Facial pigmentation with demodex Mite; a mere coincidence or an association?

Demodex mites may induce inflammatory cutaneous reactions such as papulopustular rosacea and demodex folliculitis; both may lead to post inflammatory pigmentation. A 59-year-old man presented with an asymptomatic, hyperpigmented plaque on his face. Histological and clinical findings displayed Riehl-like facial pigmentation. Multiple demodex mites at the follicular infundibulum in the biopsy material were remarkable. There are limited publications about demodex-associated pigmentation. We report this case to point out that various hyperpigmentation disorders may occur simultaneously with demodex mites.