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  • Misdiagnosed Rosacea

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    Articles, References and Anecdotal Reports

    There are articles on rosacea that mention misdiagnosed rosacea. While this isn't a massive problem, nevertheless, here is a list of different sources that mention the subject, including (if you scroll below) many anecdotal reports of misdiagnosis. If you want to add your experience with misdiagnosis please post your anecdotal report in this thread

    Articles and References

    "To the untrained eye, unusual skin presentations can cause confusion and alarm. They can also go misdiagnosed, often not getting the attention they require. This is because many skin conditions can seem similar in appearance to one another, says Shari Marchbein, board-certified dermatologist and clinical assistant professor of dermatology at New York University School of Medicine....Another common misdiagnosis is rosacea disguised as acne, says Estee Williams, a board-certified medical, cosmetic and surgical dermatologist and clinical professor in dermatology at Mount Sinai Medical Center in New York City." 
    4 Skin Conditions That Are Often Misdiagnosed, According to Dermatologists, BY ERIN NICOLE CELLETTI, Allure

    "Rosacea SKINsights sponsored by Galderma Laboratories [reveals] the lengths that women with rosacea would go to if they could get rid of their rosacea forever, and highlight the low awareness and complicated diagnosis path for this common condition. On average, women with rosacea waited at least seven months before receiving a correct diagnosis, and only half of respondents had ever heard of the condition upon the time of diagnosis. This reveals the high level of misunderstanding and confusion that surrounds rosacea..." Medical News Toda

    "Currently, rosacea is only diagnosed by clinical symptoms and can be confused with other dermatological diseases such as acne."
    New Treatment or Diagnosis for Rosacea with Existing Approved Drugs
    Tech ID: 19149 / UC Case 2007-047-0
    University of California, San Diego
    Technology Transfer Office

    "Despite its apparent high incidence, the nosology of rosacea is not well established, and the term “rosacea” has been applied to patients and research subjects with a diverse set of clinical findings that may or may not be an integral part of this disorder. In addition to the diversity of clinical manifestations, the etiology and pathogenesis of rosacea are unknown, and there are no histologic or serologic markers."
    Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea

    ''Some physicians may not be aware of or recognize rosacea and may treat patients with rosacea inappropriately as if they had adult acne.''
    Dr. Jonathan Wilkin NRS Medical Advisory Board

    "Rosacea is a common dermatologic disorder. It is frequently overlooked or misdiagnosed, particularly when mild in nature."
    Rosacea: A Review of a Common Disorder by Carolyn Knox, IJAPA

    "Patients with rosacea frequently present with coexisting skin conditions, such as seborrheic dermatitis, acne, perioral dermatitis, and melasma, which may complicate diagnosis and treatment."
    Heather Roebuck, Nurse Pract. 2011 Jan 11.

    "A committee member, Dr. Mark Dahl, a dermatologist at the Mayo Clinic in Scottsdale, Ariz., said, ''This is a syndrome with lots of different elements that is easy to diagnose when all the elements are present,'' but not as easy when only one or two of the characteristics appear."
    PERSONAL HEALTH; Sometimes Rosy Cheeks Are Just Rosy Cheeks
    By JANE E. BRODY, New York Times, March 16, 2004

    "Rosacea is a complex and often misdiagnosed condition." The Rosacea Forum Moderated by Drs. Bernstein and Geronemus

    "Whereas the classical subtypes of rosacea can be recognized quite well, the variants of rosacea may be overlooked or misdiagnosed." rosacea.dermis.net

    "Rosacea is often misdiagnosed as acne or discoid or systemic lupus erythematosus (SLE)." Christiane Northup, M.D.

    "Frequently misdiagnosed as adult acne, this chronic, progressive skin disorder affects millions." Recognizing and Managing Rosacea by Thalia Swinler, JSTOR

    "The last subtype, ocular rosacea, is common but often misdiagnosed." uspharmacist.com

    "The signs and symptoms of ocular rosacea in children may be frequently underdiagnosed or misdiagnosed..." NRS Rosacea Review, Summer 2008

    “It’s a condition that is often misdiagnosed and overdiagnosed. Sometimes a rosy cheek is just a rosy cheek.” Herbert Goodheart, M.D., a dermatologist in Poughkeepsie, N.Y., and author of “Acne for Dummies,” as quoted in the New York Times article

    "Dr. Jay points to the inherent dangers of misdiagnosis and inability to handle complications because of a limited understanding of cutaneous physiology."
    IPL: Wave of the future in rosacea therapy by John Nemec, Aug 1, 2006

    "...unusual manifestations of rosacea may be overlooked or misdiagnosed...."
    Rosacea: An Update
    Stanislaw A. Buechner
    Dermatology 2005;210:100-108 (DOI: 10.1159/000082564)

    "Rosacea is a skin condition as misunderstood as sensitive skin, and as frequently misdiagnosed." Dermilogica

    "Rosacea is a very common, but often misunderstood and misdiagnosed skin condition." skinlaboratory.com

    "Rosacea is a long lasting, non-scarring skin condition of the face that is often misdiagnosed as adult acne." Paul M. Friedman, MD

    "Rosacea is quite often misdiagnosed as any number of other skin disorders including acne." methodsofhealing.com

    "Often misdiagnosed as adult acne, allergy or eczema, Rosacea, if left untreated, tends to worsen over time...." Dana Anderson Skin Care

    "This present patient clearly had facial changes typical of acne rosacea, with erythema and telangiectasias of the cheeks, forehead, and nose. He had all the typical lid changes as well, including collarattes that are pathognomonic of staphylococcal blepharitis. Unfortunately, he had been misdiagnosed for several years…" Clinical Pearls by Janice A. Gault, p. 206

    "Due to the fact that lupus can cause a red rash across the nose and face, often in a butterfly pattern it can be confused with or misdiagnosed as rosacea. .." www.rosacea-treatment.net/

    "Dr. Callender also noted that rosacea is often misdiagnosed in patients of color, as clinicians may mistake the signs and symptoms of the condition for lupus – a systemic, autoimmune condition that commonly occurs as a “butterfly rash” involving the face."
    Treating acne and rosacea in people with skin of color - ihealthbulletin.com

    "...it's often overlooked in dark-skinned patients or misdiagnosed as lupus, which is marked by a red, butterfly-shaped rash in the center of the face,..." Shape May 2009

    "...the diagnosis of demodicosis is frequently masked by other skin diseases such as papulopustular or erythematotelangiectatic rosacea, seborrhoeic dermatitis, perioral dermatitis and contact dermatitis." Br J Dermatol. 2010 Feb 25.

    A Case of Precursor B-cell Lymphoblastic Lymphoma Misdiagnosed as Rosacea.
    Han EC, Kim DY, Chung JY, Chung HJ, Chung KY.
    Korean J Dermatol. 2008 Feb;46(2):264-267

    "It is when the first diagnosis and treatment don't work that dermatologists look deeper and often discover something called demodex." Microscopic menace may be cause of skin trouble, Jennifer Van Vrancken, Reporte, FOX 8 News: WVUE Live Stream

    "Busy doctors who cannot take a detailed history will frequently miss the diagnosis, complicated further by the fact that rosacea is a great mimic of other unrelated disorders that present with a “red face”. I have often seen classical cases of rosacea mistakenly diagnosed as acne vulgaris, lupus erythematosus, seborrheic dermatitis, contact dermatitis, and other inflammatory diseases." Albert Kligman, A Personal Critique on the State of Knowledge of Rosacea

    "Ocular rosacea is frequently misdiagnosed, particularly in the pediatric population." Eur J Ophthalmol. 2012 Jan 3:0. doi: 10.5301/ejo.5000103.

    A report, About some red faces, stated: "Diagnosis is based on different data: date and mode of appearance, characteristics of the erythema, functional signs, and associated systemic manifestations. A case of red face can have an infectious origin, caused by vascular, congenital, or acquired lesions, or be caused by photodermatosis, or be the main location of inflammatory dermatosis or collagenosis, but depending on the clinical context, many other diagnoses can be suggested."

    "Butterfly rash is a red flat facial rash involving the malar region bilaterally and the bridge of the nose. The presence of a butterfly rash is generally a sign of lupus erythematosus (LE), but it can also include a plethora of conditions. The case presented here is of a female with butterfly rash along with typical bright red discoloration of gingiva. The clinical, histopathological and biochemical investigations suggested the presence of rosacea."
    Contemp Clin Dent. 2012 Jul;3(3):356-8. doi: 10.4103/0976-237X.103637.
    Butterfly rash with periodontitis: A diagnostic dilemma.
    Aggarwal M, Mittal M, Dwivedi S, Vashisth P, Jaiswal D.

    "A 28-year-old female patient presented with extensive facial and ocular eruptions. She had a history of treatment with oral prednisolone due to the clinical diagnosis of lupus erythematosus (LE)....With the clinical diagnosis of severe oculofacial rosacea, she was successfully treated with oral doxycycline, steroid eye drops, and ocular lubricants. Histopathological features of skin biopsy were consistent with rosacea in the context of infection with Demodexfolliculorum.... Rosacea can be extremely severe and disfiguring, and it can be misdiagnosed as the pathognomonic butterfly rash of LE."
    J Ophthalmic Vis Res. 2017 Oct-Dec; 12(4): 429–433.doi:  10.4103/jovr.jovr_46_16
    PMCID: PMC5644412
    Severe Rosacea: A Case Report
    Ebrahim Shirzadeh, MD, Abbas Bagheri, MD, Mojtaba Fattahi Abdizadeh, PhD, and Mozhgan Rezaei Kanavi, MD

    Q: I was diagnosed with rosacea, but my skin isn’t responding to the rosacea treatments. In fact, it’s getting worse. Is it possible that I have both rosacea and acne?

    A: In a word, yes. For some patients, it is possible to have both rosacea and acne., Sue Chung , Patient Expert, Rosacea Misdiagnoses, Skin Health, Health Central

    "Many people with skin of color who have rosacea may experience delayed diagnosis leading to inappropriate or inadequate treatment, greater morbidity, and uncontrolled, progressive disease with disfiguring manifestations, including phymatous rosacea."
    J Am Acad Dermatol. 2018 Sep 18;:
    Global Epidemiology and Clinical Spectrum of Rosacea, Highlighting Skin of Color: Review and Clinical Practice Experience.
    Alexis AF, Callender VD, Baldwin HE, Desai SR, Rendon MI, Ta ylor SC


    Anecdotal Reports of Misdiagnosis

    The following is a partial list of anecdotal reports either of misdiagnosing rosacea for another skin disease or vice versa:

    1. Bob reports his rosacea was misdiagnosed for discoid lupus

    2. Elizabeth's initial diagnosis of rosacea turned out to be KP

    3. Andrea says her initial diagnosis of rosacea may have turned out to be pellegra

    4. Jason was misdiagnosed numerous times and was unfortunately given steroids which he believes aggravated the condition.

