DEMODICIDOSIS OR ROSACEA - WHAT DID WE TREAT

We report a 75-year-old man with a fulminant rosacea-like eruption, su ggestive of demodicidosis. Multiple Demodex folliculorum mites were fo und in facial scales and pustules and, on histological examination, in the infundibulum of pilosebaceous follicles and in the dermis, Intrad ermal mites were surrounded either by polymorphonuclear granulocytes a nd histiocytes, or by a granulomatous infiltrate containing foreign-bo dy giant cells, which had phagocytosed the parasites. Complete recover y, with disappearance of facial mites, was achieved by treatment with a combination of oral and topical metronidazole, although this drug is not known to be miticidal.