Article Type
Article
Changed
Thu, 01/10/2019 - 13:40
Display Headline
What’s Eating You? Cheyletiella Mites
Author(s)
H. Harris Reynolds, MD
Dirk M. Elston, MD

Identifying Characteristics and Disease Transmission

Cheyletiella are nonburrowing mites characterized by hooklike anterior palps (Figure 1) that have a worldwide distribution. Human dermatitis is the result of contact with an affected animal and may present as papular or bullous lesions. Cheyletiella blakei affects cats, Cheyletiella parasitovorax is found on rabbits, and Cheyletiella yasguri is found on dogs. The mites live in the outer layer of the epidermis of the host animal and feed on surface debris and tissue fluids.1 They complete an entire 35-day life cycle on a single animal host. The larval, nymph, and adult male mites die within 48 hours of separation from a host. The female mite and possibly the eggs can live up to 10 days off the host, which makes environmental decontamination a critical part of pest control.2 In animals, the mite often produces a subtle dermatitis sometimes called walking dandruff (Figure 2).3 Affected animals also can be asymptomatic, and up to 50% of rabbits in commercial colonies may harbor Cheyletiella or other mites.4

Figure 1. Cheyletiella mite with hooklike anterior palps.

Figure 2. Cheyletiella dermatitis in a cat. Image reproduced courtesy of Brooke Army Medical Center (San Antonio, Texas).

The typical human patient with Cheyletiella-associated dermatitis is a female 40 years or younger who presents with grouped pruritic papules.5 Although papules usually are grouped on exposed areas, they also may be widespread.6,7 Bullous eruptions caused by Cheyletiella mites may mimic those found in immunobullous diseases (Figure 3).8 Children may experience widespread dermatitis after taking a nap where a dog has slept.9 Pet owners, farmers, and veterinarians frequently present with zoonotic mite-induced dermatitis.10 Arthralgia and peripheral eosinophilia caused by Cheyletiella infestation also has been reported.11

Figure 3. Bullous reaction to Cheyletiella mites on a patient’s trunk. Image courtesy of Joseph L. Cvancara, MD (Spokane Valley, Washington).

Management of Affected Pets

In a case of human infestation resulting from an affected pet, the implicated pet should be evaluated by a qualified veterinarian. Various diagnostic techniques for animals have been used, including adhesive tape preparations.12 A rapid knockdown insecticidal spray marketed for use on animals has been used to facilitate collection of mites, but some pets may be susceptible to toxicity from insecticides. The scaly area should be carefully brushed with a toothbrush or fine-tooth comb, and all scales, crust, and hair collected should be placed in a resealable plastic storage bag. When alcohol is added to the bag, most contents will sink, but the mites tend to float. Vacuum cleaners fitted with in-line filters also have been used to collect mites. The filter samples can be treated with hot potassium hydroxide, then floated in a concentrated sugar solution to collect the ectoparasites.13 Often, a straightforward approach using a #10 blade to provide a skin scraping from the animal in question is effective.14

Various treatment modalities may be employed by the veterinarian, including dips or shampoos, as well as fipronil.15,16 A single application of fipronil 10% has been shown to be highly effective in the elimination of mites after a single application in cats.17 Oral ivermectin and topical amitraz also have been used.18,19 A veterinarian should treat the animals, as some are more susceptible to toxicity from topical or systemic agents.

Treatment in Humans

Cheyletiella infestations in humans usually are self-limited and resolve within a few weeks after treatment of the source animal. Symptomatic treatment with antipruritic medications and topical steroids may be of use while awaiting resolution. Identification and treatment of the vector is key to eliminating the infestation and preventing recurrence.

