• Misdiagnosed Rosacea
    Articles, References and Anecdotal Reports

    misdiagnosed_rosacea.pngArticles and References

     

    There are articles on rosacea that mention misdiagnosed rosacea. While this isn't a massive problem, nevertheless, here is a list of different sources that mention the subject

     

    "Rosacea SKINsights sponsored by Galderma Laboratories [reveals] the lengths that women with rosacea would go to if they could get rid of their rosacea forever, and highlight the low awareness and complicated diagnosis path for this common condition. On average, women with rosacea waited at least seven months before receiving a correct diagnosis, and only half of respondents had ever heard of the condition upon the time of diagnosis. This reveals the high level of misunderstanding and confusion that surrounds rosacea..." Medical News Toda

    "Currently, rosacea is only diagnosed by clinical symptoms and can be confused with other dermatological diseases such as acne."
    New Treatment or Diagnosis for Rosacea with Existing Approved Drugs
    Tech ID: 19149 / UC Case 2007-047-0
    University of California, San Diego
    Technology Transfer Office

    "Despite its apparent high incidence, the nosology of rosacea is not well established, and the term “rosacea” has been applied to patients and research subjects with a diverse set of clinical findings that may or may not be an integral part of this disorder. In addition to the diversity of clinical manifestations, the etiology and pathogenesis of rosacea are unknown, and there are no histologic or serologic markers."
    Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea

    ''Some physicians may not be aware of or recognize rosacea and may treat patients with rosacea inappropriately as if they had adult acne.''
    Dr. Jonathan Wilkin NRS Medical Advisory Board

    "Rosacea is a common dermatologic disorder. It is frequently overlooked or misdiagnosed, particularly when mild in nature."
    Rosacea: A Review of a Common Disorder by Carolyn Knox, IJAPA

    "Patients with rosacea frequently present with coexisting skin conditions, such as seborrheic dermatitis, acne, perioral dermatitis, and melasma, which may complicate diagnosis and treatment."
    Heather Roebuck, Nurse Pract. 2011 Jan 11.

    "A committee member, Dr. Mark Dahl, a dermatologist at the Mayo Clinic in Scottsdale, Ariz., said, ''This is a syndrome with lots of different elements that is easy to diagnose when all the elements are present,'' but not as easy when only one or two of the characteristics appear."
    PERSONAL HEALTH; Sometimes Rosy Cheeks Are Just Rosy Cheeks
    By JANE E. BRODY, New York Times, March 16, 2004

    "Rosacea is a complex and often misdiagnosed condition." The Rosacea Forum Moderated by Drs. Bernstein and Geronemus

    "Whereas the classical subtypes of rosacea can be recognized quite well, the variants of rosacea may be overlooked or misdiagnosed." rosacea.dermis.net

    "Rosacea is often misdiagnosed as acne or discoid or systemic lupus erythematosus (SLE)." Christiane Northup, M.D.

    "Frequently misdiagnosed as adult acne, this chronic, progressive skin disorder affects millions." Recognizing and Managing Rosacea by Thalia Swinler, JSTOR

    "The last subtype, ocular rosacea, is common but often misdiagnosed." uspharmacist.com

    "The signs and symptoms of ocular rosacea in children may be frequently underdiagnosed or misdiagnosed..." NRS Rosacea Review, Summer 2008

    “It’s a condition that is often misdiagnosed and overdiagnosed. Sometimes a rosy cheek is just a rosy cheek.” Herbert Goodheart, M.D., a dermatologist in Poughkeepsie, N.Y., and author of “Acne for Dummies,” as quoted in the New York Times article

    "Dr. Jay points to the inherent dangers of misdiagnosis and inability to handle complications because of a limited understanding of cutaneous physiology."
    IPL: Wave of the future in rosacea therapy by John Nemec, Aug 1, 2006

    "...unusual manifestations of rosacea may be overlooked or misdiagnosed...."
    Rosacea: An Update
    Stanislaw A. Buechner
    Dermatology 2005;210:100-108 (DOI: 10.1159/000082564)

    "Rosacea is a skin condition as misunderstood as sensitive skin, and as frequently misdiagnosed." Dermilogica

    "Rosacea is a very common, but often misunderstood and misdiagnosed skin condition." skinlaboratory.com

    "Rosacea is a long lasting, non-scarring skin condition of the face that is often misdiagnosed as adult acne." Paul M. Friedman, MD

    "Rosacea is quite often misdiagnosed as any number of other skin disorders including acne." methodsofhealing.com

    "Often misdiagnosed as adult acne, allergy or eczema, Rosacea, if left untreated, tends to worsen over time...." Dana Anderson Skin Care

    "This present patient clearly had facial changes typical of acne rosacea, with erythema and telangiectasias of the cheeks, forehead, and nose. He had all the typical lid changes as well, including collarattes that are pathognomonic of staphylococcal blepharitis. Unfortunately, he had been misdiagnosed for several years…" Clinical Pearls by Janice A. Gault, p. 206

    "Due to the fact that lupus can cause a red rash across the nose and face, often in a butterfly pattern it can be confused with or misdiagnosed as rosacea. .." www.rosacea-treatment.net/

    "Dr. Callender also noted that rosacea is often misdiagnosed in patients of color, as clinicians may mistake the signs and symptoms of the condition for lupus – a systemic, autoimmune condition that commonly occurs as a “butterfly rash” involving the face."
    Treating acne and rosacea in people with skin of color - ihealthbulletin.com

    "...it's often overlooked in dark-skinned patients or misdiagnosed as lupus, which is marked by a red, butterfly-shaped rash in the center of the face,..." Shape May 2009

    "...the diagnosis of demodicosis is frequently masked by other skin diseases such as papulopustular or erythematotelangiectatic rosacea, seborrhoeic dermatitis, perioral dermatitis and contact dermatitis." Br J Dermatol. 2010 Feb 25.

    A Case of Precursor B-cell Lymphoblastic Lymphoma Misdiagnosed as Rosacea.
    Han EC, Kim DY, Chung JY, Chung HJ, Chung KY.
    Korean J Dermatol. 2008 Feb;46(2):264-267

    "It is when the first diagnosis and treatment don't work that dermatologists look deeper and often discover something called demodex." Microscopic menace may be cause of skin trouble, Jennifer Van Vrancken, Reporte, FOX 8 News: WVUE Live Stream

    "Busy doctors who cannot take a detailed history will frequently miss the diagnosis, complicated further by the fact that rosacea is a great mimic of other unrelated disorders that present with a “red face”. I have often seen classical cases of rosacea mistakenly diagnosed as acne vulgaris, lupus erythematosus, seborrheic dermatitis, contact dermatitis, and other inflammatory diseases." Albert Kligman, A Personal Critique on the State of Knowledge of Rosacea

    "Ocular rosacea is frequently misdiagnosed, particularly in the pediatric population." Eur J Ophthalmol. 2012 Jan 3:0. doi: 10.5301/ejo.5000103.

    A report, About some red faces, stated: "Diagnosis is based on different data: date and mode of appearance, characteristics of the erythema, functional signs, and associated systemic manifestations. A case of red face can have an infectious origin, caused by vascular, congenital, or acquired lesions, or be caused by photodermatosis, or be the main location of inflammatory dermatosis or collagenosis, but depending on the clinical context, many other diagnoses can be suggested."

    "Butterfly rash is a red flat facial rash involving the malar region bilaterally and the bridge of the nose. The presence of a butterfly rash is generally a sign of lupus erythematosus (LE), but it can also include a plethora of conditions. The case presented here is of a female with butterfly rash along with typical bright red discoloration of gingiva. The clinical, histopathological and biochemical investigations suggested the presence of rosacea."
    Contemp Clin Dent. 2012 Jul;3(3):356-8. doi: 10.4103/0976-237X.103637.
    Butterfly rash with periodontitis: A diagnostic dilemma.
    Aggarwal M, Mittal M, Dwivedi S, Vashisth P, Jaiswal D.

    Anecdotal & Other Reports of Misdiagnosis

    The following is a massive list of anecdotal reports either of misdiagnosing rosacea for another skin disease or vice versa:

    "Just an update and to show the importance of knowing what you have, I saw a Rosacea specialist with 20 years of treating and research under his belt, and made the appointment saying "Trying to treat Rosacea" as the reason. The second I came in he was confused and wondered where the Rosacea patient was. He looked at me and told me I absolutely do not have Rosacea, he's seen thousands of cases over decades and it's simply not it. And it's not caused by being choked, ever. It was thinned skin due to Steroid Creams, and thankfully, he caught that because the General Practitioner who 'diagnosed' me with Rosacea prescribed steroid cream. The most alarming was that the general practitioner gave me Metrogel which I understand is meant to help Pimples, and I have absolutely zero of those." AlenaCena post #68

    "I've been to dermatologists in three different countries starting when I was 16, and I'm now 41. When I first started going to them, they didn't know a lot about eczema and dermatitis and the treatment course was antibiotics and cortozone creams. (Not much has changed) Even then I knew foods and hormones were triggers or the cause of the skin eruptions. I've had dermatologists tell me it's not rosacea and dermatologists tell me it is. One things for certain out of the more than 30 dermatologists I've seen in my life time, no two have had the same things to say. However last time I was at one, she did look up patronizing and say, yes we now know hormones can affect eczema...as if her telling me that made a whit of difference to what I have already known. In the UK, where they have now said it is rosacea, I have had no other tests. The dermatologists I've seen refuse to accept other countries diagnosis of food allergies. They refuse to take into consideration what I'm saying, about my upper eye lid cracking (it's been cracking there my whole life, so much so I've a deep scar) and the bubbling around my eyes, and over my brows. In the end, I think a they've learnt mo about the what some skin problems are, they seem to have bunched the rest as rosacea. Which appears to me to be a blanket term, covering a huge amount of things." Melania post #66

    full reports, "Just diagnosed with this infuriating condition after 2 years of be wrongly diagnosed and treated for both rosacea and acne. I am really clueless about this condition and need a explanation of it.. Anyone ever permanently got rid of this? My face is only affected, mainly my cheeks.," full types in the subject of this post Pityrosporum Folliculitus

    lexflorex reports, "I just want to share with you that I didn't have Rosacea. I was first diagnosed with it and prescribed a medication that didn't help me at all. So I want back to the doctor's office the 2nd time and a different doctor said I had Dematitis. I used this topical cream that they prescribed and within a few days my face cleared up. 2 weeks into it it is almost completely gone. My point is you may want to get a 2nd opinion."

    GNR reports, "...I was told I had Perioral dermatitis because there was an outbreak near my nose....Began to notice a swelling under my right eye and a red path beneath extending up the temple. It became hot and sensitive and flares when I workout with weights. Told "hmm don't know what that is, it's not rosacea (my fear was that it was) but try rozex cream to see if it goes." It didn't. Didn't change. Had a second opinion. Same as the first. "Don't know, looks like it might be fungul. Leave it until you see a dermatologist." Began to a sore eye, a few pains and watering. Went back to the second opinion to ge this checked was given a scrip for kenocomb ointment for fungus....out of desparation I went to another gp explained the whole story again. He checked the skin, told me it wasn't rosacea that it looked like a fungus infection try Nizoral 2%. Hmmm. Later that day I had an appointment with a new dermatologist who told me that I actually had seborrhec dermatitis...this sounded right as all the systems relate, rash on chest, dry skin in eyebrows, dandruff...funny I'd never connected these things and either had anyone else. He then checked the rash thing on the right side of my face and temple and told me it was rosacea. I asked about the pain in the eye, watery, and he said not connected. Gave me a print of what to expect with rosacea and out the door I went..."

