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There are two PF skin conditions that are rosacea mimics to rule out. 

(1) Pityriasis folliculorum

“Pityriasis folliculorum [PF] is an often over-looked clinical entity” and cases are ‘mostly female.’ Frank Powell, MD explains that there is ‘usually a history of rarely using soap or water to cleanse the facial skin but instead using cleansing creams.’ These individuals often apply moisturizers and complain of a burning or itchy sensation. He also states that the diagnosis of PF is ‘facilitated by use of dermatoscopy, which shows a distinctive picture of the presence of multiple white keratotic material consisting of keratin encrusted demodex mites protruding upwards from the follicular orifices.’ This condition ’seems to be caused by an over population of mites facilitated by the frequent use of creams and the lack of face washing with soap and water.’ [1]

"Topical ivermectin has recently been FDA approved as therapy for rosacea. We present the case of a woman with pityriasis folliculorum who showed significant improvement from using topical ivermectin with no adverse events related to treatment." [2]

(2) Pityrosporum Follicultis (another PF) or Malassezia folliculitis (MF)

"Pityrosporum folliculitis or Malassezia folliculitis is a skin condition caused by infection by pityrosporum yeast." Wikipedia

What is Pityrosporum Folliculitis?

Dermnet NZ

eMedicine Medscape

Simple Skin Care Science

See subheading Pityrosporum Follicultis in this post

"As acne vulgaris and MF coexist in 12.2 to 27 percent of cases, it may be necessary to combine antifungal treatments along with typical acne medications. Use of antibiotics; however, may alter normal flora and lead to the yeast’s overgrowth. For this reason, other anti-acne medications are preferred over antibiotics, as antibiotics are counterproductive." [3]

End Notes

[1] Rosacea Diagnosis and Management by Frank Powell
with a Contribution by Jonathan Wilkin

[2] Pityriasis Folliculorum: Response to Topical Ivermectin.
J Drugs Dermatol. 2017 Dec 01;16(12):1290-1292
Darji K, Burkemper NM

[3] J Clin Aesthet Dermatol. 2014 Mar; 7(3): 37–41.
Malassezia (Pityrosporum) Folliculitis
Richard M. Rubenstein, MD and Sarah A. Malerich, BS







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