References
  1. Angarano DW, Parish LC. Comparative dermatology: parasitic disorders. Clin Dermatol. 1994;12:543-550.
  2. Kunkle GA, Miller WH Jr. Cheyletiella infestation in humans. Arch Dermatol. 1980;116:1345.
  3. Rivers JK, Martin J, Pukay B. Walking dandruff and Cheyletiella dermatitis. J Am Acad Dermatol. 1986;15:1130-1133.
  4. Flatt RE, Wiemers J. A survey of fur mites in domestic rabbits. Lab Animal Sci. 1976;26:758-761.
  5. Lee BW. Cheyletiella dermatitis: a report of fourteen cases. Cutis. 1991;47:111-114.
  6. Cohen SR. Cheyletiella dermatitis. A mite infestation of rabbit, cat, dog and man. Arch Dermatol. 1980;116:435-437.
  7. Bradrup F, Andersen KE, Kristensen S. Infection in man and dog with the mite, Cheyletiella yasguri Smiley [in German]. Hautarzt. 1979;30:497-500.
  8. Cvancara JL, Elston DM. Bullous eruption in a patient with systemic lupus erythematosus: mite dermatitis caused by Cheyletiella blakei. J Am Acad Dermatol. 1997;37:265-267.
  9. Shelley ED, Shelley WB, Pula JF, et al. The diagnostic challenge of nonburrowing mite bites. Cheyletiella yasguri. JAMA. 1984;251:2690-2691.
  10. Beck W. Farm animals as disease vectors of parasitic epizoonoses and zoophilic dermatophytes and their importance in dermatology [in German]. Hautartz. 1999;50:621-628.
  11. Dobrosavljevic DD, Popovic ND, Radovanovic SS. Systemic manifestations of Cheyletiella infestation in man. Int J Dermatol. 2007;46:397-399.
  12. Ottenschot TR, Gil D. Cheyletiellosis in long-haired cats. Tijdschr Diergeneeskd. 1978;103:1104-1108.
  13. Klayman E, Schillhorn van Veen TW. Diagnosis of ectoparasitism. Mod Vet Pract. 1981;62:767-771.
  14. Milley C, Dryden M, Rosenkrantz W, et al. Comparison of parasitic mite retrieval methods in a population of community cats [published online Jun 3, 2016]. J Feline Med Surg. pii:1098612X16650717.
  15. McKeever PJ, Allen SK. Dermatitis associated with Cheyletiella infestation in cats. J Am Vet Med Assoc. 1979;174:718-720.
  16. Chadwick AJ. Use of a 0.25 per cent fipronil pump spray formulation to treat canine cheyletiellosis. J Small Anim Pract. 1997;38:261-262.
  17. Scarampella F, Pollmeier M, Visser M, et al. Efficacy of fipronil in the treatment of feline cheyletiellosis. Vet Parasitol. 2005;129:333-339.
  18. Folz SD, Kakuk TJ, Henke CL, et al. Clinical evaluation of amitraz for treatment of canine scabies. Mod Vet Pract. 1984;65:597-600.
  19. Dourmishev AL, Dourmishev LA, Schwartz RA. Ivermectin: pharmacology and application in dermatology. Int J Dermatol. 2005;44:981-988.
Article PDF
CT099005335.PDF
Author and Disclosure Information

Dr. Reynolds is from Naval Air Station Pensacola, Florida. Dr. Elston is from the Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston.

The authors report no conflict of interest.

The views expressed are those of the authors and are not to be construed as official or as representing those of the US Navy or the Department of Defense. The authors were full-time federal employees at the time portions of this work were completed. The images are in the public domain.

Correspondence: H. Harris Reynolds, MD, Aviation Medicine, Training Air Wing SIX, Naval Air Station Pensacola, 390 San Carlos Rd, Ste C, Pensacola, FL 32508 (hoyt.reynolds@navy.mil).

Issue
Cutis - 99(5)
Publications
Cutis
MDedge Dermatology
Topics
Infectious Diseases
Page Number
335-336, 355
Sections
Environmental Dermatology
Author(s)
H. Harris Reynolds, MD
Dirk M. Elston, MD
Author(s)
H. Harris Reynolds, MD
Dirk M. Elston, MD
Author and Disclosure Information

Dr. Reynolds is from Naval Air Station Pensacola, Florida. Dr. Elston is from the Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston.

