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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. Misdiagnosis is what falls under the medical umbrella called 'medical error.' You should be aware that rosacea may be a catch all diagnosis for a number of skin conditions that present with erythema and/or pimples. The list of skin conditions that need to be differentiated from rosacea is massive. It is no wonder that misdiagnosis occasionally happens. 

    Add Your Report
    If you want to add your experience with misdiagnosis please post your anecdotal report in this thread, since we are not adding to this page any more anecdotal reports. If you scroll below we have over 100 anecdotal reports of misdiagnosis. More are being added as we find more or if you add your report to this other thread

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    Articles and References from Reputable Authorities 

    "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

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    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 

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    • As a medical assistant for a dermatologist I worry about the added fragrance in the baby shampoo causing further irritation. 
    • I work as a medical assistant for a dermatologist. I definitely think it is a possibility for rosacea to through periods of remissions and flare-ups. This can be due to environmental factors as well as psychological factors. 
    • Related Articles Symptomatic vulvar demodicosis: A case report and review of the literature. J Cutan Pathol. 2020 Nov;47(11):1063-1066 Authors: Hedberg ML, Chibnall RJ, Compton LA Abstract Demodex folliculorum is a mite that commonly inhabits the pilosebaceous units of facial skin, particularly in a perioral and periorbital distribution. While typically an incidental and asymptomatic parasite, Demodex spp. are proposed to contribute to the pathogenesis of facial folliculitis, chronic blepharitis and papulopustular rosacea. Reports of demodicosis in anatomic locations other than the face are exceedingly rare. Here we report a 36-year-old woman with symptomatic Demodex spp. infestation of Fordyce spots of the labia minora. She was referred to dermatology after a 9-month history of tender red bumps on the vulva that would arise and drain over a 24 to 72 hours period, several times per week. Physical examination revealed erythema of the labia minora and introitus with a 4 mm, pink, dome-shaped soft papule on the left labium minus. Wet mount, microbiologic cultures and sexually transmitted infection (STI) screenings were unremarkable. Histopathologic examination revealed a well-circumscribed nodule of suppurative granulomatous inflammation arising in a background of mucosa with Fordyce spots, the majority of which were infiltrated by Demodex spp. Treatment with oral ivermectin and topical metronidazole cream resulted in a symptom-free period of 22 months. This case represents an unusual presentation of symptomatic Demodex infestation. PMID: 33448447 [PubMed - in process] {url} = URL to article More information on oral ivermectin
    • This question has come up at RF whether Finasteride or Minoxidil causes flushing or may be a rosacea trigger and you may be interested in knowing that apparently there isn't any consensus on this and these two drugs haven't been listed on any rosacea trigger list as far as we know. If you have anything to add to this or your experience using either of these treatments with your rosacea, please find the reply to topic button.  For more information 
    • Related ArticlesResolution of Refractory Corneal Neovascularization with Subconjunctival Bevacizumab. Case Rep Ophthalmol. 2020 Sep-Dec;11(3):652-657 Authors: Britton AK, Crayford BB Abstract Corneal neovascularization (CNV) has a variety of causes and threatens corneal clarity, thus optimal visual acuity. Conventional medical management includes topical steroids and matrix metalloproteinase inhibitors like doxycycline. Anti-vascular endothelial growth factor (anti-VEGF) agents have demonstrated promise but remain off-label for this indication. However, these agents hold value in cases refractory to first-line medical management. We report the case of a 63-year-old woman who presented with ocular rosacea and CNV affecting vision, on a background of acne rosacea. She was initially treated with fluorometholone and doxycycline, yet continued to deteriorate. Eventually she received two 1.5-mg subconjunctival injections of bevacizumab 2 months apart. CNV completely resolved and results were maintained at 4-year follow-up. This case demonstrates that refractory CNV can be effectively treated with subconjunctival injection of anti-VEGF bevacizumab. The resolution of CNV was also maintained years after injection with minimal adjunctive therapy during this period, and to our knowledge there are no other studies reporting a follow-up period of 4 years after treatment. This is a pertinent case for other clinicians treating patients in a similar situation. PMID: 33442379 [PubMed] {url} = URL to article
    • We have a new video, Welcome to the RRDi Official Website found on our WELCOME PAGE for rosacea newbies.  
    • Related ArticlesThe association of photo-induced collagen degeneration and the development of telangiectasias in rosacea. J Anat. 2021 Jan 11;: Authors: Thompson KG, Rainer BM, Leung S, Qi J, Kang S, Chien AL Abstract Rosacea is a chronic, often progressive disorder characterized by facial erythema, telangiectasias, papules, pustules, and/or rhinophyma. In this study, we investigated the tissue structure in rosacea compared to controls. We performed a case-control study between five patients with mild-to-moderate erythematotelangiectatic rosacea (ETR) and five matched controls. Facial biopsy samples from rosacea patients and controls were stained with picrosirius red for collagen and CD31 for microvessel identification. Mean collagen content was significantly greater in control samples (19.603% ±8.821%) compared to rosacea samples (16.812% ± 7.787%, p = 0.030). In contrast, mean microvessel density was significantly higher in rosacea patients (4.775 E-5 ± 1.493 E-5 µm-3 ) compared to controls (2.559 E-5 ± 8.732 E-6 µm-3 , p = 0.004). Mean microvessel lumen area was also significantly higher in rosacea patients (491.710 ± 610.188 µm2 ) compared to controls (347.879 ± 539.624 µm2 , p = 0.003). We identified a correlation between decreased collagen content and increased microvessel size and density in rosacea patients that was not observed in controls. These structural changes to the dermal matrix may contribute to the characteristic vessel growth and dilation in rosacea. PMID: 33432575 [PubMed - as supplied by publisher] {url} = URL to article
    • Gladskin makes a cream or gel for rosacea that is available in the UK on Amazon. The RRDi doesn't have an affiliate relationship with Amazon UK but in the the spirit of 'everything rosacea' we would hope rosaceans in the UK would let us know about this treatment and find the reply to topic button to report if they have success using this cream or gel. The USA Gladskin website doesn't mention this treatment. The Gladskin UK website has more information as well as the following video:  Ingredients Aqua, Propylene glycol, Hydroxypropyl methylcellulose, Glycerin, Arginine HCl, Sodium chloride, Trometamol, Staphefekt™ SA.100 C2.4, Calcium chloride. Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post?  And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register?  We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.  