    5. Kari was initially diagnosed with rosacea and later found out it was eczema.

    6. maxigee2002 said after six months of being treated for rosacea a doctor discovered she was misdiagnosed and actually had Pityrosporum Folliculitis

    7. gdybe was misdiagnosed with Crohn's disease and after six months of steroids developed rosacea.

    8. Ladonna was misdiagnosed with rosacea and it turned out to be Graves Disease. 

    9. Susan reports that she developed "a rash above my eye (below the eyebrow - a little on the lid itself). First he said it was "orbital dermatitis" and gave me topical cortisone and anti-biotics. Not sure it helped much, it seemed to go away on its own schedule, although the steroid may have lessened the itchiness. I went back and he prescribed Metrogel and more cortisone cream. He told me it was a form of rosacea."

    10. Tom says that 6 years before he was diagnosed with rosacea and treated and now says "This doctor does not think I have rosacea, instead 
    he thinks I have erythema." Tom says he thinks he might have KP. 

    11. DC says his physician misdiagnosed his dermatitis as rosacea. 

    12. NorthNova says he was misdiagnosed by dermatologists before he found out he had rosacea. 

    13. flareface reports that a dermatologist diagnosed her condition as "physiological flushing" and later she says a PA "misdiagnosed pretty much everything, gave me 3 different steroidal creams and sent me on my way." Later another derm diagnosed "contact allergy" on her eyes and prescribed a mild dose of cortisone cream for a couple days and it all cleared up. 

    14. redKen (see post #2) says his dermatologist misdiagnosed his rosacea for dermatitis. 

    15. nk104 says two dermatologists diagnosed rosacea. A third physician said it was not rosacea but neurodermitis. 

    16. Jonesy says his GP said he didn't have rosacea and later went to another physician who diagnosed urticaria. 

    17. RedFacedRedHead says her rosacea turned out to be KP.

    18. cliopatra25 says that for ten years she was misdiagnosed with acne when all the time she had rosacea. 

    19. vicky says "both my sisters was misdiagnosised collectively 10 times... and they have lupus...similar to my brother, he even had 2 positive ANA tests and thedoctor refused to treat him for lupus...... 

    20. Deb says, "I mentioned in another post that for years I was given things that were making the Rosacea worse, like retin-A and cortisone cream. I had mild rosacea then, so was misdiagnosed. For a while they thought it was Lupus since I also maintain a low-positive ANA. Their and my mistakes only made it worse, especially in the past few years." 

    21. Lisa M says, "I suffered from cystitis for years... and had to go on daily antibiotics for it for about 2 years. I also did saw a homeopath at
    the time and changed my lifestyle to no alcohol at all. I didn't know
    it at the time but I had rosacea (sadly totally misdiagnosed by
    several derms). 

    22. Mike says, "I also developed ocular rosacea a couple of
    years ago, after having facial rosacea for quite a few years. My first
    opthamologist misdiagnosed it, and treated me for months with steroids (mainly Tobradex) which ended up raising my IOP to a dangerous level. 

    23. Aurelia reports that "A teenage girl was given an "almost certain" diagnosis of ocular rosacea....The symptoms suffered by this girl did NOT match those of ocular rosacea and specialists later came up with a diagnosis of autoimmune Urticarial Vasculitis.

    24. Kerry reports that "I have found out today that I was yet again misdiagnosed and I don't have rosacea I have Lupus." 

    25. Sarah Smart says, "I am 12 weeks pregnant and my rosecea fulmins was horribly misdiagnosed by my derm (as shingles if you can imagine) and I spent 5 days in the hospital before they figured it out."Report.

    26. Kerry says, "I was misdiagnosed for 4 yrs by my gp as I have pretty severepsorisis on 60% of my body and scalp. They gave me a really strong steroid which has made my skin worse on my face.although it kept it under control. I found out 3 weeks ago i have rossacea and they
    stopped my steroids so my face has had a major eruption." 

    27. Ellen says, "my rosacea related blepharitis was misdiagnosed as seb derm." 

    28. sand7676 says, "I was misdiagnosed with acne I believe because of my skin tone. 

    29. Francois says that three derms diagnosed he had 'vascular dilation' and the last one said he had " 'Sebore' in Turkish. I looked at internet and I think it means 'Seborrhe'." 

    30. Kevin Forest says, "I've recently been diagnosed with rosacea after being misdiagnosed for ~2.5 years (errrrrr! derm aggerssion)."

    31. Joe says, "I've been misdiagnosed by numerous dermatologists who
    were in disbelieft that I would have rosacea at such a young age and
    assumed it was merely acne."

    32. Suzi LeBaron says, "I was misdiagnosed because it looked like
    rosacea -- including occular symptoms."

    33. Mike Lester says, "they called it seborrheic dermatitis, maybe rosacea. to be honest no one knew. many blood tests for lupus or something....Ive been going to doctors and doctors for my facial redness that ive had for over a year now. Well, they seem to have diagnosed me with ROSACEA!!!....I was checked for everything, lupus's, mastocytosis, carcinoids, tumors on the kidneys, brain tumors, and much, much more, some things some doctors have never even heard of. but it turns out i was misdiagnosed by the Mayo Clinic from the start, so we didnt need to go through months and months of stress, depression(which by the way i go to a psychologist now and am on PROZAC too).

    34. Stuart Clark says, "I too waited months for an appointment (on two separate occasions) and she completely misdiagnosed me." 

    35. Carol Voigt says, "I, too, was "misdiagnosed" for many years."

    36. Jeff says, "I got misdiagnosed by my previous dermatologist...So he gave me a steroid to apply twice a day, which of course, did not help. And by the time I had diagnosable rosacea..." 

    37. Eddie O'Neill says, "She said that I did NOT have bacterial conjunctivitis and had been misdiagnosed..."

    38. Chantal says, "in my early 20's (around 22-23), and was misdiagnosed for years (about 5) until the correct diagnosis of rosacea was made."

    39. Heather says, "My facial rosacea was misdiagnosed for MANY years (mainly an acne component with some redness)..."

    40. Jay Valof says, "2yrs ago i had septoplasty (deviated septum) nose surgery. soon after developed symptoms, was misdiagnosed as having asthma/allergy. 2 months ago derm. said in had rosacea..."

    41. jesseleigh says, " I just found out about a week ago I have rosacea, have been misdiagnosed with atopic dermatitis for ten years." 

    42. yoli says, "I was misdiagnosed for 2 years they thought I had dermatitis but in reality i don't itch but burn.... it took me 6 dermatologist in order to get diagnosed with Rosacea." 

    43. beecham says, "I was diagnosed in December 2007 with pustular rosacea by my new doctor, I was on oxytetracycline for about a year before with my previous doctor who had misdiagnosed me with perioral 
    dermatitis.... "

    44. LoriB says, "When I saw my general doctor while waiting for an appointment with a derm he misdiagnosed me as having acne vulgaris. He told me I don't have rosacea because my cheeks aren't red." 

    45. jodieginger says, "I was repeatedly misdiagnosed as having dermatitis and none of the derms seemed to care that I simultaneously had blepharitis simultaneously. "

    46. mineren says, "I have adult acne in addition to rosacea and
    was misdiagnosed a couple of times. "

    47. mythjedi says, "She stated that I had "contact dermatitis" and gave me doxycycline....but it wasn't long before transient, big, patchy red blotches began to form on my face and chest....I discovered that I was allergic to these pills, and I stopped taking them.... I have been
    off of the pills for six months...I went to a dermatologist and was diagnosed with rosacea..."

    48. Yvonne says, "My SD was misdiagnosed as rosacea." 

    49. Cassie Henderson says, "I was misdiagnosed by a blind derm and used hydrocotizone for three months. My rosacea went from a splotty red blotch on one cheek to an all over the face red hue very bumpy dry and ruddy looking. I then went to a derm who wasn't legally blind and started using metrogel and minocycline which helped for awhile."

    50. Keith on 07.15.09 at 12:43 pm says, "...I went to a highly accomplished and respected doctor in my area who diagnosed it as Rosacea so I guess thats what it is. Other Derms have said sundamage, Folliculitis, so it is still uncertain to me..." Scroll down to Comment # 91

    51. Lori said her acne was diagnosed as rosacea which later turned out to be also seborrhoeic dermatitis after she had taken Oracea for over a month. She was switched to Doxycycline at a higher dose and Finacea. See Comments #68, #84, #89, #93, #107, #114, #117, #123.

    52. raly says, ..."I've been "diagnosed" at different times as it being rosacea, folliculitis, sebderm or possibly just acne from both GPs and a dermatologist..." Scroll down to Post #9

    53. dan pacifik says, ".... After a second trip to the doctors, my doctor seemed to think it was rosacea so she prescribed me metro cream 0.75%....…I think! I pretty much used this for about 8 months....I went back to my doctor about this and she said it looked more like acne on my forehead....I am however skeptical over my doctors and derms diagnosis..." 

    54. kfoltz9 says, "I am a 25 year old female with what appears to be perioral dermatisis around my mouth. My family history only consists of Psoryasis and I have not had a personal experience with this. I am currently on Effexor XR. I use Aveda sensitive skin facial cleanser which does not contain any Petrolatum. I have not introduced any new cosmetic products into my regimen. The dermatologist I went to yesterday about this month-old rash (I have had one previous occurence, only less intense) did not even inspect the rash, asked me if I blushed easily or often (I do not, and told him that) and diagnosed Rosacea in about 3 seconds. 

