27th September 2016 11:18 AM
I need your help please. I have posted pictures. Could it be Demodectic Rosacea?
last November, I moved to New Zealand on a working Holiday visa and developed a facial rash. I have seen several doctors around the country but none of them have been able to make a proper diagnosis on my skin condition.
Below is a letter written by one of the dermatologists I saw :
"I first saw patient XXX on XXX for a facial rash of uncertain duration - it had been coming and going maybe for a few months. He had already seen a variety of doctors on his travels around New Zealand and had been given various diagnoses (impetigo, seborrheic dermatitis etc) and a variety of treatments (ketoconazole cream, hydrocortisone cream, fucidin cream, doxycycline tablets, itraconazole tablets, prednisolone cream, flucloxacillin tablets, pimecrolimus cream).
At the time I first saw him there was erythema and scaling and some pustules in a perioral distribution - it was a bit like a perioral dermatitis except the pustules were bigger than one would expect for that condition and furthermore there was a history of pustules on the forehead which would be an unusual site. It wasnt typical of acne either (no comedones). The pustules seemed a bit large for seborrheic dermatitis also. So it didnt fit neatly with any one condition. I gave him minocycline tabs and did a swab which was negative.
He was booked for a biopsy on XXX but the rash at that stage was quiescent and I felt that there was a low chance of getting useful information at that stage. The diagnosis is still uncertain - an inflammatory dermatosis with pustules, which includes things like perioral dermatitis, seborrheic dermatitis, rosacea, demodex folliculitis and others); infection has been excluded. A biopsy will give better results if it is done during a flare up phase."
I am currently traveling around Indonesia and my condition has not improved. This thing is not only very itchy, it is also ruining my self-esteem. I have read about demodectic rosacea and have been using permethrin 5% for about a week now but my skin is at its worst. If it is a mite infestation, is it normal that the skin gets inflamed like this? Thank you so much.
29th September 2016 12:39 PM