Asymptomatic Bilateral Demodicosis of the Nipple

Demodex parasites are obligate ectoparasites found in the sebaceous glands and hair follicles, primarily on the human head and face. They are the largest and most complex organisms in the skin microflora. Their pathogenic role as a cause of dermatoses in humans raises ongoing concerns. The species of Demodex mites have been found in skin lesions, but Demodex disease has not been accepted as a distinct entity. All skin conditions caused by Demodex mites are collectively referred to as demodicosis. This case is an incidental finding of bilateral nipple demodicosis in an otherwise healthy patient who presented to our breast unit for the first time for her annual screening mammogram. It highlights an unusual location of Demodex infestation, with bilateral nipple involvement, a finding that appears to be rare in the existing literature. Increased awareness may lead to earlier recognition and appropriate management.