    • Related ArticlesChildhood granulomatous periorificial dermatitis: case report and review of the literature. Dermatol Online J. 2020 Dec 15;26(12): Authors: Fakih A, Makhoul R, Grozdev I Abstract Childhood granulomatous periorificial dermatitis (CGPD), considered a clinical variant of perioral dermatitis, typically affects prepubertal children of African descent. It is a condition of unknown etiology characterized by the presence of a monomorphic yellow-brown papular eruption limited to the perioral, perinasal, and periocular regions that histopathologically shows a granulomatous pattern. This disorder should be differentiated from other conditions as granulomatous rosacea, sarcoidosis, and lupus miliaris disseminatus faciei. We report a case of a 9-year-old boy who presented with flesh-colored perorificial papules on the face, evolving for two months. Upon treatment with topical tacrolimus for follicular eczema, an aggravation of the condition was observed. A skin biopsy confirmed the diagnosis of CGPD. Our patient was successfully treated with a combination of topical metronidazole and topical erythromycin. PMID: 33423420 [PubMed - in process] {url} = URL to article
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    • Demodex Solutions, one of our sponsors, has graciously allowed us to award a free jar of the ZZ Cream to the best poster on our website each month. If you are the best poster of the month, you will receive a free jar of the ZZ Cream shipped to your address. So start posting!!! You have till the end of the month and someone will be awarded as the best poster and will be announced here who that poster is. 
    • Related ArticlesAntibiomania: A Rare Case of Metronidazole-Induced Mania. Cureus. 2021 Jan 01;13(1):e12414 Authors: Puri P, Parnami P, Chitkara A, Athwal PSS, Khetrapal S Abstract Metronidazole is a very commonly used drug for the treatment of ailments caused by bacteria and parasites. It can treat a vast array of conditions like rosacea, sexually transmitted diseases (STDs), liver abscess, bedsores, etc. Metronidazole comes with generic side-effects like nausea, vomiting, dizziness, metallic taste, and also rare side-effects like paresthesia, syncope, cerebellar symptoms, psychosis but mania is a rare side-effect. Here, we present a case of metronidazole induced mania in a 50-year-old male with no past medical history who initially presented with a complaint of mild fever, loss of appetite, and fatigue from the past 10-12 days. On further examination and investigations, diagnosis of the amebic liver abscess was made on the basis of USG, serum serology for amebiasis IgG, and a CT scan. Consequently, the patient was started on the drug of choice for amebic liver abscess; IV metronidazole 1.5g/day divided over the day into three doses. Other drugs that were administered were pantoprazole, paracetamol, and ondansetron. On the ninth day of admission, the patient's wife as well as the physician-daughter of the patient reported a change in the behavior of the patient which became a major concern for the family. The patient was restless, energetic, unable to sleep, had racing thoughts, elated mood, petulant, and kept singing loudly in the private patient room. There was no history of any psychiatric illness in the family. Mr. K´s manic symptoms were managed using haloperidol and lorazepam. Upon discontinuing metronidazole, there was a gradual improvement in the manic symptoms, and symptoms improved, haloperidol and lorazepam were able to be tapered down and eventually stopped. Mr. K did not require any use of any selective serotonin reuptake inhibitor (SSRIs), monoamine oxidase inhibitors (MAOIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), or any other atypical psychotropic drug. Manic-psychosis side-effect is a rare entity caused by antibiotics and the symptoms of which would disappear in a few days after stopping the antibiotic. It is also notable that this patient recovered without the use of any psychotropic drugs. Physicians should be aware of the possible neuropsychiatric side-effects of antibiotics which can lead to unnecessary workup. This side-effect did not require the use of any psychotropic drugs in this patient. PMID: 33409111 [PubMed] {url} = URL to article
    • Related Articles Rhinophyma in women: a case series. Lasers Med Sci. 2021 Jan 07;: Authors: Ismail D, Asfour L, Madan V Abstract Rosacea has an overall female predominance; however, rhinophyma, a feature attributed to advanced rosacea, is exceedingly rare in females. The impact of this condition on quality of life can be profound. Multiple treatment modalities have been described. However fully ablative carbon dioxide (CO2) laser for moderate-severe rhinophyma has been shown to be most effective with good cosmetic outcome and high patient satisfaction. We describe a series of 7 female patients presenting with rhinophyma to a tertiary NHS laser centre and a private dermatology clinic. A retrospective case review of rhinophyma management was performed, assessing presentation, treatments and outcomes. The mean age at presentation was 47 years (27-62 years). Three patients developed rhinophyma before the age of 30 years. One patient had severe, 2 patients had moderate and 4 patients had minor rhinophyma. Four patients underwent fractional CO2 laser treatment with a good cosmetic outcome. Two further patients developed scarring following fully ablative CO2 laser. Long-term low-dose oral isotretinoin was used in 3 patients following laser treatment, to prevent relapse. One patient solely received isotretinoin with a good outcome. In our experience, females suffering with rhinophyma presented for treatment at an early age and stage of severity. Fractional or fully ablative CO2 laser alone or in combination with oral isotretinoin is a very effective treatment modality. PMID: 33411129 [PubMed - as supplied by publisher] {url} = URL to article Reply to this TopicThere is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post?  And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register?  We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.  
    • Thanks Apurva.  We have a little more than $300 left in the bank which may keep us going for a few months. I can't keep this non profit organization going by myself and have devoted a huge number of volunteer hours keeping this non profit organization legal to keep our IRS exempt status going which means donating to the RRDi is tax deductible. Keeping a non profit organization exempt, legal and active requires many volunteer hours. As you mentioned, we know that thousands visit our website each month and obviously take away huge amounts of rosacea treatment data which the amount on our website is significant since it reflects over seventeen years of rosacea research data to help rosaceans control their rosacea. It would be a simple gesture of appreciation if just half the members would donate ONE DOLLAR using the PayPal Giving Fund and that would keep us going probably for a year. That is less than the cost of a cup of coffee. 
    • Apurva,  Thanks for your post. Sure hope you are not having any Covid 19 repurcussions or other health issues. Thank God you are ok and got through your illness. Sorry your rosacea flamed up during your stressful period which without a doubt added to your illness. Keep us informed of any other issues you may experience and update us using this thread.  
    • Hii everyone, I want to share my experience with you. I was corona positive last month and what was interesting is I had mild symptoms of corona and I got perfectly fit after 3 to 4 days but then I realized that I have lost my sense of smell and taste and it lasted one month and then now I am regaining slowly and after all these chaos I found that my rosacea had become more aggressive and covered almost my entire face. Blood vessels became dilated and torn and big red blotches were visible and I could not understand why this corona had this big impact on my rosacea and this aggressive effect left my skin like a peel but then I cured it slowly with mild scrubbing and gut cleaning and with healthy food. So I experienced that corona has its impact on rosacea.
    • Hello Rosaceans, if you can donate some money to our non-profit organization it would propel us to post more matter on this topic. I know that many rosaceans view our site, read each and every material, gain knowledge from this site which you will never find anywhere on other rosacea website but you never appreciate us giving some donation money. We keep asking members for some donation but I think its all throwing stone in water and admin has already declared that if we don't get money he will close the organization and then where will you read such good material from? think on this.