    Bob reports his rosacea was misdiagnosed for discoid lupus

    Gem says, "A couple of months ago I developed a rash on my forehead and was given a steroid cream for it that seemed to keep it under control for a while, then around 3 weeks ago it spread and looked angry, I went to the doctor who said it was acne the cream I was given just aggravated it, so I went back and was given another cream by a different doctor who still thought it was acne... this again aggravated it, so I started looking on the net for other ideas or medications that could help. I tried coconut oil and aloe vera topical and ingested, another trip to the GP I was given Tetracycline oral antibiotic but it was something like a 3 month course, ....I went to my doctor again today as my self treatment wasn't doing any good and I was told it looks like rosacea I've been given metronidazole gel and I've started the Tetracycline oral antibiotics again...."

    ssaeed says, "...He diagnosed me initially with Seb Derm and prescribed Desonide cream for 3 weeks. I noticed my skin got a lot better and softer during this treatment although towards the end of the treatment I started getting small pus filled acne bumps on my nose and cheek, about the size of a pore. When I saw the doc after the 3 week Desonide treatment he told me I may have symptoms of Rosacea and started me off on a treatment of Metrogel once a day and Oracea once a day in the morning."

    Ladonna says, "...my husband took me to the dermatologist and she said it was Rosacea and couldnt be anything but....So he took me to many doctors, and finally a wonderful doctor took a shot in the dark blood test and discovered my problem. Later more involved tests and scans confirmed it. I was Hyperthyroid...specifically Graves Disease..."

    Elizabeth's initial diagnosis of rosacea turned out to be KP.

    Andrea says her initial diagnosis of rosacea may have turned out to be pellegra.

    Jason was misdiagnosed numerous times and was unfortunately given steroids which he believes aggravated the condition.

    Kari was initially diagnosed with rosacea and later found out it was eczema.

    maxigee2002 said after six months of being treated for rosacea a doctor discovered she was misdiagnosed and actually had Pityrosporum Folliculitis.

    gdybe was misdiagnosed with Crohn's disease and after six months of steroids developed rosacea.

    Ladonna was misdiagnosed with rosacea and it turned out to be Graves Disease.

    Susan reports that she developed "a rash above my eye (below the eyebrow - a little on the lid itself). First he said it was "orbital dermatitis" and gave me topical cortisone and anti-biotics. Not sure it helped much, it seemed to go away on its own schedule, although the steroid may have lessened the itchiness. I went back and he prescribed Metrogel and more cortisone cream. He told me it was a form of rosacea."

    Tom says that 6 years before he was diagnosed with rosacea and treated and now says "This doctor does not think I have rosacea, instead he thinks I have erythema." Tom says he thinks he might have KP.

    DC says his physician misdiagnosed his dermatitis as rosacea.

    NorthNova says he was misdiagnosed by dermatologists before he found out he had rosacea.

    flareface reports that a dermatologist diagnosed her condition as "physiological flushing" and later she says a PA "misdiagnosed pretty much everything, gave me 3 different steroidal creams and sent me on my way." Later another derm diagnosed "contact allergy" on her eyes and prescribed a mild dose of cortisone cream for a couple days and it all cleared up.

    redKen (see post #2) says his dermatologist misdiagnosed his rosacea for dermatitis.

    nk104 says two dermatologists diagnosed rosacea. A third physician said it was not rosacea but neurodermitis.

    Jonesy says his GB said he didn't have rosacea and later went to another physician who diagnosed urticaria.

    RedFacedRedHead says her rosacea turned out to be KP.

    cliopatra25 says that for ten years she was misdiagnosed with acne when all the time she had rosacea.

    vicky says "both my sisters was misdiagnosised collectively 10 times... and they have lupus...similar to my brother, he even had 2 positive ANA tests and thedoctor refused to treat him for lupus......

    Deb says, "I mentioned in another post that for years I was given things that were making the Rosacea worse, like retin-A and cortisone cream. I had mild rosacea then, so was misdiagnosed. For a while they thought it was Lupus since I also maintain a low-positive ANA. Their and my mistakes only made it worse, especially in the past few years."

    Lisa M says, "I suffered from cystitis for years... and had to go on daily antibiotics for it for about 2 years. I also did saw a homeopath at the time and changed my lifestyle to no alcohol at all. I didn't know it at the time but I had rosacea (sadly totally misdiagnosed by several derms).

    Mike says, "I also developed ocular rosacea a couple of years ago, after having facial rosacea for quite a few years. My first opthamologist misdiagnosed it, and treated me for months with steroids (mainly Tobradex) which ended up raising my IOP to a dangerous level.

    Aurelia reports that "A teenage girl was given an "almost certain" diagnosis of ocular rosacea....The symptoms suffered by this girl did NOT match those of ocular rosacea and specialists later came up with a diagnosis of autoimmune Urticarial Vasculitis.

    Kerry reports that "I have found out today that I was yet again misdiagnosed and I don't have rosacea I have Lupus."

    Sarah Smart says, "I am 12 weeks pregnant and my rosecea fulmins was horribly misdiagnosed by my derm (as shingles if you can imagine) and I spent 5 days in the hospital before they figured it out." Report.

    Kerry says, "I was misdiagnosed for 4 yrs by my gp as I have pretty severepsorisis on 60% of my body and scalp. They gave me a really strong steroid which has made my skin worse on my face.although it kept it under control. I found out 3 weeks ago i have rossacea and they stopped my steroids so my face has had a major eruption."

    Ellen says, "my rosacea related blepharitis was misdiagnosed as seb derm."

    sand7676 says, "I was misdiagnosed with acne I believe because of my skin tone.

    Francois says that three derms diagnosed he had 'vascular dilation' and the last one said he had " 'Sebore' in Turkish. I looked at internet and I think it means 'Seborrhe'."

    Kevin Forest says, "I've recently been diagnosed with rosacea after being misdiagnosed for ~2.5 years (errrrrr! derm aggerssion)."

    Joe says, "I've been misdiagnosed by numerous dermatologists who were in disbelieft that I would have rosacea at such a young age and assumed it was merely acne."

    Suzi LeBaron says, "I was misdiagnosed because it looked like rosacea -- including occular symptoms."

    Mike Lester says, "they called it seborrheic dermatitis, maybe rosacea. to be honest no one knew. many blood tests for lupus or something....Ive been going to doctors and doctors for my facial redness that ive had for over a year now. Well, they seem to have diagnosed me with ROSACEA!!!....I was checked for everything, lupus's, mastocytosis, carcinoids, tumors on the kidneys, brain tumors, and much, much more, some things some doctors have never even heard of. but it turns out i was misdiagnosed by the Mayo Clinic from the start, so we didnt need to go through months and months of stress, depression (which by the way i go to a psychologist now and am on PROZAC too).

    Stuart Clark says, "I too waited months for an appointment (on two separate occasions) and she completely misdiagnosed me."

    Carol Voigt says, "I, too, was "misdiagnosed" for many years."

    Jeff says, "I got misdiagnosed by my previous dermatologist...So he gave me a steroid to apply twice a day, which of course, did not help. And by the time I had diagnosable rosacea..."

    Eddie O'Neill says, "She said that I did NOT have bacterial conjunctivitis and had been misdiagnosed..."

    Chantal says, "in my early 20's (around 22-23), and was misdiagnosed for years (about 5) until the correct diagnosis of rosacea was made."

    Heather says, "My facial rosacea was misdiagnosed for MANY years (mainly an acne component with some redness)..."

    Jay Valof says, "2yrs ago i had septoplasty (deviated septum) nose surgery. soon after developed symptoms, was misdiagnosed as having asthma/allergy. 2 months ago derm. said in had rosacea..."

    jesseleigh says, " I just found out about a week ago I have rosacea, have been misdiagnosed with atopic dermatitis for ten years."

    yoli says, "I was misdiagnosed for 2 years they thought I had dermatitis but in reality i don't itch but burn.... it took me 6 dermatologist in order to get diagnosed with Rosacea."

    beecham says, "I was diagnosed in December 2007 with pustular rosacea by my new doctor, I was on oxytetracycline for about a year before with my previous doctor who had misdiagnosed me with perioral dermatitis...."

    LoriB says, "When I saw my general doctor while waiting for an appointment with a derm he misdiagnosed me as having acne vulgaris. He told me I don't have rosacea because my cheeks aren't red."

    jodieginger says, "I was repeatedly misdiagnosed as having dermatitis and none of the derms seemed to care that I simultaneously had blepharitis simultaneously. "

    mineren says, "I have adult acne in addition to rosacea and was misdiagnosed a couple of times. "

    mythjedi says, "She stated that I had "contact dermatitis" and gave me doxycycline....but it wasn't long before transient, big, patchy red blotches began to form on my face and chest....I discovered that I was allergic to these pills, and I stopped taking them.... I have been off of the pills for six months...I went to a dermatologist and was diagnosed with rosacea..."

    Yvonne says, "My SD was misdiagnosed as rosacea."

    Cassie Henderson says, "I was misdiagnosed by a blind derm and used hydrocotizone for three months. My rosacea went from a splotty red blotch on one cheek to an all over the face red hue very bumpy dry and ruddy looking. I then went to a derm who wasn't legally blind and started using metrogel and minocycline which helped for awhile."

    Keith on 07.15.09 at 12:43 pm says, "...I went to a highly accomplished and respected doctor in my area who diagnosed it as Rosacea so I guess thats what it is. Other Derms have said sundamage, Folliculitis, so it is still uncertain to me..." Scroll down to Comment #91

    Lori said her acne was diagnosed as rosacea which later turned out to be also seborrhoeic dermatitis after she had taken Oracea for over a month. She was switched to Doxycycline at a higher dose and Finacea. See Comments #68, #84, #89, #93, #107, #114, #117, #123.

    raly says, ..."I've been "diagnosed" at different times as it being rosacea, folliculitis, sebderm or possibly just acne from both GPs and a dermatologist..." Scroll down to Post #9

    dan pacifik says, ".... After a second trip to the doctors, my doctor seemed to think it was rosacea so she prescribed me metro cream 0.75%....…I think! I pretty much used this for about 8 months....I went back to my doctor about this and she said it looked more like acne on my forehead....I am however skeptical over my doctors and derms diagnosis..."

    kfoltz9 says, "I am a 25 year old female with what appears to be perioral dermatisis around my mouth. My family history only consists of Psoryasis and I have not had a personal experience with this. I am currently on Effexor XR. I use Aveda sensitive skin facial cleanser which does not contain any Petrolatum. I have not introduced any new cosmetic products into my regimen. The dermatologist I went to yesterday about this month-old rash (I have had one previous occurence, only less intense) did not even inspect the rash, asked me if I blushed easily or often (I do not, and told him that) and diagnosed Rosacea in about 3 seconds.

    siliconmessiah says, "...I first went to the doctor on a "drop-in"-visit. One of them (a really shitty doctor actually) prescribed cortisone cream for my problems - I took it for a couple of weeks with no signs of getting better. I returned to a new doctor, a really good one I might add...she diagnosed me in one minute under the light of a lamp..." Scroll down to post #2

    brighteyes says, "It took me approximately 3 years (and 6 derms) to get an official diagnosis...." Scroll down to post #3

