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  • Demodectic Rosacea

    Demodectic Rosacea is a rosacea variant, just as valid a variant as Granulomatous Rosacea.

    Image of Demodex Folliculorum courtesy of National Geographic Demodex Folliculorum [1]

    The RRDi is the only non profit organization for rosacea that has officially recognized Demodectic Rosacea as a variant of rosacea. "Recently human primary demodicosis has been recognized as a primary disease sui generis and a clinical classification has been proposed. A secondary form of human demodicosis is mainly associated with systemic or local immunosuppression." [2] This is referring to a paper published in 2014 "to classify human demodicosis into a primary form and a secondary form." [3] While acknowledging the work of Dr. Chen and Dr. Plewig, whether you refer to demodicosis or demodectic rosacea we are referring to the same condition. The term 'demodectic rosacea' was coined by Dr. Plewig in an email to the RRDi on March 2, 2007 where Dr. Plewig wrote, "Concerning your questiones, demodicosis can be a disease by itself and thus being independent of rosacea. Or demodex mites heavily colonize pre-existing rosacea and thus lead to demodectic rosacea ( rosaceiform dermatosis). This is a rather complicated issue. Rosacea is usually diagnosed by inspection [of] the eye. Laboratory tests are rarely needed, for instance in gram-negative rosacea, where one needs bacteriology. The same is true for demodectic rosacea, where one has to demonstrate the mites in great numbers." [4] 

    Current concepts on rosacea is a video presentation by the Charles Institute of Dermatology, University College Dublin with Frank Powell, MD who interviews Fabienne Fortan, MD, Université libre de Bruxelles, Belgium explaining demodectic rosacea:

    Demodetic Rosacea has a long history of controversy which continues to this day. For example, note the following quote:
    "From these and other statements it is seen that in suggesting the thought that these minute forms of life are etiological factors in even some of the phases of acneform diseases, I shall be but little in accord with the highest authorities. In antagonism to these views, I may say that the results of my observations appear to indicate a close relationship of the parasites with the diseased condition."
    Demodex Folliculorum in Diseased Conditions of the Human Face
    Proceedings of the American Society of Microscopists, Vol. 8, 1886, page 123, Published by: Wiley-Blackwell

    For a comprehensive article on demodectic rosacea and why it is considered a rosacea variant click here.

    Dr. Leyda Bowes discusses demodectic rosacea (demodicosis) in this short video: 

     

    If your dermatologist dismisses demodectic rosacea you might refer him to this page, the Demodex Mite Videos available for viewing as well as this comprehensive article and comprehensive list of medical papers on this subject. Also we have an extensive category on demodectic rosacea here: 

    Forum Home >  Forums >  Public Forum >  Rosacea Topics > Demodectic Rosacea

    Demodex Update

    Just think if 10K members of the RRDi each donated one dollar and insisted on supporting a reputable clinician to study what they wanted, supporting their own research, what might be discovered? This can only happen if you want it to happen. Or you can continue to do nothing and let the status quo research continue on. [5]

    End Notes

    [1] Image of Demodex Folliculorum courtesy of National Geographic - by Darlyne A. Murawski

    [2] Iran J Parasitol. 2017 Jan-Mar; 12(1): 12–21.
    PMCID: PMC5522688
    Human Permanent Ectoparasites; Recent Advances on Biology and Clinical Significance of Demodex Mites: Narrative Review Article
    Dorota LITWIN,  WenChieh CHEN, Ewa DZIKA, and Joanna KORYCIŃSKA

    [3] Br J Dermatol. 2014 Jun;170(6):1219-25. doi: 10.1111/bjd.12850.
    Human demodicosis: revisit and a proposed classification.
    Chen W, Plewig G.

    [4] Read end note 7 in the article, Demodectic Rosacea [Variant]

    [5] Rosacea Research in Perspective of Idiopathic Diseases
    Rosacea Research in Perspective of Funding

