RESUMO
Blepharitis is a very common disease in ophthalmology, dermatology and allergy practice. It generally follows a chronic course and is frequently associated with objective and/or subjective symptoms such as epiphora, red eye, dandruff, gritty sensation, itching, burning, photophobia, and blurred vision. The purpose of this study is to analyze the prevalence of Demodex spp. in patients with symptoms of chronic blepharitis. An analytical cross-sectional study was conducted in the period between 2016 and 2020. All patients with symptoms of chronic blepharitis who underwent a parasitological test of eyelashes (Rapitest) in the Dermatology Department of the Hospital Italiano de Buenos Aires were included. Those with previously established blepharitis due to another infectious cause were excluded. We analyzed 972 patients. Sixty percent (n=585) underwent a positive Rapitest for the presence of Demodex spp. Seventy five percent (n=728) were women. There were no significant differences in the prevalence associated with sex (p=0.38). Among the patients positive for Demodex spp., 65% (n=628) were older than 60 years old. The most frequently associated symptom was itching, present in 35% (n=342). A statistically significant decrease in the number of consultations was observed during the cold months of the year (May-June-July-August). Our results show a high prevalence of Demodex spp. in patients with chronic blepharitis. As its presence reveals a direct association with age, we recommend looking for this parasite in this age group.
Assuntos
Blefarite , Infestações por Ácaros , Ácaros , Animais , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Infestações por Ácaros/epidemiologia , Prevalência , Estudos Transversais , Blefarite/epidemiologia , Blefarite/parasitologia , Prurido/complicaçõesRESUMO
OBJECTIVE: To compare the efficacy of 3 treatment options in patients with chronic blepharitis. METHODOLOGY: An experimental, randomized, controlled study was conducted on 45 patients (female 67%; Mean age: 40.5 years) diagnosed with chronic blepharitis, in order to compare the effectiveness of three treatment options. Group 1: eyelid hygiene with neutral shampoo three times/day; group 2: neutral shampoo eyelid hygiene plus topical metronidazole gel 0.75% twice/day; group 3: neutral eyelid hygiene with shampoo plus neomycin 3.5% and polymyxin 10% antibiotic ointment with 0.5% dexamethasone 3 times/day. The symptoms and signs were assessed by assigning scores from 0: no symptoms and/or signs; 1: mild symptoms and/or signs, 2: moderate symptoms and/or signs; and 3: severe symptoms and/or signs. RESULTS: A significant improvement was observed in the signs and symptoms in all 3 treatment groups. While groups 1 and 2 had more improvement in all variables studied (P<.05), Group 3 showed no clinical improvement for itching (P=.16), dry eye (P=.29), eyelashes falling (P=.16), and erythema at the eyelid margin (P=.29). CONCLUSIONS: Shampoo eyelid hygiene neutral and neutral shampoo combined with the use of metronidazole gel reported better hygiene results than neutral shampoo lid with antibiotic ointment and neomycin and polymyxin dexamethasone.
Assuntos
Antibacterianos/uso terapêutico , Blefarite/terapia , Irrigação Terapêutica , Administração Oftálmica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antibacterianos/administração & dosagem , Blefarite/tratamento farmacológico , Blefarite/microbiologia , Blefarite/parasitologia , Doença Crônica , Dexametasona/administração & dosagem , Dexametasona/uso terapêutico , Pestanas , Feminino , Géis , Preparações para Cabelo , Humanos , Masculino , Metronidazol/administração & dosagem , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Infestações por Ácaros/tratamento farmacológico , Infestações por Ácaros/terapia , Ácaros , Neomicina/administração & dosagem , Neomicina/uso terapêutico , Pomadas , Infecções Pneumocócicas/tratamento farmacológico , Infecções Pneumocócicas/terapia , Polimixinas/administração & dosagem , Polimixinas/uso terapêutico , Índice de Gravidade de Doença , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/terapia , Resultado do Tratamento , Adulto JovemRESUMO
Las blefaritis crónicas son un reto en la práctica clínica porque intervienen varios factores causales que pueden exacerbarlas o predisponer a su recurrencia. La presencia de seborrea o parásitos (ácaros) en los folículos pilosos palpebrales como el Demodex Folliculorum son condiciones que aunque controlables no son de resolución total. El artículo presenta una revisión bibliográfica de las posibilidades terapeúticas en cada caso.