    Mistica says, "...So in my case, rosacea wasn't recognised immediately and even 10 and a half years on from the orginal diagnosis, the 'diagnosis' is continuing in some ways. It looks like rosacea ( no missing that!!) and it behaves like rosacea, ... but is it just Rosacea?..." Scroll down to post #8

    IJDVL reports, "Subsequently, the initial diagnosis of allergic conjunctivitis was revised by the ophthalmologists to ocular rosacea." *

    A 32-year-old woman had developed moderate swelling, erythema and papules of the central part of her face for 8 weeks. She started to apply various topical cosmetic products sold for acne that did not help. As one of her hobbies was outdoor biking she noticed that sun exposure aggravated her skin condition, also resulting in burning and stinging sensations. She consulted her general practitioner who prescribed prednicarbat cream for topical application on the affected regions. Whereas she observed a slight improvement of the skin condition during the first week, she later on suddenly developed a severe worsening with erythema, papules and many pustules. She presented to a dermatologist and was diagnosed with "steroid rosacea". She went off the steroid, started topical treatment with metronidazole 1% and oral treatment with metronidazole 500 mg twice daily for 2 weeks. After an initial worsening during the first 3 days the skin condition rapidly improved. She continued metronidazole 500 mg once daily for another 2 weeks and then stopped. The topical treatment was continued twice daily for altogether 4 weeks and then reduced to once daily for another 4 weeks. Besides, she applied sun screen whenever she was outside. She continued intermittent topical use of metronidazole 1%. She remained free of symptoms except of an intermittent slight centrofacial erythema. See case report #1

    A 39-year-old woman was referred to a dermatology department because of worsening of her known rosacea. She had been suffering from rosacea for 3 years. After initial, short-term and intermittent oral therapy with tetracycline for periods of up to 3 weeks she had continued topical treatment with tretinoin without any problems for the last months. Suddenly, she developed an erythema of the face accompanied by strong burning that increased in the evening, decreased over night and was moderate at day time. She discontinued topical tretinoin therapy because she felt that the symptoms were caused by it. She presented to a dermatologist with a sharp erythema of the whole face with only solitary papules and pustules. Due to the patient's history and the clinical finding contact allergy was suspected. Patch testing revealed a sensitisation to cocamidopropyl betaine, a surfactant that is frequently added to shampoos and skin cleansing products. This substance could be identified in her skin cleanser. When she discontinued this product, the symptoms disappeared and the patient could continue her topical treatment.
    We recommend to precisely ask patients about all the topical drugs and cosmetics they use including skin cleansing products. Contact allergy can also occur in rosacea patients and may mislead patients and physicians. See Case Report #3

    A 56-year-old diabetic man presented erythematous papules and pustules on the neck and face who had developed since 3 months. He had been treated with topical corticosteroids for the same time period that resulted in progressive exacerbation. He additionally showed patches of hair loss in the beard area, erythema and scaling of the ears. Among various differential diagnoses the clinical picture reminded of stage II rosacea. Microscopial examination and culturing revealed Microsporum canis. He was diagnosed tinea incognito, a term that has been used to describe dermatophyte infections modified by corticosteroid treatment.
    This case report demonstrates that there is a number of other skin diseases that can mimic rosacea. (see Case Report #7)
    Gorani A, Schiera A, Oriani A: Case Report. Rosacea-like Tinea incognito. Mycoses 2002; 45: 135-137.

    A Case of Precursor B-cell Lymphoblastic Lymphoma Misdiagnosed as Rosacea.
    Han EC, Kim DY, Chung JY, Chung HJ, Chung KY.
    Korean J Dermatol. 2008 Feb;46(2):264-267

    Pete says, "...Had previously been misdiagnosed by my G.P. Had been treated with steroid creams for eczema...."

    shakti says, "...I had a horrible rash on my face which the Dr. (dermatologist) even took pictures of, but he said it was rosacea....Then a neurologist said I could have some sort of mild m.S..... I've recently had a "rosacea flare" swelling and redness around my eyes and upper cheeks, the tiredness has returned and so has pain in my bladder and gi tract...."

    belinda says, "After being misdiagnosed for 7 years, I had almost given up hope." published April 8, 2008

    mmee says, "...just wanted to say after many years of suffering with depression and social anxity because of a red face and not being able to get any information out of 3 dermatologists and about 5 GPs (they just said it was 'normal') . I've found out from a link on this website it must be Keratosis pilaris rubra faceii..."

    DylanG says, "... I finally got an appointment with a dermatologist for my rosacea. After waiting about half a year, I go to the appointment. The dermatologist walks in, doesn't even look at my face and says "There's nothing I can do about redness. Some people just have red skin". Then, to top it off, he gave me cream for acne - something which I could care less about - that has the side effect of making your face red. I was out of his office in practically two minutes with about twenty tiny tubes of acne medication I had no need for. ..." Scroll to Post #22

    Donna says, "I got results back from labs and xray..i do NOT have sarcoidosis…but still not sure what i have …i have granulomas popping out on parts of my body and my face is still not clear. I am going to a conference of doctors on the 16th to get their opinions. I was originally diagnosed with Granulomateous rosacea so lets see what opinions i get." Post #146

    liangjuany says, "I saw another doctor today and was told what I had was not rosacea but pityriasis rosea instead."

    huiness says, "another derms who told me I had acne, or folliculitis etc. When I finally decided to go back to Derm #2, he then diagnosed me with rosacea.....went to Derm #14809348. He agreed with the rosacea diagnosis but said that this was probably steroid induced..."

    mrsmoof says, "1st dermatologist thought I had dermititis.....Well, I went to a 2nd dermatologist and told her my story, symptoms.....within minutes she said it was Rosacea...." Scroll to Post #43

    "My wife was diagosed by a local Dermatologist as having Rocacea. He only did a visual inspection without any actual skin testing. He was sure it was Rocacea and prescribed an expensive cream which she would have to use for who knows how many years. Luckily she had a severe reaction to the cream, and discontinued it. She visitited her home country of Russia and was treated by a specialist. He told her she didn’t have Rocacea but had Demodex. She had one treatment by the doctor and her face is still clear after 6 months. Always get a second opinion." J Noble on 01.12.10 at 7:11 am Post #215

    says, "I think it took about 10 mins for a NHS dermatologist to tell me that I didnt have rosacea. She looked at my skin said there was no visible erythema or papules and pustules to suggest rosacea, and that I needed to stop "reading stuff on the internet". I had to actually ask for a blood test to rule out lupus etc!!!!!

    spuggylegs says, "I think it took about 10 mins for a NHS dermatologist to tell me that I didnt have rosacea. She looked at my skin said there was no visible erythema or papules and pustules to suggest rosacea, and that I needed to stop "reading stuff on the internet". I had to actually ask for a blood test to rule out lupus etc!!!!! I asked my GP if he could send me for a second opinion but he refused. The problem is that there is a lot of inequality in the NHS...and as someone who lives in a deprived area, healthcare is usually not as good as those who live in more affluent areas. (but thats another story). Well I still carried on "reading stuff on the internet" : ) and decided the only way forward was to go private..even though i couldnt really afford it. So travelled from the north east to London, and got so stressed, as we got lost a few times, and London is not the friendliest of places. By the time I had got to see the derm I was having a major flush....so after reading my medical notes, asking about family members who may have rosacea,, symptons, and looking at my skin, he diagnosed rosacea. From what i can remember the consultation lasted about 30 mins." Scroll to Post #50

    "The diagnosis of lupus flare was made by the general practioner who prescribed corticosteroids....and the patient was hospitalized....The diagnosis of erysipelas of the face was made...This coincidence is a rare condition which may lead to erroneous diagnosis and inappropriate therapy."
    A red face in a lupus patient: thinking beyond lupus rash.
    Stubbe M, Smith V, Thevissen K, Mielants H, De Keyser F.
    Acta Clin Belg. 2010 Jan-Feb;65(1):44-7.

    Rachelle C says, "My doctor diagnosed me with rosacea, delusional paristosis. The medications for these did no good. Then another dermatolgist with an allergist diagnosed me with demodex (skin mite) allergy." Scroll to Post no. 77 on 05.04.10 at 1:00 AM

    Girrlock Holmes says, "…I was finally diagnosed hypothyroid, insulin resistant and PCOS, and my doctor also thinks my symptoms fit with fibromyalgia…I saw a dermatologist who said it was not Rosacea but offered no info on what it could be. Then I saw an allergist and he said the derm had no basis for saying it was not Rosacea; it looked like it to him. So you see I have no clear diagnosis. I am waiting for a different derm to see me but it will not be for another 2 months…"

    "Terri Flynn, a 63-year-old part-time receptionist from Texas....Two different evaluators told her she had "dry eye" and prescribed artificial tears and various eye medications, while one also suggested she have her bottom eyelids lifted to help retain the moisture in her eyes....She made an appointment with a dermatologist, who "took one look at me and said, 'Yes, it's rosacea." NRS Rosacea Review Spring 2010

    comicraven reports, "I had been misdiagnosed for a while - everything from shingles to testing for lupus - and was finally properly diagnosed about 6 months ago..."

    koki says, "OK according to dermatologist # 4 , again I dont have rosacea, I explained my symptoms and he said it sounds more like an allergic reaction and when he examined my face he said it was more like eczema/seborrheic dermatitis and gave me some diflucan. ....I am glad most derms say is not rosacea..."

    stb09 says, "In May 2004, I developed a pimple on my nose that left a red mark on it for, what must've been a solid YEAR after it cleared up. I was thorougly convinced this was a scar, and went to several dermatologists to find proper treatment. Such begins my ongoing battle (and subsequent HATRED) for all dermatologists.

    The first one I saw told me that it was a mole....I sought a second opinion. This one told me it was a scar, and could only be removed by a plasic surgeon. He took my $100, and gave me the number of a plastic surgeon.

    The plastic surgeon (who was once a dermatologist) was convinced it was a pimple still, and simply lanced it and dug around in it, ultimately making it worse....

    The fourth and final dermatologist perscribed me Accutane in January of 2005 for my back acne/oily skin. He agreed with ME that whatever was on my nose was inflammed and most likely a sebacous cyst. He injected it with cortisone, and that made a tremendous difference, and today there's not a mark to be found. This is the same dermatologist that dismissed my concerns of facial redness and never spoke a word about Rosacea in spite of my ruddy complexion that I was, at the time, unaware of....I was at a new branch of my college and went to the local dermatologist to seek treatment. He told me it was probably a scar and gave me the number of a laser surgeon FOUR hours away that "might" be able to help me.

    THIS is the first time a doctor has mentioned the word "Rosacea" to me. He explained that I had a ruddy complexion, and thus, the red spot on my nose was more noticable. He went on to state that people with my complexion "could be candidates for Roscea later in life." and encouraged me to stay out of the sun......I finally decided to see a dermatologist to rule Rosacea in or out so I could get on with my life one way or the other. I went back to the local dermatologist, who had told me that someone with my complexion might be a candidate for Rosacea later in life, and was told absolutely nothing new.

    He once again told me that, maybe I'd have it one day, and maybe not. I asked him if I should try avoiding "triggers" and he said that I shouldn't bother. Because it probably wouldn't help. I asked if there was any treatment, because I've since learned Rosacea is best treated early on. He said that any creams he could give me would most likely not do anything at all for me, and would be a waste of my money. The entire visit was quite ambiguous.

    I asked him what "Pre-rosacea" was, and what the difference was between that, and a normal ruddy complexion. He told me that, in his opinion, there wasn't one. As he considers anyone with a ruddy complexion at risk for developing Rosacea, and THAT he considers to be "pre-Rosacea."

