Demodecosis in Humans. Time to listen, understand, revise and accept

In the book series "Writers Talk about Science", the stories of the most important discoveries of mankind in different fields of knowledge are published. Among them there are sometimes the very incredible stories. But so it was indeed. While reading publications or listening to my speeches at conferences, congresses, etc., did anyone think that such a situation possibly exists? Many colleagues were aware of the seriousness of the topic set forth herein which is evidenced by their publications and statements during the years after they met me. There are firms that, faithfully citing my publications, have set up the production of anti-demodectic cosmetics. The pharmaceutical industry, household industry, and network marketing have further ramped up their activities after my numerous calls to streamline the abatement efforts against demodexes and dust mites. It is well known that the microscopic mite of Demodex genus is found in all humans on all continents. However, in medicine, human demodecosis has neither been studied, nor described comprehensively.

Our research began with an accidental viewing of a patient whose skin on the face had burgundy colour, lemon-peel texture and a shape of a flying-butterfly (diagnose: Discoid lupus erythematosus). From the focus of lesion of that patient, up to 15 mobile Demodex sp. per field of vision were found, but dermatologists still deemed her safe for surrounding people. At that period of time, the skin of humans was healthier than it is at present and looked soft and clean. On such skin, the subtlest changes were easy to notice. Prior to the said period, we had been supervising patients with chronic active hepatitis (CAH) in the in-patient hospital. We had in place a methodology of clinical follow-up of the state of the skin of supervised patients with CAH. Therefore, when we began to monitor the state of the skin of other patients surrounding to the patient in the hospital, the visitors, service personnel, we began to notice, without special effort, the changes occurring on the skin of the open parts of the body of these people. So gradually we learned to recognize the signs of damage caused by demodexes to healthy skin and became involuntary observers of the spread of demodecosis among the people around us.

Continuing to monitor the skin of open parts of the body in surrounding people, we noticed the snowballing type of the spread of demodecosis and by the period of defense of the PhD degree we had a clear idea of the presence of unregistered infection among the population. However, on the background of highly developed medicine the presence of undiagnosed infection seemed implausible. Therefore on 10-VIII-1980, we self-infected with demodecosis. Its result was not long in coming.

In order to retest our findings, we arranged an examination of the entire skin of people in collectives and revealed the initial stage of demodecosis in 96% of 388,880 examined people. In 1981, daily examination of the skin of open parts of body of residents and guests of Almaty showed a catastrophic decrease in the number of people who had healthy skin (from 27% in January to 0.2% in August). In the years that followed, we encountered no persons with healthy skin.

After submitting to the Ministry of Healthcare of the report on the presence of unregistered demodecosis in the population, we were obliged to prove our position. For this purpose, for two weeks we worked in the premises of the Republican Dermatovenerologic Institute attended by seven members of the organized Commission. At that, in all 37, without exception, in-patients and out-patients who were selected by me, demodexes at different stages of development were found in the contents of 42 pathological elements of the skin. That is from the skin of back, foot, hindhead, neck, hips, shoulders, legs, hands of patients demodexes were extracted at the stage of egg, larvae, nymph-1, nymph-2, imago — a fact that was proof of the absolute pathogenicity of these mites for humans. Leadership of the Dermatovenerologic Institute did not favor the setting up of a demodecosis laboratory in Almaty but issued several brochures on demodexes marked as "Classified" and "Not Open Public".

The period from 1982 to 1990 was complicated by the fact that there was practically no possibility of actively conducting research. To continue the observations, I was urged to turn the allergist-dermatologist and move to the provincial city. The theoretical results applied for treatment of patients gave amazing results.

According to our involuntary visual observations, demodecosis among the surrounding people continues to progress with each passing year. After the collapse of the USSR, we, on our own, set up a scientific medical small enterprise "Saule", to where we invited to work V.N. Kusov (acarologist, Doctor of Biological Sciences) and laboratory technicians. The problem of Demodecosis was, as far as possible, re-explored by us comprehensively. Visual signs of mite lesion to the smooth skin were rechecked by the challenge method (Zhaxylykova, R.D., Malikov, A.M. 1982) in 8,551 people, among whom were 366 patients with allergies and 2,123 patients with allergodermatoses. Thereat, 25849 papules appeared on the examined skin. Colonies of demodexes were found in the content of 92% of 1,927 examined papules.

From 17,824 acarologically examined, Demodexes were found in 98.1%, Dermatophagoidesses were found in 0.5%, Sarcoptes scabiei - in 0.6%, onion mites, gamasid and other mites were found in 0.5%; and no mites were found in 0.3% of the affected. In 2.4% of those examined, Demodex sp., Dermatophagoides sp., and Sarcoptes scabiei were found concomitantly. In 18 people with healthy skin, all of the applied methods could find mites neither on nor in the skin. In 242 patients with pruritic diseases, 247 patients with acne disease, 18 people with atheroma, 12 ophthalmic patients with halazion, colonies of demodexes were found in the contents of all examined pathological elements of the skin. Anti-mite treatment provided full recovery to these patients, which allowed to think that they had mite disease, and to deem the prior diagnoses to be the variants of the clinical masks of demodecosis.

