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Iatrogenic Demodex folliculitis: A case report
Neha Deo1, Nasro A Isaq2, Margot S Peters2,3
1Mayo Clinic Alix School of Medicine, Rochester, Minnesota, USA.
International Journal of Rheumatic Diseases
|April 25, 2023
Summary
Iatrogenic Demodex folliculitis, a skin condition caused by Demodex mites, can arise from immunosuppressive therapy. Early diagnosis and treatment with ivermectin and metronidazole, alongside adjusted immunosuppression, led to significant patient improvement.
Area of Science:
- Dermatology
- Immunology
- Microbiology
Background:
- Demodex folliculorum mites are normal inhabitants of pilosebaceous follicles.
- Overgrowth can cause Demodex folliculitis, presenting as papules and pustules on the face and chest.
- Immunosuppressive therapy can predispose individuals to Demodex overgrowth.
Observation:
- A 51-year-old woman developed iatrogenic Demodex folliculitis while undergoing immunosuppressive treatment for an autoimmune connective tissue disease.
- The rash manifested as papules and pustules on her face.
- Histopathological examination confirmed the presence of Demodex mites within the hair follicles.
Findings:
- The patient was treated with oral ivermectin and topical metronidazole.
- Her immunosuppressive regimen was carefully reduced.
- Significant clinical improvement of the folliculitis was observed within six weeks.
Implications:
- This case highlights the importance of considering Demodex folliculitis in patients on immunosuppressants presenting with new-onset rash.
- Management involves addressing both the mite overgrowth and the underlying immunosuppression.
- Successful treatment can improve skin condition without exacerbating the autoimmune disease.
