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  2. JAAD Alcohol intake and risk of rosacea in US women Suyun Li, BA, Eunyoung Cho, ScD, Aaron M. Drucker, MD, Abrar A. Qureshi, MD, MPH, Wen-Qing Li, PhD
  3. "Researchers have found that women who consume alcohol may be more likely to develop rosacea than non-drinking women, with white wine and liquor being the biggest offenders." White wine linked to rosacea: study, New York Daily News White wine, liquor may raise women's risk of rosacea, by Honor Whiteman, Medical News Today Your Favorite Drink May Increase Your Risk of This Skin Condition, by Brittany Burhop, Senior Editor, NewBeauty Drinking White Wine Raises Your Risk of Developing Rosacea By Ashley Weatherford,The Cut, NY Mag White wine may do no favors for a woman's skin, By CBS News, KZBK Alcohol consumption increases rosacea risk in women, Science Daily White Wine Raises Women's Risk for Rosacea, NewsMax
  4. ""We also tell our patients to avoid certain ingredients in skin care and cosmetics, such as retinol, alpha hydroxy acids, and beta hydroxy acids, which can be too harsh for sensitive rosacea-prone skin." Concerned your skin care might be making symptoms worse? Read up on the signs your products are secretly damaging your face."" Got Rosacea? These Makeup Tricks Will Make It Disappear, by Lindsay Cohn, Readers Digest
  5. "We found white wine and liquor were significantly associated with a higher risk of rosacea," said study senior author Wen-Qing Li. He's an assistant professor of dermatology and epidemiology at Brown University. White wine may increase risk for rosacea in women, study says, By Kathleen Doheny, HealthDay News, UPI
  6. Tom Busby posted at RF a .pdf containing two interesting articles. The first is, "What’s all the craze about demodex?" and the second is "Factors in rosacea pathogenesis clearer." What's all the craze about demodex-Gadie-2016.pdf
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  8. Radiofrequency (RF) is used in treating catheter ablation for atrial fibrillation, coronary sinus ostium (CSOS), lung tumors, Lumbar Spinal Stenosis, hemodialysis (HD) patients with hepatocellular carcinoma (HCC), hepatocellular carcinoma, and the list just keeps going. RF is a standard medical treatment for many diseases and conditions. There are reports published that RF is used to treat rosacea. In medicine, "Radio frequencies at non-ablation energy levels are sometimes used as a form of cosmetic treatment that can tighten skin, reduce fat (lipolysis), or promote healing." Wikipedia "A technology called ELOS (electro-optical synergy) combines pulsed light or laser with bipolar radiofrequency....The results of this study suggest that the combination of optical and RF energies is effective for the treatment of rosacea. ELOS, as well as other vascular-focused lasers and light sources, provides an important treatment option for patients who fail medical therapy, reach a plateau in their response to medical therapy, or wish to avoid chronic oral therapy." [1] "Radiofrequency therapy was as effective as pulsed dye laser in treating rosacea, particularly in patients with papulopustular rosacea, according to published study results" [2] "Fractional microneedling radiofrequency (FMR) therapy resulted in modest but clinically significant improvements in the appearance and inflammation of rosacea in a small study of patients with mild to moderate rosacea." [3] Resolve Skin Laser Clinics in the United Kingdom specializes in RF for Rosacea. A "new hand-held device fires a light beam, but also emits radio frequency energy waves... [and] fires energy waves and light has been developed to treat rosacea and other skin conditions." Daily Mall You may want to ask your physician about RF as an option for your particular rosacea diagnosis. End Notes [1] J Clin Aesthet Dermatol. 2008 May;1(1):37-40. Successful treatment of erythematotelangiectatic rosacea with pulsed light and radiofrequency. Taub AF, Devita EC. [2] Dermatologic Surgery: February 2017 - Volume 43 - Issue 2 - p 204–209 doi: 10.1097/DSS.0000000000000968 Comparative Efficacy of Radiofrequency and Pulsed Dye Laser in the Treatment of Rosacea Kim, Sue-Jeong MD; Lee, Young MD; Seo, Young-Joon MD; Lee, Jeung-Hoon MD; Im, Myung MD Article in PubMed [3] Rosacea improved with fractional microneedling radiofrequency therapy December 7, 2016 by Bianca Nogrady, Dermatology News
