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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. There are reports coming out of China of using AI in computer aided diagnosis that may reduce the number of misdiagnosed rosacea in the future. 

    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 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 Today

    "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 (site is down but you can view this statement in the Wayback Machine)

    "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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    • We used to allow guests to post feedback without registering an account in this forum but now require guests to subscribe to post. Scroll below about Active vs Inactive members.  Voting Member The RRDi has now over 1000 charter members who have graciously joined providing contact information so that they can vote in our decision making of who serves on the board of directors every five years. If you want voting member status we require more than just an email address to vote. We understand that many of you do not want to provide such information so that is why we have setup the non voting member group discussed below.  Non Voting Member Who Registered an Account  We have in the past opened up our membership to anyone who provided an email address without giving us all the contact information. These non voting members who do not provide full contact information (only providing an email address) are not be able to vote for who serves on the board of directors, but will had posting privileges in the forums with access to the website. We hoped to increase our membership since many are reluctant to join if they have to provide contact information. This way, only those who really want to vote will graciously provide such information if they want to, or, opt to be a member and be totally anonymous, with only providing an email address.   By only providing an email address we are also allowing those to use their Apple or Facebook accounts to register an account with our forum, as well as Microsoft, and Google accounts. If you have any issues with registering an account, please use our support form or contact form and describe the issue so we can improve our registration process to make it as easy and user friendly as possible. By using one of the following sign in accounts below (Apple, Facebook, Microsoft, Google) it should be easy peasy (if not let us know). We are still working with Twitter and Linked in about this but you can use Apple, Facebook, Microsoft or Google login credentials with the RRDi it should be the easiest registration.   Changing to a VOTING MEMBER If you join with just an email address you are a member, however you are NOT a VOTING MEMBER. If you are a non voting member and want to become a voting member read the paragraph above on Voting Member, that explains providing contact information allows you to vote. If you do indeed provide us with your contact information, i.e., first and last name, mailing address, phone, alternate email address in your PROFILE, and want to be considered a VOTING MEMBER then contact us and explain so we can change your account setting to a voting member.  Changing to an ACTIVE MEMBER If you logged into your account and are not able to have access to parts of our website, you have become an INACTIVE MEMBER. All that is required now is to SUBSCRIBE. 
    • Int J Dermatol. 2022 Jul 3. doi: 10.1111/ijd.16341. Online ahead of print. ABSTRACT Rhinoplasty is considered a very challenging surgery since minimal changes of this central area of the face may significantly impact a person's appearance and self-awareness. This is even more challenging in thick-skinned patients because results are less predictable, and changes to the osseocartilaginous framework (OCF) may not be sufficiently visible due to the blanket effect of the thick skin. Furthermore, pre-existing skin conditions may exacerbate following surgery. Therefore, managing patients with extremely thick skin or patients who suffer from pre-existing dermatological conditions such as rosacea or acne requires a synergy of surgeons and dermatologists to achieve optimal results. In this article, we review the most significant pre- and post-surgical regimens that surgeons and dermatologists should apply in selected patients to achieve optimal results after rhinoplasty. PMID:35781878 | DOI:10.1111/ijd.16341 {url} = URL to article
    • J Clin Aesthet Dermatol. 2022 Jun;15(6):42-45. ABSTRACT BACKGROUND: Expression of inducible nitric oxide synthase (NOS) is higher in rosacea skin samples than in normal skin controls. Hydroxocobalamin is a potent inhibitor of all isoforms of NOS, capable of reducing the vasodilatations induced by nitric oxide. OBJECTIVE: We aimed to evaluate the role of hydroxocobalamin in treating facial flushing and persistent erythema of rosacea. METHODS: Thirteen patients with rosacea who displayed facial flushing and persistent erythema received 1 to 4 weekly intramuscular injections of hydroxocobalamin 1 to 2 mg. The outcomes were measured using the Clinician's Erythema Assessment (CEA) by photography and an infrared thermometer to evaluate the difference in skin surface temperature (SST) of the cheeks before and after treatment. RESULTS: Thirty minutes after the first dose of intramuscular injection of hydroxocobalamin, the mean CEA significantly reduced from 2.2± 0.6 to 1.2±0.4 (p<0.001), and average SST also significantly reduced from 36.7±0.70°C to 36.2±0.61°C (p<0.001) on the cheeks. CONCLUSION: In our patient sample, intramuscular administration of hydroxocobalamin was effective for immediate reduction of facial erythema associated with rosacea. PMID:35783562 | PMC:PMC9239126 {url} = URL to article Nutritional Deficiencies in Rosacea
