Demodex spp. Infestation in a breast-cancer patient: A case report
A 45 year-old female has been admitted to oncology clinic for a medical treatment of breast cancer. Utilizing the National Comprehensive Cancer Network guidelines (NCCN), patient's stage was T2N1MO and we have decided to apply adjuvant chemotherapy of Adriamycin, cyclophosphamide and 5-fluorouracil. Her systemic physical examination was normal except redness on her cheeks and forehead. The patient skin type was oily and her face-washing habit was use of hand soap twice a day. There was no abnormality in biochemical and haematological laboratory values. Due to the itchy redness on her cheeks and forehead, we had performed an examination for demodex before chemotherapy; and we have identified 20 mites/cm2 on her right and left cheeks, and 15 mites/cm2 on her forehead. D. folliculorum was sought in the lesion sites using the non-invasive method, known as standardised skin surface biopsy (SSSB). When our patient came to our clinic with increasing complaint of itchy rash after the first course of chemotherapy, we have reexamined demodex. The result of microscopic examination revealed large amount of demodex of 50 mites/cm2 on her right and left cheeks and 30 mites/cm2 on her forehead, which were significantly higher than the first detection results [Figures and ]. This increase probably was associated with immune suppression caused by chemotherapy.