    55. siliconmessiah says, "...I first went to the doctor on a "drop-in"-visit. One of them (a really shitty doctor actually) prescribed cortisone cream for my problems - I took it for a couple of weeks with no signs of getting better. I returned to a new doctor, a really good one I might add...she diagnosed me in one minute under the light of a lamp..." Scroll down to post #2

    56. brighteyes says, "It took me approximately 3 years (and 6 derms) to get an official diagnosis...." Scroll down to post #3

    57. Mistica says, "...So in my case, rosacea wasn't recognised immediately and even 10 and a half years on from the orginal diagnosis, the 'diagnosis' is continuing in some ways. It looks like rosacea ( no missing that!!) and it behaves like rosacea, ... but is it just Rosacea?..." Scroll down to post #8

    58. IJDVL reports, "Subsequently, the initial diagnosis of allergic conjunctivitis was revised by the ophthalmologists to ocular rosacea." *

    59. A 32-year-old woman had developed moderate swelling, erythema and papules of the central part of her face for 8 weeks. She started to apply various topical cosmetic products sold for acne that did not help. As one of her hobbies was outdoor biking she noticed that sun exposure aggravated her skin condition, also resulting in burning and stinging sensations. She consulted her general practitioner who prescribed prednicarbat cream for topical application on the affected regions. Whereas she observed a slight improvement of the skin condition during the first week, she later on suddenly developed a severe worsening with erythema, papules and many pustules. She presented to a dermatologist and was diagnosed with "steroid rosacea". She went off the steroid, started topical treatment with metronidazole 1% and oral treatment with metronidazole 500 mg twice daily for 2 weeks. After an initial worsening during the first 3 days the skin condition rapidly improved. She continued metronidazole 500 mg once daily for another 2 weeks and then stopped. The topical treatment was continued twice daily for altogether 4 weeks and then reduced to once daily for another 4 weeks. Besides, she applied sun screen whenever she was outside. She continued intermittent topical use of metronidazole 1%. She remained free of symptoms except of an intermittent slight centrofacial erythema. See case report #1 

    60. A 39-year-old woman was referred to a dermatology department because of worsening of her known rosacea. She had been suffering from rosacea for 3 years. After initial, short-term and intermittent oral therapy with tetracycline for periods of up to 3 weeks she had continued topical treatment with tretinoin without any problems for the last months. Suddenly, she developed an erythema of the face accompanied by strong burning that increased in the evening, decreased over night and was moderate at day time. She discontinued topical tretinoin therapy because she felt that the symptoms were caused by it. She presented to a dermatologist with a sharp erythema of the whole face with only solitary papules and pustules. Due to the patient's history and the clinical finding contact allergy was suspected. Patch testing revealed a sensitisation to cocamidopropyl betaine, a surfactant that is frequently added to shampoos and skin cleansing products. This substance could be identified in her skin cleanser. When she discontinued this product, the symptoms disappeared and the patient could continue her topical treatment.
    We recommend to precisely ask patients about all the topical drugs and cosmetics they use including skin cleansing products. Contact allergy can also occur in rosacea patients and may mislead patients and physicians. See Case Report #3

    61. A 56-year-old diabetic man presented erythematous papules and pustules on the neck and face who had developed since 3 months. He had been treated with topical corticosteroids for the same time period that resulted in progressive exacerbation. He additionally showed patches of hair loss in the beard area, erythema and scaling of the ears. Among various differential diagnoses the clinical picture reminded of stage II rosacea. Microscopial examination and culturing revealed Microsporum canis. He was diagnosed tinea incognito, a term that has been used to describe dermatophyte infections modified by corticosteroid treatment.
    This case report demonstrates that there is a number of other skin diseases that can mimic rosacea. (see Case Report #7)
    Gorani A, Schiera A, Oriani A: Case Report. Rosacea-like Tinea incognito. Mycoses 2002; 45: 135-137. 

    62. A Case of Precursor B-cell Lymphoblastic Lymphoma Misdiagnosed as Rosacea
    Han EC, Kim DY, Chung JY, Chung HJ, Chung KY.
    Korean J Dermatol. 2008 Feb;46(2):264-267

    63. Pete says, "...Had previously been misdiagnosed by my G.P. Had been treated with steroid creams for eczema...."

    64. shakti says, "...I had a horrible rash on my face which the Dr. (dermatologist) even took pictures of, but he said it was rosacea....Then a neurologist said I could have some sort of mild m.S..... I've recently had a "rosacea flare" swelling and redness around my eyes and upper cheeks, the tiredness has returned and so has pain in my bladder and gi tract...."

    65. belinda says, "After being misdiagnosed for 7 years, I had almost given up hope." published April 8, 2008

    66. mmee says, "...just wanted to say after many years of suffering with depression and social anxity because of a red face and not being able to get any information out of 3 dermatologists and about 5 GPs (they just said it was 'normal') . I've found out from a link on this website it must be Keratosis pilaris rubra faceii..." 

    67. Gem says, "A couple of months ago I developed a rash on my forehead and weas gicven a steroid cream for it that seemed to keep it under controlfor a while, then around 3 weeks ago it spread and looked angry, I went to the doctor who said it was acne the cream I was given just aggravated it, so I went back and was given another cream by a different doctor who still thought it was acne... this again aggravated it, so I started looking on the net for other ideas or medications that could help. I tried coconut oil and aloe vera topical and ingested, another trip to the GP I was given Tetracycline oral antibiotic but it was something like a 3 month course, ....I went to my doctor again today as my self treatment wasn't doing any good and I was told it looks like rosacea I've been given metronidazole gel and I've started the Tetracycline oral antibiotics again...." 

    68. ssaeed says, "...He diagnosed me initially with Seb Derm and prescribed Desonide cream for 3 weeks. I noticed my skin got a lot better and softer during this treatment although towards the end of the treatment I started getting small pus filled acne bumps on my nose and cheek, about the size of a pore. When I saw the doc after the 3 week Desonide treatment he told me I may have symptoms of Rosacea and started me off on a treatment of Metrogel once a day and Oracea once a day in the morning." 

    69. Ladonna says, "...my husband took me to the dermatologist and she said it was Rosacea and couldnt be anything but....So he took me to many doctors, and finally a wonderful doctor took a shot in the dark blood test and discovered my problem. Later more involved tests and scans confirmed it. I was Hyperthyroid...specifically Graves Disease..."

    70. DylanG says, "... I finally got an appointment with a dermatologist for my rosacea. After waiting about half a year, I go to the appointment. The dermatologist walks in, doesn't even look at my face and says "There's nothing I can do about redness. Some people just have red skin". Then, to top it off, he gave me cream for acne - something which I could care less about - that has the side effect of making your face red. I was out of his office in practically two minutes with about twenty tiny tubes of acne medication I had no need for. ..." Scroll to Post #22

    71. Donna says, "I got results back from labs and xray..i do NOT have sarcoidosis…but still not sure what i have …i have granulomas popping out on parts of my body and my face is still not clear. I am going to a conference of doctors on the 16th to get their opinions. I was originally diagnosed with Granulomateous rosacea so lets see what opinions i get." Post #146

    72. liangjuany says, "I saw another doctor today and was told what I had was not rosacea but pityriasis rosea instead." 

    73. huiness says, "another derms who told me I had acne, or folliculitis etc. When I finally decided to go back to Derm #2, he then diagnosed me with rosacea.....went to Derm #14809348. He agreed with the rosacea diagnosis but said that this was probably steroid induced...."

    74. mrsmoof says, "1st dermatologist thought I had dermititis.....Well, I went to a 2nd dermatologist and told her my story, symptoms.....within minutes she said it was Rosacea...." Scroll to Post #43 

    75. "My wife was diagosed by a local Dermatologist as having Rocacea. He only did a visual inspection without any actual skin testing. He was sure it was Rocacea and prescribed an expensive cream which she would have to use for who knows how many years. Luckily she had a severe reaction to the cream, and discontinued it. She visitited her home country of Russia and was treated by a specialist. He told her she didn’t have Rocacea but had Demodex. She had one treatment by the doctor and her face is still clear after 6 months. Always get a second opinion." J Noble on 01.12.10 at 7:11 am Post #215 

    76. spuggylegs says, "I think it took about 10 mins for a NHS dermatologist to tell me that I didnt have rosacea. She looked at my skin said there was no visible erythema or papules and pustules to suggest rosacea, and that I needed to stop "reading stuff on the internet". I had to actually ask for a blood test to rule out lupus etc!!!!! I asked my GP if he could send me for a second opinion but he refused. The problem is that there is a lot of inequality in the NHS...and as someone who lives in a deprived area, healthcare is usually not as good as those who live in more affluent areas. (but thats another story). Well I still carried on "reading stuff on the internet" : ) and decided the only way forward was to go private..even though i couldnt really afford it. So travelled from the north east to London, and got so stressed, as we got lost a few times, and London is not the friendliest of places. By the time I had got to see the derm I was having a major flush....so after reading my medical notes, asking about family members who may have rosacea,, symptons, and looking at my skin, he diagnosed rosacea. From what i can remember the consultation lasted about 30 mins." Scroll to Post #50

    77. Rachelle C says, "My doctor diagnosed me with rosacea, delusional paristosis. The medications for these did no good. Then another dermatolgist with an allergist diagnosed me with demodex (skin mite) allergy." Scroll to Post no. 77 on 05.04.10 at 1:00 AM

    78. Girrlock Holmes says, "…I was finally diagnosed hypothyroid, insulin resistant and PCOS, and my doctor also thinks my symptoms fit with fibromyalgia…I saw a dermatologist who said it was not Rosacea but offered no info on what it could be. Then I saw an allergist and he said the derm had no basis for saying it was not Rosacea; it looked like it to him. So you see I have no clear diagnosis. I am waiting for a different derm to see me but it will not be for another 2 months…"

    79. "Terri Flynn, a 63-year-old part-time receptionist from Texas....Two different evaluators told her she had "dry eye" and prescribed artificial tears and various eye medications, while one also suggested she have her bottom eyelids lifted to help retain the moisture in her eyes....She made an appointment with a dermatologist, who "took one look at me and said, 'Yes, it's rosacea." NRS Rosacea Review Spring 2010

    80. GNR reports, "...I was told I had Perioral dermatitis because there was an outbreak near my nose....Began to notice a swelling under my right eye and a red path beneath extending up the temple. It became hot and sensitive and flares when I workout with weights. Told "hmm don't know what that is, it's not rosacea (my fear was that it was) but try rozex cream to see if it goes." It didn't. Didn't change. Had a second opinion. Same as the first. "Don't know, looks like it might be fungul. Leave it until you see a dermatologist." Began to a sore eye, a few pains and watering. Went back to the second opinion to ge this checked was given a scrip for kenocomb ointment for fungus....out of desparation I went to another gp explained the whole story again. He checked the skin, told me it wasn't rosacea that it looked like a fungus infection try Nizoral 2%. Hmmm. Later that day I had an appointment with a new dermatologist who told me that I actually had seborrhec dermatitis...this sounded right as all the systems relate, rash on chest, dry skin in eyebrows, dandruff...funny I'd never connected these things and either had anyone else.
    He then checked the rash thing on the right side of my face and temple and told me it was rosacea. I asked about the pain in the eye, watery, and he said not connected. Gave me a print of what to expect with rosacea and out the door I went..."

