Demodex-induced follicular mucinosis

[Guide]

One more differential diagnosis with rosacea is ruling out Demodex-induced follicular mucinosis (FM) from demodectic rosacea or for that matter, rosacea in general or of its variants. A report on this states, "Higher densities of mites correlate with increased perifollicular inflammation and clinical manifestations of disease. These cases support the hypothesis that a subset of idiopathic FM arises secondary to an aberrant immune response to Demodex. Given the typically robust response of Demodex to treatment with ivermectin, identification of this subset of patients would potentially provide significant clinical benefit."

JAAD Case Rep. 2020 Apr; 6(4): 266–272.
Published online 2020 Mar 24. doi: 10.1016/j.jdcr.2020.01.014. PMCID: PMC7109359
Demodex-induced follicular mucinosis of the head and neck mimicking folliculotropic mycosis fungoides
Megan H. Trager, BA, Dawn Queen, BA, Diane Chen, MD, Emmilia Hodak, MD, Larisa J. Geskin, MD

[ElaineA]

Good surface diagnosis checking for demodex.   However, testing for an underlying case of SIBO would have provided additional interesting information.   Also comparing the types of immune system issues observed with those also found in SIBO could provide a better understanding of the types of immune system changes that allow the demodex to get overpopulated.