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

Ilaria Trave; Emanuele Cozzani; Ilaria Salvi; Aurora Parodi

doi:10.4081/dr.2023.9798

Authors

Ilaria Trave Section of Dermatology, Department of Health Sciences, University of Genoa; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://orcid.org/0000-0002-5469-4517
Emanuele Cozzani
emanuele.cozzani@unige.it
Section of Dermatology, Department of Health Sciences, University of Genoa; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://orcid.org/0000-0003-3108-4123
Ilaria Salvi Section of Dermatology, Department of Health Sciences, University of Genoa; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://orcid.org/0000-0003-0151-3126
Aurora Parodi Section of Dermatology, Department of Health Sciences, University of Genoa; IRCCS Ospedale Policlinico San Martino, Genoa, Italy. https://orcid.org/0000-0002-6622-2226

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 almostclear, mild and moderate papulopustular rosacea (PPR) and to study the differences between Demodex-positive (D+) and Demodex-negative (D-) 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 D+ than in D- patients. Among D+ 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 PPR, because they can be a sign of a more severe form of rosacea or of demodicosis.

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Trave, I., Cozzani, E., Salvi, I., & Parodi, A. (2023). Follicular scales, scalp and ocular involvement in patients with papulopustular rosacea: prevalence and association with Demodex mite proliferation. Dermatology Reports, 16(1). https://doi.org/10.4081/dr.2023.9798