    81. comicraven reports, "I had been misdiagnosed for a while - everything from shingles to testing for lupus - and was finally properly diagnosed about 6 months ago..."

    82. koki says, "OK according to dermatologist # 4 , again I dont have rosacea, I explained my symptoms and he said it sounds more like an allergic reaction and when he examined my face he said it was more like eczema/seborrheic dermatitis and gave me some diflucan. ....I am glad most derms say is not rosacea..."

    83. stb09 says, "In May 2004, I developed a pimple on my nose that left a red mark on it for, what must've been a solid YEAR after it cleared up. I was thorougly convinced this was a scar, and went to several dermatologists to find proper treatment. Such begins my ongoing battle (and subsequent HATRED) for all dermatologists.

    The first one I saw told me that it was a mole....
    I sought a second opinion. This one told me it was a scar, and could only be removed by a plasic surgeon. He took my $100, and gave me the number of a plastic surgeon.

    The plastic surgeon (who was once a dermatologist) was convinced it was a pimple still, and simply lanced it and dug around in it, ultimately making it worse....

    The fourth and final dermatologist perscribed me a prescription in January of 2005 for my back acne/oily skin. He agreed with ME that whatever was on my nose was inflammed and most likely a sebacous cyst. He injected it with cortisone, and that made a tremendous difference, and today there's not a mark to be found. This is the same dermatologist that dismissed my concerns of facial redness and never spoke a word about Rosacea in spite of my ruddy complexion that I was, at the time, unaware of....I was at a new branch of my college and went to the local dermatologist to seek treatment. He told me it was probably a scar and gave me the number of a laser surgeon FOUR hours away that "might" be able to help me.

    THIS is the first time a doctor has mentioned the word "Rosacea" to me. He explained that I had a ruddy complexion, and thus, the red spot on my nose was more noticable. He went on to state that people with my complexion "could be candidates for Roscea later in life." and encouraged me to stay out of the sun......I finally decided to see a dermatologist to rule Rosacea in or out so I could get on with my life one way or the other. I went back to the local dermatologist, who had told me that someone with my complexion might be a candidate for Rosacea later in life, and was told absolutely nothing new.

    He once again told me that, maybe I'd have it one day, and maybe not. I asked him if I should try avoiding "triggers" and he said that I shouldn't bother. Because it probably wouldn't help. I asked if there was any treatment, because I've since learned Rosacea is best treated early on. He said that any creams he could give me would most likely not do anything at all for me, and would be a waste of my money. The entire visit was quite ambiguous.

    I asked him what "Pre-rosacea" was, and what the difference was between that, and a normal ruddy complexion. He told me that, in his opinion, there wasn't one. As he considers anyone with a ruddy complexion at risk for developing Rosacea, and THAT he considers to be "pre-Rosacea."

    Before I left, I asked him for a definitive answer one way or the other, and he told me NO, I do not have Rosacea.....To the point of the original thread, I'd like to determine what it is I have. The doctor seems sure it's not Rosacea, but as evidenced by my ongoing battle with Dermatologists prior, I believe if I went to 10 Dermatologists I would receive 10 different opinions. Rosacea, ruddy complexion, acne, allergic rash, facial blushing, too much Niacin, high blood pressure, lupus...

    these people don't know anything, and with no insurance I'm not going to waste $100 a visit to find out precisely nothing.

    84. Ontarian says, "I was diagnosed with seborrheic dermatitis on my face about 5 years ago. The diagnosis was made by a dermatologist. Soon after, the dermatitis completely disappeared for a loooong time. Then, I suddenly got a red patch on my right cheek five years later, more precisely in February of 2006. It has slowly spread to my entire right cheek. It got worse in the summer. This whole time I thought I had seb. dermatitis. My family dr. said my face was dermatitic and prescribed hydrocortisone. It didn’t help. In August of 2006 I went to my dermatologist. This time, he said I had rosacea. I was shocked. I was not flushing like crazy (except maybe when I played soccer in +35 C degrees outside). My symptoms started as a small red patch on my right cheek, this could not be rosacea. I went to see another dermatologist (an old dude who thinks rosacea is a proper diagnosis only when your face is swollen like a balloon and when you are covered with pustules).
    So, now I have two doctors thinking I don’t have rosacea, and one doctor thinking I do." Posted: Tue Oct 17, 2006 1:34 pm (scroll down to find the post)

    85. Jen says, "Since I have stopped the med I was diagnosed with Perioral Dermititis and now as of yesteday the derm tells me I have acne.....The derm said I have almost all the face disorders (rosacea, acne, perioral dermititis, seb derm)....

    86. jhelli1 says, "I've been to four different doctors in the past and have gotten four different diagnosis. The last one was rosacea. Yesterday, I went to a fifth doctor and was told that I have..........eczema!

    87. fedup says, "....I went to this dermatologist maybe 2-3 times a year over about a 4 year period, every appointment he seemed to have absolutely no idea what was going on, or what he had prescribed/said the last time, he took a look at my scalp, says "its folliculitus" (the way he said it, every time, was as if it was a breakthrough and he figured out some giant mystery, even though he said the same thing last time....and sent me home with a prescription for Ceftin 500mg 2x a day for 2 weeks (insanely strong antibiotic, I know now..).....Made an appointment with a new dermatologist (roughly 2 years ago), after explaining the antibiotic fiasco, he told me my old doctor probably shouldnt be practicing medicine. He took about 10 seconds to diagnose me, looked at my scalp, and simply said "you have inflammatory rosacea."

    88. mutantfrog says, "...I always grumble to myself about rosacea...but if it turns out that I never had rosacea but instead have had an autoimmune disorder...well it's scary I'd rather take rosacea. I swear to god I'll never complain about 'rosacea' again..." Post #10 22nd July 2010, 07:40 PM

    89. quixotic_pessimist says, "Anyway, I had been seeing a dermatologist during this time period for acne that I have had for about 3 years, and he never mentioned anything about the red complexion of my nose. One time I voiced my concerns, and he pretty much dismissed them, saying that he didn't think my nose looked red. During my last meeting with him, I was a bit more belligerent (in that I brought up the grievances that I have with my red nose a few times). He then nonchalantly throws out that it is possible that I have Rosacea. How is it that I had been visiting this doctor for 3 years with the same red nose, but it is not until now that he suggests that I might have Rosacea? I don't get it."

    90. CHI_GUY says, "...First doc said, sebborhea/eczema. He gave me many different things, to list a few....Second doc, new one, diagnosed perioral derm. She gave me tetracycline. 500mg x2/day for the first month. She exclaimed that the previous doctor was treating the wrong thing, because I brought all my old meds in to show her...."

    91. Natasha says, "I have just been diagnosed with Rosacea....a week ago the doctor wrongly diagnosed excema..."

    92. hesperidianblue says, " I was going to 7 dermatologist till 2 of them agreed that is rosacea other wasn`t shore what is it often they thought it was atopic dermatitis."

    93. misdiagnosed says, "During this whole ordeal, I have seen a dermatologist (in OH) 2x. THe first time she tried to convince me it was “in my head” and reluctantly prescribed an antibiotic for adult acne. 8 weeks later, she seemed a little more open to the fact that it could be demodex and prescribed metrogel. Last week, I asked for metronidozale in a pill format because the lotion only does so much. She agreed to call it in. It is helping, but I have good and bad days, depending on the “hatching” cycle." #385 misdiagnosed on 10.08.10 at 12:45 AM

    94. Maureen says, "I have had this now for about I would say 2 years when I was told I had rosacea and lupus. Now a new dermatologist tells me no it's dermographism,..."

    95. francois can says, "I just cant believe. Today I went to see a derm. She looked at my face closely with a tool like a magnifier and said I misdiagnosed myself. She said rosacea has 4 components and someone has to have at least 3 of them to be diagnosed rosacea.....She said I have a
    condition associated with neurovascular dilaiton..."

    96. LarsMM says, "...First I went to a regular doctor and even though he ran a few tests he couldn't tell me wheat the problem was. He told me I shouldn't worry since the redness was at that time "barley noticeable". At the end of the third summer (2010) I went to another doctor and got the same response. After this visit I got somewhat frustrated since I was well aware that I had not been this red a few years earlier, as a result I started reading online and came across rosacea. I got an appointment with a dermatologist and she confirmed that I had stage one rosacea...."

    97. 444 says, "...my doctor has failed on many occasions to diagnose me properly probably due to my young age at the time and has disregarded any possiblilty of rosacea since the beggining....'

    98. claire says, "...I am 34 years old and I was wrongly diagnosed 7 years ago. I have gradually seen since then my skin get progressively worse, it is now in its advanced stages. ..." #41 claire on 05.16.09 at 8:16 PM

    99. Rachelle C says, "My doctor diagnosed me with rosacea, delusional paristosis. The medications for these did no good. Then another dermatolgist with an allergist diagnosed me with demodex (skin mite) allergy. Since I have very many allergies, this was a good bet. I treat itchy and red areas with tea tree oil and have managed to reielve my problem almost completely. The dermatologist also thinks a monthly treament with Kwellada-P would help further." #76 Rachelle C. on 05.04.10 at 1:00 AM

    100. findingaway says, "So I am no further forward...I still don't really know what it is I'm dealing with... Rosacea, SD, KP. All?" 

