Demodicosis Mimics Acneiform Eruptions in Patients With Inflammatory Bowel Disease Receiving Upadacitinib.

Wu, Hsin-Yun; Yang, Chia-Yi; Weng, Meng-Tzu; Tung, Chien-Chih; Wong, Jau-Min; Wei, Shu-Chen · Am J Gastroenterol · 2026

case_series · Level IV

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Abstract

Acne is a common side effect of inflammatory bowel disease (IBD) treatment. We investigated the role of demodicosis in acne development in patients with IBD. From 2019 to 2021, IBD patients with acneiform eruptions were referred for dermatological evaluation. We compared these patients according to the demodicosis status. Of 509 patients with IBD, 30 had acneiform eruptions. Among them, 20 had demodicosis. All were successfully treated without IBD treatment adjustments. Upadacitinib use was the only independent risk factor of demodicosis, occurring in 16 of 18 exposed patients. Demodicosis should be considered in patients with IBD having acneiform eruptions, particularly those receiving upadacitinib.

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