  9. The ROSCO panel that created the phenotype classification which the RRDi has endorsed are from all over the world (by last name, first name initial, country): Almeida LM, Brazil Bewley A, United Kingdom Cribier B, France Dlova NC, South Africa Gallo R, USA Kautz G, Germany Mannis M, USA Oon HH, Singapore Rajagopalan M, India Schaller M. Germany Steinhoff M, Ireland Tan J, Canada Thiboutot D, USA Troielli P, Argentina. Webster G, USA Wu Y, China van Zuuren EJ, Netherlands
  10. Dr. Tan Study on the Psychological Impact of Rosacea
  11. Related Articles Minocycline-Induced Hyperpigmentation in a Patient Treated with Erlotinib for Non-Small Cell Lung Adenocarcinoma. Case Rep Oncol. 2017 Jan-Apr;10(1):156-160 Authors: Bell AT, Roman JW, Gratrix ML, Brzezniak CE Abstract INTRODUCTION: While epidermal growth factor receptor (EGFR) inhibitors have improved progression-free survival in patients with non-small cell lung cancer (NSCLC), one of the most common adverse effects is papulopustular skin eruption, which is frequently severe enough to be treated with oral minocycline or doxycycline. CASE: We present a case of an 87-year-old man who developed a severe papulopustular skin eruption secondary to erlotinib therapy for NSCLC. Control of the eruption with 100 mg of minocycline twice daily for 8 months eventually led to blue-gray skin hyperpigmentation. After 30 months, this side effect was recognized as minocycline drug deposition, which was confirmed with skin biopsy. DISCUSSION: Compliance with EGFR inhibitor therapy in NSCLC is often challenging due to common side effects, most notably cutaneous skin eruptions. Treatment of cutaneous toxicities is important to preserve patient compliance with targeted cancer therapy. Use of minocycline to treat the most common cutaneous side effect (papulopustular eruption) can in turn cause blue-black skin, eye, or tooth discoloration that can nullify its benefits, resulting in suboptimal patient adherence to cancer therapy. Although this adverse effect is well known in dermatology literature as a risk when using minocycline to treat acne, rosacea, or blistering disorders, it is less well documented in oncology literature. We present this case to highlight the need for greater consideration of unique patient characteristics in selecting an oral antibiotic as a treatment modality for EGFR inhibitor skin toxicities. PMID: 28413391 [PubMed] {url} = URL to article
  12. "People look at someone with rosacea and conclude the red face is from anger, embarrassment or boozing — it’s little wonder that sufferers of this common skin condition feel stigmatized. Now recently published research co-authored by Windsor dermatologist Dr. Jerry Tan confirms what he regularly hears from his rosacea patients: Having this condition — characterized by facial redness, pimples and sometimes thickened red skin in the nasal area — frequently leads to embarrassment, loss of confidence, sadness, depression and despair." Study confirms the emotional pain rosacea inflicts, says Windsor dermatologist, by Brian Cross, Windsor Star
  13. Natural Remedies for Rosacea? By THE NEW YORK TIMES
  14. "I tried every cream imaginable; the list of creams I didn't try is shorter. I went for 13 years without a full remission; started getting the rash really bad when I was a handsome young man, and it really was tough on my self esteem. It did a number on my face, and began to cover my scalp too. The only thing that finally worked for me with long lasting, real remission, is plaquenil. My only regret is that I didn't try it sooner. Much, much sooner. In hindsight, I think it was likely lupus all along, and my experience really has me questioning how many other people with "rosaceae" are just lupus sufferers. I would encourage folks here to do an honest self audit to reconcile any symptoms that may be similar to lupus and connect the dots. And whatever you do, whatever your gut tells you, please don't give up on finding a lasting resolution. Even if I don't have lupus, the treatment for it resolved my horrible, red, burning, painful, embarrassing rash. I don't really care what we call it because I'm able to look in the mirror again. And Im feeling my age again. I hope everyone here finds a lasting remission. Don't stop until you do." Duff Man post no 221 on 4/17/2017