    • Related ArticlesOcular manifestations of rosacea: A clinical review. Clin Exp Ophthalmol. 2021 Jan 06;: Authors: Tavassoli S, Wong N, Chan E Abstract Ocular rosacea is a chronic inflammatory condition that can occur in the absence of cutaneous features. The most common ocular features are chronic blepharoconjunctivitis with eyelid margin inflammation, and meibomian gland dysfunction. Corneal complications include corneal vascularisation, ulceration, scarring and, rarely, perforation. Diagnosis is largely based on clinical signs, although it is often delayed in the absence of cutaneous changes, particularly in children. It can also be associated with systemic disorders such as cardiovascular disease. Management ranges from local therapy to systemic treatment, depending on the severity of the disease. In this review, we describe the epidemiology, pathophysiology, clinical features and treatment of rosacea and ocular rosacea. PMID: 33403718 [PubMed - as supplied by publisher] {url} = URL to article
    • Pediatric Demodicosis Associated with Gain-of-Function Variant in STAT1 Presenting as Rosacea-Type Rash. J Clin Immunol. 2021 Jan 06;: Authors: Baghad B, El Fatoiki FZ, Benhsaien I, Bousfiha AA, Puel A, Migaud M, Chiheb S, Ailal F PMID: 33404972 [PubMed - as supplied by publisher] {url} = URL to article
    • Association between Rosacea and Smoking: A Systematic Review and Meta-Analysis. Dermatol Ther. 2021 Jan 06;:e14747 Authors: Yuan X, Yin D Abstract Rosacea is a chronic inflammatory disease of the centrofacial region. However, the association between rosacea and smoking remains controversial. To evaluate the association between rosacea and smoking, we performed a systematic review and meta-analysis. A comprehensive systematic search of literature published before October 15, 2020 on online databases (including Web of Science, PubMed, Cochrane Library, and Embase) was performed. The pooled odds ratios (ORs) were calculated. Twelve articles were included, covering 80 156 controls and 54 132 patients with rosacea. Tobacco consumption was not found to increase the risk of rosacea. However, using subtype analysis (involving five articles), we found there was a decreased risk of rosacea in current smokers but an increased risk in ex-smokers. In addition, smoking appears to increase the risk of papulopustular rosacea (PPR) and phymatous rosacea (PhR). Analysis of all included studies also showed that ex-smoking was associated with an increased risk, while current smoking was associated with a reduced risk of rosacea. In order to prevent many diseases, including rosacea, the public should be encouraged to avoid smoking. This article is protected by copyright. All rights reserved. PMID: 33406295 [PubMed - as supplied by publisher] {url} = URL to article Other Systemic Cormorbidities in Rosacea Image courtesy of Wikimedia Commons
    • Related ArticlesOcular manifestations of dermatological diseases part I: infectious and inflammatory disorders. Int J Dermatol. 2021 Jan;60(1):5-11 Authors: Al Akrash LS, Al Semari MA, Al Harithy R Abstract Skin and eyes share a common embryological origin from the embryonic surface ectoderm. Ocular manifestations are one of the most important and common associations of dermatological diseases. Currently, there are few comprehensive reviews of the ocular manifestations of dermatological diseases. We have reviewed more than 40 published articles related to the ocular manifestations of the most important dermatological diseases. The search included Pubmed, Google Scholar, and Cochrane databases from 2014 to 2019. This review was divided into three parts including infections, inflammatory, genetics, connective tissue, autoimmune, neoplasms, and drug-related disorders. We excluded metabolic, endocrine, and nutrition-related dermatological diseases. The relationship of ocular manifestations and dermatological diseases is important to recognize for appropriate management since many dermatological diseases can manifest initially with ocular findings. In this part, we summarized the most common and significant ocular findings in infectious and inflammatory dermatological disorders with appropriate referral recommendations to ophthalmology. PMID: 33232519 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related ArticlesSuccessful Treatment of Periorificial Dermatitis With Novel Narrow Spectrum Sarecycline. J Drugs Dermatol. 2021 Jan 01;20(1):98-100 Authors: Graber E, Kay CR Abstract Broad spectrum tetracyclines are a well-known, widely used, and often successful treatment for use in inflammatory skin pathologies such as acne and rosacea. However, the steady rise of antibiotic resistance and gut dysbiosis associated with broad spectrum tetracyclines emphasizes the importance and responsibility of antibiotic stewardship. Narrow spectrum antibiotics have become increasingly important therapies to slow the progression of resistance as well as decrease negative side effect profiles, particularly those associated with broad spectrum tetracyclines. This case shows the successful treatment of periorificial dermatitis with a novel, narrow spectrum tetracycline, sarecycline, in a patient with underlying Crohn’s. J Drugs Dermatol. 2021;20(1):98-100. doi:10.36849/JDD.2021.5678. PMID: 33400418 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Cinnamtannin B1 attenuates rosacea-like signs via inhibition of pro-inflammatory cytokine production and down-regulation of the MAPK pathway. PeerJ. 2020;8:e10548 Authors: Kan HL, Wang CC, Cheng YH, Yang CL, Chang HS, Chen IS, Lin YC Abstract Background: Rosacea is a common inflammatory disease of facial skin. Dysregulation of innate immunity with enhanced inflammation and increased abundance of LL-37 at the epidermal site is a characteristic feature of rosacea. Cinnamtannin B1 (CB1) is a condensed tannin with anti-inflammatory and anti-microbial activities. The aims of the study were to evaluate the potential of CB1 as a therapy for rosacea and to characterize the potential mechanisms of action. Methods: We intraperitoneally administered 20 mg/kg CB1 once daily for 2 days into the LL-37-induced mouse model of rosacea. The effects of CB1 in vivo were evaluated by the observations of lesions, histology, immunohistochemistry, and the transcription and translation of pro-inflammatory cytokines and chemokines. Human keratinocyte HaCaT and monocyte THP-1 were used to characterize the effects of CB1 on LL-37-induced inflammation in vitro. The changes in pro-inflammatory chemokine interleukin-8 (IL-8) were quantitated by enzyme-linked immunosorbent assay (ELISA), and the expressions of genes involved were determined by Western blotting. Results: CB1 attenuated local redness, inflammation, and neutrophil recruitment in the mouse model of rosacea in vivo. CB1 suppressed myeloperoxidase (MPO) and macrophage inflammatory protein 2 (MIP-2) production, a functional homolog of interleukin-8 (IL-8), at the lesions. In vitro experiments confirmed that CB1 reversed the LL-37-induced IL-8 production in human keratinocytes HaCaT and monocyte THP-1 cells. CB1 inhibited IL-8 production through downregulating the phosphorylation of extracellular signal-regulated kinase (ERK) in the mitogen-activated protein kinase (MAPK) pathway. Conclusion: CB1 attenuated LL-37-induced inflammation, specifically IL-8 production, through inhibiting the phosphorylation of ERK. CB1 has potential as a treatment for rosacea. PMID: 33391878 [PubMed] {url} = URL to article More information on Cathelicidin Peptide LL-37 and Vitamin D3
    • Related Articles The Effect of Volatile Oil from Chinese Mugwort Leaf on Human Demodecid Mites In Vitro. Acta Parasitol. 2021 Jan 04;: Authors: Du J, Gao R, Zhao J Abstract BACKGROUND: Human demodecid mites including Demodex folliculorum and Demodex brevis Akbulatova can cause acne, rosacea, epifolliculitis, blepharitis, seborrheic dermatitis, perioral dermatitis, acromastitis and such skin health problems. Artemisia (Composiate) are widely distributed in temperate regions in the northern hemisphere. It has been reported that 17 species of plants in Artemisia used to be mugwort in China. Mugwort volatile oil (MVO) has antibacterial and antiviral effects, can relieve cough and asthma, acts as an expectorant, choleretic and sedative, and promotes circulation and enhances immunity. PURPOSE: This research was to observe the effect of MVO on two types of human demodecid mites in vitro. METHODS: The MVO was obtained via the supercritical CO2 extraction method, and the human demodecid mites were acquired with cellophane tape. MVO had a distinct killing effect on two types of human demodecid mites, Demodex folliculorum and Demodex brevis. The body of the demodecid mites has a classical temporal process, which consists of excitement, contractions, death and transparency. The killing time was lengthened with decreasing concentration, thus showing an evident dependence on concentration. RESULTS: The experiment showed that 3.125% was the minimum effective concentration of MVO for killing D. brevis, and 6.25% was the minimum effective concentration for killing D. folliculorum; the killing effect of MVO on D. brevis was greater than on D. follilorum. CONCLUSION: This result suggests that mugwort, which acts as a traditional Chinese herbal medicine, has a noticeable killing effect on human demodecid mites. PMID: 33394383 [PubMed - as supplied by publisher] Image courtesy of Wikimedia Commons {url} = URL to article Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post?  And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register?  We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.  