    101. Just an update and to show the importance of knowing what you have, I saw a Rosacea specialist with 20 years of treating and research under his belt, and made the appointment saying "Trying to treat Rosacea" as the reason. The second I came in he was confused and wondered where the Rosacea patient was. He looked at me and told me I absolutely do not have Rosacea, he's seen thousands of cases over decades and it's simply not it. And it's not caused by being choked, ever. It was thinned skin due to Steroid Creams, and thankfully, he caught that because the General Practitioner who 'diagnosed' me with Rosacea prescribed steroid cream. The most alarming was that the general practitioner gave me Metrogel which I understand is meant to help Pimples, and I have absolutely zero of those. AlenaCena post no 68

    102. I've been to dermatologists in three different countries starting when I was 16, and I'm now 41. When I first started going to them, they didn't know a lot about eczema and dermatitis and the treatment course was antibiotics and cortozone creams. (Not much has changed) Even then I knew foods and hormones were triggers or the cause of the skin eruptions. I've had dermatologists tell me it's not rosacea and dermatologists tell me it is. One things for certain out of the more than 30 dermatologists I've seen in my life time, no two have had the same things to say. However last time I was at one, she did look up patronizing and say, yes we now know hormones can affect eczema...as if her telling me that made a whit of difference to what I have already known. In the UK, where they have now said it is rosacea, I have had no other tests. The dermatologists I've seen refuse to accept other countries diagnosis of food allergies. They refuse to take into consideration what I'm saying, about my upper eye lid cracking (it's been cracking there my whole life, so much so I've a deep scar) and the bubbling around my eyes, and over my brows. In the end, I think a they've learnt mo about the what some skin problems are, they seem to have bunched the rest as rosacea. Which appears to me to be a blanket term, covering a huge amount of things. Melania post no 66

    103. I had a misdiagnosed case of demodex for many years. It was misdiagnosed as bacterial acne/hormonal acne and "allergic conjunctivitis". None of the treatment my 4 dermatologists prescribed ever worked. It turned into a really bad case of ocular rosacea. Early this year, I took the 2 week Oral Ivermectin + Oral Metronidazole treatment. It worked. ElaineA post no 2 

    More cases of misdiagnosed rosacea (or vice versa)