The authors report no conflict of interest.

The views expressed are those of the authors and are not to be construed as official or as representing those of the US Navy or the Department of Defense. The authors were full-time federal employees at the time portions of this work were completed. The images are in the public domain.

Correspondence: H. Harris Reynolds, MD, Aviation Medicine, Training Air Wing SIX, Naval Air Station Pensacola, 390 San Carlos Rd, Ste C, Pensacola, FL 32508 (hoyt.reynolds@navy.mil).

Author and Disclosure Information

Dr. Reynolds is from Naval Air Station Pensacola, Florida. Dr. Elston is from the Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston.

The authors report no conflict of interest.

The views expressed are those of the authors and are not to be construed as official or as representing those of the US Navy or the Department of Defense. The authors were full-time federal employees at the time portions of this work were completed. The images are in the public domain.

Correspondence: H. Harris Reynolds, MD, Aviation Medicine, Training Air Wing SIX, Naval Air Station Pensacola, 390 San Carlos Rd, Ste C, Pensacola, FL 32508 (hoyt.reynolds@navy.mil).

Article PDF
CT099005335.PDF
Article PDF
CT099005335.PDF
Related Articles
What’s Eating You? Lone Star Tick (Amblyomma americanum)
Aquatic Antagonists: Cutaneous Sea Urchin Spine Injury
What’s Eating You? Ant-Induced Alopecia (Pheidole)

Identifying Characteristics and Disease Transmission

Cheyletiella are nonburrowing mites characterized by hooklike anterior palps (Figure 1) that have a worldwide distribution. Human dermatitis is the result of contact with an affected animal and may present as papular or bullous lesions. Cheyletiella blakei affects cats, Cheyletiella parasitovorax is found on rabbits, and Cheyletiella yasguri is found on dogs. The mites live in the outer layer of the epidermis of the host animal and feed on surface debris and tissue fluids.1 They complete an entire 35-day life cycle on a single animal host. The larval, nymph, and adult male mites die within 48 hours of separation from a host. The female mite and possibly the eggs can live up to 10 days off the host, which makes environmental decontamination a critical part of pest control.2 In animals, the mite often produces a subtle dermatitis sometimes called walking dandruff (Figure 2).3 Affected animals also can be asymptomatic, and up to 50% of rabbits in commercial colonies may harbor Cheyletiella or other mites.4

Figure 1. Cheyletiella mite with hooklike anterior palps.

Figure 2. Cheyletiella dermatitis in a cat. Image reproduced courtesy of Brooke Army Medical Center (San Antonio, Texas).

The typical human patient with Cheyletiella-associated dermatitis is a female 40 years or younger who presents with grouped pruritic papules.5 Although papules usually are grouped on exposed areas, they also may be widespread.6,7 Bullous eruptions caused by Cheyletiella mites may mimic those found in immunobullous diseases (Figure 3).8 Children may experience widespread dermatitis after taking a nap where a dog has slept.9 Pet owners, farmers, and veterinarians frequently present with zoonotic mite-induced dermatitis.10 Arthralgia and peripheral eosinophilia caused by Cheyletiella infestation also has been reported.11

Figure 3. Bullous reaction to Cheyletiella mites on a patient’s trunk. Image courtesy of Joseph L. Cvancara, MD (Spokane Valley, Washington).

