SevereDemodexfolliculorum–Associated Oculocutaneous Rosacea in a Girl Successfully Treated With Ivermectin

IMPORTANCE: There is a limited therapeutic armamentarium for recalcitrant cases of childhood rosacea. OBSERVATIONS: We report the case of a 12-year-old girl who presented with severe ocular and cutaneous rosacea unresponsive to oral doxycycline, oral isotretinoin, and topical tacrolimus. A biopsy specimen showed numerous mites within the folliculosebaceous unit. Treatment with a single dose of oral ivermectin achieved resolution of her symptoms. CONCLUSIONS AND RELEVANCE: The causative role of Demodex folliculorum should be considered in immunocompetent children with rosacea or rosacea-like refractory eruptions. In such cases, treatment with ivermectin can be beneficial.