    Before I left, I asked him for a definitive answer one way or the other, and he told me NO, I do not have Rosacea.....To the point of the original thread, I'd like to determine what it is I have. The doctor seems sure it's not Rosacea, but as evidenced by my ongoing battle with Dermatologists prior, I believe if I went to 10 Dermatologists I would receive 10 different opinions. Rosacea, ruddy complexion, acne, allergic rash, facial blushing, too much Niacin, high blood pressure, lupus...these people don't know anything, and with no insurance I'm not going to waste $100 a visit to find out precisely nothing."

    Ontarian says, "I was diagnosed with seborrheic dermatitis on my face about 5 years ago. The diagnosis was made by a dermatologist. Soon after, the dermatitis completely disappeared for a loooong time. Then, I suddenly got a red patch on my right cheek five years later, more precisely in February of 2006. It has slowly spread to my entire right cheek. It got worse in the summer. This whole time I thought I had seb. dermatitis. My family dr. said my face was dermatitic and prescribed hydrocortisone. It didn’t help. In August of 2006 I went to my dermatologist. This time, he said I had rosacea. I was shocked. I was not flushing like crazy (except maybe when I played soccer in +35 C degrees outside). My symptoms started as a small red patch on my right cheek, this could not be rosacea. I went to see another dermatologist (an old dude who thinks rosacea is a proper diagnosis only when your face is swollen like a balloon and when you are covered with pustules).
    So, now I have two doctors thinking I don’t have rosacea, and one doctor thinking I do." Posted: Tue Oct 17, 2006 1:34 pm (scroll down to find the post)

    Jen says, "Since I have stopped the med I was diagnosed with Perioral Dermititis and now as of yesteday the derm tells me I have acne.....The derm said I have almost all the face disorders (rosacea, acne, perioral dermititis, seb derm)....

    jhelli1 says, "I've been to four different doctors in the past and have gotten four different diagnosis. The last one was rosacea. Yesterday, I went to a fifth doctor and was told that I have..........eczema!"

    fedup says, "....I went to this dermatologist maybe 2-3 times a year over about a 4 year period, every appointment he seemed to have absolutely no idea what was going on, or what he had prescribed/said the last time, he took a look at my scalp, says "its folliculitus" (the way he said it, every time, was as if it was a breakthrough and he figured out some giant mystery, even though he said the same thing last time....and sent me home with a prescription for Ceftin 500mg 2x a day for 2 weeks (insanely strong antibiotic, I know now..).....Made an appointment with a new dermatologist (roughly 2 years ago), after explaining the antibiotic fiasco, he told me my old doctor probably shouldnt be practicing medicine. He took about 10 seconds to diagnose me, looked at my scalp, and simply said "you have inflammatory rosacea."

    mutantfrog says, "...I always grumble to myself about rosacea...but if it turns out that I never had rosacea but instead have had an autoimmune disorder...well it's scary I'd rather take rosacea. I swear to god I'll never complain about 'rosacea' again..." Post #10 22nd July 2010, 07:40 PM

    quixotic_pessimist says, "Anyway, I had been seeing a dermatologist during this time period for acne that I have had for about 3 years, and he never mentioned anything about the red complexion of my nose. One time I voiced my concerns, and he pretty much dismissed them, saying that he didn't think my nose looked red. During my last meeting with him, I was a bit more belligerent (in that I brought up the grievances that I have with my red nose a few times). He then nonchalantly throws out that it is possible that I have Rosacea. How is it that I had been visiting this doctor for 3 years with the same red nose, but it is not until now that he suggests that I might have Rosacea? I don't get it."

    CHI_GUY says, "...First doc said, sebborhea/eczema. He gave me many different things, to list a few....Second doc, new one, diagnosed perioral derm. She gave me tetracycline. 500mg x2/day for the first month. She exclaimed that the previous doctor was treating the wrong thing, because I brought all my old meds in to show her...."

    Natasha says, "I have just been diagnosed with Rosacea....a week ago the doctor wrongly diagnosed excema..."

    hesperidianblue says, " I was going to 7 dermatologist till 2 of them agreed that is rosacea other wasn`t shore what is it often they thought it was atopic dermatitis."

    misdiagnosed says, "During this whole ordeal, I have seen a dermatologist (in OH) 2x. THe first time she tried to convince me it was “in my head” and reluctantly prescribed an antibiotic for adult acne. 8 weeks later, she seemed a little more open to the fact that it could be demodex and prescribed metrogel. Last week, I asked for metronidozale in a pill format because the lotion only does so much. She agreed to call it in. It is helping, but I have good and bad days, depending on the “hatching” cycle." #385 misdiagnosed on 10.08.10 at 12:45 AM

    LarsMM says, "...First I went to a regular doctor and even though he ran a few tests he couldn't tell me wheat the problem was. He told me I shouldn't worry since the redness was at that time "barley noticeable". At the end of the third summer (2010) I went to another doctor and got the same response. After this visit I got somewhat frustrated since I was well aware that I had not been this red a few years earlier, as a result I started reading online and came across rosacea. I got an appointment with a dermatologist and she confirmed that I had stage one rosacea...."

    444 says, "...my doctor has failed on many occasions to diagnose me properly probably due to my young age at the time and has disregarded any possiblilty of rosacea since the beggining....'

    claire says, "...I am 34 years old and I was wrongly diagnosed 7 years ago. I have gradually seen since then my skin get progressively worse, it is now in its advanced stages. ..." #41 claire on 05.16.09 at 8:16 PM

    Rachelle C says, "My doctor diagnosed me with rosacea, delusional paristosis. The medications for these did no good. Then another dermatolgist with an allergist diagnosed me with demodex (skin mite) allergy. Since I have very many allergies, this was a good bet. I treat itchy and red areas with tea tree oil and have managed to reielve my problem almost completely. The dermatologist also thinks a monthly treament with Kwellada-P would help further." #76 Rachelle C. on 05.04.10 at 1:00 AM

    findingaway says, "Dermatologist: 'Hmm' he says...'I think it's Seborrheic Dermatitits, but it could be rosacea, but I doubt it and you seriously wouldn't want that' "

    pier01980 says, "The problem is that In 4 months I've seen two dermatologist and this allergist who have diagnosed me three different things: Acne, rosacea and now Seborrhoeic dermatitis."

    Gigi says, "I have seen five different dermatologists, and each came up with a different diagnosis. (Dermatologist no. 4 and no. 5 I had seen within two weeks.)

    1. Dermatologist: Seborrhoeic Dermatitis
    2. Dermatologist: Acne Vulgaris
    3. Dermatologist: Rosacea
    4. Dermatologist: Rosacea and Acne Vulgaris
    5. Dermatologist: Rosacea and Seborrhoeic Dermatitis" Post #2

    mccinnis says, "I have been posting on here for the last 2 months about my recent diagnosis of sebderm. I have rosacea and have been tyring to figure out the difference between both as my sebderm does not seem to be typical and i wasnt convinced I had it and actually stopped using my noritate/lamisel mix as I think it was making my face red and dryer. I went to a new derm yesterday and was told I do not have sebderm but KPRF."

    OCbKA says, "I have been diagnosed with Rosacea by 3 different derms (one thought it was Perioral Dermotitis" Comment #24 May 22, 2011

    Della says, "I am so relieved that i finally have the right diagnosis. I have been going to different doctors for many years and they told me i had contact dermatitis, eczema etc. The stuff they would give me would help for just a little bit and it got to the point that i would have to apply steroid cream 2x a day just to keep it from becoming really gross. I got lucky and saw another dr and finally got rosacea." #44175 Della on August 15, 2010 at 1:20 PM

    jca says, "After wasting my time w/ one Derm who said I just have “dry irritated sensitive skin….I got a 2nd opinion. Within seconds of my new derm looking @me she siad..its rosacea." #44183 jca on August 15, 2010 at 7:09 PM

    CR says, "My rosacea showed up 2 summers ago. My eyes felt itchy and irritated. Took awhile for my dermatologist to diagnose it, in fact, I led the way with what I read on the net." #59407 CR on June 8, 2011 at 5:29 AM

    Marianne says, "I suffer from what I think is a mild case of rosacea (doctors think this is it but are confused themselves) with papules/ pustules and a bit of redness on my left cheek." #39001 Marianne on June 4, 2010 at 6:12 PM

    jill says, "...Dr. gave me script for presidone, said it was contact allergy and eye doctor gave me eye drops....went to ANOTHER dermy. said i had rosacea. gave me sulfur medicine." #34440 jill on March 25, 2010 at 9:28 AM

    Drew says, "The other clinic's diagnosis was rosacea. This one proposes Postular Acne..." by Drew on Thu Apr 23, 2009 8:02 am

    kam says, "...I went to see my GP and he said that I had rosacea...On my next visit to the GP, I was advised by another doctor that I simply had over sensitized skin from using facial scrub too often, too much hot water on my face, and more recently, persistent exposure to the sun....and I was advised to use.... Efcortelan ointment 0.5% which is a brand of hydrocortisone. I tried this for 3 months...I stopped using hydrocortisone...My skin condition never improved...." by kam on Tue Jun 17, 2008 10:36 pm

    ohdarnit!987 says, "t took doctors almost 20 years to put a name to my problem - then the dermatologist today took one look at me and listened to my issues and said 'classic textbook case'." by ohdarnit!987 on Wed Jun 01, 2011 9:32 pm

    kwb says, "I went to see a doctor about some redness in my cheeks a good many years ago, but he said no, it's probably an allergy. So, recently I began to notice some cleary defined red lines under my eyes, and a burning sensation accompanied by some redness around my nose, so, I decied to go to a new doctor, this time yes, shes said it's 'classic Rosace'"." by KWB on Fri Jun 10, 2011 4:59 am

    jodie says, "Just wanted to let the people who have helped me over the last week know that it turns out i dont have rosacea after all. Last night i was in a lot of pain with my face burning and eventually after a day in tears i went to the walk in centre and was seen by another doctor who could see my face when it was at its worst. He said that it in no way looked like rosacea at all and that i had photosensitivity, literally everytime i went outside i was getting sunburned even when it was cloudy." by jodie on Mon Jun 20, 2011 1:48 pm

    shahin 25 says, "It has been 2 months since I was dignosed with seb derm (I spent 2 months prior to denying there was anything wrong with me) in total i have had this gross foreign fungus on my face for 4 months. It seems to be getting worse. I had my second consult with my derm dr & he threw more steroids at me, but when I ask him about my seb derm he never gives me straight answers."

    bizi says, "I saw the new derm and she is very good. She is at least 70 years old. She right away said that I have acne and rosacea, which the other derm said it was all rosacea." Post #19 Nov 18 at 04:30 AM

    ziggR says, "Its weird, "Rosacea" took my derm awhile to say also. I got "its just KRPF, Its just the weather or it could just be hormones". It wasn't until they started IPL and PDL on my cheeks that the derm said it looks like Rosacea." post #10 12/11/11

    lulu says, "I was diagnosed about a year ago with Rosacea but prior to that I was diagnosed with a very rare skin condition called Pyoderma Faciale. It's a condition that bizzarely only affects females, of 20 -40 and from reading your post - the symptoms your describe are very similar to the symptoms I had when I had pyoderma faciale. I am not a doctor or a skin expert, and I am not suggesting for a minute that this is what you have, but it may nevertheless be worth mentioning to your doctor. My own GP, first diagnosed it as acne. It was only when I self referred myself to a dermatologist that pyoderma faciale was diagnosed." by lulu on Tue Dec 20, 2011 9:13 pm

    freeme3 says, "My dermatologist thinks that I have rosacea. I think that he is right....The first derm thought I just had sensitive skin and prescribed me locoid steroid cream. It helped for awhile but then it stopped working...." by freeme3 on Wed Dec 21, 2011 1:33 am

    Mister88 says, "At first I was diagnosed with eczema, then after trial and error and 10 different topical creams I was sent to a different derma sinc .my derma was out of ideas. The new doctor said I have rosacea and was given finacea."

