Primary facial demodicosis as a health problem and aesthetic challenge: A case report

Abstract

Colonization of skin by Demodex mites developing as a single facial lesion with a limited range is diagnosed relatively rarely. The presence of this type of skin lesions may hinder and thus delay the diagnostic process and application of appropriate treatment. The persistent cosmetic defect on the face is extremely onerous/embarrassing to the patient and impedes normal functioning. Describe a case of atypical presentation of primary facial demodicosis and its successful treatment. We present a case of a 38‐year‐old patient who consulted an aesthetic medicine doctor about a skin lesion, that is, erythematous‐papular lesion with single pustules persisting for more than half a year around the right eye corner and below the lower eyelid. Previous topical antibiotic treatment has proved ineffective. Diagnosis was targeted at detection of Demodex spp. invasion, which yielded a positive result. Targeted therapy with 1% topical ivermectin was implemented. Complete resolution of the skin lesions was observed after 8.5 weeks of the treatment with no further recurrence. In the case of limited scaly erythematous‐papular skin lesions with single pustules, Demodex mites should be considered as an etiological factor or one of the factors in the case of a mixed‐etiology lesion. A delayed diagnosis of visible lesions on facial skin has a negative impact on patient's well‐being and normal functioning. As diagnosis of primary demodicosis is underestimated, knowledge about this dermatosis and its clinical manifestations should be disseminated among cosmetologists and doctors of various specialties.

Data on Demodex Ectoparasite Infestation in Patients Attending an Outpatient Clinic in Greece

“…It is also worth raising awareness and knowledge about demodicosis and its clinical manifestations among aesthetic medicine doctors and cosmetologists, as a possible delayed diagnosis of visible lesions on facial skin could have a negative impact on patients' wellbeing and normal functioning [12].…”

“…The term "human demodicosis" refers to skin conditions caused by D. folliculorum and/or D. brevis infestation in humans [11]. In symptomatic cases, Demodex mites can result in skin sensitivity and dryness, cheek redness, rash, exfoliation and erythema [12].…”

Shared Makeup Cosmetics as a Route of Demodex folliculorum Infections

“…In some patients, the presence of these mites may be associated with blepharitis, rosacea, chalazion, perioral dermatitis, or idiopathic follicular mucinosis of the head and neck [5][6][7][8][9][10]. Cases of local dermatological lesions caused by increasing Demodex populations have been reported as well [11].…”