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    • As a medical assistant for a dermatologist I worry about the added fragrance in the baby shampoo causing further irritation. 
    • I work as a medical assistant for a dermatologist. I definitely think it is a possibility for rosacea to through periods of remissions and flare-ups. This can be due to environmental factors as well as psychological factors. 
    • Related Articles Symptomatic vulvar demodicosis: A case report and review of the literature. J Cutan Pathol. 2020 Nov;47(11):1063-1066 Authors: Hedberg ML, Chibnall RJ, Compton LA Abstract Demodex folliculorum is a mite that commonly inhabits the pilosebaceous units of facial skin, particularly in a perioral and periorbital distribution. While typically an incidental and asymptomatic parasite, Demodex spp. are proposed to contribute to the pathogenesis of facial folliculitis, chronic blepharitis and papulopustular rosacea. Reports of demodicosis in anatomic locations other than the face are exceedingly rare. Here we report a 36-year-old woman with symptomatic Demodex spp. infestation of Fordyce spots of the labia minora. She was referred to dermatology after a 9-month history of tender red bumps on the vulva that would arise and drain over a 24 to 72 hours period, several times per week. Physical examination revealed erythema of the labia minora and introitus with a 4 mm, pink, dome-shaped soft papule on the left labium minus. Wet mount, microbiologic cultures and sexually transmitted infection (STI) screenings were unremarkable. Histopathologic examination revealed a well-circumscribed nodule of suppurative granulomatous inflammation arising in a background of mucosa with Fordyce spots, the majority of which were infiltrated by Demodex spp. Treatment with oral ivermectin and topical metronidazole cream resulted in a symptom-free period of 22 months. This case represents an unusual presentation of symptomatic Demodex infestation. PMID: 33448447 [PubMed - in process] {url} = URL to article More information on oral ivermectin
    • This question has come up at RF whether Finasteride or Minoxidil causes flushing or may be a rosacea trigger and you may be interested in knowing that apparently there isn't any consensus on this and these two drugs haven't been listed on any rosacea trigger list as far as we know. If you have anything to add to this or your experience using either of these treatments with your rosacea, please find the reply to topic button.  For more information 
    • Related ArticlesResolution of Refractory Corneal Neovascularization with Subconjunctival Bevacizumab. Case Rep Ophthalmol. 2020 Sep-Dec;11(3):652-657 Authors: Britton AK, Crayford BB Abstract Corneal neovascularization (CNV) has a variety of causes and threatens corneal clarity, thus optimal visual acuity. Conventional medical management includes topical steroids and matrix metalloproteinase inhibitors like doxycycline. Anti-vascular endothelial growth factor (anti-VEGF) agents have demonstrated promise but remain off-label for this indication. However, these agents hold value in cases refractory to first-line medical management. We report the case of a 63-year-old woman who presented with ocular rosacea and CNV affecting vision, on a background of acne rosacea. She was initially treated with fluorometholone and doxycycline, yet continued to deteriorate. Eventually she received two 1.5-mg subconjunctival injections of bevacizumab 2 months apart. CNV completely resolved and results were maintained at 4-year follow-up. This case demonstrates that refractory CNV can be effectively treated with subconjunctival injection of anti-VEGF bevacizumab. The resolution of CNV was also maintained years after injection with minimal adjunctive therapy during this period, and to our knowledge there are no other studies reporting a follow-up period of 4 years after treatment. This is a pertinent case for other clinicians treating patients in a similar situation. PMID: 33442379 [PubMed] {url} = URL to article
    • We have a new video, Welcome to the RRDi Official Website found on our WELCOME PAGE for rosacea newbies.  
