• PDF / 170,362 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 94 Downloads / 161 Views

DOWNLOAD

REPORT

---

1 S

Acute inflammatory Demodex-induced pustulosis and burning: case report A 9-year-old boy developed acute inflammatory Demodex-induced pustulosis during treatment with mometasone for facial redness and itch; he also developed burning sensation during treatment with permethrin for the acute inflammatory Demodexinduced pustulosis [not all routes stated; dosages not stated]. The boy presented to the medical center with a facial rash (current presentation). He reported six months history of intermittent itch and mild facial redness for which he was prescribed mometasone ointment. He had been using the ointment almost daily. During this treatment, he developed new red papules on the cheek which progressed to entire face with the appearance of pus bumps. Following the current presentation, clinical examination revealed confluent oedematous, erythematous facial plaques with crusting and numerous fragile pustules, and body temperature of 104.5°F. The differential diagnosis involved pustular psoriasis, impetiginised contact dermatitis, cutaneous candidiasis and acute localised exanthematous pustulosis. His WBC was elevated, and wound cultures grew moderate Corynebacterium bovis. Histopathology of submental skin revealed many follicular and subcorneal Demodex with groups of neutrophils. A superficial and deep perivascular and perifollicular infiltrate of neutrophils, lymphocytes, and histiocytes were also observed. Eventually, based on the examinations and clinical presentation, a diagnosis of exuberant, inflammatory, Demodex-associated facial pustulosis triggered by the topical mometasone use was considered. The boy’s treatment was started with cephalexin, clindamycin and mupirocin with minimal reduction in erythema. He continued to develop new pustules on his ears. He was then treated with 5% permethrin cream, which he failed to tolerate due to burning sensation. Thereafter, he received treatment with ivermectin and a significant improvement was noted. He instructed to use a gentle non-medicated facial cleanser and a non-comedogenic moisturizer as an outpatient. Guzman AK, et al. Acute inflammatory Demodex-induced pustulosis in an immunocompetent patient related to topical steroid use. Pediatric Dermatology 37: 985-986, No. 5, 803517743 Sep 2020. Available from: URL: http://doi.org/10.1111/pde.14315

0114-9954/20/1832-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

Reactions 28 Nov 2020 No. 1832