title: Recalcitrant papulopustular rosacea in an immunocompetent patient responding to combination therapy with oral ivermectin and topical permethrin.
abstract: A 68-year-old healthy man presented with papulopustular rosacea (PPR) recalcitrant to multiple therapies, including permethrin cream 5%. Histologic examination detected the presence of chronic folliculitis and numerous Demodex organisms. A diagnosis of rosacealike demodicidosis was rendered, and the patient was treated with oral ivermectin and permethrin cream 5%, resulting in resolution of the folliculitis. Demodex infestation should be considered in any patient with rosacealike dermatitis resistant to conventional rosacea therapies. If infestation is demonstrated in these patients, oral ivermectin in combination with topical permethrin is a safe and effective therapeutic option.
authors.affiliation: Indiana University School of Medicine, Indianapolis 46202, USA.
authors.forename: Kattie J
authors.initials: KJ
authors.lastname: Allen
authors.forename: Carrie L
authors.initials: CL
authors.lastname: Davis
authors.forename: Steven D
authors.initials: SD
authors.lastname: Billings
authors.forename: Nico
authors.initials: N
authors.lastname: Mousdicas
mesh_terms: D000279:Administration, Cutaneous; D000284:Administration, Oral; D000368:Aged; D000977:Antiparasitic Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D006801:Humans; D007306:Insecticides / Q000008:administration & dosage*; D007559:Ivermectin / Q000008:administration & dosage*; D008297:Male; D008924:Mite Infestations / Q000150:complications / Q000188:drug therapy; D026023:Permethrin / Q000008:administration & dosage*; D012393:Rosacea / Q000188:drug therapy* / Q000469:parasitology
chemical_list: D000977:Antiparasitic Agents; D007306:Insecticides; D026023:Permethrin; D007559:Ivermectin