    • “Many types of non-501(c)(3) tax-exempt organizations including social welfare organizations, business leagues and trade associations, social clubs, voluntary employees’ beneficiary associations, cemetery companies, and veterans’ organizations, among others, are prohibited, by statute, from allowing inurement of net earnings or assets of the organization to benefit any insider. An insider is a person who has a personal or private interest in the activities of the organization such as an officer, director, or a key employee. An example of prohibited inurement would include payment of unreasonable compensation to an insider.” Private Benefit and Inurement, Page 5, Compliance Guide for Tax-Exempt Organizations From 1998 thru 2019 the NRS has received in donations/revenue  $15.5 million and spent over $10 million (65%) on private contractors owned by Sam Huff who serves on the board of directors of the NRS.  During this same period the NRS spent less than 10% of the revenue on rosacea research. For details on the math for this period click here. What do you think?  Sam Huff has served on the board of directors of the NRS for over twenty years. The NRS has spent over 60% of the majority of the donations/revenue received during this period on two private contractors owned by Sam Huff, Glendale Communications Group, Inc and Park Mailing and Fulfillment, Inc (see for yourself). Could Sam Huff be an 'example of prohibited inurement' [that] 'would include payment of unreasonable compensation to an insider'? What You Can Do Can you do anything about it?  Here are two recommendations:  (1) Write the IRS that you want this non profit to be investigated:  Internal Revenue Service Exempt Organizations Determinations Room 4024 P.O. Box 2508 Cincinnati, OH 45201 RE: National Rosacea Society (EIN: 36-4120334) Here is a sample letter for your consideration:  01_05_21.pdf You may want to include in your letter that the IRS reconsider whether the NRS qualifies as a 501 c 3 since "A tax-exempt organization that does not restrict its participation in certain activities and does not absolutely refrain from others, risks failing the operational requirements for exemption from income tax and jeopardizing its tax-exempt status." [1] The NRS acts more like a 501 c 6 since the majority of its spending benefits businessmen and dermatologists qualifying it as a business league or professional association. For more information see the post about the difference between a non profit and a not for profit or how non profits work.  (2) Support the RRDi with your donations and stop donating to the NRS which is obviously spending the vast majority of its donations/revenue not on benefiting the public but instead benefits businessmen and dermatologists. You don't have to worry about the NRS going under since the pharmaceutical companies that donate to the NRS will continue to do so since these companies are happy with how the NRS spends it money and benefit since dermatologists benefit from the money these pharmaceutical companies are giving to the NRS and you can probably figure out why this arrangement will continue on. The NRS is embedded in this relationship and both are benefiting so the NRS won't miss your paltry donation since it receives most of its funding from pharmaceutical companies that have a vested interest in how the NRS supports 10% of its donations/revenues on rosacea research.  End Notes  [1] Compliance Guide for Tax Exempt Organizations, Publication 4221-NC (Rev. 9 -2014) Catalog Number 52447N, Department of the Treasury Internal Revenue Service p4221nc.pdf
    • "Recent publications certify that the disease appears to be universal and does not just affect Caucasians." An Bras Dermatol. 2020 Nov-Dec; 95(Suppl 1): 53–69.Consensus on the therapeutic management of rosacea – Brazilian Society of DermatologyClivia Maria Moraes de Oliveira, Luiz Mauricio Costa Almeida, Renan Rangel Bonamigo, Carla Wanderley Gayoso de Lima, Ediléia Bagatinf
    • In harmony with this thread, it is time to review the activities of the NRS for 2019 since the NRS doesn't post its Form 990 for 2019 until the END of 2020 which anyone can download and review on its financial page by clicking here (scroll to the bottom of the page to find the Form 990 download). The page paints a very pretty picture with a graph and a list of expenses which shows 'Research Grants' in the amount of $231,526. Here is a screen shot for your enjoyment:  The Form 990 for 2019 that the NRS reports to the Internal Revenue Service shows a very different picture than the math in the above screen shot for research grants. The actual amount shown on Form 990 for research grants is only $23,315 which is ten times less what is shown above. Here is a screen shot of Form 990, Schedule I, which shows the Regents of the University of California at Irvine received the grant: So you can choose to believe what the NRS publishes on its financial page, painting a pretty picture of how it spends ten times the amount shown on rosacea research on its website, or you can read for yourself Form 990 reported to the Internal Revenue Service and discover yourself, but the math on the Form 990 shows ten times less.  The Form 990 for 2019 shows that the NRS received in donations and revenue $303,013 and the total expenses were $419,490.  If you note below in the screenshot of the first page, you can see LINE 13, Grants and similar amounts paid (Part IX, column (A), lines 1-3) in the amount of $23,315. You will be hard pressed to find anywhere reported ten times that amount on research grants.  So the NRS spent 7% of its donations/revenue received in 2019 on rosacea research. To understand this better, for every dollar received by the NRS in 2019 seven cents was spent on rosacea research in 2019. What is enlightening in Form 990 for 2019 is how much the NRS spent on Glendale Communications Group in 2019 which is shown below in this screenshot reported as Section B. Independent Contractors with the same address as the NRS in the amount of $285,871:  That means that Glendale Communications group received 94% of the total amount received in donations/revenue for the 2019 year. Glendale Communications Group, Inc., is owned by Sam Huff. The Form 990 for this year also has an interesting report shown in the screenshot below on Schedule L regarding 'Business Transactions Involving Interested Persons.'  This is how the NRS operates.  nrs_990_2019.pdf