    Blackhawk says, "'Im currently 30 year old male (symptoms started at 28 / 29), and have been to about 5-6 dermatologists in the Chicagoland area over the past year and a half.....Every dermatologist tells me something different. I've been told its different forms of dermatitis/rosacea....So my latest visit to the derm told me I had a combo or seb dermatitis / rosacea."

    bobbydazler1981 says, "I have been told by Doctors initially that i had eczema, then Seborrheic Dermatitis, now 2 days ago i was told i have Acute Dermatitis."

    adinet says, "I was originally told I had rosacea then told I didn't!" Post #42 - 1st December 2011 01:02 AM

    "I was diagnosed with Rosacea many years ago and lived with it for a long time believing my doctor even though he did nothing other than ask me a few questions and peek at my skin from 4 feet away. No blood tests, nothing like that. I was in and out of his office in less then three minutes." Scully555 Post #18 19th September 2009 • "After years of misdiagnosis from two or three "specialists" I finally did what a coworker suggested.... It turns out I was using a heavily medicated dandruff shampoo loaded with "tar"......When I stopped using the shampoo, my face cleared up 100% within a few weeks and never came back...." Scully555 Post #20

    shan says, "I was offically diagnosed with a Sulphite allergy and produce anti-histamine and an allergic response.....I was also told I had Roseacea. Let me make myself clear, this is not a mis-diagnosis, as I had originally been diagnosed with Roseacea by my GP." See post #47 March 20, 2012

    trojan10 says, "a few derm's said i have rosacea, another said i just have sensitive skin and not rosacea YET." post #1 March 28, 2012

    Boiling_Point says, "* One says that I have Seb Derm and that I should use a Ketaconazole 2% dandruff schampo on scalp and face. * One says that I definitely not have Seb derm, it is Rosacea that I have and she tells me there's not much to do for me than to accept my current state (using Metronidazole-cream)."

    cherylarose says, "...My personal experience was a misdiagnosis for over 7 years (and 4 dermatologists). Perhaps your quote above is general for the forum, or perhaps you directed the statement to me. I want to assure you that I don't intend to mislead anyone by my personal experience with rosacea; I do in fact have rosacea which was diagnosed by Dr. Soldo. Even after the diagnosis, for confirmation, I underwent a series of allergy tests complete with IgE, so eczema has already been ruled out...." Post #48 24th April 2012 01:44 AM
    "Most of the dermatologists treated the condition as adult acne and prescribed Retin-A. The tipping point came when I had perioral inflammation and the doctor prescribed Elidel and topical steroids (for eczema) and the rosacea (of course) became much worse. That drove me to seek out a new dermatologist. When I was diagnosed by Dr. Soldo, he told me that the Retin-A in particular exacerbates Rosacea which made sense because my skin had several dry patches and redness but the pustules still remained. Dr. Soldo prescribed Finacea which has done a marvelous job as an exfoliant. However, it doesn't prevent flare ups from my food triggers. I also cannot use salicylic acid as it causes inflammation of the pustules and redness." Post #52 4th May 2012

    MOLLOBHG posts in the subject, "4 different doctors, 4 different diagnoses." and then says, "I've recently been told I have rosacea...... I'm still hoping there's a chance this doctor's got it wrong (as well)..." on Sun May 06, 2012 4:40 am

    dee62 says, "I was just formally diagnosed with Rosacea on Monday. I have known that I have it for some time. 1 of my doctor's diagnosed it back in 2008, after I had shingles on my face. My most recent doctor had said it was ezcema."on Wed May 02, 2012 10:40 pm

    j88e says, "Initially, I was diagnosed with contact dermatitis because this developed shortly after I had a bad reaction to a topical benzoyl peroxide/clindamycin medication I had been prescribed for acne. When it wouldn't go away, my dermatologist clung to her initial diagnosis and prescribed stronger and stronger steroids. I was skeptical, so I went to another dermatologist who instantly diagnosed rosacea."

    Lorraine says, "I was diagnosed with seborrheic dermatitis initially, then when I started complaining of redness to my cheeks the derm diagnosed me with mild rosacea." #53893 Lorraine on April 6, 2011 at 11:18 AM

    John says, "ive been diagnosed with rosacea for a few months now but for the last 11 years i’ve had this pimply rash on my forehead that would come and go . the first derm i saw said it was a fungal infection caused by the propecia i was taking for hair loss) so he gave me antifungal cream, lotion , shampoo with sulfa face scrub pads and sulfa lotion to put on and zithromax to take. then i moved too far away to see him so i went to a different derm as the rash came back a few months after i stopped the antifungals and this guy said i was fine -everyone has pimples now and then. The third one said I had acne and gave me a prescription face wash that worked pretty good for a few months. Then I went to a 4th guy who said I had rosacea." #102973 john on June 5, 2012 at 12:21 PM

    Lpkm says, "All of the doctors I have seen or spoken to have no clue about SD and instantly diagnose Rosasea - this has happened to me 3 times and i have SD not rosacea." Post #4 June 9,2012 at 9:39 AM Luke then gives details of his experience with four different doctors at this post.

    Cdw1262 says, "I just had my appointment with my primary care doctor today. He looked at some pictures briefly but basically said it was just some sort of infection, happens all the time, and gave me a perscription for a topical cream. I said well what about rosacea, and he blew me off and said no way, that only happens to old men's noses who have been drinking their whole lives and not to worry about it. I still have a follow up with a dermatologist scheduled for a few months from now." Cdw1262 Post #7 June 13, 2012

    davem81 says, "My dermatologists wavered between treating me for 'acne vulgaris' and 'acne rosacea' for a long time." davem81 Post #14 June 18, 2012

    Opinwyd says, "I have been seen by many dermatologists and the diagnosis vary each time but nothing seems to be effective. Anything from Rosacea, which they then prescribed me with several rosacea type medicines like metronidazol cream or noritate and none of it helps. Another said it was a histamine release and said take zyrtec or benadryl, that didnt work." Opinwyd Post #6 June 24, 2012

    Joejon says, "After about 10 years (I'm now 25), 10+doctors, 3 dermatologists, $1000's of dollars, countless hours of trial and error with OTC and prescription products and medications for acne I have finally been diagnosed with possible rosacea. None of the previous doctors or derm's even hinted at rosacea and I really didn't know what it was until now." Joejon Post #1 June 28, 2012

    padie says, "One of my daughters came across your post and brought it to my attention. Her sister, my youngest daughter, suffered rosacea fulminans several years ago and I thought I would share some of her experience with you. She was incorrectly diagnosed with acne initially and the condition had time to get far worse than it might have with a proper diagnosis from the beginning. We switched doctors because we knew it was not simple acne. Both of her sisters had suffered acne and she never had, so we knew what acne was and what she had was certainly not. We were lucky to see the new doctor's physician's assistant who listened patiently to her story (how her face had been clear and then suddenly she was getting multiple cysts and green puss was coming out of some of them). He said he did not know what the condition was but would find out. He called the next day and we went back to the office to hear that she had this very rare condition: rosacea fulminans." Post #6 July 18, 2012 at 05:18 AM

    buratino29 says, "In one year two dermatologists failed to diagnose me with rosacea until I persuaded the third that it is rosacea. I basically had to diagnose myself and then prove it in front of audience." Post #130 3rd April 2013 06:28 PM



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  • Posts

    • "And if the machine shows rosacea what would you recommend for that? I heard there is a new cream on the market that works well." Kristin Auble "Yes, it’s called Rhofade and it just received FDA approval. So that’s exciting. We also have a laser called the Vbeam that helps with vascular issue such as rosacea. So I would recommend a combo of the cream and laser treatment." Dr. David Shafer, New York City Tech Alert: 3D Imaging May Be The Secret to Perfect Skin, by Kristin Auble, W Magazine
    • Dermata Therapeutics, a San Diego development-stage biotech advancing new treatments for rosacea, eczema, and related dermatological diseases, said it has secured $5 million in additional funding from private investors and entered into a $5 million credit facility with Silicon Valley Bank. Dermata has developed DMT210 which is for rosacea.  Dermata Secures $10M in Combined Financing for Skin Treatments, by Bruce V Bigelow, Xconomy, San Diego
    • The Dermatologist Forms Collaboration with The National Rosacea Society, PRWeb, Benzinga
    • "A recent study in the British Journal of Dermatology makes a case for treating and managing rosacea based on the clinical presentation, or phenotype." Global Consensus on Rosacea Treatments by Phenotype, by Jennifer Newton, Medical News Bulletin
    • You've probably heard of common skin conditions like psoriasis and eczema, but do you also know about rosacea? If not, you've got to listen up. "Rosacea is abnormal blood vessel growth in all layers of the skin, caused by internal problems and inflammation within the body and skin," says Julia T. Hunter, MD, a dermatologist and founder of Wholistic Dermatology. This abnormal blood vessel growth is the result of low thyroid, fungal overgrowth internally, gut inflammation, and chronic sun overexposure, she says.

