Childhood granulomatous periorificial dermatitis: Ivermectin as a novel therapeutic approach

We report the case of a 9-year-old boy with typical clinical and histopathologic features of childhood granulomatous periorificial dermatitis. Despite multiple previous treatment attempts, the condition persisted. The patient had a concurrent history of asthma and was receiving daily inhaled fluticasone therapy. Management was challenging, as the patient exhibited resistance to conventional treatments, possibly owing to the use of inhaled corticosteroids, where discontinuation is usually the first step. Therapy with topical and a single dose of oral ivermectin was employed successfully, likely owing to its anti-inflammatory and anti-parasitic effects on Demodex spp. To our knowledge, this is the first case of ivermectin use in this condition. Both topical and systemic ivermectin appear to be safe and efficacious therapeutic options.