medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-339medsovet-9406Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESСпорные вопросы гиперинвазии клещами рода Demodex при розацеа и акнеControversial issues of hyperinfestation with Demodex mites in rosacea and acnehttps://orcid.org/0000-0003-3261-6718ТамразоваО. Б.TamrazovaO. B.

Тамразова Ольга Борисовна - профессор РАН, д.м.н., профессор кафедры детских инфекционных болезней, Российская медицинская академия непрерывного медицинского образования; руководитель службы детской дерматологии, Детская городская клиническая больница имени З.А. Башляевой;

125993, Москва, ул. Баррикадная, д. 2/1, стр. 1; 125373, Москва, ул. Героев Панфиловцев, д. 28

Olga B. Tamrazova - Dr. Sci. (Med.), Professor RAS, Professor of the Department of Pediatric Infectious Diseases, Russian Medical Academy of Continuous Professional Education; Head of Children Dermatology Department, Bashlyaeva City Children’s Clinical Hospital.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993; 28, Geroev Panfilovtsev St., Moscow, 125373

anait_tamrazova@mail.ruhttps://orcid.org/0000-0002-4672-697XТамразоваА. В.TamrazovaA. V.

Тамразова Анаит Вардановна - к.м.н., доцент кафедры дерматовенерологии и косметологии.

121359, Москва, ул. Маршала Тимошенко, д. 19, стр. 1а

Anait V. Tamrazova - Cand. Sci. (Med.), Associate Professor at the Department of Dermatovenerology and Cosmetology.

19, Bldg. 1а, Marshal Timoshenko St., Moscow, 150000

anaittamrazova@gmail.comhttps://orcid.org/0000-0003-4615-7356БаграмоваГ. Э.BagramovaG. E.

Баграмова Гаянэ Эрнстовна - д.м.н., профессор кафедры пластической и эстетической хирургии с курсом дерматологии.

125371, Москва, Волоколамское шоссе, д. 91

Gayane E. Bagramova - Dr. Sci. (Med.), Professor of the Department of Plastic and Aesthetic Surgery with a Course in Dermatology.

91, Volokolamskoe Shosse, Moscow, 125371

bagramovaga@mail.ruРоссийская медицинская академия непрерывного медицинского образования; Детская городская клиническая больница имени З.А. БашляевойРоссияRussian Medical Academy of Continuous Professional Education; Bashlyaeva City Children’s Clinical HospitalRussian FederationЦентральная государственная медицинская академия Управления делами Президента Российской ФедерацииРоссияCentral State Medical Academy of Department for Presidential Affairs of the Russian FederationRussian FederationФедеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий Федерального медико-биологического агентства РоссииРоссияFederal Clinical Research Centre for Specialized Healthcare and Medical Technology of Russia’s Federal Medical-Biological AgencyRussian Federation2025300920250145762Copyright © Тамразова О.Б., Тамразова А.В., Баграмова Г.Э., 20252025Тамразова О.Б., Тамразова А.В., Баграмова Г.Э.Tamrazova O.B., Tamrazova A.V., Bagramova G.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/9406

Клещи рода Demodeх (D. folliculorum и D. brevis) являются наиболее распространенными эктопаразитами на коже человека, частота носительства которых достигает 100% в старших возрастных группах. Большая часть населения является бессимптомными носителями, однако увеличение колоний клещей рода Demodeх, наблюдаемое при снижении активности врожденного иммунитета, а также при дисфункции эпидермального барьера, может приводить к ферментативному повреждению структур сально-волосяного фолликула, механическому закрытию протока сальных желез, активации провоспалительных цитокинов, а также изменению микробного равновесия в коже, что является одним из ключевых факторов патогенеза заболеваний сальных желез. Впервые обнаруженные почти два столетия назад, они до сих пор остаются предметом дискуссий, посвященных их роли как в нормальном микробиоме кожи, так и в патогенезе таких заболеваний, как акне, розацеа, периоральный, себорейный дерматит и др. В обзоре представлены современные научные данные об этиологии, эпидемиологии и патогенетической роли клещей рода Demodeх в развитии акне и розацеа – наиболее распространенных заболеваний сальных желез, а также предложены методы этиотропной коррекции клещевой гиперинвазии. Роль бактерий в патогенезе розацеа несомненна и подтверждается эффективностью антибиотиков тетрациклинового ряда, которые не проявляют активность в отношении самих клещей рода Demodex. Тем не менее на сегодняшний день мнения исследователей расходятся относительно того, связаны ли положительные эффекты тетрациклинов при розацеа с их противомикробным действием или в большей степени с присущей им противовоспалительной активностью.

Demodex mites (D. folliculorum and D. brevis) are the most common ectoparasites found on human skin, with carriage rates reaching up to 100% in older age groups. The majority of the population are asymptomatic carriers; however, an increase in Demodex mite colonies, observed with decreased innate immune activity and epidermal barrier dysfunction, can lead to enzymatic damage of pilosebaceous follicle structures, mechanical blockage of sebaceous gland ducts, activation of pro-inflammatory cytokines, and disruption of microbial balance in the skin. These factors are key in the pathogenesis of sebaceous gland diseases. First identified nearly two centuries ago, Demodex mites remain a subject of ongoing debate regarding their role both in the normal skin microbiome and in the pathogenesis of diseases such as acne, rosacea, perioral dermatitis, seborrheic dermatitis, and others. This review presents current scientific data on the etiology, epidemiology, and pathogenetic role of Demodex mites in the development of acne and rosacea – the most common sebaceous gland diseases. Additionally, methods for etiotropic correction of mite hyperinfestation are proposed.

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The authors declare that there are no conflicts of interest present.