      10 Things You Need to Know About Rosacea—Whether You Have It or Not, by AUBREY ALMANZA, Reader's Digest
    • Related Articles Ivermectin therapy for papulopustular rosacea and periorificial dermatitis in children: A series of 15 cases. J Am Acad Dermatol. 2017 Mar;76(3):567-570 Authors: Noguera-Morel L, Gerlero P, Torrelo A, Hernández-Martín Á PMID: 28212765 [PubMed - in process] {url} = URL to article
    • The topical use of oxymetazoline 0.05% solution in the management of rosacea has been primarily limited to data from case series involving fewer than 10 patients and demonstrating sustained improvements in both erythema and flushing. Alhough oxymetazoline is not recognized in national guidelines, an international consensus statement recognizes the possible therapeutic role of oxymetazoline in the management of rosacea, despite the limited evidence. Hosp Pharm. 2013 Jul-Aug; 48(7): 558–559.
      Published online 2013 Jul 9. doi:  10.1310/hpj4807-558
      PMCID: PMC3839519
      Oxymetazoline (Topical): Rosacea
      Joyce A. Generali, RPh, MS, FASHP, (Editor) and Dennis J. Cada, PharmD, FASHP, FASCP
    • I haven't used the Soolantra since February 13, 2017 so for more than 72 hours my skin has been healing and I don't have the burning feeling I had, so I thought I would take three more photos to show my skin condition after using Soolantra for 105 days, just three days later. 
    • Maria, 
      Actually I am cheap, since it costs me around $40/jar for the ZZ cream which I actually prefer. But since I have insurance in my old age now, I would prefer to pay a nominal fee for a sulphur treatment if it works reasonably well. I was using the sulphur butter due to a post made by Joanne Whitehead, PhD, (Assistant Director of the RRDi) since it was cheap and it works sort of ok, but I don't like the oily part of the formula since my skin is already oily. The ZZ cream is so different and it dries up my skin which is wonderful, and it feels cool when you put it on due to the menthol in it. I just love it and have one jar left as an emergency jar. So if the Americans can make a cheaper sulphur topical I am willing to give it a try and apparently there are a number of them. My insurance wouldn't approve the one my dermatologist prescribed yesterday (not sure of the exact Rx that was denied) and it takes days to do the documents to get it approved and my doctor doesn't like having his staff write up these letters (such are the woes of the American Medical System), so I heard he can write a Rx for a generic sulphur drug that my insurance will accept. Time will tell what Rx I get.  As to the demodex population, I think I nuked all those little buggers with the ivermectin. My face is healing nicely each day now and I plan on doing nothing but washing with water for the next few days and then I will take photos of my face to show you the difference. I read a post in RF from Toen (post #684) how he only uses Soolantra occasionally which seems like a good idea to me, like if I get a pustule, since I noticed the Soolantra seems to work rather nicely on them and reduces them quickly, within a couple of days. I think I just over did the Soolantra. You would think that someone would mention this, that Soolantra is powerful, that more is not good sometimes. I can still get more tubes of Soolantra if I want. But I think the one I have which is half gone will last me months. 
    • It could be the case that your demodex is resistant to ivermectin and after all these years of sulpur usage it's also resistant to sulfur, so I wouldn't expect much of this generic sulfur cream. I know you have the feeling that sulfur controls it, but obviously it's not a cure, otherwise you wouldn't search for other options, Brady. Maybe you could try the permethrin cream. I just read an article about permethrin being effective in ivermectin-resistant cases of scabies infection, the same should apply for demodex.
    • Well done Brady. I think you have given Soolantra a fair go. You should have seen something really good by now so I don't blame you for ditching it. I have a similar problem with it and at the moment I need to use Tacrolimus to keep the inflammation at bay. I don't think I'm going to last much longer.  Anyway I'm curious. Your Derm doesn't seem to be having huge success with his patients on Soolantra. 25% is quite a low success rate, especially when compared to the 70% success rate in the one year study. Of course I accept that a certain percentage could have ditched it too early in their treatments, but 1 in 4 is still quite low. You told your Derm that you have good results with sulfur so obviously he prescribed what you wanted. But I'd love to know what your Derm is having most success with treating the 3 out of 4 who failed on Soolantra. 
    • Maria,  You are so kind. My face has been burning where I have been applying the Soolantra everynight, even when I wash it off in the am, the burning continues. I explained all this the dermatologist who said to stop using it. I really did give it a go. There must be something in the Soolantra that irritates my skin. It has been over 24 hours since I applied the Soolantra and my face has already started to calm down and cool off. The burning has almost completely gone. I am going to let my skin rest for a few days to recover from this and then apply the sulphur generic prescription my dermatologist prescribed since I have experienced good results from the sublimed sulphur in the ZZ cream. However, the ZZ cream costs more than my generic prescription since I have insurance. I am now convinced that Soolantra just isn't for me. My dermatologist says one out of four of his rosacea patients gets excellent results with Soolantra. I may in the future use a dab of Soolantra on a zit to see what happens, but no more night applications for me. 
    • Brady, what if you have such a heavy infestation with demodex, that it makes it hard for your skin to deal with the die off by itself? I think you should try taking oral antibiotics along with Soolantra and push through this phase for another month. You have put such an effort to this, it would be a pity if you quit earlier.
    • Went to the dermatologist today and he advised me to stop Soolantra since I am not a candidate for this treatment. After 105 days, I was hoping Soolantra would work for me, but alas, as you can see below, my rosacea seems to inflamed too much from using Soolantra. My dermatologist prescribed a generic sulphur based cream for me to try since I have responded well in the past to similar treatment using the ZZ cream. I have to pick up the prescription and will start another review later. Here are my photos for today: 
    • I conveniently forgot to mention that earlier. For me and my family to buy only on coupon prescription drugs
    • Phymatous rosacea presenting with leonine facies and clinical response to isotretinoin. Australas J Dermatol. 2017 Feb;58(1):72-73 Authors: Wee JS, Tan KB PMID: 28195321 [PubMed - in process] {url} = URL to article
    • I will share my experience. Before I started taking the drug I went online and looked at people's opinions. I noticed that there were several people who had reported problems with rebound flushing. I also noticed that in the clinical trial, the actual success rate compared to placebo was shockingly low. I am not a medical expert so I decided to shrug it off and take use the cream anyway.  My skin looked somewhat unnatural, kind of yellow, since there was no red in it. 
    • Conclusions Combined therapy was superior in decreasing the D. folliculorum count in all groups and in reducing the mite count to the normal level in rosacea and in anterior blepharitis. On the other hand, the two regimens were comparable in reducing the mite count to the normal level in acne and peri-oral dermatitis lesions. International Journal of Infectious Diseases
      Volume 17, Issue 5, May 2013, Pages e343–e347
      Evaluation of the efficacy of oral ivermectin in comparison with ivermectin–metronidazole combined therapy in the treatment of ocular and skin lesions of Demodex folliculorum
      Doaa Abdel-Badie Salema, Atef El-shazlya, Nairmen Nabiha, Youssef El-Bayoumyb, Sameh Salehc
    • Related Articles Friends or Foes? Host defense (antimicrobial) peptides and proteins in human skin diseases. Exp Dermatol. 2017 Feb 13;: Authors: Niyonsaba F, Kiatsurayanon C, Chieosilapatham P, Ogawa H Abstract
      Host defense peptides/proteins (HDPs), also known as antimicrobial peptides/proteins (AMPs), are key molecules in the cutaneous innate immune system. AMPs/HDPs historically exhibit broad-spectrum killing activity against bacteria, enveloped viruses, fungi and several parasites. Recently, AMPs/HDPs were shown to have important biological functions, including inducing cell proliferation, migration and differentiation; regulating inflammatory responses; controlling the production of various cytokines/chemokines; promoting wound healing; and improving skin barrier function. Despite the fact that AMPs/HDPs protect our body, several studies have hypothesized that these molecules actively contribute to the pathogenesis of various skin diseases. For example, AMPs/HDPs play crucial roles in the pathological processes of psoriasis, atopic dermatitis, rosacea, acne vulgaris, systemic lupus erythematosus and systemic sclerosis. Thus, AMPs/HDPs may be a double-edged sword, promoting cutaneous immunity while simultaneously initiating the pathogenesis of some skin disorders. This review will describe the most common skin-derived AMPs/HDPs (defensins, cathelicidins, S100 proteins, ribonucleases and dermcidin) and discuss the biology and both the positive and negative aspects of these AMPs/HDPs in skin inflammatory/infectious diseases. Understanding the regulation, functions and mechanisms of AMPs/HDPs may offer new therapeutic opportunities in the treatment of various skin disorders. This article is protected by copyright. All rights reserved.
      PMID: 28191680 [PubMed - as supplied by publisher] {url} = URL to article
    • "There are many effective treatments for rosacea. Some common topical medications include metronidazole, azalaic acid, ivermectin, or sulfur-based products. Oral antibiotics are commonly used, such as doxycycline, especially when papules and pustules are present. Redness and broken blood vessels are much more difficult to treat with medications. A topical medication that was originally designed to treat glaucoma can be used, providing temporary relief by blanching the superficial blood vessels. This medication, called Mirvaso, is very effective for some people but, unfortunately, not all patients are responsive." Reviewing Rosacea, By Darrel Arthurs, ARNP, DCNP , Dermatology Education & Practice from NADNP, Healthcare POV, Advance Web
    • There are a number of papers indicating niacinamide improves rosacea. You may want to ask your dermatologist about niacinamide. You can purchase niacinamide over the counter (non prescription). Niacinamide eases rosacea inflammation
      June 01, 2010 By Lisa Samalonis, Dermatology Times Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea.
      Cutis. 2005 Aug;76(2):135-41
      Authors: Draelos ZD, Ertel K, Berge C A review of nicotinamide: treatment of skin diseases and potential side effects.
      J Cosmet Dermatol. 2014 Dec;13(4):324-8
      Authors: Rolfe HM
    • There are papers indicating that Niacinamide improves rosacea. For example, Helen M. Torok, M.D. reports in an article in Dermatology Times, "Niacinamide can be an effective treatment for the inflammation related to rosacea"  Several non prescription topicals containing Niacinamide are Acnessential, InstaNatural Niacinamide Serum, Paula's Choice RESIST 10% Niacinamide Booster, The Posh Company B3 Nicinamide Serum, and Luminositie Niacinamide B3 Cream.  
    • I guess some could be sceptical about Soolantra's ability to kill demodex. Especially since there are no studies to prove it. Sometimes oral meds don't work as well, or even not at all, when transformed into a topical device. But I believe there is some proof that Soolantra is as effective as oral ivermectin. You may have read this study http://www.sciencedirect.com/science/article/pii/S120197121201315X It compares oral ivermectin to oral ivermectin and metronidazole in the reduction of demodex and improvement of symptoms in 4 different skin conditions. The author of this study did make one observartion which is very much identical to so many testimonials we read about from users of Soolantra. Here is a paragraph from the study: "In the cases who received ivermectin alone, there was a gradual reduction in the mean follicle mite count at the first week visit . However, rebound elevation in the mite count was evident in the third week in some patients with rosacea and those with anterior blepharitis lesions." This was only a 4 week study so obviously there was no report of a 6th week rebound.
    • Ivermectin is supposed to kill mites. I am simply not having the success that many have reported happens to them using Soolantra. I was hoping the fourth month would really be more of an improvement but so far I am not impressed. I am seeing the dermatologist on Feb 15 and get a professional evaluation on my progress. I can tell you that using the ZZ cream works way better for me than Soolantra. I guess I am one of those who responds better to sulphur treatment than Ivermectin. 
    • Brady, from your last 2 posts would I be correct in saying you're not convinced that Soolantra kills demodex?   
    • Related Articles Ten-year incidence and prevalence of clinically diagnosed blepharitis in South Korea: A nationwide population-based cohort study. Clin Exp Ophthalmol. 2017 Feb 09;: Authors: Rim TH, Kang MJ, Choi M, Seo KY, Kim SS Abstract
      IMPORTANCE: Blepharitis is one of the most common conditions. However, no study has yet evaluated the epidemiology by evaluating a large population-based sample.
      BACKGROUND: To evaluate the incidence and prevalence of clinically diagnosed blepharitis in South Korea.
      DESIGN: Nationwide population-based study.
      PARTICIPANTS: We investigated the Korean National Health Insurance Service-National Sample Cohort, a representative 1 million-sample of the Korean population, for patients diagnosed with blepharitis according to the Korean Classification of Diseases.
      METHODS: Annual and overall incidence and prevalence of blepharitis during the study period (2004-2013) were estimated after excluding chronic blepharitis patients, diagnosed during 2002-2003. Sociodemographic factors and comorbidities associated with blepharitis were evaluated using Cox proportional hazard regression.
      MAIN OUTCOME MEASURES: The first occurrence of blepharitis (Korean Classification of Diseases [KCD], H010, corresponding to the International Classification of Diseases-9-Clinical Modification [ICD-9-CM], 373.0).
      RESULTS: A total of 1,116,363 individuals over 9,698,118 person-years were evaluated (mean follow-up: 8.7 years) from 2004 to 2013. The overall incidence was 1.1 (95 % Confidence Interval [CI], 1.1 - 1.1) per 100 person-years. The incidence increased with time (0.9 versus 1.3 per 100 person-years, in 2004 and 2013, respectively) and was higher in female patients (1.3 versus 0.9 per 100 person-years, respectively). The incidence was higher in both the elderly and children than in adolescents or young adults. The overall prevalence was 8.1% (95% CI: 8.0-8.1) among subjects aged 40 years or older. Chalazion, gastritis, Sjögren's syndrome, pterygium, rosacea, prostatic hypertrophy, atopy, irritable bowel disease, and peptic ulcer were associated with an increased incidence of blepharitis in the multivariable Cox model.
      CONCLUSIONS: We found that blepharitis was a relatively common disease, and is associated with various ocular and systemic conditions.
      PMID: 28183148 [PubMed - as supplied by publisher] {url} = URL to article
    • Trump’s longtime doctor, Harold N. Bornstein, revealed in a New York Times story Wednesday that Trump takes the antibiotic tetracycline to stave off rosacea, which causes redness and bumps on the skin, and Propecia to keep his hair voluminous. Beauty companies selling non-prescription remedies think the president should reconsider his hair-loss and rosacea solutions. “We know there’s a better way than pill popping for rosacea,” exclaimed Alexandra Calvo, founder of the rosacea-fighting brand NuRevealOrganics. “Trump needs to watch his diet and cut out rosacea food triggers such as avocados, chocolate, yogurt and cheese. Living a lavish lifestyle also may not be the best for rosacea since spa days in the sweltering sauna, and long days on the beach under intense sun both cause rosacea flare-ups.” Salvo additionally recommended a skin-care regimen that includes NuRevealOrganics’ Bella Rosa Oil Cleanser and Rosehip Healing Night Face Cream. Beauty Companies Offer Trump Rosacea, Hair-Loss Advice – and Products
      The president's personal prescription drug plan includes medications for baldness and redness.
      By Rachel Brown, Fashion / Fashion Scoops, WWD
    • Drug Therapies for Rosacea Drug  Dosage Form FDA Indication for Rosacea Adverse Event topical metronidazole (Metrogel, Metrocream, Metrolotion, Noritate, Rosadan) gel, cream, or lotion Varies by product -
      Metrogel : inflammatory lesions of rosacea.
       
