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Granulomatous rosacea: a case report
© The Author(s). 2017
Received: 13 December 2016
Accepted: 23 July 2017
Published: 20 August 2017
Granulomatous rosacea is a rare chronic inflammatory skin disease with an unknown origin. The role of Demodex follicularum in its pathogenesis is currently proved.
We report a case of a 54-year-old Moroccan man with a 3-month history of erythematous, nonpruritic papules on the lateral side around the eyes. Dermoscopy and histology confirmed the diagnosis of granulomatous rosacea.
We describe another clinical presentation of granulomatous rosacea with a clinical-dermoscopic-pathological correlation.
Granulomatous rosacea (GR) is a rare chronic inflammatory skin disease reported primarily in middle-aged women . It is thought to be a particular form of rosacea on the basis of unique clinical and histological findings of granulomas; it is characterized by erythematous papules most commonly affecting the face; and it tends to have a chronic course . We present the case of a 54-year-old man with a 3-month history of GR associated with demodecidosis.
The role of Demodex in GR’s pathogenesis was debated in the last decade, with recent data highlighting its significant role in triggering GR . Our observation confirmed that this mite plays an important role in stimulation of the immune system and the formation of granulomas in GR in unusual sites. In our patient, the presence of Demodex in the follicular openings was confirmed by histology, and we noticed that a granulomatous infiltrate was agglomerated around the pilosebaceous follicles containing the mite. Dermoscopy confirms the presence of the characteristic vascular polygons, not only in conventional rosacea [4, 5] but also in GR. In our patient, we also noticed the most indicative dermoscopic whitish features of demodicidosis, called Demodex tails and Demodex follicular openings [6, 7].
We report an original observation of GR with a rare localization and an association with demodicidosis.
We are indebted to the patient, who gave us his consent for publication. We thank the medical staff of the department of anatomopathology for their enormous help.
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AK drafted the manuscript. AK and FZM revised the manuscript critically for important intellectual content. Both authors read and approved the final manuscript.
Ethics approval and consent to participate
The patient was informed and gave his informed consent.
Consent for publication
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
The authors declare that they have no competing interests.
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