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    • Related Articles Real-Time Video Microscopy of In Vitro Demodex Death by Intense Pulsed Light. Photobiomodul Photomed Laser Surg. 2020 Jan 27;: Authors: Fishman HA, Periman LM, Shah AA Abstract Objective: To directly observe the in vitro real-time effects of intense pulsed light (IPL) on a Demodex mite extracted from an eyelash of a patient with ocular rosacea. Background: Demodex is a risk factor in the pathogenesis of oculofacial rosacea, meibomian gland dysfunction (MGD), and dry eye disease (DED). Recent studies suggested IPL to control or eradicate Demodex organisms in the periocular area. Despite encouraging reports, the direct effect of IPL on Demodex is not well understood. Methods: An eyelash infested with Demodex was epilated from a 62-year-old female patient with oculofacial rosacea. Following isolation and adherence of a mite onto a microscope slide, real-time video microscopy was used to capture live images of the organism before, during, and after administration of IPL pulses. IPL pulses were delivered with the M22 IPL (Lumenis), with IPL settings used for treatment of DED due to MGD (the "Toyos protocol"). A noncontact digital laser infrared thermometer was used to measure the temperature of the slide. Results: Before the IPL pulses, legs of the Demodex mite spontaneously moved in a repetitive and semicircular motion. During administration of IPL, spontaneous movements of the legs continued. Immediately after administration of five IPL pulses, the temperature of the slide increased from room temperature to 49°C. Immediately afterward, the Demodex mite became completely immobilized. The legs appeared retracted, smoother, less corrugated, bulkier, and less well-defined. Movement of the Demodex mite was not observed at the hourly inspections for 5 h and after 24 h following the application of IPL pulses. Conclusions: Our video directly demonstrates the effect of IPL on a live Demodex mite extracted from a freshly epilated eyelash. The results suggest that IPL application with settings identical to those used for treatment of DED due to MGD causes a complete destruction of the organism. PMID: 31985328 [PubMed - as supplied by publisher] {url} = URL to article
    • Walter Freyne, the owner of Demodex Solutions, has assisted me in comparing the Original ZZ cream ingredients with the cosmetic version and has approved this comparison which is now published through the RRDi. While I love the original ZZ cream, I think the cosmetic version is better because it dissolves better and feels creamer or softer. 
    • The RRDi is please to announce that Tara O'Desky, D.C., has graciously volunteered for the RRDi MAC. She has a website where she explains how the Rosacea Forum helped her control her rosacea. We grateful for Dr. O'Desky volunteering for our non profit organization as a medical advisor. 
    • Nicholas,  Thanks for the link to the article, which is a good find! I have added artemesinin to the list of anti-malaria treatments used for successful rosacea treatment. Technically, artemisinin is not an anti-viral, but an anti-malaria treatment used on Plasmodium falciparum, a protozoa. Hopefully, we will hear of anecdotal reports of Rosaceans using artemisinin for rosacea with positive results. Your volunteering to post such articles is what the RRDi is all about, helping rosaceans with rosacea research! Artemisinin is available over the counter. 
    • https://www.sciencedirect.com/science/article/pii/S0753332219310339
    • Welcome to the RRDi,  What treatment are you using for your rosacea? Is it working?
    • Yes they may be linked because roscaea is a kind of chronic inflammatory condition which may or may not be associated with co-morbidities and can occur with other co-expressing conditions. Rosacea can co-exist with other inflammatory conditions. If you are an elderly person and you have been diagnosed with a form of dementia, it is linked to chronic inflammation that means neuroinflammatory condition and neuropeptides are associated with this inflammation because they are the mediators of inflammation and neuropeptides circulate between the brain and peripheral tissues and hence found in the skin and is the cause of your rosacea because chronic skin inflammatory conditions are associated with neuropeptides.
    • I have just been diagnosed with bvFTD a form of early dementia .... developed rosacea at the beginning of the year when my bvFTD was getting worse, frighening to realise they are linked   
    • The Netherlands has endorsed the new phenotype classification of rosacea, as published in the British Journal of Dermatology. For more information. 
    • Related Articles Rosacea treatment guideline for The Netherlands. Br J Dermatol. 2020 Jan 23;: Authors: van Zuuren EJ, van der Linden MMD, Arents BWM Abstract The classification of rosacea has evolved from a subtyping into a phenotype approach1-3 and an updated systematic review on interventions in rosacea using this approach was recently published.4 Therefore, we developed a new evidence-based guideline for all physicians and skin therapists involved in the management of patients suffering from rosacea. A patient information leaflet based on this guideline was produced. The Working Group (WG) consisted of dermatologists (4), general practitioner (1), ophthalmologist (1), plastic surgeon (1), skin therapists (2), patient (1) and staff members of the Dutch Society of Dermatology and Venereology (2). All affiliated organizations participated in external review. PMID: 31970753 [PubMed - as supplied by publisher] {url} = URL to article
    • An article about any conflict of interest (COI) with the authors of dermatological textbooks is an interesting read, highlighting the need for more transparency acknowledging the funding of the authors. [1] Note this paragraph:  "In recent years, dermatologists’ relationship with industry has increased immensely. The global pharmaceutical market in dermatology is projected to exceed $34 billion per year by 2023 (Prescient & Strategic Intelligence, 2018). The relationship with industry is a complicated subject. Support from industry has been important for the advancement of dermatology and has provided funding support for a range of activities, including clinical trials, educational materials, and travel support for residents and fellows. These funds are integral for the growth and maintenance of the specialty. For example, exhibit revenue from technical exhibits at large meetings helps support registration and educational costs for attendees and provides funding for other non-income-producing activities. The pervasiveness of industry is incontrovertible and spans a gamut ranging from continuing medical education programs to educational grants to advertisements in journals (Sams and Freedberg, 2000)." Here are some highlights of the study:  (1) The study was limited to eight textbooks and states about these that all eight "are listed on the American Academy of Dermatology (AAD) website as board preparation resources recommended by members of the AAD Resident and Fellows committee under the category of general dermatology textbooks."  "The most recent editions of eight commonly used books were selected and are listed as follows: Dermatology (4th edition, 2017), Andrews’ Diseases of the Skin: Clinical Dermatology (12th edition, 2015), Dermatology Secrets Plus (5th edition, 2015), Genodermatoses: A Clinical Guide to Genetic Skin Disorders (2nd edition, 2004), Comprehensive Dermatologic Drug Therapy (3rd edition, 2012), Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence (5th edition, 2015), Dermatology: Illustrated Study Guide and Comprehensive Board Review (2nd edition, 2017), and Clinical Dermatology: A Manual of Differential Diagnosis (3rd edition, 2003)." (2) "The total compensation for 381 authors in 2016 was $5,892,221....The top 10% of dermatologists who collected payments received $5,267,494, which represented 89% of the total payment amount.....The payment distribution was skewed with a minority of dermatologists receiving the majority of payments." (3) "Given the financial incentives of pharmaceutical companies, the pharmaceutical industry has a particular interest in targeting young physicians in training as they foster their own disease treatment and prescribing patterns." (4) "This study helps to further characterize the relationship between authors of general dermatology textbooks and industry. Continued discussion to foster transparency among physicians, regulators, and the public with regard to various topics, such as policies, physician behaviors, and the potential for CoI in educational resources, is important." The paper acknowledges the limitations such as only USA physicians were included and other limitations. But you do get an idea of why transparency should be acknowledged in the textbooks that dermatologists are using so that as the authors of the study put it, "Whether industry payments to authors affect the quality of information in dermatology textbooks for better or for worse remains uncertain" so that "readers can draw their own conclusions." End Notes [1] International Journal of Women's Dermatology Conflicts of interest among dermatology textbook authors  Jorge Roman, MD, David J. Elpern, MD, and John G. Zampella, MD Etcetera Related to skin industry funding of textbook authors are the following two posts:  Rosacea Research in Perspective of Funding Rosacea Research in Perspective of Idiopathic Diseases    
    • Interesting that Actinic Folliculitis should be considered in a differential diagnosis with rosacea. It has been suggested that photo damage may be responsible in rosacea which is one of the threories. 
    • Related Articles Off-label Uses of Topical Pimecrolimus. J Cutan Med Surg. 2019 Jul/Aug;23(4):442-448 Authors: Ladda M, Sandhu V, Ighani A, Yeung J Abstract Pimecrolimus is a topical calcineurin inhibitor currently approved for second-line use in the management of mild-to-moderate atopic dermatitis in patients age 2 years and older. Given the safety profile and nonsteroidal mechanism of pimecrolimus, there has been significant interest in its use in the treatment of a variety of dermatological conditions. This article reviews research that has been published on the off-label uses of topical pimecrolimus, with a focus on published RCTs. Convincing evidence exists supporting pimecrolimus' efficacy in oral lichen planus and seborrheic dermatitis. For other conditions studied to date, pimecrolimus may prove to be a useful treatment alternative when conventional agents fail. Adverse events seen with its off-label use were typically application site reactions, the most common being a transient burning sensation. In summary, pimecrolimus appears to be an effective agent in the treatment of multiple dermatological conditions and may be worth considering as a pharmacologic alternative in several conditions when first-line treatment fails, or for areas that are more susceptible to the adverse effects of topical corticosteroids. PMID: 31053034 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles First reported cases of Actinic folliculitis treated successfully with topical retinoid. Clin Exp Dermatol. 2020 Jan 22;: Authors: Rahman S, Powell J, Al-Ismail D Abstract Actinic Folliculitis (AF) is a rare recurrent seasonal photodermatosis, relatively newly characterised by non pruritic, monomorphic pustules and papules appearing 4 - 24 hours after exposure to sunlight. Lesions usually affect the face but also appear on the upper chest and arms. Resolution normally occurs within 7 - 10 days with cessation of sunlight exposure. AF is resistant to standard treatments used for acne vulgaris and acne rosacea with only oral retinoids previously being reported as effective. We report the first 2 cases of actinic folliculitis responding extremely effectively to a topical retinoid. PMID: 31965609 [PubMed - as supplied by publisher] {url} = URL to article
    • Mosquitoes and Virus and Imiquimod Cream As noted in the post on Protozoa and Rosacea, treatment for malaria [protozoa] has improved some cases of rosacea using mepacrine, chloroquine, and hydroxychloroquine. An article published in Science Daily [1] points out, "There are hundreds of viruses spread by biting mosquitoes which can infect humans...At present, there are no anti-viral medicines and few vaccines to help combat these infections." The article discusses using a skin cream with the active ingredient imiquimod and reports, "By applying skin cream after a bite, researchers found that they could pre-emptively activate the immune system's inflammatory response before the virus becomes a problem. The cream encouraged a type of immune cell in the skin, called a macrophage, to suddenly spring into action to fight off the virus before it could spread around the body." Wouldn't it be novel for 10K RRDi members to get together and each donate a dollar and then sponsor a clinical researcher to investigate if using imiquimod as the active ingredient might improve rosacea?  Do you think any pharmaceutical company or other rosacea non profit organization would ever investigate this? How do you get 10K RRDi members to come together and  all agree that this should be done?  Maybe we might learn that some rosaceans somehow apply this imiquimod cream by diluting it with a moisturizer, coconut oil, shea butter, or something to see if this improves their rosacea. If so, then possibly, as this thread points out, could a virus be connected to rosacea?   End Notes  [1] Mosquito-borne diseases could be prevented by skin cream, Science Daily
    • Bacteriophage are a particular virus that are included in the human microbiome that "have been used for over 90 years as an alternative to antibiotics in the former Soviet Union and Central Europe as well as in France." Human Microbiome, Brady Barrows Some researchers are trying to find foods that encourage bacteriophage to act as an antibiotic in the gut, for example, stevia, they say as the "most potent prophage inducer" and explains, "The ability to kill specific bacteria, without affecting others, makes these compounds very interesting." "These findings are important. Scientists now know that the microbiome can influence our physical and mental health; it can also cause inflammation and increase cancer risk. If scientists can work out how to alter the microbiome in specific ways, they can, in theory, remove or reduce these risks." Common foods alter gut bacteria by influencing viruses, MedicalNewsToday
    • "Retinoids have the potential to cause varying degrees of myositis and their rapid identification could prevent major complications." Source