      Metrocream,  Metrolotion, Rosadan: inflammatory papules and pustules of rosacea.
       
      Noritate:
      inflammatory lesions and erythema of rosacea Pruritus, stinging, irritation, dryness   oral doxycycline (Oracea) oral capsule only inflammatory lesions (papules and pustules) of rosacea nasopharyngitis, sinusitis, diarrhea, hypertension   azelaic acid (Finacea) gel inflammatory papules and pustules of mild to moderate rosacea Stinging, irritation, burning   brimonidine (Mirvaso) gel persistent (non-transient) erythema of rosacea Pruritus, burning, irritation, dryness, erythema   ivermectin (Soolantra) cream inflammatory lesions of rosacea Burning, skin irritation   oxymetazoline (Rhofade) cream persistent facial erythema associated
      with rosacea Irritation, burning, worsening inflammatory lesions of
      rosacea   Treatment Options for Rosacea, Mel Seabright, PharmD, MBA, Pharmacy Times
    • They found rosacea patients were 46% more likely than controls to have celiac disease; 45% more likely to have Crohn’s disease; 19% more prone to ulcerative colitis; and had a 34% higher rate of irritable bowel syndrome. The co-occurrence of Helicobacter pylori infection and small intestinal bacterial overgrowth was significantly higher among patients with rosacea at baseline, but the risk of developing incident Helicobacter pylori infection or small intestinal bacterial overgrowth during follow-up was insignificant, the study’s lead author Alexander Egeberg, M.D., Ph.D., department of dermatology and allergy, Herlev and Gentofte Hospital, Hellerup, Denmark, tells Dermatology Times. Rosacea and gastro disorders possibly related, Large study supports likelihood of yet-to-be-defined link, By Lisette Hilton, Dermatology Times  
    • While there’s no way to cure rosacea, New York City dermatologist Dr. Amy Wechsler knows a few simple ways to help control it in winter. She noted that in addition to seasonal changes, flareups can be triggered by a wide variety of factors like stress, sleep deprivation, spicy food, drinking too much alcohol, travel, trying new products, having a cold or being sick in any way. “People with rosacea often have sensitive skin, so dry, cold weather can exacerbate this,” she said. In addition to whatever medication or regimen your dermatologist recommends, here are three simple ways to manage your redness in the wintertime, according to Wechsler:  3 Tips And Tricks For Defeating Rosacea In The Winter, Carly Ledbetter, Lifestyle Editor, The Huffington Post
    • Related Articles A Report of Two Cases of Solid Facial Edema in Acne. Dermatol Ther (Heidelb). 2017 Feb 06;: Authors: Kuhn-Régnier S, Mangana J, Kerl K, Kamarachev J, French LE, Cozzio A, Navarini AA Abstract
      INTRODUCTION: Solid facial edema (SFE) is a rare complication of acne vulgaris. To examine the clinical features of acne patients with solid facial edema, and to give an overview on the outcome of previous topical and systemic treatments in the cases so far published.
      METHODS: We report two cases from Switzerland, both young men with initially papulopustular acne resistant to topical retinoids.
      RESULTS: Both cases responded to oral isotretinoin, in one case combined with oral steroids. Our cases show a strikingly similar clinical appearance to the cases described by Connelly and Winkelmann in 1985 (Connelly MG, Winkelmann RK. Solid facial edema as a complication of acne vulgaris. Arch Dermatol. 1985;121(1):87), as well as to cases of Morbihan's disease that occurs as a rare complication of rosacea.
      CONCLUSION: Even 30 years after, the cause of the edema remains unknown. In two of the original four cases, a potential triggering factor was identified such as facial trauma or insect bites; however, our two patients did not report such occurrencies. The rare cases of solid facial edema in both acne and rosacea might hold the key to understanding the specific inflammatory pattern that creates both persisting inflammation and disturbed fluid homeostasis which can occur as a slightly different presentation in dermatomyositis, angioedema, Heerfordt's syndrome and other conditions.
      PMID: 28168623 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Activation of p38 and Erk Mitogen-Activated Protein Kinases Signaling in Ocular Rosacea. Invest Ophthalmol Vis Sci. 2017 Feb 01;58(2):843-848 Authors: Wladis EJ, Swamy S, Herrmann A, Yang J, Carlson JA, Adam AP Abstract
      Purpose: Rosacea-related cutaneous inflammation is a common cause of ocular surface disease. Currently, there are no specific pharmacologic therapies to treat ocular rosacea. Here, we aimed at determining the differences in intracellular signaling activity in eyelid skin from patients with and without ocular rosacea.
      Methods: This was an observational, comparative case series including 21 patients undergoing lower lid ectropion surgery at one practice during 2013 and 2014 (18 patients with rosacea, 13 control patients), and 24 paraffin-embedded archival samples from Albany Medical Center, selected randomly (12 patients with rosacea, 12 control patients). Cutaneous biopsies resulting from elective lower lid ectropion surgery were analyzed by Proteome Profiler Human Phospho-Kinase Array, Western blot, and/or immunohistochemistry.
      Results: Samples derived from ocular rosacea patients showed increased levels of phosphorylated (active) p38 and Erk kinases. Phosphoproteins were mainly localized to the epidermis of affected eyelids.
      Conclusions: This finding provides a novel potential therapeutic target for treatment of ocular rosacea and possibly other forms of rosacea. Further testing is required to determine if p38 and Erk activation have a causal role in ocular rosacea. The selective activation of keratinocytes in the affected skin suggests that topical pathway inhibition may be an effective treatment that will ultimately prevent ocular surface damage due to ocular rosacea.
      PMID: 28170535 [PubMed - in process] {url} = URL to article
    • Development and Clinical Validation of a Novel Photography-based Skin Erythema Evaluation System: A Comparison with the Calculated Consensus of Dermatologists. Int J Cosmet Sci. 2017 Feb 08;: Authors: Cho M, Lee DH, Doh EJ, Kim Y, Chung JH, Kim HC, Kim S Abstract
      Erythema is the most common presenting sign of skin conditions [1,2]. Erythema reflects the degree of inflammation associated with various diseases, such as atopic dermatitis, psoriasis, and lupus erythematosus; it is also cosmetically troublesome in subjects with flushing, rosacea, and photoaging [3,4]. In addition, there are vascular disorders that present with erythema, such as nevus flammeus, telangiectasia, and post-acne erythema [5]. Various therapeutic devices, medicines, and cosmetics have been developed to improve these dermatological conditions [6,7]. These modalities need to be validated objectively for dermatologists, patients, and regulatory agencies [8-10]. Various studies are in progress on both improvement of skin conditions and their objective measurement [11,12]. The evaluation of skin condition is highly dependent on dermatologists' judgments based on naked eyes, and the results can vary depending on the dermatologists' expertise and bias [13,14]. It is convenient to perform an evaluation using photographs, but this approach is affected by variation in the environment, such as uneven brightness and light type [15]. This article is protected by copyright. All rights reserved.
      PMID: 28178365 [PubMed - as supplied by publisher] {url} = URL to article
    • Sorry if I was off topic. I wish I could be one of those who could eat or drink anything. I read somewhere (can't find it now) that at a recent dermatologists convention a discussion of the mystery of how Soolanta improves Rosacea with no data on demodex density counts (whether the count is lowered). However there is data that it works better than Mirvaso or Metronidazole. 
    • Sorry Brady but I didn't say that those using Soolantra would notice a better improvement with a low carb diet. I was referring to the 30% of participants in the Soolantra study who failed to see any improvement. 70% of participants were clear/almost clear without any mention of a diet. Also, I have no idea what most of your last post has to do with my previous post. What exactly Soolantra does for Rosacea may very well still be a little up in the air. My previous post was specifically looking at your case, where it seems that Soolantra or ZZ cream will treat your secondary symptoms, and diet addresses the primary cause. Or maybe it's the other way round. I was hoping that Soolantra could have treated both aspects of your Rosacea, but that doesn't seem to be the case so far.  Like I've said, there have been some people on the Soolantra thread who have reported being able to eat and drink whatever they want while using Soolantra. But I guess this may not apply to all of us.  
    • Rory, It has never been proven whether killing the mites improves the rosacea or if the density count is different when using Soolantra. Do the numbers actually go down after using Soolantra? We really don't know for sure. There are no studies done on this.  A paper published by the American Journal of Clinical Dermatology in April 2015 succinctly clarifies the controversy:  “According to Rothman’s model of causality, Demodex mites are probably a non-necessary and non-sufficient cause of rosacea.” What we do know is that Soolantra use with improvement of rosacea implies that treating for demodectic rosacea is warranted. In other words, if it works for some then it is a valid treatment.  As for sugar/carbohydrate avoidance, you will note that physicians rarely if ever mention this as a rosacea trigger. Only the RRDi recognizes sugar/carbohydrate as a rosacea trigger. There are few, if any, clinical papers on this subject. I do agree with you that if those who use Soolantra also avoided sugar/carbohydrate they would notice better improvement. 
    • Not sure, but most reports say demodex folliculorum is the culprit. Never have tested for demodex. 
    • Related Articles Erythroid Differentiation Regulator 1 as a Novel Biomarker for Hair Loss Disorders. Int J Mol Sci. 2017 Feb 03;18(2): Authors: Woo YR, Hwang S, Jeong SW, Cho DH, Park HJ Abstract
      Erythroid differentiation regulator 1 (Erdr1) is known to be involved in the inflammatory process via regulating the immune system in many cutaneous disorders, such as psoriasis and rosacea. However, the role of Erdr1 in various hair loss disorders remains unclear. The aim of this study was to investigate the putative role of Erdr1 in alopecias. Skin samples from 21 patients with hair loss disorders and five control subjects were retrieved, in order to assess their expression levels of Erdr1. Results revealed that expression of Erdr1 was significantly downregulated in the epidermis and hair follicles of patients with hair loss disorders, when compared to that in the control group. In particular, the expression of Erdr1 was significantly decreased in patients with alopecia areata. We propose that Erdr1 downregulation might be involved in the pathogenesis of hair loss, and could be considered as a novel biomarker for hair loss disorders.
      PMID: 28165377 [PubMed - in process] {url} = URL to article
    • I noticed where some people reported being able to eat anything after treatment with Soolantra. But i can see that you haven't been that lucky. There was no mention of any kind of diet used in the Soolantra studies.But maybe the 30% who failed to see any improvement could have benefited from restricting carbs. From what I understand so far about you, neither ZZ cream nor Soolantra would help if you didn't adhere to a low carb diet. If that's the case then Its somewhat disappointing because it shows that you still haven't got to the route cause of your particular type of Rosacea. 
