spp. and seborrheic dermatitis and diabetes mellitus. Culturable microorganisms of the ocular surface were found in 8.7% of participants who were uninfested and in all patients infested with D. folliculorum. We isolated Staphylococcus aureus, Acinetobacter baumannii, Streptococcus pneumoniae, Klebsiella oxytoca, and Bacillus spp. from the conjunctival sac only in patients infested with D. folliculorum. This indicates an increased probability of colonization by pathogenic bacteria in patients with demodicosis. Therefore, patients infested with D. folliculorum should undergo a microbiological examination of conjunctival swabs. [ABSTRACT FROM AUTHOR]

Simple Summary: The aim of the study was to analyse the community of parasitic mites in mouflons Ovis aries musimon from the Polish population introduced from the Mediterranean area. It was important to determine whether these parasites were specific to or typical of the genus Ovis and whether foreign species had appeared with the mouflons that might pose a parasitological threat to the native fauna or, according to the theory of parasites lost, the introduction contributed to the loss of the original fauna of parasitic mites and the subsequent repopulation of the vacant microhabitats by species typical of local bovids, cervids, and other ungulates. Forty-one mouflons, obtained by hunting, were examined. Two species of mites were found, including Demodex musimonis sp. nov., previously unknown demodecid mites, probably specific to the mouflon. These discoveries were accompanied by the tick Ixodes ricinus, a parasite common in many parts of Europe with a wide host range, and Lipoptena cervi, a parasitic fly typical of ungulates. The new species represents the first finding of a skin mite of the family Demodecidae in wild representatives of the caprine Caprinae, and the present study is the first to examine the parasitic arthropods of the mouflon, including ectoparasites and skin mites. Demodex musimonis sp. nov. occurred asymptomatically in the mouflon, and as a specific species does not pose a threat to the native fauna. In contrast, the presence of I. ricinus clearly indicates a broadening of the reservoir for pathogens transmitted by epidemiologically significant ectoparasite species in Europe. A greater understanding of mite biodiversity and ecology can explain their preference for microhabitats within host bodies, i.e., as ecto-, meso-, and endoparasites. Similarly, learning about the patterns formed by mite communities in wild animals can shed light on the mechanisms of parasitosis development in their domesticated counterparts. Hence, the present study examined the acarofauna of the mouflon, introduced to Poland in the early 20th century from a region of endemic occurrence. Forty-one individuals were examined for the presence of ectoparasites between 2010 and 2013; later, skin fragments were analysed for the presence of skin mites. A new species of Demodecidae, Demodex musimonis sp. nov., was discovered in the skin of the pasterns of 14.6% mouflons, as well as the ectoparasitic tick Ixodes ricinus (prevalence 29.3%) and ungulate-typical fly Lipoptena cervi (34.1%). However, no mites typical for ovine Ovis (Psorergatidae, Psoroptidae) were noted, nor any colonisation of microhabitats by species from local ungulates, resulting from the loss of original parasites during the introduction. A comparison of the acarofauna of the mouflon and domestic sheep Ovis aries aries suggests that a mite community with a complex structure and the co-occurrence of different families may be formed. However, it is not known whether the acarofauna of domestic sheep is derived from wild ancestors or the process of domestication. Even so, the peculiar Demodecidae must have been part of the natural parasitofauna of wild sheep, of which only D. musimonis sp. nov. has been recognised so far. [ABSTRACT FROM AUTHOR]

Demodicosis is one of the most important external parasitic diseases found in carnivores. Three species of the Demodex mite inhabit the skin of dogs and related species, D. canis being the most prevalent. This paper describes the first case of infestation with D. injai in a golden jackal in Romania. An emaciated golden jackal female body found in Timiș County, western Romania, was examined at Parasitology Department of Faculty of Veterinary Medicine, Timișoara. The gross lesions were present on different regions of the body: feet, tail, axillary and inguinal areas, and skin folds as well, consisting of erythema, extensive severe alopecia with lichenification, seborrhea, and scaling. In order to establish diagnosis, microscopic examination of skin scrapes, trichogram (hair plucking), acetate tape test (impression), fungal culture, and PCR were performed. Both microscopic measurements and PCR analysis have confirmed the presence of D. injai. [ABSTRACT FROM AUTHOR]