    • Related ArticlesLaser and light-based therapies in the management of rosacea: an updated systematic review. Lasers Med Sci. 2021 Jan 03;: Authors: Husein-ElAhmed H, Steinhoff M Abstract Unlike other rosacea therapies which need daily takings or applications over long periods, the edge of lasers and light-based therapies (LLBT) is the limited number of sessions to achieve improvement. The proper selection of the adequate physical device in accordance with the patients' skin features and rosacea-related signs and symptoms should be considered and the management with physical sources should be updated as new data become available. This article reviews and discusses the current use of lasers and light-based therapies in rosacea with reference to all the available literature.This systematic review demonstrates the quality of evidence to support any recommendation on LLBT in rosacea is low-to-moderate. Among all the available devices, PDL holds the most robust evidence. Treatments options should be tailored for each specific clinical scenario as it is unlike that single modality results in complete resolution. Platforms that include two or more devices and combined therapies with topical agents are suitable and they warrant further investigations. PMID: 33389310 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Carotid intima-media thickness and serum proinflammatory cytokine levels in rosacea patients without cardiovascular risk factors. Dermatol Ther. 2021 Jan 02;: Authors: Ertekin SS, Koku Aksu AE, Koçyiğit A, Güler EM, Baykara Ulusan M, Gürel MS Abstract BACKGROUND: There is a growing body of evidence linking rosacea to various systemic disorders, even though data regarding the association between rosacea and cardiovascular diseases are presently controversial. We sought to investigate the potential association of rosacea with subclinical atherosclerosis and serum proinflammatory/proatherogenic markers. METHODS: This study included 44 patients with rosacea and 44 age- and sex-matched healthy control subjects. Patients with traditional cardiovascular risk factors or a history of cardiovascular events were excluded. Demographic, clinical, and laboratory data, including serum interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) levels were assessed. Carotid intima-media thickness (CIMT) and carotid plaques were measured by carotid ultrasonography. RESULTS: Serum IL-1β (p<.001), IL-6 (p<.001), TNF-α (p<.001), and hs-CRP (p<.001) levels were significantly higher in the patient group compared to the control group. Mean CIMT values did not differ significantly between the patient group and control group (p>.05). Patients with moderate to severe rosacea had a significantly greater CIMT than those with mild rosacea (p=.047). Rosacea patients with eye involvement had a significantly greater CIMT than those without eye involvement (p=.008). There was no significant correlation between CIMT values and inflammation parameters. CONCLUSIONS: Rosacea is associated with increased systemic inflammation parameters. In the absence of other traditional cardiovascular risk factors, rosacea does not seem to affect mean CIMT value. However, specific subgroups such as patients with moderate to severe disease or with eye involvement are associated with increased subclinical atherosclerosis and may require additional attention for cardiovascular disease prevention. This article is protected by copyright. All rights reserved. PMID: 33389789 [PubMed - as supplied by publisher] {url} = URL to article  More information on systemic cormorbidities in rosacea
    • "Ivermectin 1% cream QD had favorable incremental cost-effectiveness when compared with metronidazole 0.75% cream BID and dominated azelaic acid 15% gel BID in the treatment of papulopustular rosacea in the United States. Therefore, ivermectin 1% cream QD may be a good first-line treatment for papulopustular rosacea, providing additional clinical benefit at no or low additional cost."  Manag Care Spec Pharm. 2016 Jun;22(6):654-65.  doi: 10.18553/jmcp.2016.15210. Epub 2016 Apr 28. Cost-Effectiveness of Ivermectin 1% Cream in Adults with Papulopustular Rosacea in the United States Alain Taieb, Linda Stein Gold, Steven R Feldman, Viktor Dansk, Evelina Bertranou  
    • Related ArticlesDifferential expression of microRNAs in the skin tissue of patients with severe papulopustular rosacea. J Dermatol Sci. 2020 Dec 23;: Authors: Seo SM, Hong JY, Lee HJ, Yang NG, Chung EH, Lee SY, Park YL, Lee SH, Lee SH, Lee DW, Shin MJ, Ryu S, Kim JE PMID: 33386184 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesAn unusual case of acquired facial pigmentation. BMJ. 2020 10 28;371:m3388 Authors: Bryan P, Lloyd-Lavery A PMID: 33115725 [PubMed - in process] {url} = URL to article
    • Volunteering is at the core of the RRDi non profit organization. Watch this short video about why you should volunteer to post at the RRDi forum or at the very least donate one dollar to keep the RRDi going. 