  15. "It’s also important to take a holistic approach to your lifestyle if you suffer from rosacea. Eating an anti-inflammatory diet can help reduce flare-ups. And beauty blends, like The Beauty Chef’s Inner Glow Powder, can nourish your skin from the inside out." Everything You Need To Know About Rosacea, By Emily Waight, sporteluxe
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  17. Mistica at RF reported about Dawn M Lamako who posted her treatment for PD using Sugardyne (sugar as an antimicrobial) which she explains with incredible detailed references to documents and photos. Be sure to scroll all the way down to see Dawn's photos of the treatment. "Sucrose monocaprate showed the strongest antibacterial activity against all tested bacteria, especially Gram-positive bacteria." Food Chem. 2015 Nov 15;187:370-7. doi: 10.1016/j.foodchem.2015.04.108. Epub 2015 Apr 24. In vitro antibacterial activities and mechanism of sugar fatty acid esters against five food-related bacteria. Zhao L, Zhang H, Hao T, Li S. "There are several ways in which salt and sugar inhibit microbial growth. The most notable is simple osmosis, or dehydration." "In summary, we presented in this report a simple and efficient approach for the preparation of sugar derived Schiff bases. The synthesized D-glucosamine derivatives were shown to possess biological activity when evaluated for antimicrobial activity against Gram-positive and Gram-negative bacterial and fungi strains." International Journal of Carbohydrate Chemistry Volume 2013 (2013), Article ID 320892, 5 pages Synthesis and Antimicrobial Activity of Carbohydrate Based Schiff Bases: Importance of Sugar Moiety Helmoz R. Appelt, Julieta S. Oliveira, Roberto C. V. Santos, Oscar E. D. Rodrigues,4 Maura Z. Santos, Elisiane F. Heck, and Líria C. Rosa How do salt and sugar prevent microbial spoilage?, Scientific American "Studies showed that solutionof appropriate sugar concentration incubated at pH 7.0 and 35° C were lethal to the bacterial species studied." In Vitro Study of Bacterial Growth Inhibition in Concentrated Sugar Solutions: Microbiological Basis for the Use of Sugar inTreating Infected Wounds "Sugars have been used as wound dressings for at least 4,000 years in many parts of the world." The Antimicrobial Activity of Sugar Against Pathogens of Wounds and Other Infections of Man S. Selwyn, J. Durodie
  18. Jane Chertoff, Brit+Co, wrote an article about an 'All-in-One Skincare Product' called Rozatrol which is developed by Board-certified dermatologist Zein Obagi which is sold on Dr. Obagi's website, Zo Skin Health, Inc., which describes the product as "An enzymatic exfoliator provides ultra-mild exfoliation, while amino acids support optimal microcirculation to prevent the signs of premature aging." Watch this promotion video by Zo Skin Health, Inc. UK: Ingredients Water (Aqua, Eau), Glycerin, Cetyl Alcohol, Helianthus Annuus (Sunflower) Seed Oil, C12-15 Alkyl Benzoate, Palmitoyl Glycine, Neopentyl Glycol Diethylhexanoate, Dimethicone, Panthenol, Potassium Cetyl Phosphate, PEG-100 Stearate, Glyceryl Stearate, Lactose, PEG-36 Castor Oil, PEG-12 Glyceryl Laurate, Phenoxyethanol, Xanthan Gum, Magnesium Aluminum Silicate (Argilla), Brassica Oleracea Italica (Broccoli) Extract, Panthenyl Triacetate, Farnesyl Acetate, Farnesol, Aminomethyl Propanol, Caprylyl Glycol, Milk Protein/Protéine du lait, Chlorphenesin, Neopentyl Glycol Diisostearate, Hydrolyzed Algin, Papain, Marrubium Vulgare Meristem Cell Culture, Leontopodium Alpinum Meristem Cell Culture, Benzalkonium Chloride, Stearyl Alcohol, Myristyl Alcohol, Disodium EDTA, Lactic Acid, Titanium Dioxide, Carbomer, 1,2-Hexanediol, Citric Acid, Lecithin, Algin, Alcohol, Tocopherol.