Infestation with Demodex mites is a common occurrence, especially in adults and the elderly. More recent attention has been paid to the presence of Demodex spp. mites in children, even ones without comorbidities. It causes both dermatological and ophthalmological problems. The presence of Demodex spp. is often asymptomatic, thus it is suggested to include parasitological investigation tests in dermatological diagnostics, in addition to bacteriological analysis. Literature reports show that Demodex spp. are related to the pathogenesis of numerous dermatoses, including rosacea or demodicosis gravis, and common eye pathologies reported by patients such as dry eye syndrome or ocular surface inflammatory conditions, such as blepharitis, chalazia, Meibomian gland dysfunction, and keratitis. Treatment of patients is a challenge and is usually prolonged, therefore it is important to carefully diagnose and properly select the therapy regimen for the treatment to be successful, and with minimal side effects, especially for young patients. Apart from the use of essential oils, research is ongoing for new alternative preparations active against Demodex sp. Our review was focused on the analysis of the current literature data on the available agents in the treatment of demodicosis in adults and children. [ABSTRACT FROM AUTHOR]

Atopic dermatitis is a chronic relapsing dermatopathology involving IgE against allergenic materials present on mammalian epithelial surfaces. Allergens are as diverse as pet danders, and polypeptides expressed by microbes of the mammalian microbiome, e.g., Malassezia spp. The Acari Hypothesis posits that the mammalian innate immune system utilizes pathogen-bound acarian immune effectors to protect against the vectorial threat posed by mites and ticks. Per The Hypothesis, IgE-mediated allergic disease is a specious consequence of the pairing of acarian gastrointestinal materials, e.g., allergenic foodstuffs, with acarian innate immune effectors that have interspecies operability. In keeping with The Hypothesis, the IgE profile of atopic patients should include both anti-acarian antibodies and specious antibodies responsible for specific allergy. Further, the profile should inform on the diet and/or environment of the acarian vector. In this regard, the prevalence of Demodex and Dermatophagoides on the skin of persons suffering from atopic dermatitis is increased. Importantly, the diets of these mites correspond well with the allergens of affected patients. In this report, roles for these specific acarians in the pathogenesis of atopic dermatitis are proposed and elaborated. [ABSTRACT FROM AUTHOR]

To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for the treatment of refractory multiple and recurrent chalazia without surgery or curettage. This was a retrospective controlled study. Patients with multiple and recurrent chalazia, who had performed the conventional treatment at least 2 months without any surgery or curettage, were enrolled in this study. Twenty-nine consecutive multiple recurrent chalazia (12 patients) were assigned to receive either the combination of IPL and MGX or MGX alone as a control. Each eye underwent one to four treatment sessions with 2-week intervals. Parameters were evaluated before and 1 month after the final treatment session. Clinical assessments included symptom, size of each chalazion, lid margin abnormalities, corneal and conjunctival fluorescein staining, meibum grade, the number of Demodex mites, the Schirmer value and meiboscore. All parameters except meiboscore and the Schirmer value were significantly improved with IPL-MGX therapy, whereas only meibum grade was significantly improved with MGX alone. There were no adverse events which occurred in either group. IPL-MGX was safe and effective for multiple and recurrent chalazia without surgery or curettage by reducing the size of chalazion and improving lid margin abnormalities and meibum grade. [ABSTRACT FROM AUTHOR]

The purpose of this study was to compare the differences between uneven meibomian gland (MG) atrophy with and without Demodex infestation based on the index of uneven atrophy score (UAS). In this retrospective cohort study, 158 subjects were recruited, including 66 subjects in the Demodex-positive MGD group, 49 subjects in the Demodex-negative MGD group, and 43 subjects as normal control. No significant difference was verified in OSDI, TMH, TBUT, CFS, lid margin score, and meibograde (all p > 0.05) between the Demodex-positive MGD group and the Demodex-negative MGD group. The UAS index of the upper eyelid or both eyelids was significantly higher in the Demodex-positive group in comparison with the normal control group and Demodex-negative group and the difference was statistically significant between the three groups. The UAS was significantly positive correlation with OSDI (r = 0.209, p < 0.05), lid margin score (r = 0.287, p < 0.001), and meibograde (r = 0.356, p < 0.001), which has a significant negative correlation with TBUT (r = −0.248, p < 0.05). Thus, Demodex infestation can cause uneven MG atrophy and we propose a novel index of UAS, which is used to evaluate uneven atrophy of MGs and as a morphological index of Demodex infestation. [ABSTRACT FROM AUTHOR]

