An 11-year-old boy presented with a several-year history of erythema, accompanied by scaling, papules, and pustules predominantly affecting the nose and perioral region (Fig. 1A). In recent months, this had also been associated with blepharitis. The child had a past medical history of chronic mucocutaneous candidiasis and exhibited an immune dysregulation syndrome associated with gain-of-function (GOF) in the STAT1 (signal transducer and activator of transcription 1) pathway.
Dermatoscopic examination revealed Demodex tails emerging from follicular openings, along with diffuse erythema and dilated reticular vessels (Fig. 1B), leading to the diagnosis of rosacea.
In recent years, several articles have described the association between demodicosis and early-onset rosacea-like lesions, with facial and ocular involvement in patients with STAT1 GOF.
Dermatoscopic findings allow a rapid and noninvasive diagnosis of demodicosis and, consequently, enable appropriate treatment to be offered to the patient.