Targeted anti-mite treatment provided recovery in 92% of 43,198 admitted. Before they applied to us, those patients had been followed up with diagnoses: allergologic - 57.7%; dermatologic - 37.4%; ophthalmologic - 1.4%; rheumatologic - 1.2%; oncologic - 0.5%; gynecologic - 0.4%; endocrinologic - 0.4%; surgical - 0.3%; urological - 0.2%; psychiatric - 0.1%. In modern medicine, above-listed diagnoses are classified as non-communicable diseases (NCDs), however, the positive outcome of the anti-mite treatment testified to the demodectic etiology of the disease in treated cases.

In clinical medicine, demodectic blepharoconjunctivitis, red acne and discoid lupus erythematosus are diagnosed as separate diseases (Vostroknutova, T.M., Mokronosova, M.A. 2007). However, at demodecosis the skin and visible mucous membranes are totally affected by demodexes, therefore treatment of local manifestations of demodecosis does not provide complete recovery. This assertion is confirmed by complete recovery of 2,620 patients with acne disease, 49 patients with discoid lupus erythematosus, and 86 patients with demodectic blepharoconjunctivitis.

It should be emphasized that in recent years, patients have increasingly complained of itching and insects crawling in the muscles of the thigh, inside of the bronchi, nose sinuses, genitals, etc. Allergists have noted an increase in allergies of internal organs. The above cumulative information aims at the need to investigate internal organs with respect to their affection by demodexes.

It is well known that components of bodies and excreta of mites are foreign to the human body, i.e. are allergenic. An immunocompetent body always produces antibodies (Ab) to allergens (Ag). Revealed by us, the fact of snowballing spread of demodecosis among the population in 1970s, among other reasons, could therefore be a harbinger of that allergy whose exponential growth was noted by specialists at the close of the past century. Manifestations of allergy, as demodecosis, first start on the skin and mucous membranes that communicate with the external environment. As demodecosis progresses, the number of absorbed Ag and that of formed in response to them Ab increase. Gradually, the number of Ab reaches the maximum and then the antibody-producing function of the host organism begins to weaken. So, first the picture develops of immunocompromise, followed by that of immune deficiency, described in detail by researchers, in the presence of parasitic superinvasion in the skin and entire body (De Dulanto, F., Camacho-Martinez, F. 1979).

The results of some facts reported in the scientific literature are quite explainable from the point of view of demodecosis which actually exists, but was revealed by us. For example, the allergy indicator IgE in the blood of patients with pollinosis, whom the researchers relocated to the environment of the extreme North, increased because there were demodexes in their body, although there was no pollen in the air. Description of the sensations of people who have experienced anaphylactic shock in the form of a total stirring of insects in the body and unbearable itching, also speaks in favor of the mite underlying cause of these reactions. The prolonged (since 1841) coexistence of demodexes with humans, according to the laws of biology, could well develop from symbiosis to ecto-, and then - to endoparasitism (Scriabin, K.I. 1923). As confirmation of the latter may be the growth of allergies from the internal organs, which has been noted by allergists. Some researchers have been trying to develop immunotherapy for allergies to mites (Zeytun E., S. Dogan S., Ünver E., Özcucek F. 2018), which is impossible because immunity to mites never develops, and it is an axiom.

In humans, the favorite places for demodexes are skin, mucous and serous membranes derivatives. When subcutaneous fat tissue is affected, a "creak of snow" under the fingers is observed, its airiness increases. Currently, the most outstanding clinical signs of demodecosis are: red (different shades) colour of the face and/or of all skin, alopecia, unpleasant body odor, a variant of obesity, cellulite, and others.

The attack rate of demodexes at all the inhabitants of the Earth and the global prevalence of clinical masks of demodecosis among the NCDs are evidence to the pandemic spread of demodecosis. At the same time, NCDs are the most common cause of death worldwide (World Health Statistics. 2013). Therefore, if demodecosis is involved in the doubling of the incidence of some NCDs and the projected doubling of the incidence of other NCDs, then the elimination of the pandemic demodecosis should ensure a reduction in morbidity and mortality of people from NCDs (Zhaxylykova, R. 2016).

Researchers have revealed: on their surface and inside of their body, demodexes carry microorganisms smaller than themselves, such as viruses, bacteria, protozoa, eggs of helminths, etc. (Gupta, S.K. 2010). These microorganisms can get into the macroorganism from external cover of demodexes, at their death or with their excrement, then activate and, in turn, cause in the macroorganism the disease of various organs and systems of bacterial, viral, fungal, or of other nature. Such a situation sooner or later develops in the body of the affected by demodexes, therefore demodecosis is a primary chronic associative disease.

Thus, our research suggests that the Demodex mite is not currently a symbiont of human skin. It inhabits in colonies in countless derivatives of the skin and visible mucous membranes of humans and causes human demodecosis. Like Demodex, the demodecosis it causes, is spread pandemically. Demodecosis is a primary chronic immune associative infectious disease, manifestations and complications of which, due to the lack of proper abatement, are progressing year by year and continue to spread. Demodecosis and its clinical masks are not diagnosed and therefore are treated incorrectly. Timely diagnosis and development of effective treatments for clinical masks of demodecosis should reduce the morbidity of people from a large part of so widely widespread and continuing to spread NCDs in humans. We have been informing the competent authorities about this for 38 years through appeals, publications, speeches at congresses and conferences, via the website www.allergy.kz, etc. It's time for colleagues to listen, comprehend, re-check and then make the necessary decision.