Demodex-associated Folliculitis : The American Journal of Dermatopathology

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Letters To The Editor

Demodex-associated Folliculitis

Forton, Fabienne M.D.

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The American Journal of Dermatopathology 20(5):p 536-537, October 1998.
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To the Editor:

I appreciated R. Vollmer's interesting study, published in the American Journal of Dermatopathology in 1996 (1). I published a comparable study in 1986 (2) and am glad to find that Dr. Vollmer found similar results.

  1. I analyzed 69 skin biopsies, each containing at least 3 Demodex. He analyzed 24 biopsies, containing at least 1 Demodex.
  2. I found Demodex in 56% of inflamed follicles (n = 287) and in only 29% of noninflamed follicles (n = 423) (p < 0.001). He found Demodex in 42% of inflamed follicles (n = 208) and in only 10% of non-inflamed follicles (n = 180) (p < 0.0009).
  3. I found inflammation in 57% of follicles with Demodex (n = 284) and in 29% of follicles without Demodex (n = 426) (p < 0.001). He found inflammation in 83% of follicles with Demodex (n = 105) and in 43% of follicles without Demodex (n = 283) (p < 0.0009).

Dr. Vollmer writes: "The most elegant study to relate the number of mites to clinical rosacea was that of Bonnar et al. (3)." I published a comparable study in the same year, 1993, also with cyanoacrylate glue, and introduced the concept of standardized skin surface biopsy to evaluate the Demodex density (4). I was also glad to find that Bonnar et al.'s results were comparable with mine.

I appreciate the interesting study of Dr. Vollmer, but I do not understand why he did not refer to my first nor my second work, which are both closely related to his study and his discussion.

Fabienne Forton, M.D.

Brussels, Belgium


1. Vollmer RT. Demodex-associated folliculitis. Am J Dermatopathol 1996;18:589-91.
2. Forton F. Demodex et inflammation périfolliculaire chez l'homme: revue et observation de 69 biopsies. Ann Dermatol Venereol 1986;113:1047-58.
3. Bonnar E, Eustace P, Powell FC. The Demodex mite population in rosacea. J Am Acad Dermatol 1993;28:443-8.
4. Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case control study using standardized skin-surface biopsy. Br J Dermatol 1993;128:650-9.
© 1998 Lippincott Williams & Wilkins, Inc.