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    The purpose of the Rosacea Research & Development Institute [RRDi] is to fund research and development for finding a cure for rosacea by establishing a Medical Advisory Committee [MAC] of the best available minds on rosacea and to publish the results of this endeavor to the public and professional groups. This MAC will provide the direction of the research. Research may also include studying various treatments for the control of rosacea in multi-center, double blind, placebo controlled clinical trial studies. The RRDi is commited to support patient advocacy for those suffering from rosacea. This organization is open to the public and membership is free and has been organized by rosaceans for rosaceans. This organization is a non-profit corporation registered in the State of Hawaii and 501 (c) (3) tax-exempt status approval has been obtained from the IRS effective June 7, 2004. The Articles of Incorporation, the Bylaws, and the Conflict of Interest Policy are available for the public.

     

    Membership is open to the public and is free. Rosaceans are specially invited to join. All who join become members of the corporation and for now this number is not limited but may be revised in the future by the institute. There are two categories of members: 

    Voting Member (a member who choses voluntarily to provide contact information such as first and last name, mailing address and phone number, email addresses)

    Non Voting Member (a member who only provides one email address)

    A rosacean is anyone who is diagnosed by a physician as having rosacea. All that is necessary to be designated a voting member is a statement from the member that a diagnosis of rosacea has been obtained from a physician as well as the contact information mentioned above for voting members. Voting members should be rosacea sufferers (rosaceans). 

    Non-rosaceans are permitted to join and should identify themselves as such upon demand from the institute. Non-rosaceans are those who have not obtained a diagnosis of rosacea by a physician. 

    Any member of the institute may be removed from the membership at any time at the sole discretion of the institute. Rules of the institute are published and available to the public. Violation of the rules may be grounds for termination as a member of the institute. Membership in the institute is a privilege.

    Funding will provide a rosacea MAC of the best available minds on finding a cure for this disease. The selection of who is chosen to be in this MAC will be based on not only the qualifications of the individual but also from nominations by both rosacean and non rosaceans members of the institute.

    Sources of funding to the institute will be publicized including the name of the donor unless the donor requests anonymity. Expenses of the institute will be publicized down to the last cent, showing where all the spending went and for what purpose since transparency is a core principle of our non profit organization. 

    The philosophy and spirit of this institute is that funding should predominately be used for research and development and not for the administration of the institute. Volunteers are an integral part of this spirit and we hope to include member rosaceans and non-rosaceans who are willing to help the purpose of the institute become a reality. We need your help to find a cure for rosacea, to research rosacea, to publish the findings of this research and provide a MAC of the best available minds on rosacea. The views and suggestions of rosaceans will be an integral part in directing the research on rosacea, in choosing the MAC and the directors of the institute. Voting members of the institute will have a voice in the decision making of the institute, although directors of the institute will make all final decisions.

    Members of the institute will not profit from the institute however the Medical Advisory Committee members or members may be compensated for services rendered to the institute.

    Members will elect a board of directors which will include:

    Director, Assistant Director, Secretary, Treasurer and other board members. The board of directors will decide all matters of the institute and will be volunteers.

    Funding on rosacea research by the RRDi will not be used on animal testing.

    Our Mission Statement may be read by clicking here.

    This charter may be revised from time to time by the institute when deemed appropriate at the sole discretion of the institute.