Management of Affected Pets

In a case of human infestation resulting from an affected pet, the implicated pet should be evaluated by a qualified veterinarian. Various diagnostic techniques for animals have been used, including adhesive tape preparations.12 A rapid knockdown insecticidal spray marketed for use on animals has been used to facilitate collection of mites, but some pets may be susceptible to toxicity from insecticides. The scaly area should be carefully brushed with a toothbrush or fine-tooth comb, and all scales, crust, and hair collected should be placed in a resealable plastic storage bag. When alcohol is added to the bag, most contents will sink, but the mites tend to float. Vacuum cleaners fitted with in-line filters also have been used to collect mites. The filter samples can be treated with hot potassium hydroxide, then floated in a concentrated sugar solution to collect the ectoparasites.13 Often, a straightforward approach using a #10 blade to provide a skin scraping from the animal in question is effective.14

Various treatment modalities may be employed by the veterinarian, including dips or shampoos, as well as fipronil.15,16 A single application of fipronil 10% has been shown to be highly effective in the elimination of mites after a single application in cats.17 Oral ivermectin and topical amitraz also have been used.18,19 A veterinarian should treat the animals, as some are more susceptible to toxicity from topical or systemic agents.

Treatment in Humans

Cheyletiella infestations in humans usually are self-limited and resolve within a few weeks after treatment of the source animal. Symptomatic treatment with antipruritic medications and topical steroids may be of use while awaiting resolution. Identification and treatment of the vector is key to eliminating the infestation and preventing recurrence.

Identifying Characteristics and Disease Transmission

Cheyletiella are nonburrowing mites characterized by hooklike anterior palps (Figure 1) that have a worldwide distribution. Human dermatitis is the result of contact with an affected animal and may present as papular or bullous lesions. Cheyletiella blakei affects cats, Cheyletiella parasitovorax is found on rabbits, and Cheyletiella yasguri is found on dogs. The mites live in the outer layer of the epidermis of the host animal and feed on surface debris and tissue fluids.1 They complete an entire 35-day life cycle on a single animal host. The larval, nymph, and adult male mites die within 48 hours of separation from a host. The female mite and possibly the eggs can live up to 10 days off the host, which makes environmental decontamination a critical part of pest control.2 In animals, the mite often produces a subtle dermatitis sometimes called walking dandruff (Figure 2).3 Affected animals also can be asymptomatic, and up to 50% of rabbits in commercial colonies may harbor Cheyletiella or other mites.4

Figure 1. Cheyletiella mite with hooklike anterior palps.

Figure 2. Cheyletiella dermatitis in a cat. Image reproduced courtesy of Brooke Army Medical Center (San Antonio, Texas).

The typical human patient with Cheyletiella-associated dermatitis is a female 40 years or younger who presents with grouped pruritic papules.5 Although papules usually are grouped on exposed areas, they also may be widespread.6,7 Bullous eruptions caused by Cheyletiella mites may mimic those found in immunobullous diseases (Figure 3).8 Children may experience widespread dermatitis after taking a nap where a dog has slept.9 Pet owners, farmers, and veterinarians frequently present with zoonotic mite-induced dermatitis.10 Arthralgia and peripheral eosinophilia caused by Cheyletiella infestation also has been reported.11

Figure 3. Bullous reaction to Cheyletiella mites on a patient’s trunk. Image courtesy of Joseph L. Cvancara, MD (Spokane Valley, Washington).

Management of Affected Pets

In a case of human infestation resulting from an affected pet, the implicated pet should be evaluated by a qualified veterinarian. Various diagnostic techniques for animals have been used, including adhesive tape preparations.12 A rapid knockdown insecticidal spray marketed for use on animals has been used to facilitate collection of mites, but some pets may be susceptible to toxicity from insecticides. The scaly area should be carefully brushed with a toothbrush or fine-tooth comb, and all scales, crust, and hair collected should be placed in a resealable plastic storage bag. When alcohol is added to the bag, most contents will sink, but the mites tend to float. Vacuum cleaners fitted with in-line filters also have been used to collect mites. The filter samples can be treated with hot potassium hydroxide, then floated in a concentrated sugar solution to collect the ectoparasites.13 Often, a straightforward approach using a #10 blade to provide a skin scraping from the animal in question is effective.14

Various treatment modalities may be employed by the veterinarian, including dips or shampoos, as well as fipronil.15,16 A single application of fipronil 10% has been shown to be highly effective in the elimination of mites after a single application in cats.17 Oral ivermectin and topical amitraz also have been used.18,19 A veterinarian should treat the animals, as some are more susceptible to toxicity from topical or systemic agents.

