To the Editor.—
We read with interest the article in the March issue of the Archives (115:343-344,1979) by Ecker and Winkelmann on "Demodex Granuloma." The presence of an extrafollicular D folliculorum surrounded by an inflammatory granulomatous reaction in a biopsy specimen from the perioral region suggested causal relationship. It was stated that "skin scrapings" were not done and there was no treatment follow-up. Demodex granuloma is probably a variant of rosacea-like demodicidosis, and if pus and scales had been examined on a potassium hydroxide wet mount, the organisms would probably have been found in abundance and the condition would probably have responded to a compound sulfur ointment.The authors referred to several of our previous publications on rosacealike demodicidosis1-3 and indicated that there was considerable skepticism regarding a possible pathogenic role of Demodex in such conditions.We have tried to emphasize a number of observations that the authors failed
Ayres S, Mihan R. Demodex Granuloma. Arch Dermatol. 1979;115(11):1285–1286. doi:10.1001/archderm.1979.04010110001002
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