Follicular scales, scalp and ocular involvement in patients with papulopustular rosacea: prevalence and association with Demodex mite proliferation

• Main Authors: Ilaria Trave (Author), Emanuele Cozzani (Author), Ilaria Salvi (Author), Aurora Parodi (Author)
• Format: Book
• Published: PAGEPress Publications, 2023-08-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.4081/dr.2023.9798; 2036-7392; 2036-7406
• Keywords: rosacea; Demodex; follicular scales; scalp symptoms; ocular symptom; Dermatology; RL1-803
• Source: Dermatology Reports (2023)

Facial follicular scales, dandruff, scalp itching and ocular alterations are lesser-known signs of rosacea and demodicosis. The aim of this prospective original study was to investigate the presence of these signs and symptoms in patients with almost-clear, mild and moderate papulopustular rosacea and to study the differences between Demodex-positive and Demodex-negative rosacea. Twenty-seven out of 60 patients (45%) presented follicular scales, 24 (40%) ocular involvement and 22 (36.67%) scalp involvement. Follicular scales were more frequently observed in mild and moderate than in almost-clear rosacea (p<0.001). Itching of the scalp was more frequently reported in patients with moderate rosacea than in those with mild disease (p=0.05). Follicular scales (p=0.002) and scalp itching (p=0.05) were more frequently reported in Demodex-positive than in Demodex-negative patients. Among Demodex-positive patients, scalp itching was more frequently reported in mild than in almost clear rosacea (p=0.01) and ocular symptoms associated to scalp itching were more frequently reported in moderate than in almost-clear rosacea (p=0.05). We suggest looking for these signs and symptoms in all patients with papulopustular rosacea, because they can be a sign of a more severe form of rosacea or of demodicosis.