BACKGROUND
According to the 323 Federal law from 21.11.11 (Ed. from 25.06.12) «About the basis of health protection of citizens of the Russian Federation», clinical diagnosis, presented to the patient, is clearly rubrified and includes the following sections: underlying condition, complications of the underlying condition, comorbid condition. Subsection of demodicosis on primary and secondary process is unreasonably. The primary process is the early stage of the disease, and the secondary is the later. There are differences in the clinical manifestations of the pathological process when etiological factor is identified. Improvement of demodicosis classification and objectification of its diagnosis methods are the basis of rational approach to the choice of adequate therapy.
OBJECTIVE
To prove a new approach to the demodicosis classification with consideration to the basis of the dermatological propaedeutics and features of agent parasitizing in the skin.
MATERIAL AND METHODS
Literature data, showing the approach to the demodicosis classification, were studied and systematized at the first stage. Clinical and parasitological examinations of 24 patients were done and the demodicosis diagnosis was confirmed in 91.7% of cases at the second stage. Dermatoscopy and authors’ methods of laboratory diagnosis of mite-borne were used.
RESULTS
The arranging of primary and secondary demodicosis is unreasonably. Demodicosis can be separate nosological form, comorbid condition, complication of dermatoses, associated with demodicosis, and drug-induced complication of therapy, demodicosis hyperinvasion and noninvolved demodicosis hyperinvasion. Clinical finding of typical demodicosis is characterized by polymorphism of rashes (68.2%), presented by follicular papules, including micropustule, microvesicle or spikes on the surface, follicular pustules with yellow purulences (45.5%), presence of mild erythema (22.7%). Sampling while pressing out the content of follicular papules allows to verify the diagnosis in 91.7% of cases. The presence of pyogenic flora and Demodex mites antagonism excludes the necessity of sampling from pustules to verify the diagnosis.
CONCLUSION
Lack of the study of biocenotic interactions between Demodex mites and other agents of skin microbiome shows the necessity of further research in this direction.
