RATIONALE: Lupus miliaris disseminatus faciei (LMDF) is an inflammatory granulomatous skin disease without a clear etiology that frequently involves the middle area of the face and the upper eyelids . Pathological features of the disease include caseation necrosis and epithelioid granuloma . Consensus treatment for LMDF is currently unavailable . PATIENT CONCERNS: A 47-year-old Chinese female patient who presented with facial pruritic, erythematous papules 8 months before this study . She was diagnosed with skin tuberculosis at another hospital and given antituberculosis medication . However, the treatment was not efficacious . DIAGNOSES: In this study, the diagnosis of Demodex-induced LMDF was made by a dermatologist according to physical examination, skin biopsy pathology, and microscopic examination .
INTERVENTIONS: The patient was given ornidazole tablets (500âmg twice a day) and recombinant bovine basic fibroblast growth factor gel (0.2âg/cm twice a day) for an 8-week period .
OUTCOMES: Eight weeks after the treatment, the facial erythematous papules were improved, and no new skin lesions were observed . The patient showed no signs of recurrence during the 6-month follow-up . LESSONS SUBSECTIONS: This case showed that ornidazole combined with recombinant bovine basic fibroblast growth factor gel might be useful in treatment of Demodex-induced LMDF . In addition, the results suggested that pathological caseation necrosis was caused by a series of inflammatory and immune responses to Demodex infection.