Treatment in Humans

Cheyletiella infestations in humans usually are self-limited and resolve within a few weeks after treatment of the source animal. Symptomatic treatment with antipruritic medications and topical steroids may be of use while awaiting resolution. Identification and treatment of the vector is key to eliminating the infestation and preventing recurrence.

References
  1. Angarano DW, Parish LC. Comparative dermatology: parasitic disorders. Clin Dermatol. 1994;12:543-550.
  2. Kunkle GA, Miller WH Jr. Cheyletiella infestation in humans. Arch Dermatol. 1980;116:1345.
  3. Rivers JK, Martin J, Pukay B. Walking dandruff and Cheyletiella dermatitis. J Am Acad Dermatol. 1986;15:1130-1133.
  4. Flatt RE, Wiemers J. A survey of fur mites in domestic rabbits. Lab Animal Sci. 1976;26:758-761.
  5. Lee BW. Cheyletiella dermatitis: a report of fourteen cases. Cutis. 1991;47:111-114.
  6. Cohen SR. Cheyletiella dermatitis. A mite infestation of rabbit, cat, dog and man. Arch Dermatol. 1980;116:435-437.
  7. Bradrup F, Andersen KE, Kristensen S. Infection in man and dog with the mite, Cheyletiella yasguri Smiley [in German]. Hautarzt. 1979;30:497-500.
  8. Cvancara JL, Elston DM. Bullous eruption in a patient with systemic lupus erythematosus: mite dermatitis caused by Cheyletiella blakei. J Am Acad Dermatol. 1997;37:265-267.
  9. Shelley ED, Shelley WB, Pula JF, et al. The diagnostic challenge of nonburrowing mite bites. Cheyletiella yasguri. JAMA. 1984;251:2690-2691.
  10. Beck W. Farm animals as disease vectors of parasitic epizoonoses and zoophilic dermatophytes and their importance in dermatology [in German]. Hautartz. 1999;50:621-628.
  11. Dobrosavljevic DD, Popovic ND, Radovanovic SS. Systemic manifestations of Cheyletiella infestation in man. Int J Dermatol. 2007;46:397-399.
  12. Ottenschot TR, Gil D. Cheyletiellosis in long-haired cats. Tijdschr Diergeneeskd. 1978;103:1104-1108.
  13. Klayman E, Schillhorn van Veen TW. Diagnosis of ectoparasitism. Mod Vet Pract. 1981;62:767-771.
  14. Milley C, Dryden M, Rosenkrantz W, et al. Comparison of parasitic mite retrieval methods in a population of community cats [published online Jun 3, 2016]. J Feline Med Surg. pii:1098612X16650717.
  15. McKeever PJ, Allen SK. Dermatitis associated with Cheyletiella infestation in cats. J Am Vet Med Assoc. 1979;174:718-720.
  16. Chadwick AJ. Use of a 0.25 per cent fipronil pump spray formulation to treat canine cheyletiellosis. J Small Anim Pract. 1997;38:261-262.
  17. Scarampella F, Pollmeier M, Visser M, et al. Efficacy of fipronil in the treatment of feline cheyletiellosis. Vet Parasitol. 2005;129:333-339.
  18. Folz SD, Kakuk TJ, Henke CL, et al. Clinical evaluation of amitraz for treatment of canine scabies. Mod Vet Pract. 1984;65:597-600.
  19. Dourmishev AL, Dourmishev LA, Schwartz RA. Ivermectin: pharmacology and application in dermatology. Int J Dermatol. 2005;44:981-988.
References
  1. Angarano DW, Parish LC. Comparative dermatology: parasitic disorders. Clin Dermatol. 1994;12:543-550.
  2. Kunkle GA, Miller WH Jr. Cheyletiella infestation in humans. Arch Dermatol. 1980;116:1345.