    • Related Articles Anticancer effect of Amygdalin (vitamin B17) on hepatocellular carcinoma cell line(HepG2) in the presence and absence of Zinc. Anticancer Agents Med Chem. 2020 Jan 19;: Authors: El-Desouky MA, Fahmi AA, Abdelkader IY, Nasraldin KM Abstract BACKGROUND: Amygdalin (Vitamin B-17) is a naturally occurring vitamin found in the seeds of the fruits of Prunus Rosacea family including apricot, bitter almond, cherry, and peach. OBJECTIVE: The purpose of this study was to examine the effect of amygdalin with and without zinc on hepatocellular carcinoma (HepG2) cell line. METHODS: MTT assay was used to evaluate the cytotoxicity of amygdalin without zinc, amygdalin + 20µmol zinc, and amygdalin + 800µmol zinc on HepG2 cell lines. The cell cycle distribution assay was determined by flow cytometry. Apoptosis was confirmed by Annexin V-FITC/PI staining assay. Moreover, the pathway of apoptosis was determined by the percentage of change in the mean levels of P53, Bcl2, Bax, cytochrome c, and caspase-3. RESULTS: Amygdalin without zinc showed a strong anti-HepG2 activity. Furthermore, HepG2 cell lines treatment with amygdalin + 20µmol zinc and amygdalin + 800µmol zinc showed a highly significant apoptotic effect than the effect of amygdalin without zinc. Amygdalin treatment induced the cell cycle arrest at G2/M and increased the levels of P53, Bax, cytochrome c, and caspase-3 significantly, while it decreased the level of anti-apoptotic Bcl2. CONCLUSION: Amygdalin is a natural anti-cancer agent which can be used for the treatment of hepatocellular carcinoma. It promotes apoptosis via the intrinsic cell death pathway (the mitochondria-initiated pathway) and cell cycle arrest at G/M. The potency of amygdalin in HepG2 treatment increased significantly by the addition of zinc. PMID: 31958042 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Myositis Induced by Isotretinoin: A Case Report and Literature Review. Am J Case Rep. 2020 Jan 20;21:e917801 Authors: Rivillas JA, Santos Andrade VA, Hormaza-Jaramillo AA Abstract BACKGROUND Retinoid-induced myositis is a rare condition encountered in clinical practice. Its occurrence implies a diagnostic challenge due to the multiple causes associated with myopathic syndromes. The most common clinical presentation is generalized affection. Focal myositis is even less frequent and easily misdiagnosed as muscular disease of other etiology. CASE REPORT We describe a case of 45-year-old male with a history of nephrolithiasis and rosacea diagnosed by dermatology, who was management with isotretinoin 1 mg/kg per day in 2 doses with clinical improvement. Later, he presents muscle pain in the upper limbs with marked functional limitation associated by choluria, without muscular pains in other location; he had no history of using another medication. At his physical examination, vital signs were normal, with edema and pain in the bilateral bicipital region associated with limitation for flexion-extension of shoulders and elbows and high levels of creatine phosphokinase (CPK). He was transferred to the intensive care unit where he received fluid therapy because of the high risk of deterioration of renal function, very high CPK levels, and a history of obstructive uropathy. One year after this hospitalization, the cutaneous symptoms worsened and the patient voluntarily restarted isotretinoin and 5 months later he presented again with the same symptoms of the first episode. CONCLUSIONS Drug-induced myositis should be taken into consideration in the differential diagnosis of myopathic syndromes. Retinoids have the potential to cause varying degrees of myositis and their rapid identification could prevent major complications. PMID: 31958335 [PubMed - in process] {url} = URL to article
    • Ok so it has been a long journey for you with respect to rosacea. Yes this theory does not go completely with only fair skin people get rosacea. There are some published research on rosacea in skin of color people. I am an Indian and I also have olive skin with yellow undertone and the bizarre thing is Indian skin is something very acclimatized to sun rays because of its extreme hot and humid climate and we do not get easily anything related to skin but when I got this condition five years ago it was unknown to me and initially it was in an exaggerated condition difficult to control and handle but gradually I understood with trial and error considering my diet what I eat what I apply on my face and environmental and immune conditions. Now still it remits and relapses with frequent episodes but now I know how to manage it.
    • Have a good weekend! Sent from my SM-N910V using Tapatalk
    • Can Demodex Mites Transfer From Pets to Humans?
    • Antonia,  The general consensus is that the mites on cats or dogs are a different species, however, as pointed out above, scabies and other demodex can infect a human from a pet. There should be more research on this but as it stands now the data shows that the species of mites on humans are different than on pets, generally speaking. Each mammal usually has its own species of demodex mites. The point of this post is that since we do know that mites can travel from pets to humans, there is a possibility that demodex do indeed infect humans from pets. You certainly don't want to be infected with scabies. 
    • I agree good post I am trying Soolantra now so I will post updates soon. Sent from my SM-N910V using Tapatalk
    • I get a itchy skin and hives during the summer from my cat I got it so bad I had to take steriods to help clear up my skin. I dont get it from any other cats just him. I wont get rid of him he means too much to me so I tolerate it. Do you think he has these mites or? Sent from my SM-N910V using Tapatalk
    • Can you send me the Amazon link for the injectable one? Sent from my SM-N910V using Tapatalk
    • Everyone on here and in this support group should post something on here, in a world with people who dont have Rosacea and doctors giving you pills and cream saying there is no cure which I heard from my skin doctor often, this is a way to vent and relate and meet. Sent from my SM-N910V using Tapatalk
    • Hello Apurva, I have had Rosacea since my 20's, I probably saw a skin doctor in my 30's and been on Doyxcycline for over 10 years I believe. It's been a frustrating blur but in a nutshell too long. I have a fan at work I turn on no matter how cold I am to cool down my flares. I get red at home too not just work but atleast at home its easier to deal with. I am sorry you are dealing with this too, I feel your pain believe me! They say Rosacea mainly affects fair skin, I am part spanish and german I have olive skin so that theory isn't true. Tell me about your history if you wish. Sent from my SM-N910V using Tapatalk
    • May be It's not about eating blueberry bar and then getting red blotchy cheeks.sometimes the environmental factors are the triggers. because there are so many factors which trigger rosacea inflammation. genetic, environmental, your immune system, microbial flora of your skin, food triggers and many more. and the condition you described that when you do not eat and you just seat at work not taking stress even if in relaxed state you get red for no reason and this happens to me exactly. So I think the environmental factor may work here because with the onset of fall and continue with winter our body adjusts with the temperature called thermoregulation.You can read about it here : https://irosacea.org/forums/topic/4120-autumn-and-rosacea-flare-ups/?tab=comments#comment-5278 Could you please tell me when did your rosacea condition start? you are new to this condition or it's been a long?
    • I didn't read this till after my previous post. Good you are taking Tumeric and probiotics. Keep taking them. 
    • Not sure which Blueberry Kind bar you are eating but I found the above Nutrition Facts Label to show you how much carbohydrate is in this bar which shows 24 grams in a 35 gram serving. You can subtract the 2.5 grams of dietary fiber since fiber has no significant energy to consider.* So technically the above serving is 21.5 grams of carbohydrate in a 35 gram serving. That means this bar is 61% carbohydrate. This is a high carbohydrate food. When you carefully go through the Nutrition Facts Label for everything you eat in a day, you are probably, without a doubt eating a high carbohydrate diet. There is ample evidence that sugar/carbohydrate is a rosacea trigger in anecdotal reports. For that matter, any proposed rosacea trigger is based upon surveys or anecdotal reports, therefore, listing sugar/carbohydrate as a rosacea trigger is just as valid as any other proposed rosacea trigger, no matter who makes the list.  So usually the question is what should you eat for thirty days to see if reducing sugar/carbohydrate improves your skin?  Eat high protein and fat. Eating high protein/fat for thirty days poses absolutely no health risk contrary to what you might learn from any source. After the thirty days you can then decide based upon what you learn whether this improves your rosacea and other issues. This will not be easy because sugar is an addiction. So you simply have to balance whether having your skin issues improve is worth the effort to get off of sugar for just thirty days.  Also since you are taking doxycycline, you will need to build up your good flora with probiotics, which is now an accepted medical treatment for rosacea. Short term antibiotics for rosacea may be required to control rosacea, but long term antibiotic treatment for rosacea can produce some unwanted side effects and risks. You need to decide whether taking long term antibiotics are worth those side effects and risks. Probiotics offer an alternative.  How long did you use Soolantra? Why did you stop using it?  It is good you are taking supplements, herbals and vitamins. Have you read this post? Don't give up, you will find a way to control your rosacea and other issues.  *To learn why fiber is not a significant source of energy, read the article, Carbohydrate Not Essential For Human Survival  
    • Methanobrevibacter smithii image courtesy of Cedars Sinai Bacteria has been implicated in rosacea with a huge amount of clinical papers on this subject. Demodex is now without a doubt linked to a significant number of rosacea cases. At least one fungus has been associated with rosacea, and we have papers indicating treatment for one particular protozoa improves rosacea, however virus has not been ruled out in rosacea. The human microbiome includes the skin which contains a number of different microbes. [1] One microbe that has generally been totally ignored is archea, which has never been ruled out as having anything to do with rosacea.  Archea and Rosacea "Methanobrevibacter smithii is the predominant archaeon in the human gut." The general public has little if any knowledge of this microbe which has been known to exist in the human microbiome for some time now. "Archaea are a major part of Earth's life. They are part of the microbiota of all organisms. In the human microbiota, they are important in the gut, mouth, and on the skin. They may play roles in the carbon cycle and the nitrogen cycle." [2] The chief reason that archea is basically totally ignored as having anything to do with rosacea is that there is no known archea human pathogen. Furthermore, due to the bias the scientific community has towards bacteria which focuses research on bacteria ignoring most of the other microbes, including archea, little is known about archea.    "A deeper knowledge of human microbiome composition and microbe-host interactions will contribute to clarify the mechanism of development of rosacea and possibly will provide innovative therapeutic approaches." [3] Basically we have no idea what role archea plays in the skin microbiome due to a lack of investigation into this subject. Hence, little is known of what role archea may play in rosacea. There is absolutely no motive to investigate this since who would fund such a study? Hopefully someday some research will discover the role archea plays in the human microbiome and whatever revelations are discovered may alter our understanding of archea.  Do you want to fund such a study? Could 10K members of the RRDi get together and each donate one dollar to fund such a study? Only with your help could we reach such a goal. Think about it. [4] End Notes [1] "Microorganisms inhabiting superficial skin layers are known as skin microbiota and include bacteria, viruses, archaea and fungi." Future Microbiol. 2013 Feb;8(2):209-22. doi: 10.2217/fmb.12.141. Skin microbiota: overview and role in the skin diseases acne vulgaris and rosacea. Murillo N, Raoult D. "In the GI tract, the microbiome is made up of trillions of microbes including bacteria and other microbes such as fungi and archaea. The skin is also colonized by an equally complex microbiome that varies with host genetic and environmental influences. Emerging research suggests that the collection of microbial communities that populate the skin and GI tract, rather than single microorganisms alone, is responsible for disease." Dermatol Pract Concept. 2017;7(4):31–37. Published 2017 Oct 31. doi:10.5826/dpc.0704a08 Diet and rosacea: the role of dietary change in the management of rosacea Emma Weiss and Rajani Katta "Human skin hosts a diverse ecosystem of bacteria, fungi, viruses, mites, and archaea."  Skin Microbiota and Your Health, by Chris Kresser, Kresser Institute [2] Archea, Wikipedia [3] Journal of Clinical Gastroenterology 48 Suppl 1, Proceedings From The 7th Probiotics, Prebiotics & New Foods Meeting Held In Rome On September 8-10, 2013:S85-S86 · November 2014; DOI: 10.1097/MCG.0000000000000241  Skin Microbiome and Skin Disease The Example of Rosacea Mauro Picardo [4] More thoughts on this subject to think about:Rosacea Research in Perspective of FundingRosacea Research in Perspective of Idiopathic Diseases
    • A paper written in 2017 about diet and rosacea never once mentions sugar/carbohydrate as a rosacea trigger and parrots the diet triggers promoted by the NRS while admitting that "Dietary triggers are also frequently cited by patients, although there is a lack of research in this area. In one survey by the National Rosacea Society of over 400 patients, 78% had altered their diet due to rosacea. Of this group, 95% reported a subsequent reduction in flares." The NRS has never listed sugar/carbohydrate as a rosacea trigger, even though the number of anecdotal reports continue to grow that indeed sugar/carbohydrate is just as valid a rosacea trigger as any of the other NRS proposed triggers. The paper about diet and rosacea is cited below:  Dermatol Pract Concept. 2017;7(4):31–37. Published 2017 Oct 31. doi:10.5826/dpc.0704a08 Diet and rosacea: the role of dietary change in the management of rosacea Emma Weiss and Rajani Katta
    • I also am trying Tumeric Supplements now and a probotics. Sent from my SM-N910V using Tapatalk
    • Hello thank you for replying. I just ate a Blueberry Kind Bar and got red blotchy cheeks, so much for "good grains". I tried Finacea, Mirvaso, trying Soolantra all generic brands. Natural products I tried pumpkin seed extract, licorice root, Madagascar Centella, vitamins a thru all. I am not sure I have those 2 autoimmune diseases but a skin doctor told me maybe I have one of those too being I flare get red no matter what I eat and even if I dont eat I sit at work and can get red for mo reason (not stress). I am taking Doxycycline right now my doctor tried to switch me over to Minocycline which was a nightmare my skin freaked out so I am back on Doxycycline. I cant even find a local doctor to help or make a diagnosis if I have them besides Rosacea. I am premenopausal and I hear that as a excuse from doctors. I dont see why no matter what I do or dont do my skin is like this. I wil try no sugar. Sent from my SM-N910V using Tapatalk