  19. Violetsareblue started a thread at RF about this special type flushing and Lizzy added her thoughts, while elegantsquatlobster said she also suffers from this phenomenon so I started this thread to list the different treatment protocols offered and will continue to update this list here. If you have something to offer please reply to this thread with your thoughts. Treatments Offered Accutane Anafranil (see post #10 elegantsquatlobster) Beta blocker for two months and it made cheeks calm but nose gradually worse Capsaicin (see post #4 elegantsquatlobster) Clonidine (lower the dose - high dose causes nose flushing) Cold Gel packs Erythromycin gel Ice Chips (eating) Metronidazole gel Paxil Probiotics Steroids Treatments for Phymatous (Rhinophyma) - See subheading, Treatments
  20. Related Articles [Granulomatous periocular eruption]. Ann Dermatol Venereol. 2017 Apr 11;: Authors: Moncourier M, Pralong P, Pinel N, Templier I, Leccia MT Abstract BACKGROUND: Herein, we report a case of atypical periorificial dermatitis in a patient that had been receiving treatment for some time for atopic dermatitis. The specific feature of this rash was its periocular predominance with no perioral involvement, its clinical aspect and its histological picture evocative of sarcoidosis. PATIENTS AND METHODS: A 33-year-old man was being treated for a atopic dermatitis limited to the face and poorly responsive to dermal corticosteroids. Treatment was initiated with topical tacrolimus 0.1%. After 4 years, dependence on this treatment was noted, with daily application being needed to control the lesions. One year later, symmetric lesions were seen on the eyelids and periorbital regions; these were erythematous, micropapular and poorly delineated in a setting of oedema. Biopsy revealed epithelioid granulomatous inflammation, and, to a lesser degree, sarcoidal giant-cell features without caseous necrosis. Staging tests to identify systemic sarcoidosis were negative. Treatment with hydroxychloroquine at 400mg per day and discontinuation of topical tacrolimus resulted in complete remission of the lesions within 2 months. Hydroxychloroquine was discontinued after 6 months, and no relapses had occurred after 2 years of follow-up. DISCUSSION: Three diagnostic hypotheses may be posited for these granulomatous facial lesions. We opted for a diagnosis of granulomatous periorificial dermatitis despite the fact that exclusively periorbital involvement is rare (this condition is generally associated with perioral dermatitis). The second was that of pure cutaneous sarcoidosis, but the topography and clinical appearance of the lesions did not correspond to any of the cutaneous forms classically described. The third was that of tacrolimus-induced granulomatous rosacea, but the histological picture is different. CONCLUSION: The present case underscores the fact that a histological appearance of sarcoidosis on skin biopsy may be associated with perioral dermatitis. PMID: 28410769 [PubMed - as supplied by publisher] {url} = URL to article
  21. A noted authority on rosacea, Dr. Frank Powell "insists that episodes of flushing are not a prerequisite for making a diagnosis of rosacea, and that some patients can develop the full-blown disease without a prior history of frequent flushing. Rebora too, another investigator, says that flushing is not a necessary stage in the sequence leading up to the full-blown 'red face'." Powell in his book wrote a chapter on Flushing and Blushing and confirms what other clinicians have found that while both are seen 'sufficiently often enough' in rosacea patients and both flushing and/or blushing are the 'first features of rosacea to appear in some patients," nevertheless, "flushing and blushing are not necessarily a component of the clinical picture in all patients with rosacea." Source List of Anecdotal Reports of Rosaceans Who Report No Flushing "I run each morning and don't really seem to flush aside from being hot. My face is back to the way it was when I woke up within 5 minutes after stopping. I had a few cups of coffee and no change. The only change in redness seems to come from applying my Lotion which subsides. What are some general thoughts on Flushing?" clfergus (post no 1) 21st April 2009 03:16 PM "Flushing seems to be a critical symptom to the dx of rosacea and I don't think I flush. I don't even blush." Rhea (post no 1) 24th August 2012 01:58 PM