    • Related ArticlesThe association of photo-induced collagen degeneration and the development of telangiectasias in rosacea. J Anat. 2021 Jan 11;: Authors: Thompson KG, Rainer BM, Leung S, Qi J, Kang S, Chien AL Abstract Rosacea is a chronic, often progressive disorder characterized by facial erythema, telangiectasias, papules, pustules, and/or rhinophyma. In this study, we investigated the tissue structure in rosacea compared to controls. We performed a case-control study between five patients with mild-to-moderate erythematotelangiectatic rosacea (ETR) and five matched controls. Facial biopsy samples from rosacea patients and controls were stained with picrosirius red for collagen and CD31 for microvessel identification. Mean collagen content was significantly greater in control samples (19.603% ±8.821%) compared to rosacea samples (16.812% ± 7.787%, p = 0.030). In contrast, mean microvessel density was significantly higher in rosacea patients (4.775 E-5 ± 1.493 E-5 µm-3 ) compared to controls (2.559 E-5 ± 8.732 E-6 µm-3 , p = 0.004). Mean microvessel lumen area was also significantly higher in rosacea patients (491.710 ± 610.188 µm2 ) compared to controls (347.879 ± 539.624 µm2 , p = 0.003). We identified a correlation between decreased collagen content and increased microvessel size and density in rosacea patients that was not observed in controls. These structural changes to the dermal matrix may contribute to the characteristic vessel growth and dilation in rosacea. PMID: 33432575 [PubMed - as supplied by publisher] {url} = URL to article
    • Gladskin makes a cream or gel for rosacea that is available in the UK on Amazon. The RRDi doesn't have an affiliate relationship with Amazon UK but in the the spirit of 'everything rosacea' we would hope rosaceans in the UK would let us know about this treatment and find the reply to topic button to report if they have success using this cream or gel. The USA Gladskin website doesn't mention this treatment. The Gladskin UK website has more information as well as the following video:  Ingredients Aqua, Propylene glycol, Hydroxypropyl methylcellulose, Glycerin, Arginine HCl, Sodium chloride, Trometamol, Staphefekt™ SA.100 C2.4, Calcium chloride. Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post?  And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register?  We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.  
    • Related ArticlesChildhood granulomatous periorificial dermatitis: case report and review of the literature. Dermatol Online J. 2020 Dec 15;26(12): Authors: Fakih A, Makhoul R, Grozdev I Abstract Childhood granulomatous periorificial dermatitis (CGPD), considered a clinical variant of perioral dermatitis, typically affects prepubertal children of African descent. It is a condition of unknown etiology characterized by the presence of a monomorphic yellow-brown papular eruption limited to the perioral, perinasal, and periocular regions that histopathologically shows a granulomatous pattern. This disorder should be differentiated from other conditions as granulomatous rosacea, sarcoidosis, and lupus miliaris disseminatus faciei. We report a case of a 9-year-old boy who presented with flesh-colored perorificial papules on the face, evolving for two months. Upon treatment with topical tacrolimus for follicular eczema, an aggravation of the condition was observed. A skin biopsy confirmed the diagnosis of CGPD. Our patient was successfully treated with a combination of topical metronidazole and topical erythromycin. PMID: 33423420 [PubMed - in process] {url} = URL to article
    • Related Articles Facial and neck erythema associated with dupilumab treatment: A systematic review. J Am Acad Dermatol. 2021 Jan 08;: Authors: Jo CE, Finstad A, Georgakopoulos JR, Piguet V, Yeung J, Drucker AM Abstract BACKGROUND: Dupilumab-associated facial and/or neck erythema was not reported in phase 3 clinical trials for the treatment of atopic dermatitis, but there have been a number of reports of patients developing this adverse event in clinical practice. OBJECTIVE: To outline all cases of reported dupilumab-associated facial and/or neck erythema to better characterize this adverse event, identify potential etiologies and management strategies. METHODS: A search was conducted on EMBASE and PubMed databases. Two independent reviewers identified relevant studies for inclusion and performed data extraction. RESULTS: A total of 101 patients from 16 studies were reported to have dupilumab-associated facial and/or neck erythema. 52/101 (52%) had baseline atopic dermatitis facial and/or neck involvement and 45/101 (45%) reported different cutaneous symptoms from pre-existing atopic dermatitis, possibly suggesting a different etiology. Suggested etiologies included rosacea, allergic contact dermatitis, and head and neck dermatitis. Most commonly used treatments included topical corticosteroids, topical calcineurin inhibitors, and antifungal agents. In the 57 patients with data on the course of the AE, improvement was seen in 29, clearance in 4, no response in 16, and worsening in 8 patients. 11/101 (11%) discontinued dupilumab due to this adverse event. LIMITATIONS: Limited diagnostic testing, non-standardized data collection and reporting across studies, and reliance on retrospective case reports and case series. CONCLUSION: Some patients on dupilumab develop facial and/or neck erythema which differs from their usual atopic dermatitis symptoms. Prompt identification and empiric treatment may minimize distress and potential discontinuation of dupilumab due to this adverse event. PMID: 33428978 [PubMed - as supplied by publisher] {url} = URL to article More information on dupilumab
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