Classification defines two different forms: primary forms, characterized by the absence of preexisting or concurrent inflammatory dermatoses, abnormal mite colonization and healing after adequate acaricides treatment and secondary demodicosis, usually associated with systemic or local immunosuppression. folliculorum and Demodex brevis are normally benign skin residents, which might become pathogenic when present in excessive number and/or because of an immune imbalance. Human demodicosis is still a controversial entity, because D. The patient refused to consent for a biopsy, due to the risk of unaesthetic scarring.įigure 1: Annular erythematous scaly lesions with an active border composed of honey-colored crusts, irregular margins and clear borders on the right jawįigure 2: Lesion on the left nasal pyramidįigure 3: Photomicrograph of a potassium hydroxide mount of a lesion scraping showing characteristic features of Demodex folliculorum (magnification ×10) The mites were 0.3–0.4 mm long, with four legs and a long striated posterior segment, suggesting Demodex folliculorum. More than five mites were present in the same field at very low magnification (4×). However, microscopic examination of scraping from lesion, clarified with potassium hydroxide, revealing abundant demodex mites. Investigations included microbiological cultures, which excluded bacterial infections. The patient, who was a student of law, was not taking any drug, had no pets and played soccer as a hobby. Previous treatments with topical antibiotic–steroid and antifungal formulations were not effective, and there was occurrence of a new lesion on the left nasal pyramid. The patient had burning and stinging sensation rather than itching. A 20-year-old Caucasian man presented at the dermatology clinic of Cagliari University with an annular erythematous scaly lesion on the right jaw, which appeared 2 months before and was enlarging with an active border, studded with honey-colored crusts.
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