  22. Related Articles Dermatological comorbidity in psoriasis: results from a large-scale cohort of employees. Arch Dermatol Res. 2017 Apr 12;: Authors: Zander N, Schäfer I, Radtke M, Jacobi A, Heigel H, Augustin M Abstract The field of dermatological comorbidity in psoriasis is only passively explored with contradictory results. Objective of this study was to further investigate the complex field of psoriasis and associated skin diseases by identifying skin comorbidity patterns in an extensive cohort of employees in Germany. Retrospective analysis of data deriving from occupational skin cancer screenings was conducted. From 2001 to 2014 German employees between 16 and 70 years from different branches underwent single whole-body screenings by trained dermatologists in their companies. All dermatological findings and need for treatment were documented. Point prevalence rates and their 95% confidence intervals were computed. Logistic regression analysis was performed to calculate odds ratios (OR) of single dermatological diseases to occur together with psoriasis controlled for age and sex. Data from 138,930 persons (56.5% male, mean age 43.2) were evaluated. Psoriasis point prevalence was 2.0%. Of those 20.6% had unmet treatment needs of their disease. Onychomycosis was the most frequent dermatological comorbidity with a prevalence of 7.8%. Regression analysis found rosacea (OR = 1.40, 95% CI 1.13-1.72) and telangiectasia (OR = 1.25, 95% CI 1.10-1.41) to be significantly associated with psoriasis. 17.2% of psoriasis patients had at least one further finding requiring treatment. The highest treatment needs were found for onychomycosis (3.4%), tinea pedis (3.1%), and verruca plantaris (1.0%). It can be concluded that persons with psoriasis are at increased risk to suffer from comorbid skin diseases, which should be considered in treatment regimens. Particular attention should be paid to fungal diseases of the feet. PMID: 28405739 [PubMed - as supplied by publisher] {url} = URL to article
  23. Related Articles The subunit method: A novel excisional approach for rhinophyma. J Am Acad Dermatol. 2016 Jun;74(6):1276-8 Authors: Hassanein AH, Caterson EJ, Erdmann-Sager J, Pribaz JJ PMID: 27185440 [PubMed - indexed for MEDLINE] {url} = URL to article
  24. Oxidative stress reflects an imbalance between the systemic manifestation of reactive oxygen species and a biological system's ability to readily detoxify the reactive intermediates or to repair the resulting damage. Wikipedia Ferritin is a universal intracellular protein that stores iron and releases it in a controlled fashion. The protein is produced by almost all living organisms, including algae, bacteria, higher plants, and animals. In humans, it acts as a buffer against iron deficiency and iron overload.[3] Ferritin is found in most tissues as a cytosolic protein, but small amounts are secreted into the serum where it functions as an iron carrier. Plasma ferritin is also an indirect marker of the total amount of iron stored in the body, hence serum ferritin is used as a diagnostic test for iron-deficiency anemia. Wikipedia These results support the role of oxidative stress and affected metabolism of iron in etiology of rosacea. The higher presence of ferritin in skin cells of rosacea patients explains the exacerbation of symptoms by exposure to UV light, that releases ferritin free iron, which is fundamental in the generation of oxidative stress. [1] The statistically significant differences in the expression of ferritin, higher peroxide levels, and lower antioxidative potential support the onset of systemic oxidative stress in patients with rosacea. [2] Iron and/or ferritin accumulation are known to occur under pathological conditions in many inflammatory skin diseases or in human skin chronically exposed to UV light. [3] For more info. End Notes [1] Lijec Vjesn. 2011 Jul-Aug;133(7-8):288-91. The role of oxidative stress and iron in pathophysiology of rosacea. Tisma VS, Poljak-Blazi M. [2] J Am Acad Dermatol. 2009 Feb;60(2):270-6. doi: 10.1016/j.jaad.2008.10.014. Epub 2008 Nov 25. Oxidative stress and ferritin expression in the skin of patients with rosacea. Tisma VS, Basta-Juzbasic A, Jaganjac M, Brcic L, Dobric I, Lipozencic J, Tatzber F, Zarkovic N, Poljak-Blazi M. [3] J Photochem Photobiol B. 2000 Jan;54(1):43-54. Contrasting effects of excess ferritin expression on the iron-mediated oxidative stress induced by tert-butyl hydroperoxide or ultraviolet-A in human fibroblasts and keratinocytes. Giordani A, Haigle J, Leflon P, Risler A, Salmon S, Aubailly M, Mazière JC, Santus R, Morlière P.
