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.
Keywords: Demodex; cosmetic dermatology; esthetics; eyelid; facial redness; primary facial demodicosis.
© 2020 The Authors. Journal of Cosmetic Dermatology published by Wiley Periodicals LLC.