To explore the safety and feasibility of low fluence intense pulsed light (IPL) for treating pediatric patients with moderate-to-severe blepharitis and to analyze potential factors associated with the recovery of meibomian glands (MG) dropout, a retrospective, noncomparative study, including 17 blepharitis patients (33 eyes) aged between 5 and 16 years old was conducted. All of the participants were given 4 continuous sessions of low-fluence (9–12 J/cm2) IPL at 3–4 week intervals. Corneal fluorescein staining (CFS), tear breakup time (BUT), inferior tear meniscus height, Demodex presence, and MG morphology were examined before and after the treatment. Results indicated that CFS, BUT and MG morphology (central/total gland area ratio and gland signal index) had significantly improved (p < 0.05). Symptoms and signs such as severe corneal neovascularization, limbal pannus and conjunctival congestion also subsided. Among age, gender, presence of Demodex and interval before diagnosis, age initiating the formal treatment was confirmed as a negatively correlated factor of the recovery of MG dropout (p = 0.032, B = −1.755). No notable adverse events were reported. In conclusion, low fluence IPL seems to be a safe and effective alternative for moderate-to-severe pediatric blepharitis, and MG dropout is prone to recover in younger patients. [ABSTRACT FROM AUTHOR]

Demodex folliculorum and Demodex brevis are commonly present on facial skin and frequently noted via Reflectance Confocal Microscopy (RCM) examination. These mites inhabit follicles and are often seen in groups of two or more, although D. brevis is usually found as a solitary mite. When observed through RCM, they are typically present as refractile, round groupings seen on a transverse image plane inside the sebaceous opening, as they are vertically oriented, and their exoskeletons refract under near-infrared light. Inflammation may occur, leading to a variety of skin disorders; nonetheless, these mites are considered to be part of normal skin flora. a 59-year-old woman presented to our dermatology clinic for confocal imaging (Vivascope 3000, Caliber ID, Rochester, NY, USA) of a previously excised skin cancer for margin evaluation. She did not exhibit symptoms of rosacea or active inflammation of the skin. Incidentally, a solitary demodex mite was noted in a milia cyst nearby the scar. The mite appeared to be trapped in the keratin-filled cyst and was positioned horizontally to the image plane such that its entire body was captured in a coronal orientation as a stack. Demodex identification using RCM can provide clinical diagnostic value in the context of rosacea or inflammation; in our case, this solitary mite was thought to be part of the patient's normal skin flora. Demodex are practically ubiquitous on the facial skin of older patients and are frequently noted during RCM examination; however, the orientation of the mite referenced herein is uncommon, allowing for a unique view of its anatomy. The use of RCM to identify demodex may become more routine as access to technology grows. [ABSTRACT FROM AUTHOR]

The European bison (wisent) Bison bonasus is not only the largest terrestrial mammal in Europe, but also an example of the successful restitution and reintroduction of a species that became extinct in nature at the beginning of the 20th century. Even so, it remains a rare, protected species, and one susceptible to varied threats, including diseases. It has a specific parasitofauna, comprising only a few specific species retained with the last hosts in the restitution process, and some others acquired from other ungulates, or via environmental interactions. The current data on parasitic arthropods originated from the winter season, and less frequently, from autumn and early spring. The present study contains the first information on the occurrence of arthropods in the European bison (n = 6) in the summer season, which is the period of their increased activity. Data on the seasonal and populational dynamics of ectoparasites have been verified; specific parasite species (Demodex bisonianus, Bisonicola sedecimdecembrii, and recently described Demodex bialoviensis) and typical parasite species (Chorioptes bovis, Ixodes ricinus) have been recorded. The data refer to the information from other study periods, summarizing and valorizing data on parasitic arthropods in the form of a global checklist. These arthropods occur in European bison frequently (prevalence reaches up to 100%), but they are present in small numbers, and do not present a burden for the host; only sometimes, with high intensity of infection, they cause parasitoses (chorioptosis, mallohagosis). However, as an effect of regular activity, by penetrating the skin of the host, they create gateways for secondary infections, and hematophagous parasites (e.g., ticks) can be vectors of pathogens that can be hazardous, even at low infection levels. The identification of the parasitological threats faced by European bison is not only important from the standpoint of the study object, i.e., the Białowieża Forest European bison population, from which the existing bison population of Europe has been derived, but also the fact that their transfer to different parts of Europe can entail the additional transfer of their parasites. [ABSTRACT FROM AUTHOR]