  • Posts

    • There are several acne treatments used to treat rosacea, i.e., Dapsone, Sarecycline, Azithromycin, Minocycline, and the list continues, not to mention the plethora of over the counter acne treatments to consider. A typical example of an acne treatment, Benzaclin, that is also used to treat rosacea is discussed in the following paper:  “Based on the theory that rosacea shares the same inflammatory features of acne, a recent study showed that, just as the combination of benzoyl peroxide 1 percent and clindamycin 5 percent gel is a powerful treatment modality for reducing Propionibacterium acnes levels, it also significantly reduces the papules and pustules of rosacea, according to Debra L. Breneman, M.D..… ‘Benzaclin, once daily, was found to be well tolerated and effective in the reduction of papules and pustules in patients with rosacea,’ said Dr. Breneman. ‘This lends credence to the theory that P. acnes is a potential aggravating factor in rosacea. This gives dermatologists a very effective treatment for rosacea.’ ” [1] Herbal Extracts for Acne  One report on the 'clinical efficacy of herbal extracts in treatment of mild to moderate acne vulgaris' concludes, "This herbal extracts can be a new therapeutic option for patients with mild to moderate acne vulgaris who are reluctant to use drugs." [2]  The herbal extracts include: Mangosteen extract Lithospermum officinale extract Tribulus terrestris L. extract Houttuynia cordata Thunb extract End Notes [1] Dermatology Times Publish date: Apr 1, 2003 P. Acnes Possible Factor in Rosacea BenzaClin a significant Tx in lesion reduction Beth Kapes Another example similar to above paper discussing topical benzoyl peroxide 5%/clindamycin 1% (BP/C) gel (BenzaClin) concluded, "These results showed that BP/C was significantly more effective than vehicle in improving papules and pustules associated with rosacea.' Cutis. 2004 Jun;73(6 Suppl):11-7. Photographic review of results from a clinical study comparing benzoyl peroxide 5%/clindamycin 1% topical gel with vehicle in the treatment of rosacea. Leyden JJ, Thiboutot D, Shalita A. [2] J Dermatolog Treat. 2019 Oct 16:1-5. doi: 10.1080/09546634.2019.1657792. [Epub ahead of print] Clinical efficacy of herbal extracts in treatment of mild to moderate acne vulgaris: an 8-week, double-blinded, randomized, controlled trial. Yang JH, Hwang EJ, Moon J, Yoon JY, Kim JW, Choi S, Cho SI, Suh DH.
    • image courtesy of WikiMedia Commons The RRDi financial situation is continuously posted at this url and as of this date, March 30, 2020, we have $771.42 in the bank. Based upon how we are spending donations (the income includes the small amount of affiliate fees we receive from Amazon) we will run out of funds in several months. So we are concerned about this and decided to first post this on our website before using the newsletter tool and send this same announcement to the members who have opted to receive our newsletter. You may wonder how much we are spending in donations currently and for the first three months of 2020 we averaged our expenses to $164/month. You can view how we spent donations for last year here. So you can see our current funds will only last us several months at the present rate of expenditure.  So let's compare this with how much money the NRS spends its donations (who is one of the other non profit organizations for rosacea). The only way we can get an idea how the NRS spends its donations is to look at the last financial report filed by the NRS as shown on Form 990 that the NRS files with the Internal Revenue Service for 2018 which is available for public viewing (the NRS releases its 2019 Form 990 much later and when it does we always review it since we have been reviewing how the NRS spends its donations since 1998).  So let's compare how the NRS spends it donations, that is, the amount each month is spent with what the RRDi spends each month.  For 2018, the NRS received in donations a total of $465,042. During this same period the NRS spent a total of $601,532 (yes the NRS can spend more than it takes in because of the assets they own which the NRS draws upon when the expenses are greater than donations). So on average, in 2018 the NRS spent over $50,000 each month! What did the NRS spend most of it donations on? The answer if you investigate is $432,408 was spent for the year (over $36,000 each month on average) on two private contractors owned by the director/president of the NRS, Sam Huff. So if you are happy with how the NRS is spending its donations that is just one of the other non profit organizations for rosacea that will continue if the RRDi runs out of funds and can't pay our monthly expenses.  So the comparison is: RRDi spends                           NRS spends $164/month                           $50,000/month (of this amount $36,000 is spent on two private contractors owned by Sam Huff) Just for the record, the NRS claims on its Form 990 for 2018 that 25.31% of the total donations received in 2018 were from public support. What is one of the most interesting revelations found on the from its Form 990 for 2018 report is that it reveals how much money was received from the pharmaceutical companies which is shown in a screen shot below: The above screen shot doesn't reveal for how long a period each of the above pharmaceutical companies have been giving the NRS 'excess contributions' but it does reveal the amounts. So if you are happy the way these pharmaceutical companies are contributing to the NRS and the way the NRS is spending its contributions and if the RRDi runs out of funds to keep going, you will surely have the NRS since it has lots of money to spend, especially on two private contractors owned by Sam Huff, the director/president of the NRS.  So it is simply up to you whether you want the RRDi to keep going or simply dissolve because of lack of funds. If you want to help out the RRDi there are two options, (1) donate, or, (2) volunteer (and help us get donations). If you have any questions or concerns, why not find the green reply button and post?
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