A punch biopsy was done to diagnose a progressive pustular facial rash in a middle-aged woman. The biopsy specimen disclosed an intact extrafollicular Demodex folliculorum, which may be the causative organism. A review of 30 cases of granulomatous facial lesions from the Mayo Clinic indicated that this finding is uncommon.
(Arch Dermatol 115:343-344, 1979)
Ecker RI, Winkelmann RK. Demodex Granuloma. Arch Dermatol. 1979;115(3):343-344. doi:10.1001/archderm.1979.04010030051021