    • Related Articles Facial Erythema in an Elderly Man. JAMA Dermatol. 2020 05 01;156(5):587-588 Authors: Navarrete-Dechent C, Busam KJ, Markova A PMID: 32211818 [PubMed - in process] Abstract {url} = URL to article
    • This probiotic has come to my attention, although I haven't tried it.  It is supposedly better than the majority of probiotics that are found on shop shelves as it contains strains used in research, which have demonstrated benefits.  Personally, I don't tolerate probiotics and it has been suggested my adverse reactions may be due to  SIBO. However, I am not certain about that as my face is much calmer and  in general free of P&P's unless I take probiotics of any kind that I have tried thus far.  There is mention on the linked site that Daily Synbiotic may be suitable for  people who have SIBO as it bypasses the small intestine and resists digestion until it has reached the large colon. I am not convinced, however  it may be true. Has anyone tried this  Daily Synbiotic? If so, it would be  helpful if they shared their results.  https://my.seed.com/daily-synbiotic  
    • "The formula of hypochlorous acid is HOCl. A chemist discovered hypochlorous acid in 1834. It is a primary compound of innate immunity. This acid is effective to use against a wide range of microorganisms." [1]  "0.01% hypochlorous acid (HyClear™) was effective in disinfecting hybrid contact lenses and cases contaminated with bacteria, a yeast, and adenovirus." [2] Demodex "HOCl has potent antimicrobial properties. Laboratory studies show that it effectively kills the nymph form of the Demodex mites, as well as the Bacillus oleronius and Staphylococcus aureus bacteria that live on eyelids and that are found inside the Demodexgut. In addition, HOCl also neutralizes the inflammatory toxins released by both mites and bacteria." [3] Bacteria "In a recent study, a saline hygiene solution preserved with pure hypochlorous acid was shown to reduce the bacterial load significantly without altering the diversity of bacterial species on the eyelids. After 20 minutes of treatment, there was >99% reduction of the Staphylococci bacteria" [4] Fungus "In our study, hypochlorous acid, 0.01%, effectively eliminated all molds (including Fusarium and Aspergillus) and yeasts (Candida spp.) tested, with fungicidal activity observed in as little as 15 seconds. This rapid fungicidal and sporicidal activity is a significant advantage over traditional antifungal treatments that require hours or even days to show activity and may not be active against conidia (spores). Unlike some antifungal agents that are active against certain species but not others, hypochlorous acid showed rapid and potent activity against all species tested, including the genera Acremonium, Aspergillus, Fusarium, Mucor, and Candida. This broad spectrum of activity makes hypochlorous acid an attractive candidate for a global antifungal prophylaxis agent, especially in developing countries." [5] Virus HOCI is produced by our white blood cells, so our body recognizes it. At 200 ppm, HOCl is also listed by the FDA as Generally Recognized As Safe (GRAS), and is listed as being safe for use on food-contact surfaces by the USDA without the requirement of a rinse step. With HOCL there are no health risks with normal use, as evidenced by all zeros on safety data sheet. HOCL kills the Covid 19 virus. [6] Treatments Clinical Reset by CelleRx is a pure hypochlorous acid, .01% as a preservative in saline. Alevicyn is another treatment.  Amazon Hypochlorous Acid Treatments Active Skin Repair Spray Avenova Antimicrobial Eyelid and Lash Cleanser Briotech Topical Skin Spray BRIOTECH Topical Skin Spray 4 oz CleanSmart Antimicrobial Skin Cleanser Curativa Bay Hypochlorous Spray Mist Defense Antimicrobial Skin Cleanser Heyedrate Dry Eye Relief Kit Heyedrate Hypochlorous Lid and Lash Cleanser Ocusoft Hypochlor OCuSOFT HypoChlor 0.02% Hypochlorous Acid Eyelid and Eyelash Gel Puracyn Plus Wound and Skin Cleanser SkinSmart Antimicrobial Clear Spray Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post?  And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register?  We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.   End Notes HOCI image courtesy of Wikimedia Commons [1] Does Hypochlorous Acid Eliminate Fungus?, Holistic Density, USA, Joe Doctora [2] ARVO Annual Meeting Abstract  |   June 2020 The Disinfection of Bacterial, Fungal, and Viral Contaminated Contact Lenses and Cases with Hypochlorous Acid Eric G Romanowski; Kathleen A Yates; John E Romanowski; Alex Mammen; Deepinder K Dhaliwal; Vishal Jhanji; Robert M Q Shanks; Regis P Kowalski [3] New Approaches for Fighting Demodex Mites, Dr. Kathryn Najafi-Tagol, MD, Founder and Medical Director of the Eye Institute of Marin, New Medical Life Sciences [4] Stroman, D. W; Mintun, K; Epstein, A. B; Brimer, C. M; Patel, C. R; Branch, J. D; Najafi-Tagol, K (2017). "Reduction in bacterial load using hypochlorous acid hygiene solution on ocular skin". Clinical Ophthalmology. 11: 707–714. doi:10.2147/OPTH.S132851. PMC 5402722. PMID 28458509. [5] Cornea. 2015 Dec; 34(12): 1599–1605. Fungal Infections Following Boston Type 1 Keratoprosthesis Implantation: Literature Review and In Vitro Antifungal Activity of Hypochlorous Acid Silvia Odorcic, MD, FRCSC, Wolfgang Haas, PhD, Michael S. Gilmore, PhD, and Claes H. Dohlman, MD, PhD [6] New Study Proves That Hypochlorous Acid Kills Novel Coronavirus, The Maritime Executive Is hypochlorous acid key to reducing coronavirus risk?, Digital Journal  
    • Related ArticlesOVERVIEW OF TIKTOK'S MOST VIEWED DERMATOLOGIC CONTENT AND ASSESSMENT OF ITS RELIABILITY. J Am Acad Dermatol. 2020 Dec 21;: Authors: Villa-Ruiz C, Kassamali B, Mazori DR, Min M, Cobos G, LaChance A PMID: 33359080 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesInvestigating the relationship between rosacea and use of vasodilatory medications in a hospital-wide population. J Am Acad Dermatol. 2020 Dec 23;: Authors: Abid R, Reid AT, Zafar F, Powers EM, Powers JG PMID: 33359782 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesPediatric rosacea in a patient with a dark phototype: Clinical and dermoscopic features. Clin Case Rep. 2020 Dec;8(12):3257-3259 Authors: Chabchoub I, Litaiem N, Zeglaoui F Abstract Rosacea is rare in children and patients with dark phototype. Dermoscopy helps make the correct diagnosis. Positive family history of rosacea is reported in affected children, which suggests a strong familial inheritance of the disorder. PMID: 33363916 [PubMed] {url} = URL to article
    • Related ArticlesDoxycycline-Associated Dual Cutaneous Adverse Reaction to the Drug (CARD): Case Report of Concurrent Photosensitivity and Morbilliform Exanthem to Doxycycline. Cureus. 2020 Nov 18;12(11):e11546 Authors: Jacob JS, Cohen PR Abstract Antibiotics have been observed to cause drug-induced reactions. These can include a cutaneous adverse reaction to the drug (CARD) such as photosensitivity. A 51-year-old woman initiated doxycycline monohydrate for rosacea. Within nine days, she developed two different, simultaneous skin rashes: a phototoxic reaction and a morbilliform drug eruption. The medication was stopped; topical and oral corticosteroids were initiated. Within two weeks, her rashes resolved. Common cutaneous adverse reactions to doxycycline include photosensitivity and morbilliform exanthem. Less common skin side effects include bullous eruptions, lupus-like eruptions, pigmentary disorders, and vasculitis. Albeit uncommon, doxycycline-associated dual CARD - such as the photosensitivity and morbilliform exanthem - may occur. PMID: 33365215 [PubMed] {url} = URL to article
