case_images: PMC8449553_01
case_images: Facial follicular hyperkeratotic spicules on right anterior jaw line.
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case_images: The patient reported with dry skin with numerous follicular hyperkeratotic spicules with a rough consistency in the anterior aspect of the right jaw and across the mid-zone that could be palpated on physical examination (Figure 1).
case_images: Facial follicular hyperkeratotic spicules after three weeks of treatment with 5% permethrin.
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case_images: The patient was initially prescribed a topical application of 5% Permethrin cream twice daily; however, a three-week follow-up examination revealed only 70% improvement with evident follicular spicules (Figure 2).
case_images: Fully resolved follicular hyperkeratotic spicules after treatment with 1% Ivermectin cream for three weeks.
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case_images: The next three-week follow-up revealed that the follicular spicules had cleared entirely (Figure 3).