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Case Reports
. 2018 Jul-Aug;93(4):566-569.
doi: 10.1590/abd1806-4841.20187171.

Demodicosis as treatment complication of amicrobial pustulosis of the folds

Marilia Formentini Scotton Jorge  1 , Lívia Maria Zanardi Miguel  1 , Cíntia Santos Braghiroli  1 , Juliano Vilaverde Schmitt  1
Affiliations
Case Reports

Demodicosis as treatment complication of amicrobial pustulosis of the folds

Marilia Formentini Scotton Jorge et al. An Bras Dermatol. 2018 Jul-Aug.

Abstract

Amicrobial pustulosis of the folds is a chronic relapsing neutrophilic dermatosis characterized by sterile pustules compromising skin folds, scalp, face and periorificial regions. It predominantly affects women. Demodicosis is an inflammatory disease associated with cutaneous overpopulation of the mite Demodex spp., the pathogenesis of which is not completely established, but is frequently related to local immunodeficiency. A case of a young woman with amicrobial pustulosis of the folds, and isolated worsening of facial lesions, is reported; investigation revealed overlapping demodicosis. There was complete regression of lesions with acaricide and cyclin treatment. This case warns of a poorly diagnosed but disfiguring and stigmatizing disease, often associated with underlying dermatoses or inadvertent treatments on the face.

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Conflict of interest statement

Conflict of interests: None.

Figures

Figure 1
Figure 1
Lesions of amicrobial pustulosis of the folds. A - Edema, erythema, pustules and ulcerations on the pinna; B - Erythema, crusts and fissures on the nostrils; C - Papules and pustules in the axillary cavity; D - Diffuse erythema and pustules in the pubic region
Figure 2
Figure 2
Facial lesions of demodicosis before and after treatment. A - Evident worsening of the facial lesions, with infiltration of the malar regions and increase in the number of pustules; B - Evident regression of the lesions after four weeks of acaricidal treatment
Figure 3
Figure 3
Histopathological exam of facial papular lesion) A - Hyperkeratosis with follicular plugs and granulomatous foci; B - Infundibular dilation with Demodex spp. (arrow) and associated folliculitis (Hematoxylin & eosin, x40)
See this image and copyright information in PMC

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