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    • Related ArticlesEnhanced Pulsed Dye Laser for Facial Rejuvenation. Lasers Surg Med. 2020 Aug 10;: Authors: Victor Ross E, Chodkiewicz H, Javvaji S, Zumwalt J, Kutscher TD, Tran C Abstract BACKGROUND AND OBJECTIVES: To evaluate the efficacy of an enhanced pulsed dye laser (PDL) for treatment of facial-dyschromia. STUDY DESIGN/MATERIALS AND METHODS: Thirteen patients were enrolled in the study. Nine patients were female, four were male, with a mean age of 61 years. All patients presented with either facial telangiectasia, rosacea, pigment, or a combination thereof. At the initial evaluation, test spots were performed to determine the subject's response to selected treatment parameters. In the study, the enhanced 595 nm PDL deployed a spot size range of 5-12 mm with fluences ranging from 8 to 18 J/cm2 . Pulse duration was 10 milliseconds. Enhancements in this device included the option for contact or cryogen spray cooling, increased maximum pulse energy, increased repetition rate, option for addition of radiofrequency (RF), an option for a 15 mm spot size, and longer dye life. The smaller spots were used only for focal low contrast pigmented lesions that persisted after overall facial treatment with the larger spot. Smaller fluences were applied for general rejuvenation with the 12 mm spot (mean ~9 J/cm2 ). Sapphire contact cooling was applied at 10°C. A smaller area of the skin was reserved (typically pre-auricular area) for addition of RF energy just before the pulse (40-70 J/cm3 ) over 100 milliseconds with a 20 milliseconds delay between the end of the RF pulse and beginning of the laser pulse. The minimum fluence that achieved vessel closure/vessel bluing and/or slight immediate pigment darkening was applied based on test spots performed just before treatment to the entire face. Determinations of improvement were made by evaluation of photographs with standard settings using polarized and nonpolarized images. Up to three treatments were performed approximately 1 month apart with follow-up visits 1 and 3 months after the final treatment. RESULTS: Evaluation by a panel of blind observers determined a mean clearance of at least 50% in all lesions, while 77% of lesions had 50-75% clearance, and 23% of lesions had 76-100% clearance. Pain was approximately 4/10. Subjective lesion improvement and satisfaction rates were 3 out of 4 and 3.6 out 4, respectively. CONCLUSION: An enhanced PDL is effective in one pass treatments for facial rejuvenation with considerably less operative time than previous commercially available systems. A second pass applied to focal challenging lesions results in even more improvement, in a single treatment session. Lasers Surg. Med. © 2020 Wiley Periodicals LLC. PMID: 32779273 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles[Strawberry and raspberry anaphylaxis]. Rev Med Liege. 2020 Jul;75(7-8):494-496 Authors: Collins A, Derkenne B, Giebels K, Carvelli T Abstract Strawberry IgE-mediated hypersensitivity is often reported rarely confirmed. Only a few cases are described in medical literature, unlike other fruits of the rosacea family. Strawberry is rich in histamine. It can cause histamine release syndrome, especially when eaten in large quantities. However IgE-mediated hypersensitivity exists. We reported the case of a 9-year-old boy with a history of strawberry and raspberry anaphylaxis. PMID: 32779896 [PubMed - in process] {url} = URL to article
    • Quantification for Demodex Density Counts What are the numbers revealing? In normal humans demodex density is reported to be "1 or 2 per square centimetre of skin". In rosacea sufferers with demodectic rosacea "the number rises to 10 to 20." [1] Methods and Tools Used to Quantify  There are a number of methods or tools used to quantify demodex density counts. We will continue to update this page as we learn more.  Cellophane Tape Method, Scraping, Plucking Eyelash and Eyebrow Hair "Methods used to collect Demodex mites from humans include biopsy, the cellophane tape method (placing tape on the face to stick to the mites), scraping areas where mites are likely to reside, and plucking eyelash and eyebrow hairs." [2] Confocal Laser Scanning Microscope (CLSM) A paper published by the British Journal of Dermatology reports, "With the help of CLSM it is possible to non-invasively detect, image and quantify Demodex mites in facial skin of patients with rosacea." [3] The Confocal Laser Scanning Microscope [CLSM] hopefully will be in every dermatologist's office so that we can get some data on how may sufferers have demodectic rosacea. [4] Another paper discusses the Confocal LS Microscope and stated, "there are limitations to the use of this method to accurately detect absolute numbers of mites in human skin." [5] An article in 2014 says, "Reflectance confocal microscopy is a fast, direct and noninvasive method for Demodex-associated diseases and it is superior to SSSB for Demodex mite detection." [6] According to a Russian study, the CLSM in vivo method is the best method of quantifying demodex density counts which needs to be validated by comparing the other tools used.  