Abstract
Demodex brevis and Demodex folliculorum are two species of ubiquitous parasites whose role in human disease continues to be fully elucidated. Demodex most commonly causes symptomatic infestations confined to the head and neck. Clinically, symptoms may mimic acne vulgaris, papulopustular rosacea, perioral dermatitis, and seborrheic dermatitis, among others. Practitioners must maintain a high level of suspicion to avoid a misdiagnosis.
Highlights
A 42-year-old man with skin-type II was referred to our dermatology outpatient clinic for a 10-year history of a rash on his face, upper chest and upper back
Exam was remarkable for erythematous plaques with collarettes of scale on the upper chest and upper back, as well as generalized facial erythema without telangiectasias, pustules, or papules (Figure 1)
Periodic acidSchiff (PAS) stain was negative for fungus
Summary
A 42-year-old man with skin-type II was referred to our dermatology outpatient clinic for a 10-year history of a rash on his face, upper chest and upper back. These flares would last for several days and would resolve regardless of attempted treatments. The patient was unable to identify any triggers for his flares and denied any exacerbation of symptoms by sunlight. A punch biopsy of the mid chest was performed and histopathology revealed a slight spongiotic dermatitis with a sparse superficial perivascular infiltrate and the presence of Demodex mites within the hair follicles (Figure 2).
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