Skin, parasites, worms, demodex, face, tentacles, moxidectin
Please advise on identification of these skin
parasites - after using albendezole and praziquantel (worked last year when taken for 4 weeks+ but seems to have little effect now), found topical application of Moxidectin gel after daily debriding of all flat ribbon like
parasites (dozens at first in 4 different areas of face, but reducing every day with Moxi treatments), has been only treatment that has produced marked positive results (after 3 days application, 75% improvement so far).
Microscopic photos attached below...
Ribbon like flat
parasites shown in photos in 3) came from deeper under layer of skin, but exact same examples also often removed from surface (barely attached), especially around edges of any open "wound" areas, twice have found white version traveling along lower lip (not attached/embedded yet).
Note in photos that when "sacs" removed and pressed between microscopic slide and slide cover (oil immersion between), many ova emerge - see these in photos 2) and 4). Not shown is these photos is that sacs often contain several string/thread like worms as well.
Also oval shaped rings look like textbook threadworm ova... but there are clearly other parasite(s) involved that look like demodex on steroids.
Spider like
parasite has 8 legs - 2 photos in 5) - looks like a daddy long legs. Rare to find but have removed three of these intact... I could could be destroying samples when removing and there could be many more - detached legs are commonly found on slides.
Some examples seem almost "wired" (attached by fibers that take full strength to remove and feel like wire when tugged by surgical grade fine precision tweezers) and very hard to remove (tentacles/threads spread out up to 1/2
inch distance inside skin - both in linear channel and random dispersement - again attachment under skin very hard to dislodge).
NOTE: Photo montages contain a mix of parasites - but all were removed from same areas of face (just outside of corners of mouth, top ridge of nose and base edge of one side of nose, between eyes, and side of face - channels connecting nose to between eyes was clearly visable til Moxi treatment knocked it down), in the same time frame (middle of Jan - first week of feb 2018 when this infection all blew up and spread very rapidly - each day worsening).
Have fought this type thing for 3 years - beating it for a couple of months last year, only to have it start up again after ending treatments. Each reoccurrence tends to be worse than the previous (dormant eggs? resistence to meds?).
Any expertise appreciated - these things have wrecked havic in face, many buried deeply in skin -
First set of photos 1) includes one
inch worm pulled intact - photos taken two hours after extraction so dried by then. also extracted is sample of what looks like threadworm ova (related photos are contained in other photo montages)
PHOTOS:
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