  25. The 32-year-old blogger suffers rosacea, which causes red flushing to the face – similar to when a person blushes. 'I LOOKED LIKE A TOMATO' Who is Lex Gillies? Beauty blogger who ditched gluten and dairy to combat rosacea flare ups, By Lizzie Parry, The Sun
  26. Overcome Rosacea with 75 herbs. The most spectacular solution! Successful treatment of rosacea with Arquebusade Herbal Water. Rosacea, facial redness, skin thickening around the nose. Ladislaus testimonial about how hi overcome it. My rosacea illness and the details of my healing process: About 3 years ago, the disease of rosacea symptoms appeared on my nose and at the bottom of my nose. The veins became dilated then eventually small pustular nodules, like acne appeared on my face. Its development was gradual and very stubborn. I quickly realized that I cannot cope alone with this skin problem, and surely will need help from specialist. The specialists did not encourage me with rapid improvement at all. I asked the opinion of several dermatologists, but none of them could promise me permanent cure. I visited a dermatologist specializing in the treatment of rosacea. He prescribed me medicine beside using various creams. When the creams weren’t effective, the doctor switched my treatment to a topical steroid cream. At first, my condition improved dramatically, but after stopped using it the symptoms returned even stronger than before. I Iwas very embittered! At this point, the dermatologist recommended a very expensive and painful laser procedure. I went to the laser treatments faithfully because I wanted to get better more than anything else. Unfortunately, this didn’t bring my long-awaited cure, either. I had read everything I could find about this disease and all of its possible cures, simply because I did not want to accept having to live the rest of my life with rosacea. In the spring of 2013, a dermatologist suggested trying his specially-prepared, medicated liquid mixture to. To my dismay, one of its components made my skin sensitive to light. After trying it on my nose, I woke up the next morning to find my nose had turned completely black. It looked like it had rotted away! To make matters worse, the sunshine turned my nose into a pulsating, burning lump of absolute pain. This is how my nose looked like from rosacea, which did not get any better from laser treatment or from steroid cream either. I went back to the dermatologist who had prescribed this “miracle” mixture and found myself supplied with more various medicines to treat the swelling and applying cold compresses on the area to reduce the inflammation, but nothing changed. I couldn’t go to work, couldn’t leave the house, I was completely helpless. The dermatologist told me that it would take several days for the dead skin to peel off and for the new skin to form on my nose. When I imagined what this would be like, I panicked even more. After a few days of experimentation I turned to another specialist. To the recommendation of the new dermatologist I bought a bottle of Swiss made Arquebusade Herbal Water from 75 herbs which was unknown to me at that time. She told me to spray the red patches on my face 5-6 times a day and use nothing else other than this. By day 6, I could see a few encouraging signs, the first time in a long time I felt any hope of a real improvement. The pain subsided, the swelling is reduced and my skin wasn’t as bright red anymore. Day by day my nose became more and more beautiful, and there was no sign of the promised peeling either. I became more confident and I can say that after consuming 3 x 100 ml bottles, which was sufficient for about 4 weeks almost restored my nose to its original state. While I struggled with a painful redness, I wouldn’t have thought that I would also deal with rosacea. While I was combating this sore itchiness, it did not even occur to me that I would be taking care of the rosacea as well. The most important is: After about four weeks, when there was no sign of the painful redness, I experienced that the broken blood vessels and pustules developed