The Hidden Culprit Unraveled by Dermoscopy: A Rare Case of Pediatric Facial Demodicosis

We report a rare case of pediatric facial and ocular demodicosis in an immunocompetent seven-year-old with chronic centrofacial papulopustular lesions and recurrent blepharitis misdiagnosed over several years. Dermoscopic examination revealed a high-density Demodex infestation on facial skin and eyelashes, leading to a definitive diagnosis. A combined treatment approach using topical and systemic metronidazole, along with targeted ocular therapy, achieved complete remission. This case highlights the diagnostic power of dermoscopy and underscores the importance of considering demodicosis in children with refractory facial and ocular involvement.