    • Related ArticlesSafety and Efficacy of an Augmented Intense Pulse Light Protocol for Dry Eye Syndrome and Blepharitis. Photobiomodul Photomed Laser Surg. 2020 Dec 28;: Authors: Zhang-Nunes S, Guo S, Lee D, Chang J, Nguyen A Abstract Objective: We evaluated the safety and efficacy of an augmented BroadBand Light (BBL™) protocol on the upper and lower eyelids in improving meibomian gland dysfunction (MGD) and/or dry eye disease (DED). Background: DED, often associated with MGD, can cause significant morbidity and accounts for 3.54 billion U.S. dollars of health care spending yearly. Intense pulsed light (IPL) has been used to treat MGD DED with some success. BBL therapy, a high-quality IPL machine, shows much promise for decreasing inflammation and redness in rosacea, as well as hyperpigmentation from sun damage. Methods: A retrospective medical chart review was performed for MGD DED and/or hyperpigmentation patients who received BBL therapy between January 1, 2015, and February 28, 2020. Inclusion criteria included patients who underwent at least one BBL treatment. Each treatment involved the upper and lower eyelids, as well as cheeks, nose, and face. Each MGD DED subject completed the Ocular Surface Disease Index (OSDI) and underwent pre- and post-treatment standard clinical examinations. Results: Forty-seven patients had treatment without significant adverse effects; all patients with MGD DED reported improvement in their dry eye or blepharitis. BBL was determined to be a safe and effective treatment. There were no changes in visual acuity (p = 0.555) and OSDI scores were improved (p = 0.016). There was one case each of mild corneal/conjunctival abrasion, temporary hyperpigmentation, and two of temporary eyelash thinning. Patients with MGD also showed significant improvement in blepharitis and reduced hordeolum frequency after BBL treatment. Conclusions: This novel IPL/BBL protocol appears safe and effective for treating dry eye and blepharitis. PMID: 33370543 [PubMed - as supplied by publisher] {url} = URL to article
    • There are a growing number of members who are concerned with hiding their identity when posting in our public forum. Of course, using a cryptic display name is one way to do this and you can learn about this feature by reading this post and scrolling down to Change Your Display Name.  Hide Your Online Status There is another feature available to you so that you can HIDE YOUR ONLINE STATUS so that you are anonymous. After you have setup your RRDi member account you login to your ACCOUNT SETTINGS.  Find Settings > Security and Privacy > Hide My Online Status  Click the HIDE MY ONLINE STATUS button and Voila!!! So what does this do exactly?   There is a page where you can view what MEMBERS are currently logged in or how many guests are browsing the site. By HIDING YOUR ONLINE STATUS you are considered an ANONYMOUS member currently logged in. Here is the page:  https://irosacea.org/online/
    • Michelle, Really appreciate your post. Your plate is obviously full and I understand. Hang in there and wish you much success with your website. If you have a diagnosis with rosacea you may qualify to serve on the board of directors and you can work on improving the RRDi website since I have made this run for seventeen years and would love to hand the baton to someone younger. It would be a shame for the RRDi to dissolve but the handwriting is on the wall. Interested in running the RRDi the way you think it should be run?
    • Hello Brady, I wanted to offer some explanation as to why I've not been active on this forum. First of all it's the structure of a forum. Personally, I have a challenge navigating them. For me & how my brain works I just haven't done well with seeing/understanding how to navigate forums so I've not engaged in them very much. Unlike Reddit which I've recently joined for the reselling community posts I've never noticed RRDI to send you a thread that you've posted on directly to you like Reddit does, so I will click on the heading & see what was just written & then I'll respond, otherwise I don't go on to reddit & search etc.,. I don't understand how to navigate Reddit much either and it's not a priority. Visually too much going on. I am not on social media/FB much at all especially since my husband left our marriage unexpectedly a few years ago, but when we were together & I was dealing with a lot of other health issues & my parents health issues & focusing on him & his music career. I've had a lot of health issues & life losses that have eclipsed rosacea so that it fell to the bottom of the list.  For me I've found that my acne rosacea is triggered by allergies & sensitivities that are odd so they wouldn't be easily caught. I had to eliminate these sources as much as possible, some of which are not always possible for example shopping in stores pre-pandemic my face would break out as I'm reactive to formaldehyde resin which is sprayed on a ton of items found in my fav TJ Maxx, Marshalls & Homegoods (especially) stores. I'd go out that day with a perfectly clear face & shop for several hours & end up with 4-6 rosacea pimples by the end of the night. A friend of mine joked that we should record it. Wearing a surgical mask makes my face break out, yes the surgical ones, because they have some sort of chemical on them. Titanium dioxide, coco-betaine & prior even foods triggered it. I have to wash my face twice a day with Honest brand face cleanser as it is free of coco-betaine which is the main cleansing ingredient in all hand soaps, shampoos & cleansers. I use Dessert Essence Free (something) shampoo & conditioner because it is free of coco-betaine & I found two hand pump cleansers free of that ingredient as well. I use a handful of other skincare products (too many to list) including Renee' Rouleau's line which is fabulous, she has a acne spot treatment which will eliminate the red rosacea bumps overnight. I use titanium dioxide free makeup as well.  Another odd thing is I can use this amazing lotions, creams on my face & it helps my face but if I put it on my neck it'll break out in hives so I'm still trying to discern which ingredient I'm allergic to now, it's coming down to aloe vera & rosemary as well as blue tansy. My body chemistry is constantly changing with some health issues leaving while others enter in, including new sensitivities that give me pseudo allergic reactions even affect my heart rhythm etc., and traditional doctors do not want to hear this type of thing so I just stay away from the docs, work with a great integrative nutritionist & my own research & live a life of continuous evolving experimentation. I have my own website beingwellwithmichelle.com that I've not posted on in about 2 years nevermind engage on. I may get back to it this year but I"m not sure. I look at the photos of me on there & they were from 2012 or so & I don't recognize that sweet innocent 40 something. I had high hopes for my life/wellness coaching practice working with other high achieving women with chronic health challenges but due to the marriage ending & all that went with that I had to focus on my mindbodywellness & not on helping others. So many things going on in my life just trying to survive & put myself & my self-care first has been my priority & now with the pandemic things are even more disjointed. I spent over 35 years trying to figure out my health challenges rosacea being the most obvious to others & the one that first came around age 20 when I got Lyme disease then disappeared & returned 20 plus years later & I'm 51 now & still am learning how it expresses itself in my body. For now I've got it under control which is nice. I take a mindbodyspirit approach combining a bunch of philosophies & a metaphysical approach to wellness too. I hear these people with COVID-19 speak about "long haul" symptoms & that's been the story of my life since I got mono at age 15 but doctors looked at me like I was crazy. I've had 3/4's of the symptoms people have talked about COVID causing in all systems. I had Lyme disease as well yet it wasn't properly diagnosed. I got on doxycycline for the rosacea outbreak at age 20 & within a few months my neurological symptoms left. I had tested positive ANA factor, RH factor & had signs of infection but back in the late 80's no one was putting it all together with Lyme as they do now.  To be honest, I had to take a giant step back & just try to live & do & be instead of constantly focusing on what is wrong with me & that included stepping away from the rosacea forum among many others.  I started reselling clothes online & that has been a nice distraction from illness & dysfunction. I want to still help others including sharing my experiences with rosacea but I'm not sure exactly what that's going to look like. It seems each year when I think I'm going to get off of SSDI & work again another life or health tragedy strikes & I'm just at that point of trying to live under the radar. I'm literally alone in my condo daily & haven't seen anyone in a year except for a handful of people at a distance, grocery shopping, dropping off things to my Dad etc., I've not even been able to see my Mom due to her being in a nursing home facility. I got sick last year with a respiratory virus that I've still not fully recovered from & that was last Dec-this April. So I got a head start on the quarantine. So I apologize for not being more active here or anywhere actually, but to be honest there have been so many other things going on that I've just not wanted to focus on illness & issues whenever I don't have to. I hope you can understand.   
