A 16-year-old woman was referred to the dermatology clinic with pustules and erythema on her face for one year. The pustule initially appeared on both cheeks and later extended to the entire face, accompanied by pain and itch. The lesion became more noticeable following sun exposure and spicy food consumption. The patient had previously been treated, and the treatment response was initially good, but the symptoms recurred. The patient's right eye became red and sore. She also became more sensitive to light in the last few months. There was no history of fever, hair loss, dandruff, mouth ulcers, headaches, coughing/shortness of breath, abdominal pain, and genitourinary disorders.
Dermatological examination of both cheeks and nasal revealed multiple scattered-to-concentrated erythematous lesions with lenticular-to-plaque size and well-defined border, also erythematous papules and pustules in several places. Ocular examination showed conjunctivitis with periorbital oedema. Dermoscopic examination of the cheek showed telangiectasia. Demodex folliculorum was identified on skin scraping examination with 20% potassium hydroxide.
Complete blood count, white blood cell differential count, and kidney function tests were within normal limits. Antinuclear antibody (ANA) test yields positive results with a titer of 1:320 showing a centriole and rough speckled pattern, while anti-dsDNA level was within normal limits (<10 IU/mL). C3 and C4 levels were within normal limits (89.8 and 20.2 mg/dL, respectively; normal range: 85–160 and 10–40 mg/dL, respectively).
Following 2 weeks of therapy, the patient showed an improvement of the lesions on both cheeks and nasal. The number of papules and pustules and the degree of erythema were also significantly reduced, and we also identified a remarkable improvement of the ocular abnormalities.
Like
Answers
Save
Share