Papulopustular demodicosis: a case report

https://doi.org/10.19106/JMedSci005504202309

Sri Mariyani(1*), Kristiana Etnawati(2)

(1) Department of Dermatology dan Venereology Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
(2) Department of Dermatology dan Venereology Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Primary demodicosis is an infestation of Demodex colonization >5 mites/cm2 without pre-existing or concomitant inflammatory skin disease. Primary demodicosis is divided into 3 variants i.e. spinulata, papulopustular and nodulocystic. Several topical and systemic agents are used in the Demodex facial treatment. A 22 y.o. man complained of acne on his face three months ago. On physical examination, there were pustules, multiple erythematous papules, ice pick atrophic scars, and box and rolling scars. KOH examination found the Demodex number > 5 mites/cm2. No spores were found. The patient received oral and topical metronidazole therapy. Papulopustular demodicosis is a follicular inflammation caused by Demodex mites. The inflammatory stage shows a predilection for the perioral, periorbital, and periauricular regions. According to the pattern of morphology and localization of the centrofacial area, some cases of demodicosis are often referred to as Rosacea-like (rosaceiform) demodicosis. The treatment goals are to reduce the overall number of mites and treat the underlying condition. This paper reports a case of papulopustular demodicosis of the face. The diagnosis was made by history taking and physical examination using the diagnostic criteria for demodicosis. Clinical improvement was obtained after oral and topical metronidazole therapy for two weeks.

Keywords


demodicosis; Demodex; rosacea-like; papulopustular; metronidazole

Full Text:

PDF


References


1. Przydatek-Tyrajska R, Sedzikowska A, Bartosik K. Primary facial demodicosis as a health problem and aesthetic challenge: A case report. J Cosmet Dermatol 2021; 20(2):420-4.
https://doi.org/10.1111/jocd.13542
2. Luebbers HT, Lanzer M, Graetz KW, Kruse AL. Demodicidosis: an uncommon erythema after cranio-maxillofacial surgery. Br J Oral Maxillofac Surg 2013; 51(8):e267-8.
https://doi.org/10.1016/j.bjoms.2012.10.003
3. Aktas Karabay E, Aksu Cerman A. Demodex folliculorum infestations in common facial dermatoses: acne vulgaris, rosacea, seborrheic dermatitis. An Bras Dermatol 2020; 95(2):187-93.
https://doi.org/10.1016/j.abd.2019.08.023
4. Elston CA, Elston DM. Demodex mites. Clin Dermatol 2014; 32(6):739-43.
https://doi.org/10.1016/j.clindermatol.2014.02.012
5. Mochtar M, Toha S, Murasmita A. Demodikosis di RSUP Dr. Moewardi Surakarta. MDVI 2015; 42(1):28-3.
6. Chen W, Plewig G. Human demodicosis: revisit and a proposed classification. Br J Dermatol 2014; 170(6):1219-25.
https://doi.org/10.1111/bjd.12850
7. Hedberg ML, Chibnall RJ, Compton LA. Symptomatic vulvar demodicosis: A case report and review of the literature. J Cutan Pathol 2020; 47(11):1063-6.
https://doi.org/10.1111/cup.13816
8. Jacob S, VanDaele MA, Brown JN. Treatment of Demodex-associated inflammatory skin conditions: a systematic review. Dermatol Ther 2019; 32(6):e13103.
https://doi.org/10.1111/dth.13103
9. Lam NSK, Long XX, Griffin RC, Chen MK, Doery JC. Can the tea tree oil (Australian native plant: Melaleuca alternifolia Cheel) be an alternative treatment for human demodicosis on skin? Parasitology 2018; 145(12):1510-20.
https://doi.org/10.1017/S0031182018000495
10. 10.Douglas A, Zaenglein AL. A case series of demodicosis in children. Pediatr Dermatol 2019; 36(5):651-4.
https://doi.org/10.1111/pde.13852
11. Yun CH, Yun JH, Baek JO, Roh JY, Lee JR. Demodex mite density determinations by standardized skin surface biopsy and direct microscopic examination and their relations with clinical types and distribution patterns. Ann Dermatol 2017; 29(2):137-42.
https://doi.org/10.5021/ad.2017.29.2.137
12. Forton F, Seys B, Marchal JL, Song AM. Demodex folliculorum and topical treatment: acaricidal action evaluated by standardized skin surface biopsy. Br J Dermatol 1998; 138(3):461-6.
https://doi.org/10.1046/j.1365-2133.1998.02125.x
13. Plewig G KA. Acne and Rosacea. 3rd ed. Berlin Heidelberg: Springer; 2000.
14. Forton FMN, De Maertelaer V. Papulopustular rosacea and rosacea-like demodicosis: two phenotypes of the same disease? J Eur Acad Dermatol Venereol 2018; 32(6):1011-6.
https://doi.org/10.1111/jdv.14885
15. Yan Y, Chen H, Chen L, Cheng B, Diao P, Dong L, et al. Consensus of Chinese experts on protection of skin and mucous membrane barrier for health-care workers fighting against coronavirus disease 2019. Dermatol Ther 2020; 33(4):e13310.
https://doi.org/10.1111/dth.13310
16. Hua W, Zuo Y, Wan R, Xiong L, Tang J, Zou L, et al. Short-term skin reactions following use of N95 respirators and medical masks. Contact Dermatitis 2020; 83(2):115-21.
https://doi.org/10.1111/cod.13601
17. Desai SR, Kovarik C, Brod B, James W, Fitzgerald ME, Preston A, et al. COVID-19 and personal protective equipment: Treatment and prevention of skin conditions related to the occupational use of personal protective equipment. J Am Acad Dermatol 2020; 83(2):675-7.
https://doi.org/10.1016/j.jaad.2020.05.032
18. Cunliffe WJ, Burton JL, Shuster S. The effect of local temperature variations on the sebum excretion rate. Br J Dermatol 1970; 83(6):650-4.
https://doi.org/10.1111/j.1365-2133.1970.tb15759.x



DOI: https://doi.org/10.19106/JMedSci005504202309

Article Metrics

Abstract views : 1415 | views : 1313




Copyright (c) 2023 Sri Mariyani, Kristiana Etnawati

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.