    • Everything what you apply outside will somewhat work only to reduce them a little but will not cure the root cause and the root cause is your internal system mainly your gut because you know that gut has immense immunity and microflora too and yes fasting improves everything and do not take it as a ritual to do in a particular day but make it a regular regimen. See if you eat you last meal (dinner) atleast at 7pm and after then you do not eat anything, simply having water and then you have your next day breakfast at 10 or 11am then you have given your gut a long time to digest your food and to heal your condition. Try to eat such foods which take less time to digest so that your body has more time to heal. Yes I have been able to significantly reduce my facial symptoms with diets and fasting but I will be true, I sometimes am not able to maintain such diet and fasting due to some other conditions like when I am travelling or when I am someone's home and if I am not able to maintain then my skin tells me that yes  something is wrong going on inside. I agree with your thoughts but I have never used any topical treatment after my oral and topical antibiotics in my early rosacea experience and then I left everything topical and work on inside. I will tell you one more experiment which I will start and then I will share that experience with you and then I will elaborate what I do.
    • Please everyone who is a part of this group and has been with this organization for a long time, you can understand that we can only provide you the information about rosacea if this organization runs. So please understand if you know the work of this organization and want to get more new information. Please help with donation.
    • As everyone knows, 2020 has been a turbulent year and is ending. So is the RRDi. Our financial situation is meager and we have about two months left and we will be making the decision to shut down and dissolve. Rosaceans have left and gone away to the social media rosacea groups and prefer it that way. We have done our best and made a run at trying to help rosacea sufferers for seventeen years and the support presently to continue simply isn't there. No donations simply means the end of the RRDi. The saddest part to me is losing all the rosacea data on this website. I care, but I can't keep this website going by myself. 
    • I understand your reluctance to part with a donation to those with their hand out. It is one of the reasons I was appalled at how the other non profits for rosacea spend their donations. All you do is check it out for yourself, using Form 990 and see how the other non profits for rosacea spend their money. The two other non profits in the USA are the NRS and the AARS. The Canadian non profit, ARSC, does not disclose how they spend their donations. Compare that with what the RRDi spends its donations on, right now keeping this website going by checking the Site Index, the forums, and the articles. We believe in transparency and disclose how we spend our funds on our financial page. I encourage you to visit the other rosacea non profits and see how they spend their donations. Furthermore, the RRDi is the only one founded by rosacea sufferers. We are similar to how the Erythromelagia Association spends its donations and is run by those suffering from erythromelagia.
    • I've been casually searching around the internet about rosacea help, treatment, doctors, etc.  I have a doctor who is trying different things, he calls me his most stubborn case of it.  What's interesting here is that it reveals classic snake oil salesmen at their craft.  Facebook is a joke, so it does not surprise me that there are hidden agendas by the creators/moderators/admins of these different social media sites.  Preying on people with diseases.  How nice.  If I could help to actively pursue the cause and cure, I would do it, but where does one start?  Throwing money at every last person who has their hand out and a promise leads to an empty pocket and a broken heart. 
    • Related ArticlesAssociation between rosacea and cardiovascular disease: A systematic review and meta-analysis. J Cosmet Dermatol. 2020 Dec 21;: Authors: Zhang J, Yan Y, Jiang P, Liu Z, Liu Y, Liu Y, Wang X, Li M, Xu Y Abstract BACKGROUND: Rosacea and cardiovascular diseases (CVD) are chronic inflammatory disorders. While CVD is the leading cause of mortality globally, increasing evidence indicates that CVD prevalence could be higher among patients with rosacea. AIMS: This review aimed to determine the association between the prevalence of CVD and rosacea. PATIENTS/METHODS: A systematic review of observational studies with controls available in MEDLINE, EMBASE, PubMed, Cochrane, and Web of Science databases was conducted. We performed a pooled meta-analysis using random-effects weighting. Overall, 11 studies met the inclusion criteria, which indicated increased odds for at least one risk factor of CVD, including diabetes, high blood pressure, or dyslipidemia. RESULTS: The pooled meta-analysis indicated an association of rosacea with higher odds of insulin resistance or diabetes (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.97-1.45), high systolic blood pressure (OR, 1.96; 95% CI, 1.35-2.84), dyslipidemia (OR, 1.50; 95% CI, 1.19-1.88), and CVD (OR, 6.65; 95% CI, 2.80-15.76). No publication bias was detected. The effect of confounding factors due to overlapping symptoms and lack of individual-level data were limitations of this review. CONCLUSION: Patients with rosacea have a high risk of CVD. However, further studies are warranted to confirm the association between rosacea and CVD. PMID: 33350031 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Contact sensitization to cosmetic series of allergens in female patients with rosacea: A prospective controlled study in China. J Cosmet Dermatol. 2020 Dec 22;: Authors: Chen B, Yu F, Chen W, Yao Z, Yang X, Zhang D, Hao F Abstract BACKGROUND: Allergic contact dermatitis to cosmetics (ACDC) complicates the diagnosis and treatment of rosacea, and is increasingly observed in daily practice. AIMS: The present study aimed to identify the contact allergens responsible for ACDC in Chinese female rosacea patients with or without suspected ACDC (SACDC). METHODS: From a total of 1267 women with rosacea, 122 with SACDC, 145 without SACDC, and 100 age-matched healthy controls without rosacea or SACDC were examined on a voluntary basis. Skin patch tests with C-1000 cosmetic series (Chemotechnique Diagnostics, Malmo, Sweden) were conducted, including 20 selected allergens. RESULTS: Positive allergic reaction was found in 85.2% and 33.8% of SACDC and non-SACDC (P < .001), respectively, and 27.0% of healthy volunteers. Most reactions occurred at day 3, and the majority of all the examinees including normal controls reacted to more than 1 allergen. In SACDC patients, leading allergens were methylchloroisothiazolinone/methylisothiazolinone (28.7%), linalool hydroperoxide (27.1%), fragrance mix I (21.3%), methylisothiazolinone (17.2%), limonene hydroperoxides (16.4%), formaldehyde (14.8%), myroxylon pereirae (13.9%), and propolis (10.7%); the overall allergic reaction rate positively correlated with new onset of facial pruritus (P < .001). The occurrence of irritant contact reactions correlated with positive allergic reactions in rosacea patients with or without SACDC (P = .032 or P < .001, respectively). CONCLUSIONS: Preservatives and fragrances are primary culprits for ACDC in Chinese female rosacea patients. Patch testing should be considered in the suspected patients. PMID: 33350569 [PubMed - as supplied by publisher] {url} = URL to article MORE INFORMATION ON COSMETICS 
    • Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post?  And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register?  We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.  
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