Paichitrojjana Anon
School of Anti-Aging and Regenerative Medicine, Mae Fah Luang University, Bangkok, 10110, Thailand.
Clin Cosmet Investig Dermatol. 2022 Mar 19;15:497-501. doi: 10.2147/CCID.S358000. eCollection 2022.
Demodicosis is caused by mite infestation and can present with a variety of clinical manifestations, including pityriasis folliculorum type, rosacea-like type, folliculitis-like type and perioral dermatitis-like type. Therefore, this skin condition is often misdiagnosed or underdiagnosed. This report presents a 19-year-old woman with a history of pityriasis folliculorum type demodicosis and successful treatment with oral ivermectin. After one year of remission, the patient began to develop a dry, itchy rash on her face for one month before multiple small edematous papules and pustules gradually appeared on both cheeks. The patient was first diagnosed as acne vulgaris and treated with doxycycline for 2 weeks, but the clinical symptoms did not show any signs of improvement. After reassessment based on clinical presentation and laboratory examination that found multiple mites from pustules and rash on both cheeks, the patient was diagnosed with folliculitis-like type demodicosis. However, this patient still had a very good response to oral ivermectin and metronidazole gel, and all clinical symptoms disappeared within 4 weeks after treatment. This is a case report of demodicosis imitating acne vulgaris and the first report demonstrating a change in clinical manifestations of demodicosis from pityriasis folliculorum type to folliculitis-like type.
蠕形螨病由螨虫感染引起，可表现出多种临床表现，包括毛囊糠疹型、酒渣鼻样型、毛囊炎样型和口周皮炎样型。因此，这种皮肤疾病常被误诊或漏诊。本报告介绍了一名19岁女性，有毛囊糠疹型蠕形螨病病史，口服伊维菌素治疗成功。缓解一年后，患者面部开始出现干燥、瘙痒性皮疹1个月，随后双侧脸颊逐渐出现多个小水肿丘疹和脓疱。患者最初被诊断为寻常痤疮，用多西环素治疗2周，但临床症状未显示任何改善迹象。根据临床表现和实验室检查重新评估，发现双侧脸颊脓疱和皮疹中有多个螨虫后，患者被诊断为毛囊炎样型蠕形螨病。然而，该患者对口服伊维菌素和甲硝唑凝胶仍有很好的反应，治疗后4周内所有临床症状均消失。这是一例模仿寻常痤疮的蠕形螨病病例报告，也是首例显示蠕形螨病临床表现从毛囊糠疹型转变为毛囊炎样型的报告。