Zoonotic scabies (ZS), also referred to as "pseudoscabies", is considered a self-limiting disease with a short incubation period and transient clinical skin signs. It is commonly thought that Sarcoptes scabiei mites from animals are unable to successfully reproduce and persist on human skin; however, several ZS case reports have mentioned the persistence of symptoms and occasionally mites for weeks. The aim of this review was to collect and organize the sparse literature explicitly referring to S. scabiei zoonotic transmission, focusing on the source of the outbreak, the circumstances leading to the transmission of the parasite, the diagnosis including the identification of the Sarcoptes "strain" involved, and the applied treatments. A total of 46 articles, one conference abstract and a book were collected describing ZS cases associated with twenty animal hosts in five continents. Dogs were by far the most common source among pet owners, while diverse livestock and wildlife contributed to the caseload as an occupational disease. Genetic epidemiological studies of ZS outbreaks are still limited in number, but tools are available to fill this knowledge gap in the near future. Further research is also needed to understand the apparent heterogeneity in the morbidity, disease severity and timing of the response to treatment among people infected with different animal-derived strains. [ABSTRACT FROM AUTHOR]

Cat demodicosis is uncommon to rare, and is caused by Demodex cati, Demodex gatoi and another unnamed species. The investigated patient was a mix-breed, 10-year-old feline with no dermatological history. Alopecia, erythema, minor erosions and ulcerations and crusts, associated with pruritus and self-trauma, were observed on the head. Dark, agglutinated cerumen was also present in the external ear canal. The agent causing the skin condition in the feline patient was identified as being a Demodex genus mite, based on the specific, morphological characteristics noticed upon the microscopic examination of deep skin scrapes. Biological samples were collected from the patient with to perform a PCR assay for clear species-determination and morphological assessment. PCR amplification of DNA extracted from the Demodex mites produced a single band of ~330 bp, indicating the presence of the D. cati species. The acaricidal treatment consisted of topical treatment using a fluralaner and moxidectin-based spot-on. Upon follow-up appointments, scheduled three times at a monthly interval, the patient failed to provide a positive result upon deep skin scrapes. The negative scrapes were also accompanied by the complete resolution of the existing lesions. In conclusion, this is the first molecular study to highlight the presence of Demodex cati within the feline population of Romania, and the fluralaner-moxidectin spot-on therapy has led to a complete recovery of the feline patient affected by feline demodicosis. [ABSTRACT FROM AUTHOR]

Background. Abnormal uterine bleeding (AUB) is a common gynecologic condition, and proper management is based on the histological evaluation of an adequate endometrial sample obtained via biopsy. The aims of this study were to evaluate factors influencing the reliability and success rate of Pipelle endometrial sampling for histopathological diagnosis. Methods. One hundred and eighty patients with AUB underwent endometrial sampling using both Pipelle and dilatation and curettage (D&C) procedures at the Clinical Academic Department of Women's Health, University Medical Center between January 2019 and April 2021. We analyzed the effects of age, menopausal status, ethnicity, body mass index (BMI), provider experience, and procedure indication on the success and reliability of each procedure. Results. Pipelle sampling was successful in 144 (80.56%) women, while D&C was successful in 164 (91.11%) women. Analysis using Fisher's exact test showed that age, menopausal status, and biopsy indication were factors affecting the success rate of both methods, while ethnicity, BMI, and physician experience had no influence. Overall concordance in the histopathological results between Pipelle and D&C was 91.72%. Conclusion. Pipelle sampling was found to be reliable for the detection of endometrial carcinoma and endometrial hyperplasia, while its reliability was low in cases of endometrial polyps. The endometrial sampling approach should be personalized in daily clinical practice for women with AUB, and Pipelle sampling is not suitable for all patients. If an endometrial polyp is suspected, the physician should consider other diagnostic tools, bearing in mind all of the factors influencing endometrial sampling success and reliability rates. [ABSTRACT FROM AUTHOR]