  3. Rivers JK, Martin J, Pukay B. Walking dandruff and Cheyletiella dermatitis. J Am Acad Dermatol. 1986;15:1130-1133.
  4. Flatt RE, Wiemers J. A survey of fur mites in domestic rabbits. Lab Animal Sci. 1976;26:758-761.
  5. Lee BW. Cheyletiella dermatitis: a report of fourteen cases. Cutis. 1991;47:111-114.
  6. Cohen SR. Cheyletiella dermatitis. A mite infestation of rabbit, cat, dog and man. Arch Dermatol. 1980;116:435-437.
  7. Bradrup F, Andersen KE, Kristensen S. Infection in man and dog with the mite, Cheyletiella yasguri Smiley [in German]. Hautarzt. 1979;30:497-500.
  8. Cvancara JL, Elston DM. Bullous eruption in a patient with systemic lupus erythematosus: mite dermatitis caused by Cheyletiella blakei. J Am Acad Dermatol. 1997;37:265-267.
  9. Shelley ED, Shelley WB, Pula JF, et al. The diagnostic challenge of nonburrowing mite bites. Cheyletiella yasguri. JAMA. 1984;251:2690-2691.
  10. Beck W. Farm animals as disease vectors of parasitic epizoonoses and zoophilic dermatophytes and their importance in dermatology [in German]. Hautartz. 1999;50:621-628.
  11. Dobrosavljevic DD, Popovic ND, Radovanovic SS. Systemic manifestations of Cheyletiella infestation in man. Int J Dermatol. 2007;46:397-399.
  12. Ottenschot TR, Gil D. Cheyletiellosis in long-haired cats. Tijdschr Diergeneeskd. 1978;103:1104-1108.
  13. Klayman E, Schillhorn van Veen TW. Diagnosis of ectoparasitism. Mod Vet Pract. 1981;62:767-771.
  14. Milley C, Dryden M, Rosenkrantz W, et al. Comparison of parasitic mite retrieval methods in a population of community cats [published online Jun 3, 2016]. J Feline Med Surg. pii:1098612X16650717.
  15. McKeever PJ, Allen SK. Dermatitis associated with Cheyletiella infestation in cats. J Am Vet Med Assoc. 1979;174:718-720.
  16. Chadwick AJ. Use of a 0.25 per cent fipronil pump spray formulation to treat canine cheyletiellosis. J Small Anim Pract. 1997;38:261-262.
  17. Scarampella F, Pollmeier M, Visser M, et al. Efficacy of fipronil in the treatment of feline cheyletiellosis. Vet Parasitol. 2005;129:333-339.
  18. Folz SD, Kakuk TJ, Henke CL, et al. Clinical evaluation of amitraz for treatment of canine scabies. Mod Vet Pract. 1984;65:597-600.
  19. Dourmishev AL, Dourmishev LA, Schwartz RA. Ivermectin: pharmacology and application in dermatology. Int J Dermatol. 2005;44:981-988.
Issue
Cutis - 99(5)
Issue
Cutis - 99(5)
Page Number
335-336, 355
Page Number
335-336, 355
Publications
Cutis
MDedge Dermatology
Publications
Cutis
MDedge Dermatology
Topics
Infectious Diseases
Article Type
Article
Display Headline
What’s Eating You? Cheyletiella Mites
Display Headline
What’s Eating You? Cheyletiella Mites
Sections
Environmental Dermatology
Inside the Article

Practice Points

  • Cheyletiella mites can cause a range of cutaneous and systemic symptoms in affected individuals.
  • Diagnosis can be difficult and requires a high level of suspicion, with inquiries directed at animal exposures.
  • Identification of the animal vector and treatment by a knowledgeable veterinarian is necessary to prevent recurrence in humans.
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Teaser Media
Article PDF Media