Crusted Demodicosis in an Immunocompetent Pediatric PatientReport as inadecuate




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Case Reports in Dermatological Medicine - Volume 2014 2014, Article ID 458046, 3 pages -

Case ReportDermatology Department, Hospital Universitario “Dr. José Eleuterio González,” Universidad Autónoma de Nuevo León, Avenida Francisco I. Madero Poniente s-n y Avenida Gonzalitos, Colonia Mitras Centro, 64460 Monterrey, NL, Mexico

Received 11 July 2014; Accepted 27 September 2014; Published 12 October 2014

Academic Editor: Alireza Firooz

Copyright © 2014 Guillermo Antonio Guerrero-González et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Demodicosis refers to the infestation by Demodex spp., a saprophytic mite of the pilosebaceous unit. Demodex proliferation can result in a number of cutaneous disorders including pustular folliculitis, pityriasis folliculorum, papulopustular, and granulomatous rosacea, among others. We report the case of a 7-year-old female presenting with pruritic grayish crusted lesions over her nose and cheeks, along with facial erythema, papules, and pustules. The father referred chronic use of topical steroids. A potassium hydroxide mount of a pustule scraping revealed several D. folliculorum mites. Oral ivermectin 200 μg-kg, single dose plus topical permethrin 5% lotion applied for 3 consecutive nights were administered. Oral ivermectin was repeated every week and oral erythromycin plus topical metronidazole cream was added. The facial lesions greatly improved within the following 3 months. While infestation of the pilosebaceous unit by Demodex folliculorum mites is common, only few individuals present symptoms. Demodicosis can present as pruritic papules, pustules, plaques, and granulomatous facial lesions. To our knowledge, this is the first reported case of facial crusted demodicosis in an immunocompetent child. The development of symptoms in this patient could be secondary to local immunosuppression caused by the chronic use of topical steroids.





Author: Guillermo Antonio Guerrero-González, Maira Elizabeth Herz-Ruelas, Minerva Gómez-Flores, and Jorge Ocampo-Candiani

Source: https://www.hindawi.com/



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