Simple Summary: Canine chronic inflammatory enteropathy (CIE) is a gastrointestinal (GI) inflammatory condition that requires histopathology of intestinal biopsies for definitive diagnosis. This can be performed endoscopically or surgically; with the former being more common as it is less invasive. In recent years, research has identified that different types of inflammatory disease and histologic severity can exist at different locations within the GI tract, known as discordance. There is a lack of understanding of the clinical impact of lesion oversight in dogs with discordant biopsies between locations. Therefore, current recommendations are to procure endoscopic biopsies from both the upper intestinal (stomach and duodenum) and lower small intestinal tract (ileum) when possible. The rate of discordance between different GI locations has not been assessed in dogs with non-inflammatory enteropathies, i.e., neoplastic etiology, nor compared between endoscopic and surgically collected biopsy specimens. Here, we report that the rate of discordance between the duodenum and ileum in CIE is similar between endoscopic biopsy and surgical biopsy specimens and confirm that discordance between upper and lower GI biopsies exist for small-cell lymphoma. There were no clinicopathologic variables that were correlated with discordance. We conclude that for all dogs with chronic GI signs, concurrent duodenal and ileal biopsies should be performed. Histopathologic discordance between gastrointestinal (GI) locations in canine chronic inflammatory enteropathy (CIE) has prompted recommendations to biopsy both the duodenum and ileum, while further evaluation is required for non-CIE. We aimed to determine the concordance of histopathologic diagnosis between duodenal and ileal endoscopic or full-thickness biopsy specimens for all dogs with CIE and GI neoplasia and to assess the association between histopathologic discordance between GI locations with clinicopathologic variables. Seventy-nine dogs were eligible, with endoscopic (74) or full-thickness (5) biopsy specimens. Clinicopathological data were recorded for all dogs. Concordance of histopathologic diagnosis was retrospectively assessed for concurrent duodenal and ileal biopsy specimens by a single board-certified veterinary pathologist using the modified World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group guidelines. Sixty-seven dogs were diagnosed with CIE and 5 with enteric-associated T-cell lymphoma-2 (EATL-2). Concordance of histologic diagnosis between duodenal and ileal sites was similar between endoscopic (73.0%) and full-thickness (80.0%) biopsy groups. For the CIE cases, lymphoplasmacytic enteritis had the highest concordance (73.0%) and eosinophilic enteritis the least (16.7%). Of the 5 neoplastic cases, 5/5 (100%) were present at the duodenum but only 3/5 (60%) in the ileum. No clinicopathologic variables demonstrated a statistically significant association with discordance. We conclude that the level of discordance necessitates concurrent biopsy of both duodenum and ileum in all dogs with chronic GI signs. The rate of EATL-2 was lower than rates reported for cats. [ABSTRACT FROM AUTHOR]

Simple Summary: This paper describes a new species, Demodex crocidurae, inhabiting the hairy skin of Crocidura suaveolens. It also redescribes the most morphologically similar form: Demodex talpae from Talpa europaea, a species known from Hirst's 1921 description. Following a differential diagnosis, it was concluded that these are separate species with different features important in the taxonomy of Demodecidae, inhabiting analogous microhabitats in different species of hosts. Only six parasitic species of Demodecidae mite have thus far been described from the Soricomorpha, these being associated with the common shrew Sorex araneus Linnaeus, 1758, and the Mediterranean water shrew Neomys anomalus Cabrera, 1907 (two species from each host), and with the lesser white-toothed shrew Crocidura suaveolens (Pallas, 1811) and the European mole Talpa europaea Linnaeus, 1758 (one from each host species). Presently, Demodex crocidurae, a new species, has been described from the territory of Poland for C. suaveolens; in order to confirm its validity, it was necessary to redescribe D. talpae Hirst, 1921, from T. europaea, a demodecid species first described by Hirst in 1921 from England and then noted only in Poland. Both species colonized the hairy skin of the body in their hosts, where no disease symptoms of infestation were observed. However, D. crocidurae showed higher infection parameters (prevalence 100%, mean intensity 11.7, intensity range 3–26 individuals) than those of D. talpae (30.0%, 4.7, 2.0–8.0), possibly due to different host biology. [ABSTRACT FROM AUTHOR]

Simple Summary: Sarcoptic mange caused by the mite Sarcoptes scabiei is a worldwide-distributed skin infestation with a wide range of hosts, among them several species within the Felidae family. Sarcoptes scabiei was diagnosed in a dead adult female European wildcat (Felis silvestris silvestris) from Spain. This is the first description of Sarcoptes scabiei in a European wildcat. Since this is a species of conservation concern due to its critical demography in the southernmost population of the Iberian Peninsula, the impacts of infectious diseases, including sarcoptic mange, should be considered during disease surveillance programs of the species' populations. Sarcoptic mange caused by the mite Sarcoptes scabiei is a worldwide-distributed skin infestation with a wide range of hosts, among them several species within the Felidae family. Sarcoptes scabiei was diagnosed in a dead adult female European wildcat (Felis silvestris silvestris) from Spain, based on histological evaluation of skin biopsies and identification of the arthropod from skin scrapings and molecular methods. This is the first description of Sarcoptes scabiei in a European wildcat. Due to its critical demography in the southernmost population of the Iberian Peninsula, the impacts of infectious diseases, including sarcoptic mange, as a new potential threat should be considered during disease surveillance programs of the species' populations. [ABSTRACT FROM AUTHOR]

