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Granulomatous rosacea-like demodicidosis.
Julia Yu-Yun Lee1, Chao-Kai Hsu
1Department of Dermatology, College of Medicine, National Cheng Kung University, Tainan, Taiwan. yylee@mail.ncku.edu.tw
Dermatology Online Journal
|March 6, 2008
Summary
Demodex granuloma can mimic granulomatous rosacea. Identifying extrafollicular Demodex mites in skin biopsies is crucial for accurate diagnosis and effective treatment of demodicidosis.
Area of Science:
- Dermatology
- Parasitology
Background:
- Demodicidosis encompasses various presentations, including pityriasis folliculitis and rosacea-like eruptions.
- Demodex mites are implicated in several dermatological conditions.
Observation:
- A middle-aged woman presented with recurrent facial papules resembling granulomatous rosacea.
- Skin biopsy revealed extrafollicular Demodex mites within a perifollicular inflammatory infiltrate.
Findings:
- The patient was diagnosed with demodicidosis (Demodex granuloma).
- Treatment with systemic and topical metronidazole, plus low-dose oral prednisolone, led to papule resolution within 3 weeks.
Implications:
- Demodex granuloma can be misdiagnosed as granulomatous rosacea.
- Histopathological identification of extrafollicular Demodex mites is key for correct diagnosis.
- This case highlights the importance of considering demodicidosis in rosacea-like presentations.
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