earlier during the light therapy have disappeared from my nose. I had to go through in such a calvary in order to get rid of my rosacea skin disease which made my life miserable for years. I started using Arquebusade Herbal Water on my face as well after shaving, and this was all I used nothing else. After 4 weeks and spraying my face 5-6 times a day I have achieved a nice and visible result on my face as well. This how my nose looked like 4 weeks after I started using the Arquebusade Herbal Water from 75 Herbs. Rosacea is strongly connected to diet, and now I can immediately see it on myself how my eating habits cause my symptoms free skin break out in redness. For example, if I eat hot, spicy food or drink alcohol, the redness is sure to re-appear. I’ve noticed when I’m stressed, it doesn’t help either and have to miss saunas and steam rooms as well. It is a pity, because I like all of them. I pay attention to what I eat as much as I can, but I’ve discovered that if I still eat spicy food or to take a steam bath, I can get away with it relatively sinless as long as I spray my face with Arquebusade Herbal Water when the symptoms first appear, especially around my nose. This way I can prevent the swelling of blood vessels and the formation of pustules even if I sin a bit from time to time. The Arquebusade Herbal Water has become part of my life. It’s always within hand’s reach in the car or in my bag. When I need it, I just reach out and spray my face with it. It doesn’t hurt at all, and I know that the last thing I want is to be in such a hopeless situation trying all kinds of useless treatments like before. If this can help you, I willingly share the address of their website: http://arquebuse-water.com/
  27. Related Articles Demodex Mite Density Determinations by Standardized Skin Surface Biopsy and Direct Microscopic Examination and Their Relations with Clinical Types and Distribution Patterns. Ann Dermatol. 2017 Apr;29(2):137-142 Authors: Yun CH, Yun JH, Baek JO, Roh JY, Lee JR Abstract BACKGROUND: Demodicosis is a parasitic skin disease caused by Demodex mites, and the determination of mite density per square centimeter is important to diagnose demodicosis. Standardized skin surface biopsy (SSSB) and direct microscopic examination (DME) are commonly used to determine Demodex mites density (Dd). However, no study has previously compared these two methods with respect to clinical types and distribution patterns of demodicosis. OBJECTIVE: The aim of this study was to compare the value of SSSB and DME findings in reference to the clinical types and distribution patterns of demodicosis. METHODS: The medical records of 35 patients diagnosed with demodicosis between December 2011 and June 2015 were retrospectively reviewed. Demodicosis was classified according to four clinical types (pityriasis folliculorum, rosacea type, acne type, and perioral type) and three distribution patterns (diffuse pattern, U-zone pattern, and T-zone pattern). Two samples, one for SSSB and one for DME, were obtained from a lesion of each patient. RESULTS: In all patients, mean Dd and the proportion with a high Dd (>5D/cm(2)) by DME (14.5±3.3, 80.0%, respectively) were higher than by SSSB (5.5±1.3, 37.1%, respectively; p<0.01, p=0.02, respectively). In terms of clinical types, for rosacea type, mean Dd and proportion with a high Dd by DME (12.4±3.5, 84.6%, respectively) were significantly greater than those determined by SSSB (3.6±1.2, 23.1%; p=0.04, p=0.04, respectively). In terms of distribution pattern, for the diffuse pattern, mean Dd and the proportion with a high Dd by DME (17.5±3.7, 100%, respectively) were significantly higher than those determined by SSSB (6.0±2.7, 26.7%; p<0.01, p<0.01, respectively). CONCLUSION: The results of our study revealed that DME is a more sensitive method for detecting Demodex than SSSB, especially in patients with diffuse pattern and suspected rosacea type. Further research is needed to confirm this finding. PMID: 28392639 [PubMed] {url} = URL to article
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