Cancer cachexia displays a complex nature in which systemic inflammation, impaired energy metabolism, loss of muscle and adipose tissues result in unintentional body weight loss. Cachectic patients have a poor prognosis and the presence of cachexia reduces the tolerability of chemo/radio-therapy treatments and it is frequently the primary cause of death in advanced cancer patients. Early detection of this condition could make treatments more effective. However, early diagnostic biomarkers of cachexia are currently lacking. In recent years, although solid biopsy still remains the "gold standard" for diagnosis of cancer, liquid biopsy is gaining increasing interest as a source of easily accessible potential biomarkers. Moreover, the growing interest in circulating microRNAs (miRNAs), has made these molecules attractive for the diagnosis of several diseases, including cancer. Some muscle-derived circulating miRNA might play a pivotal role in the onset/progression of cancer cachexia. This topic is of great interest since circulating miRNAs might be easily detectable by means of liquid biopsies and might allow an early diagnosis of this syndrome. We here summarize the current knowledge on circulating muscular miRNAs involved in muscle atrophy, since they might represent easily accessible and promising biomarkers of cachexia. [ABSTRACT FROM AUTHOR]

Epidemiological studies link Sarcoptes scabiei infection and impetigo. Scabies mites can promote Streptococcus pyogenes (Group A Streptococcus) and Staphylococcus aureus infections by breaching the skin barrier and excreting molecules that inhibit host innate immune responses. However, little is known about the composition and the function of the scabies-associated microbiota. Here, high-throughput whole-metagenome sequencing was used to explore the scabies-associated microbiome. Scabies mites including their immediate microenvironments were isolated from two patients with severe scabies in Northern Australia. Two ~45–50 million paired-end reads Illumina libraries were generated of which ~2 (5.1%) and 0.7 million (1.3%) microbial reads were filtered out by mapping to human (hg19) and mite draft genomes. Taxonomic profiling revealed a microbial community dominated by the phylum Firmicutes (A: 79% and B: 59%) and genera that comprise Streptococcus, Staphylococcus, Acinetobacter, and Corynebacterium. Assembly of the metagenome reads resulted in genome bins representing reference genomes of Acinetobacter baumannii, Streptococcus dysgalactiae (Group C/G), Proteus mirablis and Staphylococcus aureus. The contigs contained genes relevant to pathogenicity and antibiotics resistance. Confocal microscopy of a patient skin sample confirmed A. baumannii, Streptococci and S. aureus in scabies mite gut and faeces and the surrounding skin. The study provides fundamental evidence for the association of opportunistic pathogens with scabies infection. [ABSTRACT FROM AUTHOR]

The enzymatic and antifungal profiles of dermatophytes play an important role in causing infections in humans and animals. This study aimed to assess the virulence factors produced by Microsporum canis strains, in vitro antifungal profile and the relationship between virulence, antifungal profile and occurrence of lesions in animals and humans. A total of 100 M. canis strains from humans with tinea corporis (n = 10) and from animals presenting (n = 64) or not (n = 26) skin lesions was employed to evaluate phospholipase (Pz), hemolytic (Hz), lipase (Lz), catalase (Ca), and thermotolerance (GI) activities. In addition, in vitro antifungal profile was conducted using the CLSI broth microdilution method. A statistically significant difference (p < 0.05) in Lz and Ca values was revealed among strains from hosts with and without lesions. Voriconazole, terbinafine, and posaconazole were the most active drugs followed by ketoconazole, griseofulvin, itraconazole, and fluconazole in decreasing activity order. The significant positive correlation between azole susceptibility profile of M. canis and virulence factors (i.e., hemolysin and catalase) suggest that both enzyme patterns and antifungal susceptibility play a role in the appearance of skin lesions in animals and humans. [ABSTRACT FROM AUTHOR]

The Hippo signaling pathway plays a key role in regulating organ size and tissue homeostasis. Hippo and two of its main effectors, yes-associated protein (YAP) and WWTR1 (WW domain-containing transcription regulator 1, commonly listed as TAZ), play critical roles in angiogenesis. This study investigated the role of the Hippo signaling pathway in the pathogenesis of rosacea. We performed immunohistochemical analyses to compare the expression levels of YAP and TAZ between rosacea skin and normal skin in humans. Furthermore, we used a rosacea-like BALB/c mouse model induced by LL-37 injections to determine the roles of YAP and TAZ in rosacea in vivo. We found that the expression levels of YAP and TAZ were upregulated in patients with rosacea. In the rosacea-like mouse model, we observed that the clinical features of rosacea, including telangiectasia and erythema, improved after the injection of a YAP/TAZ inhibitor. Additionally, treatment with a YAP/TAZ inhibitor reduced the expression levels of YAP and TAZ and diminished vascular endothelial growth factor (VEGF) immunoreactivity in the rosacea-like mouse model. Our findings suggest that YAP/TAZ inhibitors can attenuate angiogenesis associated with the pathogenesis of rosacea and that both YAP and TAZ are potential therapeutic targets for patients with rosacea. [ABSTRACT FROM AUTHOR]

