Unilateral Papulopustular Dermatosis: Demodex Mites Bridging Rosacea and Demodicosis

Jesús Iván Martínez-Ortega1, Tiffany Karoly Medina Angulo2, Jacqueline E Mut Quej3

  • 1Dermatology, Dermatology Institute of Jalisco, Zapopan, MEX.

Cureus
|April 2, 2025
PubMed

Insights

Unilateral papulopustular rosacea (PPR) is rare. A case study found high Demodex mite density in a unilateral facial rash, successfully treated with topical ivermectin, highlighting Demodex in atypical rosacea.

Area of Science:

  • Dermatology
  • Parasitology

Background:

  • Papulopustular rosacea (PPR) is a common inflammatory skin condition.
  • Its exact cause is unknown, but Demodex mite overgrowth is often implicated.
  • Unilateral PPR is uncommon and may provide insights into disease mechanisms.

Observation:

  • A 68-year-old female presented with a chronic, localized rash on her right cheek.
  • Skin examination revealed redness and scaling.
  • A skin surface biopsy confirmed a high density of Demodex mites.

Findings:

  • The patient was diagnosed with demodicosis, a condition caused by Demodex mite infestation.
  • Treatment with topical ivermectin cream led to substantial improvement in symptoms within four weeks.
  • This case supports the role of Demodex mites in inflammatory facial conditions.

Implications:

  • Highlights the importance of considering demodicosis in diagnosing unusual facial rashes.
  • Suggests Demodex mite density should be evaluated in rosacea and related conditions.
  • Supports incorporating Demodex mite management into treatment strategies for facial dermatoses.

Related Concept Videos

Desmosomes01:05

Desmosomes

The term desmosome derives from the Greek words "desmo" and "soma" meaning "adhesion bodies." This structure was first observed during the late 1800s and described as small, dense nodules in the epidermis. Desmosomes are button-like structures that help form an interlinked network of intermediate filaments across the cells. These junctions are  essential to hold cells together under mechanical stress and to maintain tissue integrity. Desmosomes are multi-protein complexes comprising desmosomal...
Papillary Dermis01:11

Papillary Dermis

Dermis
The dermis might be considered the "core" of the integumentary system, as distinct from the epidermis and hypodermis. It contains blood and lymph vessels, nerves, and other structures, such as hair follicles and sweat glands. The dermis is made of two layers of connective tissue that comprise an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts.
Papillary Layer
The papillary layer is made of loose, areolar connective tissue, which means the collagen and...
Accessory Structures of the Skin: Sebaceous Glands01:21

Accessory Structures of the Skin: Sebaceous Glands

A sebaceous gland is a type of oil gland found almost all over the skin ( except palms and soles) and helps lubricate and waterproof the skin and hair. Most sebaceous glands are associated with hair follicles. They generate and excrete sebum, a mixture of lipids, onto the skin surface, thereby naturally lubricating the dry and dead layer of keratinized cells of the stratum corneum, keeping it pliable.
These glands that produce the oils on the skin and hair are holocrine glands. The mature...
Skin Diseases and Disorders01:23

Skin Diseases and Disorders

Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
Gram-positive Staphylococcus spp. and Streptococcus spp. are responsible for many of the most common skin infections. However, many...
The Skin Microbiota01:27

The Skin Microbiota

The human skin serves as a complex ecosystem inhabited by a diverse community of microorganisms, including bacteria, fungi, and viruses. This microbiome plays a critical role in maintaining skin health and defending against pathogenic invaders. The composition of microbial communities varies significantly across different regions of the body, influenced primarily by the local levels of moisture and sebum.Regional Variation in Skin MicrobiotaCutibacterium acnes predominantly colonizes sebaceous...
Acne Infection01:27

Acne Infection

Acne is a multifactorial skin condition primarily affecting adolescents and young adults, with a global prevalence estimated to exceed 75% in this demographic. The condition is characterized by the formation of comedones (blackheads and whiteheads), papules, pustules, nodules, and, in severe cases, cysts, particularly in areas rich in sebaceous glands such as the face, neck, chest, and back. The pathogenesis involves increased sebum production, follicular hyperkeratinization, colonization by...