    • Brady, do you think you have demodex folliculorum or brevis?
    • Rory,  Basically I controlled my rosacea with my Rosacea Diet and the ZZ cream all those years. This didn't cure it, but it works to control it. If I went off my diet I would get a zit or two or even more depending on how far I strayed from my diet. My rosacea really shows up quickly after I eat sugar/carbohydrate whether on the ZZ cream or Soolantra. For the past year I was using the Sulphur Butter to save some money and see if it works, which it does but not as good as the ZZ cream since my skin is oily and I prefer the way the ZZ cream dries up my skin.  I read all those incredible results of those who say Soolantra works for them and simply wanted to try it. Today Soolantra seems to be improving my skin so I am hoping after four months it works. Most reports from users say they have to keep using it on a maintenance basis dabbing it on a flareup to keep it under control. With my insurance Soolantra is cheaper than the Sulphur Butter.  My understanding is that if demodex is the culprit, demodex simply keep coming back, hence, the need to keep using Soolantra.  The only way to know if a rosacea treatment works is to try it. And we know that it takes time, usually months, to know for sure. 
    • Related Articles De novo characterization of microRNAs in oriental fruit moth Grapholita molesta and selection of reference genes for normalization of microRNA expression. PLoS One. 2017;12(2):e0171120 Authors: Wang X, Li Y, Zhang J, Zhang Q, Liu X, Li Z Abstract
      MicroRNAs (miRNAs) are a group of endogenous non-coding small RNAs that have critical regulatory functions in almost all known biological processes at the post-transcriptional level in a variety of organisms. The oriental fruit moth Grapholita molesta is one of the most serious pests in orchards worldwide and threatens the production of Rosacea fruits. In this study, a de novo small RNA library constructed from mixed stages of G. molesta was sequenced through Illumina sequencing platform and a total of 536 mature miRNAs consisting of 291 conserved and 245 novel miRNAs were identified. Most of the conserved and novel miRNAs were detected with moderate abundance. The miRNAs in the same cluster normally showed correlated expressional profiles. A comparative analysis of the 79 conserved miRNA families within 31 arthropod species indicated that these miRNA families were more conserved among insects and within orders of closer phylogenetic relationships. The KEGG pathway analysis and network prediction of target genes indicated that the complex composed of miRNAs, clock genes and developmental regulation genes may play vital roles to regulate the developmental circadian rhythm of G. molesta. Furthermore, based on the sRNA library of G. molesta, suitable reference genes were selected and validated for study of miRNA transcriptional profile in G. molesta under two biotic and six abiotic experimental conditions. This study systematically documented the miRNA profile in G. molesta, which could lay a foundation for further understanding of the regulatory roles of miRNAs in the development and metabolism in this pest and might also suggest clues to the development of genetic-based techniques for agricultural pest control.
      PMID: 28158242 [PubMed - in process] {url} = URL to article
    • What I find odd are the ups and downs you're experiencing with Soolantra. I have read many stories of people having these ups and downs with ZZ cream which is believed to be a purge or Demodex die-off. But since you were using ZZ for years before starting Soolantra, I would have thought the purge or die-off or whatever the ups and downs really are, were well behind you. Did you suffer flares when you started ZZ cream years ago?
    • I would say the ZZ cream works better. However, the ZZ cream is more expensive than Soolantra since my insurance pays for it. 
    • "Almost a decade and a half has elapsed since the initial proposition of criteria for rosacea diagnosis and grouping into common presentations or subtypes. Reappraisal of these items suggests shortcomings in case-finding and diagnostic accuracy that require revision to facilitate rather than undermine future investigation. Subtyping of rosacea, a post-hoc means of grouping more common presentations, can be and has been subverted inappropriately to imply strict categories without adequate consideration of the varying phenotypic presentation of individuals and the potential for temporal variation. Scales for rosacea severity are also confounded by similar multidimensional aspects represented in subtyping. In clinical investigation, this can interfere with study of the course of singular features of rosacea and their measurement." Br J Dermatol. 2017 Jan;176(1):197-199. doi: 10.1111/bjd.14819.
      Shortcomings in rosacea diagnosis and classification.
      Tan J, Steinhoff M, Berg M, Del Rosso J, Layton A, Leyden J, Schauber J, Schaller M, Cribier B, Thiboutot D, Webster G; Rosacea International Study Group.
    • Rosacea is a chronic skin condition whose symptoms are a persistent redness of the skin of the cheeks, nose, chin and forehead, excessive blushing, and small, dilated blood vessels. There can also be swelling and pimple-like bumps on the skin. More extreme cases can involve the eyes and swelling and disfigurement of the nose. It can begin at any age, and seems to have a hereditary component, as fair-skinned people of northwestern European descent are most affected. Women are three times as likely to develop Rosacea, and the incidence increases at menopause. Its cause is unknown. Rosacea: Diagnosis and treatment, Niagara This Week - St. Catharines, Sponsored Content, In Your Neighbourhood, METROLAND MEDIA GROUP
    • Related Articles Acne and Rosacea. Dermatol Ther (Heidelb). 2017 Jan;7(Suppl 1):43-52 Authors: Picardo M, Eichenfield LF, Tan J Abstract
      Acne, one of the most common skin diseases, affects approximately 85% of the adolescent population, and occurs most prominently at skin sites with a high density of sebaceous glands such as the face, back, and chest. Although often considered a disease of teenagers, acne is occurring at an increasingly early age. Rosacea is a chronic facial inflammatory dermatosis characterized by flushing (or transient facial erythema), persistent central facial erythema, inflammatory papules/pustules, and telangiectasia. Both acne and rosacea have a multifactorial pathology that is incompletely understood. Increased sebum production, keratinocyte hyper-proliferation, inflammation, and altered bacterial colonization with Propionibacterium acnes are considered to be the underlying disease mechanisms in acne, while the multifactorial pathology of rosacea is thought to involve both vasoactive and neurocutaneous mechanisms. Several advances have taken place in the past decade in the research field of acne and rosacea, encompassing pathogenesis and epidemiology, as well as the development of new therapeutic interventions. In this article, we provide an overview of current perspectives on the pathogenesis and treatment of acne and rosacea, including a summary of findings from recent landmark pathophysiology studies considered to have important implications for future clinical practice. The advancement of our knowledge of the different pathways and regulatory mechanisms underlying acne and rosacea is thought to lead to further advances in the therapeutic pipeline for both conditions, ultimately providing a greater array of treatments to address gaps in current management practices.
      PMID: 28150107 [PubMed - in process] {url} = URL to article
    • Related Articles 9th Skin Academy Symposium: Building Bridges in Dermatology Chair's Introduction. Dermatol Ther (Heidelb). 2017 Jan;7(Suppl 1):1-3 Authors: Blume-Peytavi U Abstract
      An introduction to the proceedings sharing an overview of presentations given as part of the 9th Skin Academy Symposium, held in Barcelona, Spain, April 9-10, 2016. The Skin Academy is an international and interdisciplinary dermatology initiative created to contribute to the growth in scientific knowledge of those dealing with skin diseases. This year's meeting aimed to 'build bridges' between the latest research and everyday clinical practice, providing dermatologists with important updates on some of the most common skin diseases, as well as current 'hot' topics.
      PMID: 28150110 [PubMed - in process] {url} = URL to article
    • Related Articles Four cases of Morbihan disease successfully treated with doxycycline. J Dermatol. 2017 Feb 02;: Authors: Okubo A, Takahashi K, Akasaka T Abstract
      Morbihan disease (MD) is rosacea-like disease characterized by persistent lymphedema on the upper half of the face. Currently, there is no established standard treatment for MD. Recently, MD has been reported to be associated with the infiltration of mast cells. The aim of this study was to investigate the association of treatment response and mast cell infiltration in MD. We report four cases of MD that were successfully treated with long-term oral doxycycline therapy.
      PMID: 28150340 [PubMed - as supplied by publisher] {url} = URL to article
    • The brave blogger took to Insta to share her story of rosacea with a selfie showing half of her face with makeup and half without. Lex expressed her difficulty in posting the photo - which shows the rosacea on her face - at first: "This photo was hard to take and is even harder to post. Every single time I take a photo of my bare skin I am still shocked, because this is not how I picture myself." She then goes on to explain how she feels it was important to share the image in order to show how much of a positive impact makeup can have on our confidence and the way we feel about ourselves. Blogger and rosacea sufferer Lex Gillies shares brave before & after Instagram post, By Rebecca Fearn, Glamour
    • “Practically, in our current phenotypic-led classification, it’s not important to be grouping into subtypes. It’s more important to be categorizing based on patients’ presentation in terms of signs and symptoms,” he says. “So, if they simply presented with centrofacial erythema that would be diagnostic of rosacea, but we wouldn’t go onto subtype. We would just leave them as is, as that predominant phenotype. Then, we would manage them based on that, with various treatment options that are indicated for background centrofacial erythema.” Dr. Jerry Tan, Updated guidelines for diagnosis, treatment of rosacea
      Focus on phenotype-led diagnosis, classification
      By Lisette Hilton, Dermatology Times
    • "President Trump takes medication for three ailments, including a prostate-related drug to promote hair growth, Mr. Trump’s longtime physician, Dr. Harold N. Bornstein, said in a series of recent interviews. The other drugs are antibiotics to control rosacea, a common skin problem, and a statin for elevated blood cholesterol and lipids." Donald Trump’s Longtime Doctor Says President Takes Hair-Growth Drug, By LAWRENCE K. ALTMAN, M.D., FEBRUARY 1, 2017, New York Times Doctor claims Trump takes medication for hair growth, rosacea, cholesterol
      by: Michelle Ewing, KIRO7, Cox Media Group National Content Desk Updated: Feb 2, 2017 - 12:45 AM Doctor claims Trump takes medication for hair growth, rosacea, cholesterol
      Michelle Ewing, The Atlanta Journal Constitution, Cox Media Group National Content Desk
    • Looks good Brady. I'm curious. How would you compare compare your results so far with Soolantra to years of using ZZ cream?  I started Soolantra again 2 weeks ago. 
    • Dr. Jerry Tan has an excellent video explaining Demodex Blepharitis.