Rosacea is a common and chronic inflammatory skin disease that is characterized by dysfunction of the immune and vascular system. The excessive production and activation of kallikerin 5 (KLK5) and cathelicidin have been implicated in the pathogenesis of rosacea. Coptis chinensis Franch (CC) has been used as a medicinal herb in traditional oriental medicine. However, little is known about the efficacy and mechanism of action of CC in rosacea. In this study, we evaluate the effect of CC and its molecular mechanism on rosacea in human epidermal keratinocytes. CC has the capacity to downregulate the expression of KLK5 and cathelicidin, and also inhibits KLK5 protease activity, which leads to reduced processing of inactive cathelicidin into active LL-37. It was determined that CC ameliorates the expression of pro-inflammatory cytokines through the inhibition of LL-37 processing. In addition, it was confirmed that chitin, an exoskeleton of Demodex mites, mediates an immune response through TLR2 activation, and CC inhibits TLR2 expression and downstream signal transduction. Furthermore, CC was shown to inhibit the proliferation of human microvascular endothelial cells induced by LL-37, the cause of erythematous rosacea. These results demonstrate that CC improved rosacea by regulating the immune response and angiogenesis, and revealed its mechanism of action, indicating that CC may be a useful therapeutic agent for rosacea. [ABSTRACT FROM AUTHOR]

Simple Summary: Genodermatoses represent inherited disorders of the skin that mostly follow a monogenic mode of inheritance. Heritable connective tissue disorders such as classical Ehlers–Danlos syndrome (cEDS) belong to this group of human rare diseases that sporadically occur in other species. Herein, affected cattle are reported showing skin lesions including cutis laxa clinically and pathologically resembling cEDS in humans. Microscopic findings in the deeper dermis were consistent with collagen dysplasia. Whole-genome sequencing (WGS) identified a most likely disease-causing mutation in the COL5A2 gene. The COL5A2 gene is known to be associated with dominant inherited cEDS forms in mice and humans, but so far, it was not shown to cause a similar phenotype in domestic animals. The disease phenotype examined herein showed co-segregation with the identified missense variant within the maternal line across two generations and is most likely due to a spontaneous mutation event. Rare non-lethal disorders such as cEDS in livestock are mostly not diagnosed, but might affect animal welfare and thus lower the value of affected animals. WGS-based precision diagnostics allows understanding rare disorders and supports the value of surveillance of cattle breeding populations for harmful genetic disorders. Classical Ehlers–Danlos syndrome (cEDS) is a heritable connective tissue disorder characterized by variable degrees of skin hyperextensibility and fragility, atrophic scarring, and generalized joint hypermobility. The purpose of this study was to characterize the clinicopathological phenotype of a cEDS-affected Holstein calf and to identify the causative genetic variant associated with the disorder by whole-genome sequencing (WGS). A 3-day-old female Holstein calf was referred because of easily induced skin detachment and hyperextensibility in the neck. A complete clinical investigation was performed in the calf, dam, and maternal-grandmother. The calf and dam showed hyperextensibility of the neck skin and atrophic scarring; additionally, the calf presented skin fragility. Moreover, the histopathology of biopsies from the calf and its dam showed that the collagen bundles in affected skin areas were wavy, short, thin, and surrounded by edema and moderate to severe acute hemorrhages. Genetic analysis revealed a private heterozygous missense variant in COL5A2 (c.2366G>T; p.Gly789Val) that was present only in the calf and dam. This confirmed the diagnosis of cEDS and represents the first report of a causal variant for cEDS in cattle and the first COL5A2-related large animal model. [ABSTRACT FROM AUTHOR]

