Demodex Folliculitis and Recent Dupilumab Administration

Pediatrics. 2021 May;147(5):e2020029520. doi: 10.1542/peds.2020-029520.

Abstract

Two adolescent boys presented with acute acneiform eruptions in the setting of recent dupilumab administration. Subsequent investigation via direct scraping of pustules revealed live Demodex mite colonization of the face. These adolescent patients represent a population not commonly associated with Demodex folliculitis, and we theorize their baseline commensal Demodex mite population may have increased as a consequence of dupilumab-induced, focused immunomodulation. We recommend that pediatricians consider Demodex potentially etiologic in patients presenting with new onset acneiform or rosacea-like dermatoses in patients treated with dupilumab.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Animals
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antiparasitic Agents / administration & dosage
  • Child
  • Dermatitis, Atopic / drug therapy
  • Facial Dermatoses / drug therapy
  • Facial Dermatoses / parasitology*
  • Folliculitis / parasitology*
  • Humans
  • Immunomodulation*
  • Ivermectin / administration & dosage
  • Male
  • Mite Infestations / complications*
  • Mite Infestations / drug therapy
  • Mites

Substances

  • Antibodies, Monoclonal, Humanized
  • Antiparasitic Agents
  • dupilumab
  • Ivermectin