Demodex folliculorum and Demodex brevis are external parasites that reside in human hair follicles and sebaceous glands, most commonly on the cheeks, chin, nose, and eyelids, inhabiting the eyelash follicles. The prevalence of Demodex spp. varies with age. The highest concentration of mites is observed in older people, being almost 100%, and the lowest is found in children. Although the presence of parasites does not directly lead to the development of pathological symptoms, their high density is associated with diseases such as rosacea or blepharitis. This manuscript delves into the biological characteristics of Demodex folliculorum and Demodex brevis with consideration of current diagnostic techniques for detecting Demodex mites. It also aims to provide an in-depth analysis of the role Demodex mites play in the development of various dermatological conditions, with a review of the current therapeutic approaches for managing Demodex-related diseases.

Superficial fungal infections (SFIs) remain a common dermatological issue in the pediatric population, with varying prevalence across regions and age groups. This study aimed to assess the epidemiology of SFIs among children and adolescents in northern Poland in the years 2019 to 2024. A retrospective analysis was conducted on 1237 patients under 18 years of age who underwent direct mycological examination and culture, due to suspicion of SFIs. Data were evaluated based on age, gender, infection site, fungal species identified, and place of residence. The prevalence of SFIs in the studied population was 21.4%. The most frequently isolated fungi were Microsporum canis and Trichophyton rubrum complex. Infection patterns varied by age: tinea capitis and tinea cutis glabrae predominated in younger children, while adolescents were more affected by tinea pedis and onychomycosis. A higher proportion of positive results was observed in rural patients, although more urban dwellers were tested. Species distribution also varied with gender and place of residence. No significant change in SFI prevalence or pathogen profile was observed over the study period. This study provides updated insights into the epidemiology of SFIs in Polish children, highlighting the influence of demographic and environmental factors. The findings underscore the importance of accurate diagnosis and suggest a need for further research into behavioral and socio-economic contributors to infection patterns.

Superficial fungal infections are common conditions affecting the skin, hair, and nails, primarily caused by dermatophytes, yeasts, and less frequently, molds. Humid climates, prolonged summer seasons, immunodeficiencies, diabetes and socioeconomic factors such as poor hygiene and overcrowding promote them. Children are particularly susceptible due to their immature immune systems and other contributing factors. The infections are classified based on the site involved and include, among others, scalp infections, athlete’s foot, or nail infections (onychomycosis). Scalp mycoses are primarily caused by dermatophytes of the genera Trichophyton and Microsporum, which may originate from human or animal sources. Onychomycosis is rare in young children, with Trichophyton rubrum and Trichophyton mentagrophytes being the most frequently isolated pathogens. The increasing incidence in pediatric populations is linked to atopy, immune disorders, and immunosuppressive therapies. Treatment involves topical and systemic medications, depending on the location and severity of the infection. Maintaining proper hygiene, addressing risk factors, and monitoring therapy are essential to prevent recurrence. Focusing on children, this review explores current epidemiological trends, diagnostic practices, and treatment options related to superficial fungal infections.

Off-label treatment is the use of a drug approved for marketing, outside the registration in terms of indication, age group, dose or route of administration. Despite the constant appearance of new preparations on the market, treatment outside the SmPCs guidelines is a current clinical problem. It is believed that it is based on the needs of patients unmet by classical therapy methods. This work focuses on off-label treatment in inflammatory dermatoses such as atopic dermatitis, psoriasis, acne vulgaris and rosacea. Publications on this subject, available on PubMed, Google Scholar and the Cochrane Library, were analyzed in the form of a review, taking into account the mechanisms of action, efficacy and safety of preparations. Based on the literature analysis, it can be concluded that the use of drugs outside the SmPC indications is a common situation in dermatology. However, it is difficult to determine its exact frequency—there is a lack of data on the prevalence of off-label appliances in inflammatory dermatoses from a European perspective. Publications demonstrate varying effectiveness and safety of this form of therapy, depending on the specific preparation. Off-label treatment in dermatology remains an important and current clinical issue that should be explored in further research.

The presence of Demodex spp. mites on the skin is a common phenomenon in the human population. In most people, it is an asymptomatic infestation, but in some patients, it can contribute to the occurrence of diseases such as demodicosis, rosacea, or blepharitis, as well as non-specific symptoms. In this study, the results of tests assessing the presence of Demodex spp. by direct microscopic examination (DME) in 2508 patients from northern Poland with the suspicion of demodicosis were retrospectively analyzed. A total of 3684 tests were performed. Among them, only 1585 (43.02%) revealed the presence of Demodex spp., while 2099 (56.98%) were negative. It was shown that in the analyzed population of patients with clinical suspicion of demodicosis, the degree of confirmation of the presence of Demodex spp. positively correlated with the patient’s age (p = 0.001) and the mite was mainly found on the edges of eyelids and on the facial skin. Additionally, in men, the presence of Demodex was more often confirmed than in women (p = 0.004). In conclusion, the proper diagnosis of demodicosis still constitutes an important clinical problem due to the non-specificity of symptoms and the low confirmation of clinical suspicions of infestation by DME, especially in lower age groups.

Background/Objectives: Alopecia areata is an autoimmune disorder affecting approximately 2% of the global population and is associated with a substantial impairment in quality of life. Owing to the limited number of approved therapeutic options, off-label pharmacotherapy is frequently employed in clinical practice when managing this disease. Methods: This retrospective study analyzed electronic medical records of patients treated for alopecia areata at the University Clinical Centre in Gdańsk between 2014 and 2024 to characterize the epidemiological profile and real-world treatment patterns. Results: A total of 334 affected patients were identified, including 199 diagnosed exclusively with alopecia areata and others presenting with immune-mediated comorbidities, most commonly atopic dermatitis and psoriasis. Among patients with isolated disease, women were more frequently affected and were older at diagnosis than men. Most individuals were managed in the outpatient setting, and demographic characteristics remained stable throughout the study period. Off-label pharmacotherapy was used in 77.9% of all patients and in 99.4% of those receiving drug treatment, with no significant associations observed between off-label use and age, sex, place of residence, or calendar year. Glucocorticosteroids, administered both topically and systemically, were the most commonly prescribed off-label agents (65.3%), and monotherapy was the predominant treatment strategy. Conclusions: These findings highlight the extensive reliance on off-label therapies in routine management of alopecia areata in a real-world European clinical setting.