Demodecidae are the most specialized parasitic mites of mammals; they typically inhabit the skin, but they have been found in other tissues and organs. They can cause demodecosis (a disease which is hazardous and difficult to cure) in humans, domestic animals and livestock. They are parasites with high host and topical specificity. They have been found for most orders of mammals, and they are common in the populations of numerous host species. Therefore, they not only constitute an important subject of veterinary and medical study, but also comprise an excellent model for faunistic and parasitological analyses concerning different aspects of functioning and evolution of the host–parasite relationship. The current level or knowledge of demodecid mites is irregular and fragmentary, and numerous questions require elaboration and ordering, from the taxonomic diversity to geographic distribution and relations with hosts. Such data may be of use i.a. for the development of more efficient and reliable diagnostic methods, as well as understanding the etiology and pathogenesis mechanisms of demodecosis, currently a contentious issue. The present paper lists all formally-described valid species of demodecid mites, together with other functioning specific names, verified and with comments on their status. This is significant for correct species identification and demodecosis diagnostics. The list has been drawn up on the basis of data acquired in the period 1842−2020. It contains 122 valid species of parasite, including their hosts and geographic distribution, data on parasitism, as well as only the second record of Demodexsciurinus in Eurasian red squirrel Sciurus vulgaris in over 100 years since its initial discovery. [ABSTRACT FROM AUTHOR]

Infection is an important factor leading to the exacerbation of heart failure (HF), resulting in hospitalization. Demodex species are obligatory parasites in human skin, and increased density was reported in immunocompromised patients. In this study, we aimed to investigate the Demodex density in hospitalized HF patients compared to that of healthy controls. Methods: This study included 36 HF patients and 36 age and sex-matched healthy controls. Five standardized biopsies were taken from the face of participants and assessed for Demodex by a light microscope. Results: At least one Demodex mite was detected in 20 HF patients and nine of the control group. The number of Demodex mites was significantly higher in the HF group (median 1; min. 0 and max. 10) compared to the control group (median 0; minimum. 0 and maximum. 3). Demodicidosis was positive in 14 of the HF patients. Demodicidosis was not detected in the control group. Conclusions: This study showed that Demodex positivity is more common in HF patients hospitalized for HF exacerbation. Demodicidosis should be considered in hospitalized HF patients. [ABSTRACT FROM AUTHOR]

Brucellosis is an important bacterial zoonosis caused by B. abortus and B. melitensis in Pakistan. The status of canine brucellosis caused by B. canis remains obscure. In total, 181 serum samples were collected from stray and working dogs in two different prefectures viz. Faisalabad (n = 87) and Bahawalpur (n = 94). Presence of antibodies against B. canis and B. abortus/B. melitensis was determined using the slow agglutination test (SAT) and ELISA, respectively. Real-time PCR was performed to detect and differentiate Brucella DNA at the species level. In Faisalabad, the serological prevalence was found to be 9.2% (8/87) and 10.3% (9/87) by SAT and ELISA, respectively. Only one of the ELISA positive samples (1.15%) yielded amplification for B. abortus DNA. In Bahawalpur, 63.8% (60/94) samples were found positive by SAT; however, none of the samples was positive by ELISA or by real-time PCR. Location, age (≥1 year) and body condition (weak) were found to be associated with B. canis infection, whereas presence of wounds was found to be associated with B. abortus infection only. These findings point towards a risk of transmission from dog to livestock and humans and vice versa. The study expects to draw the attention of concerned authorities towards infection prevention and animal welfare. This study warrants further epidemiological investigation on brucellosis in pet dogs and their owners. To the best of our knowledge, this is first ever report on B. canis and B. abortus in dogs in Pakistan. [ABSTRACT FROM AUTHOR]

Background and Objectives : Demodex species are common obligatory parasites and normally present in low number in human beings. Immunosuppression was suggested to be associated with increased density of Demodex mites. Systemic glucocorticoids, cyclosporine, methotrexate, and azathioprine are commonly used immunosuppressive agents. We aim to determine the pre- and post-treatment Demodex densities in patients receiving immunosuppressive therapy and compare with those of healthy subjects. Materials and Methods : Demodex density was investigated at the beginning, first, and third months of the immunosuppressive therapy in 45 patients who received methotrexate, cyclosporine, systemic steroid, or azathioprine treatments and in 45 healthy subjects at the same time as the patients. Five standardized skin surface biopsies were taken from cheeks, forehead, nose, and chin of the patients and control group. The presence of five or more parasites in 1 cm 2 area was considered as positive. Results : Demodex test was negative at the beginning of the treatment in all patients. Demodex test was positive in one patient in the first and third months of treatment and in three patients only in the third month of treatment. In the control group, Demodex test was determined as positive in just one healthy individual at the beginning, first and third months of the study. When the patient and control groups were evaluated in terms of Demodex number, there was a statistically significant difference in Demodex density in patients treated with immunosuppressive treatment in the first and third months when compared with the control group ( p < 0.05). Conclusion : Immunosuppressive treatment might increase the number of Demodex mites and demodicidosis should be kept in mind in patients on immunosuppressive treatment.