Persistent Facial and Chest Papular and Pustular Eruption in a Stem Cell Transplant Patient
November 2021
in “
Transplantation direct
”
demodex folliculitis Demodex folliculorum pilosebaceous unit hematopoietic stem cell transplant bacterial folliculitis sirolimus-induced pustular drug eruption cutaneous graft-versus-host-disease cGVHD oral ivermectin topical permethrin Demodex mite stem cell transplant bacterial infection drug eruption graft-versus-host disease ivermectin permethrin
TLDR A 68-year-old man improved after being correctly diagnosed and treated for a skin condition caused by mites, following a stem cell transplant.
The document discusses a case of a 68-year-old male patient who developed a severe and atypical case of demodex folliculitis, a condition caused by inflammation of the pilosebaceous unit due to the Demodex folliculorum mite, after receiving a hematopoietic stem cell transplant. The patient's condition was initially misdiagnosed as bacterial folliculitis, sirolimus-induced pustular drug eruption, and cutaneous graft-versus-host-disease (cGVHD), leading to ineffective treatments. However, after scrapings of pustules revealed numerous Demodex folliculorum mites, the patient was diagnosed with demodex folliculitis and treated with oral ivermectin and topical permethrin, leading to significant improvement. The document emphasizes the importance of considering demodex folliculitis as a potential diagnosis in immunocompromised patients presenting with a refractory papulopustular eruption, and the need for prompt scraping of a pustule for diagnosis to improve treatment outcomes.