Cellophane Tape Method (CTP, Squeezing Method, Skin Scrapings, and the Standardized Skin Surface Biopsy (SSSB) "To collect mites for further research, the cellophane tape method (CTP), squeezing method, or skin scrapings can be used. CTP seems to be more effective with a positive rate at 91%, whereas squeezing gives a 34% positive diagnosis. Standardized Skin Surface Biopsy (SSSB) is the most commonly used method for comparing densities of mites between patients with dermatoses and healthy controls." [7] SNS [superficial needle-scraping]  Direct Microscopic Examination (DME) & SSSB Compound Microscope image courtesy of Wikimedia Commons "Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are commonly used to determine Demodex mites density (Dd)." [8] Another paper in Thailand states that SSSB has been 'considered to be the gold standard technique' but after careful investigation that the Skin Scraping technique is just as valid. [9] Microscope (simple) Potassium Hydroxide (KOH) "Potassium hydroxide (KOH) preparation of skin scrapings is a much simpler procedure that can be used to detect pathogens in the superficial skin...Potassium hydroxide preparation of skin scrapings is an effective, time saving and practical technique to detect Demodex mites with accuracy comparable to the standard biopsy method." [9] "Potassium hydroxide preparation of skin scrapings is an effective, time saving and practical technique to detect Demodex mites with accuracy comparable to the standard biopsy method." [9] SLI [scattered light intensity] SSSB with DME Better Than CLSM? According to one report,  if you use a skin scraping with a light microscope, no, which says, "The severity of the condition does not depend on the quantitative load of the mites in the scrape." However when using a 'Confocal laser scanning in vivo microscopy', yes, which this same report concludes, "Confocal laser scanning in vivo microscopy is an effective diagnostic method to detect Demodex mites that does not require preliminary preparation for analysis and allows detecting Demodex mites at the level of the spiky epidermis layer, which is not accessible for scarification, to identify the species belonging to the size of Demodex mites (from 100 up to 200 μm - Demodex brevis, 200 to 400 μm – Demodex folliculorum)." [10] SSSB [standardized skin surface biopsy]  DERMOSCOPY The advantage of dermoscopy can be shown in a report by Friedman et al which states,"Our case is an example of how dermoscopy could have helped in demodicidosis recognition, since the patient was incorrectly treated with topical steroids possibly with the diagnosis of seborrheic dermatitis. However, when we evaluated the patient, dermoscopy did not reveal what would be expected for seborrheic dermatitis (dotted vessels in a patchy distribution and fine yellowish scales), but revealed, instead, features associated with demodicidosis (“Demodex tails” and “Demodex follicular openings”). [11] "In 54 patients, the dermoscopy examination yielded a specific picture consisting of Demodex "tails" and Demodex follicular openings. In patients with an inflammatory variant of demodicidosis, reticular horizontal dilated blood vessels were also visualized. Microscopically, skin scrapings demonstrated Demodex in 52 patients. Overall, the dermoscopy findings showed excellent agreement with the microscopy findings (kappa value 0.86, 95% CI 0.72–0.99, P < 0.001)." Dermoscopy of demodicidosis shows the so-called "Demodex tails", which are visualised as creamy/whitish gelatinous threads protruding out of follicular openings (black arrow), and “Demodex follicular openings”, which appear as round and coarse follicular openings containing light brown/greyish plugs surrounded by an erythematous halo (black arrowhead) (f).  See Fig 4, Item f  [12] A paper by Karabay et al shows photos of using SSSB. [13] Do It Yourself (DIY) Supereyes Macro Lens-Disposable Dermatoscope Supereyes Smartphone Microscope Camera Adapter Thumbnail-squeezing method End Notes [1] Demodex Density Count - What are the Numbers? [2] Plos | OneUbiquity and Diversity of Human-Associated Demodex MitesMegan S. Thoemmes , Daniel J. Fergus, Julie Urban, Michelle Trautwein, Robert R. Dunn [3] Br J Dermatol. 2012 Jun 20. doi: 10.1111/j.1365-2133.2012.11096.x.  Non-invasive in vivo detection and quantification of Demodex mites by confocal laser scanning microscopy.Sattler EC, Maier T, Hoffmann VS, Hegyi J, Ruzicka T, Berking C. [4] Counting Demodex Mites with a Confocal Laser MicroscopeDavid Pascoe, Rosacea Support Group [5] Br J Dermatol. 2013 Feb 16. doi: 10.1111/bjd.12280.  Demodex quantification methods: Limitations of Confocal Laser Scanning Microscopy (CLSM). Lacey N, Forton FM, Powell FC. [6] Skin Res Technol. 2014 Feb 13.Reflectance confocal microscopy vs. standardized skin surface biopsy for measuring the density of Demodex mites.Turgut Erdemir A, Gurel MS, Koku Aksu AE, Bilgin Karahalli F, Incel P, Kutlu Haytoğlu NS, Falay T. [7] Iran J Parasitol. 2017 Jan-Mar; 12(1): 12–21. PMCID: PMC5522688Human Permanent Ectoparasites; Recent Advances on Biology and Clinical Significance of Demodex Mites: Narrative Review ArticleDorota LITWIN,  WenChieh CHEN, Ewa DZIKA, and Joanna KORYCIŃSKA [8] Ann Dermatol. 2017 Apr; 29(2): 137–142.Demodex Mite Density Determinations by Standardized Skin Surface Biopsy and Direct Microscopic Examination and Their Relations with Clinical Types and Distribution PatternsChul Hyun Yun, Jeong Hwan Yun, Jin Ok Baek, Joo Young Roh, and Jong Rok Lee [9] Indian J Dermatol Venereol Leprol [View Image] Skin scrapings versus standardized skin surface biopsy to detect Demodex mites in patients with facial erythema of uncertain cause – a comparative study Sumanas Bunyaratavej, Chuda Rujitharanawong, Pranee Kasemsarn, Waranya Boonchai, Chanai Muanprasert, Lalita Matthapan, Charussi Leeyaphan [10] Dermatol Reports. 2019 Jan 23; 11(1): 7675.Clinical picture, diagnosis and treatment of rosacea, complicated by Demodex mitesAlexey Kubanov, Yuliya Gallyamova, and Anzhela Kravchenko [11] Dermatol Pract Concept. 2017 Jan; 7(1): 35–38.Usefulness of dermoscopy in the diagnosis and monitoring treatment of demodicidosisPaula Friedman, Emilia Cohen Sabban, and Horacio Cabo [12] Int J Dermatol. 2010 Sep;49(9):1018-23.Dermoscopy as a diagnostic tool in demodicidosis.Segal R, Mimouni D, Feuerman H, Pagovitz O, David M. [13] An Bras Dermatol. 2020 Mar-Apr; 95(2): 187–193.Demodex folliculorum infestations in common facial dermatoses: acne vulgaris, rosacea, seborrheic dermatitisEzgi Aktaş Karabay and Aslı Aksu Çerman  
    • Soolantra prices may vary but a 45 gram tube costs approximately $12.91/gram if you don't have insurance to cover it. Check with your insurance provider for your actual cost. The price below is a screen shot from GoodRx. 
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