    • Welcome to the RRDi community support. If you are suffering from rosacea plus gastatory face flushing* and erythromelagia, we can only empathize with your situation. Your condition is extreme and quite unusual. Not many rosaceans are suffering as much as you are suffering. Have you tried avoiding sugar and carbohydrate or at the very least reduced your intake to see if this improves your situation? Sugar is the fire that burns rosacea. It is not expensive to avoid sugar, in fact, you will save money avoiding sugar. Basically, all you do it eat high protein/fat for thirty days to see if your skin improves. Eating high protein/fat for just thirty days and drinking lots of water is not a health risk since it is only temporary. You may learn that you need more protein/fat instead of the high sugar/carbohydrate to control your rosacea. For example, you may not know how eating macaroni and cheese is a high carbohydrate meal. Our bodies are mostly water, protein and fat and carbohydrate only takes a very small percentage of our body mass. It is simply something that you can rule out to see if this helps your skin.  In order to recommend topicals, we would need to know what topicals you have tried. Also what oral medications or vitamins/supplements or any other oral treatments have you tried?  How long have you been suffering from this?  * "Gustatory flushing affects both sides of the face and is associated with excessive salivation, tear production and nasal secretion with no history of parotid gland injury. This may be reproduced by chewing a chilli pepper and holding it in the mouth for 5 minutes." Flushing, DermNet NZ
    • Thank you any help would be appreciated. Sent from my SM-N910V using Tapatalk
    • Hello I am new to this site and suffer with Rosacea plus I believe one of those other autoimmune diseases. No matter what I eat either my nose gets super red or chin or cheeks. There is absolutely no help available for us. I am tired of being on antibodotics and creams that hardly help or dry my skin out. You would think they would have discovered some cure by now. Rosacea is sadly overlooked and the suffering of anyone who has it. I understand everyones frustration and feelings. I dont know about you but I tried a gluten free diet, no dairy/cheese not only is that expensive it didnt help much. Does anyone else have any ideas or suggestions? I hope you are all okay and know you are not alone!   Sent from my SM-N910V using Tapatalk    
    • Related Articles Characterization and Analysis of the Skin Microbiota in Rosacea: Impact of Systemic Antibiotics. J Clin Med. 2020 Jan 09;9(1): Authors: Woo YR, Lee SH, Cho SH, Lee JD, Kim HS Abstract Systemic antibiotics are extensively used to control the papules and pustules of rosacea. Hence, it is crucial to understand their impact on the rosacea skin microbiota which is thought to be perturbed. The purpose of this study was to compare the makeup and diversity of the skin microbiota in rosacea before and after taking oral antibiotics. We also compared the skin microbiota at baseline according to age and rosacea severity. A longitudinal cohort study was performed on 12 rosacea patients with papules/pustules and no recent use of oral and topical antimicrobials/retinoids. Patients were prescribed oral doxycycline, 100 mg, twice daily for six weeks. Skin areas on the cheek and nose were sampled for 16S ribosomal RNA gene sequencing at baseline, and after six weeks of doxycycline treatment. Eleven females and one male aged 20-79 (median 51) with a median Investigator's Global Assessment score of 3 (moderate) were enrolled. At baseline, Staphylococcus epidermidis was the most dominant species followed by Cutibacterium acnes (formerly Propionibacterium acnes). In the 60 Over-age group, the prevalence of Cutibacterium acnes was lower than that of the 60 & Under-age group. Rosacea severity increased with age and was associated with a decrease in the relative abundance of Cutibacterium acnes and an increase of Snodgrassella alvi. Across all subjects, antibiotic treatment reduced clinical rosacea grades and was associated with an increase in the relative abundance of Weissella confusa (P = 0.008, 95% CI 0.13% to 0.61%). Bacterial diversity (alpha diversity) was not significantly altered by antibiotics treatment. Principal coordinates analysis showed mild clustering of samples by patient (ANOSIM, Analysis of Similarity, R = 0.119, P = 0.16) and scant clustering with treatment (ANOSIM, R = 0.002; P = 0.5). In conclusion, we believe that rosacea has a unique age-dependent characteristic (i.e., severity). Although we were not able to pinpoint a causative microbiota, our study provides a glimpse into the skin microbiota in rosacea and its modulation by systemic antibiotics. PMID: 31936625 [PubMed] {url} = URL to article
    • Related Articles Huge rhinophyma in a complicated patient successfully treated with CO2 laser. Dermatol Ther. 2019 05;32(3):e12850 Authors: Tortorella R, Mori E, Rovesti M, Casanova D, D'Astolto R, Scrivani S, Bertolani M, Zucchi A, Feliciani C PMID: 30714265 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Belo Essentials Tranexamic +Kojic acid Belo Essential Kojic Acid +Tranexamic Acid Soap Belo Essentials Tranexamic +Kojic acid Intensive Whitening Face And Neck Cream  
    • Related Articles Topical 10% Tranexamic acid for erythematotelangiectatic steriod induced rosacea. J Am Acad Dermatol. 2020 Jan 10;: Authors: Jakhar D, Kaur I, Misri R PMID: 31931084 [PubMed - as supplied by publisher] {url} = URL to article
    • Colorized electron micrograph showing malaria parasite [protozoa] Image courtesy of Wikimedia Commons Protozoa and rosacea has not been considered in any clinical paper known to date. However, there is a "link between protozoa, vitamin B12 deficiency, acne and depression" according to at least one clinical paper. [1] This same source states the following about rosacea:  "Rosacea is another inflammatory skin disease that causes facial redness but it is different from acne, the common denomination being inflammation. Metronidazole, a synthetic antibacterial and antiprotozoal agent of the nitroimidazole class, is used against protozoa such as Trichomonas vaginalis,  amebiasis, and giardiasis. Metronidazole is extremely effective against anaerobic bacterial infections and is also used to treat Crohn’s disease, antibiotic-associated diarrhea and rosacea. The nitroimidazoles class of agents used to treat G. lamblia infection includes metronidazole, tinidazole, ornidazole, and secnidazole. This class was discovered in 1955 and was found to be highly effective against several protozoan infections." [1] "Protozoa constitute a group of microorganisms, also known as protists, some of which are responsible for serious diseases in humans, such as malaria and Chagas' disease and inflammatory disease conditions." [1] A significant number of deaths due to diarrhea are caused by three protozoas - Entamoeba, Cryptosporidium, and Giardia.  The human microbiome includes a number of different microbes, including protozoa. The NRS substantiates that protozoa are included in the human microbiome by publishing this statement,  "Microbes include bacteria, fungi, protozoa [bold added] and others, and may be found in greatest concentrations in the ears, nose, mouth, vagina, digestive tract, anus and the skin." [2] Very little is known about protozoa and rosacea. What exactly are protozoa? "Protozoa (also protozoan, plural protozoans) is an informal term for single-celled eukaryotes, either free-living or parasitic, which feed on organic matter such as other microorganisms or organic tissues and debris. Historically, the protozoa were regarded as "one-celled animals", because they often possess animal-like behaviors, such as motility and predation, and lack a cell wall, as found in plants and many algae.  Although the traditional practice of grouping protozoa with animals is no longer considered valid, the term continues to be used in a loose way to identify single-celled organisms that can move independently and feed by heterotrophy." Wikipedia Treatment Used for Malaria Have Proved Successful in Rosacea There has been some treatments for malaria [protozoa] that have been used to treat rosacea such as mepacrine, artemisinin, chloroquine, and hydroxychloroquine that have proved successful in some rosacea patients.   Protozoa has never been ruled out as having a connection with rosacea. There simply isn't much data on this subject.  There needs to be more clinical studies done on protozoa and rosacea. Since protozoa has never been ruled out in causing rosacea, who would support such an investigation? Would you? Just think if 10K members of the RRDi each donated one dollar and insisted on supporting a reputable clinician to study protozoa and rosacea, what might be discovered?  End Notes [1] Research, September 2015; DOI: 10.13140/RG.2.1.1087.9200 PROTOZOAL LINK BETWEEN SEVERE ACNE, RISK OF ATTEMPTED SUICIDE AND IMMUNE SUPPRESSION: A direct peripheral blood test to confirm microparasitic infections,  Beldeu Singh [2] The Ecology Of Your Face: Demodex, Rosacea And You, National Rosacea Society
    • I hope others try this. I was just pointing out I couldn't find any essential oil available. Are the leaves available for purchase somewhere?
    • Yes I know this very well it has its medicinal properties and used for food and pharmaceutical industry considering its compounds but not much research has been done on this plant when it comes to skin diseases especially for rosacea and the link you provided It is already mentioned in my articles reference note. Yes you can not find the essential oil online that is why how I made this concoction oil I have explained this in my article.
    • There are some papers indicating using mepacrine for the treatment of rosacea. One paper published in The Lancet, May 1952 written by Borrie Peter and another paper published in 1955.  Another paper mentions using mepacrine and chloroquine in combination to treat rosacea. [1] Scarlet Letters has an interesting article discussing using mepacrine and plaquenil in treating rosacea.  End Notes [1] Br J Dermatol. 1955 Dec;67(12):421-5. Mepacrine and chloroquine in the treatment of rosacea. BRODTHAGEN H.
    • "Considering properties of the identified major compounds, essential oils of both studied myrtaceae could be used in the medicine field including the food, pharmaceutical and cosmetic industry."  https://www.sciencedirect.com/science/article/pii/S222116911630404X Amazon doesn't sell Callistemon viminalis essential oil. A google search doesn't show how to purchase it either. Maybe someone can find it?  
    • I would like all of you to test this natural extract for your rosacea inflammed skin. Its extract has high antimicrobial and anti-inflammatory effects and has shown some strong effects towards some bacterial species found on skin. You can use it as a pure essential oil or better make a concoction with your preferred oil. Your contribution would mean a lot and help me recognize my work and research on this. I am soon coming with other natural products for rosacea. Comment your experience.
    • A recent study published International Immunopharmacology that hydroxychloroquine "improved rosacea in rosacea-like mice and mast cells (MCs)" and investigated "the effects of HCQ treatment for rosacea patients". The paper concludes, "In vitro, HCQ suppresses LL37-induced MCs activation in vitro, including the release of inflammatory factors, chemotaxis, degranulation and calcium influx. Moreover, HCQ attenuated LL37-mediated MCs activation partly via inhibiting KCa3.1-mediated calcium signaling. Thus, these evidences suggest HCQ ameliorated rosacea-like dermatitis may be by regulating immune response of MCs. Finally, the 8-week HCQ treatment exerted satisfactory therapeutic effects on erythema and inflammatory lesions of rosacea patients, indicating that it is a promising drug for rosacea in clinical treatment." Since hydroxychloroquine is available worldwide in generic form we should hear more reports from rosaceans who will ask their physician for a prescription to confirm these results. Duff Man reported in 2017 that this worked for him. Another thread at RF in 2010/2011 has a few others who have tried it discuss their experience. antwantsclear [post no 240 and post no 243] reports taking hydroxychloroquine starting in 2011 and continues to use it for flushing.  One paper published in the Archives of Dermatology, January 2011, indicates that 3 out of 5 patients with neurogenic rosacea were successful using hydroxychloroquine. 
    • Duff Man told us in 2917 that Plaquenil (Hydroxychloroquine) which has been used to treat lupus works for rosacea. A recent paper published confirms this and states, " Finally, the 8-week HCQ treatment exerted satisfactory therapeutic effects on erythema and inflammatory lesions of rosacea patients, indicating that it is a promising drug for rosacea in clinical treatment." Since Hydroxychlorquine is available in a generic prescription and is available around the world in such brand names as Plaquenil, Hydroquin, Axemal, Dolquine, Quensyl, and Quinoric rosaaceans can refer to this paper and ask their physician for a prescription for an eight week course. We should be hearing reports whether more report success with this treatment.  Hydroxychloroquine Suppresses LL37-induced Mast Cells Mepacrine  
    • Related Articles Dermoscopy of idiopathic facial aseptic granuloma: report of 2 cases. Clin Exp Dermatol. 2020 Jan 10;: Authors: Salerni G, Peralta R, Bertaina C, Gorosito M, Fernández-Bussy R Abstract Idiopathic facial aseptic granuloma (IFAG) is an uncommon childhood condition, characterized by one or more asymptomatic erythematous-violaceous nodules, usually located on the cheeks and eyelid [1]. IFAG heals spontaneously usually without scarring after a few months to a year. The pathogenesis of this disease is unclear; the most current hypothesis is that represents a form of paediatric rosacea [2]. PMID: 31919863 [PubMed - as supplied by publisher] {url} = URL to article
    • Hydroxychloroquine is a novel therapeutic approach for rosacea. Int Immunopharmacol. 2020 Jan 06;79:106178 Authors: Li J, Yuan X, Tang Y, Wang B, Deng Z, Huang Y, Liu F, Zhao Z, Zhang Y Abstract Rosacea is a chronic inflammatory disease in face. Hydroxychloroquine (HCQ), an anti-malaria drug, was reported to have anti-inflammation activities. However, the role of HCQ on rosacea remains unclear. In this study, we revealed the potential molecular mechanism by which HCQ improved rosacea in rosacea-like mice and mast cells (MCs). Moreover, the effects of HCQ treatment for rosacea patients were investigated. In this study, we found HCQ ameliorated the rosacea-like phenotype and MCs infiltration. The elevated pro-inflammatory factors and mast cell protease were significantly inhibited by HCQ treatment in rosacea-like mice. In vitro, HCQ suppresses LL37-induced MCs activation in vitro, including the release of inflammatory factors, chemotaxis, degranulation and calcium influx. Moreover, HCQ attenuated LL37-mediated MCs activation partly via inhibiting KCa3.1-mediated calcium signaling. Thus, these evidences suggest HCQ ameliorated rosacea-like dermatitis may be by regulating immune response of MCs. Finally, the 8-week HCQ treatment exerted satisfactory therapeutic effects on erythema and inflammatory lesions of rosacea patients, indicating that it is a promising drug for rosacea in clinical treatment. PMID: 31918061 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles The importance of good photography in clinical trials and in the clinic. Br J Dermatol. 2019 05;180(5):978 Authors: Tanghetti E PMID: 31025752 [PubMed - indexed for MEDLINE] {url} = URL to article
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