Facial demodicosis with sharply demarcated islands of sparing: A case series

We report a case series of 11 patients with facial demodicosis exhibiting a distinctive “island sparing” pattern—sharply demarcated areas of unaffected skin within diffuse erythematous facial lesions. Dermoscopic findings revealed characteristic Demodex tails and follicular plugs, and all patients showed partial to complete clinical improvement with anti-Demodex therapy. This is the first description of such a sparing pattern in immunocompetent individuals, highlighting a novel diagnostic clue for facial demodicosis.