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Classification Of Rosacea Remains Controversial

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From: Latkany, MD Robert

Subject: RE: RRDi MAC Members Please Comment on Topic

Date: July 6, 2010 10:33:48 AM HST

To: Brady Barrows

In general I would agree. However, if dividing the type of rosacea into subtypes helps explain different etiologies then it is necessary and will be helpful to guide physicians into different treatment directions. But until we better understand why people get rosacea this is all insignificant.

Robert Latkany, MD


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Robert Brodell, MD

Subject: Re: Please take five minutes to comment

Date: July 21, 2010 10:52:08 AM HST

To: Barrows Brady

The best way to categorize acne rosacea would be into subgroups that are treated in the same manner......I like erythrotelangiectatic rosacea as a subset where infection is not a key issue and antibiotics might be less important than evolving vasoconstricting drugs, laser therapy and coverups. Papulopusular acne and many of the variants mentioned in the previous comment are related to demodex, bacterial infection, and pityrosporon yeast.....to the extent that most respond to antibiotics, I have always favored bacteria as a key part of the pathogenesis in most patients, though the antiinflammatory effects of antibiotics may explain their benefits as well. The subset that is associated with seborrheic dermatitis is best treated like rosacea, plus ketoconazole cream bid to cover the pityrosporon that induces seb derm. There will always be some controversy here, but this is the approach I would take if I were a thought leader!

Robert Brodell, MD

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