Rosacea-like demodicidosis associated with acquired immunodeficiency syndrome

We present a 35-year-old patient with acquired immunodeficiency syndrome wh o had demodicidosis on his face, characterized by multiple papules and papu lopustules, associated pruritus, numerous mites on skin-surface biopsy and in biopsy specimens, and rapid response to topical treatment with permethri n. It seems likely that Demodex infestation does not manifest unless local or systemic immune function is altered, leading to the proliferation of the organism and subsequent disease.