    • Front Med (Lausanne). 2022 Jun 16;9:835843. doi: 10.3389/fmed.2022.835843. eCollection 2022. ABSTRACT Sight is arguably the most important sense in human. Being constantly exposed to the environmental stress, irritants and pathogens, the ocular surface - a specialized functional and anatomical unit composed of tear film, conjunctival and corneal epithelium, lacrimal glands, meibomian glands, and nasolacrimal drainage apparatus - serves as a crucial front-line defense of the eye. Host defense peptides (HDPs), also known as antimicrobial peptides, are evolutionarily conserved molecular components of innate immunity that are found in all classes of life. Since the first discovery of lysozyme in 1922, a wide range of HDPs have been identified at the ocular surface. In addition to their antimicrobial activity, HDPs are increasingly recognized for their wide array of biological functions, including anti-biofilm, immunomodulation, wound healing, and anti-cancer properties. In this review, we provide an updated review on: (1) spectrum and expression of HDPs at the ocular surface; (2) participation of HDPs in ocular surface diseases/conditions such as infectious keratitis, conjunctivitis, dry eye disease, keratoconus, allergic eye disease, rosacea keratitis, and post-ocular surgery; (3) HDPs that are currently in the development pipeline for treatment of ocular diseases and infections; and (4) future potential of HDP-based clinical pharmacotherapy for ocular diseases. PMID:35783647 | PMC:PMC9243558 | DOI:10.3389/fmed.2022.835843 {url} = URL to article
    • We are pleased to announce that members can now post REVIEWS in our affiliate store. Here is a screen shot of a review: In the screen shot above the review can be viewed if you click on the tab PRODUCT REVIEWS and MEMBERS can RESPOND TO THIS REVIEW. So if you find an item in our store and you have used the item and want to review it all you do is, (1) Find the item in the store, (2) login with your RRDi account (only requires registering with an email address), (3) Scroll down to the product information tab and next to this tab find the PRODUCT REVIEWS tab and click on it. (4} Find the WRITE A REVIEW black button and click on it (5) Write your review in the comment box
    • You may have some thoughts on the subjects of anonymity, transparency and posting on the internet. This post is our explanation of how we understand these three subjects and if you have any thoughts on this, you are welcome to hit the REPLY TO THIS TOPIC button and add your thoughts (requires subscription to post).  RRDi The RRDi is transparent when it comes to how we spend our donations with our financial page. We have the Guidestar Seal of Platinum Transparancy.  Privacy Policy Our privacy policy is second to none and we challenge anyone to find any loop holes or tell us how we can improve it.  Private Member Forum  We have implemented measures so that only members can view the member forum using the Invision Community platform which is the most secure and private rosacea forum on the internet.  If you use Sign in with Apple, you can hide your email address totally, the ultimate in privacy registration. However, Windows, Linux, and Android users are welcome and can basically have the same anonymity by reading how to do this and taking extra steps recommended to have the same security and privacy in the most private and secure rosacea forum group on planet earth.  Guests Guests used to able to create a cryptic display name and post in our Guest Forum on our website for free in areas open to guests without registering an email address until the end of June 2022. Effective since then guests are not allowed to post anymore without donating for a subscribtion and gain total access to our website. Guests can only view a small percentage of our free information on rosacea. 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Are you aware that when you join a private social media rosacea group that when you post any other member of the group can now view your profile? How private is that? Members of the RRDi can only view what you ALLOW to be viewed in your public profile. Only the RRDi staff can view your email address.  Usually most rosaceans want anonymity (read below how you can hide your true identity when joining the RRDi in the subheading, CHANGE YOUR PROFILE, and learn how to Change Your Display Name to a cryptic display name), but at the same time want transparency with the non profit organization they join while totally remaining anonymous as a member. There is a fine balance between anonymity and transparency and the RRDi allows you to have both if you join as a member and has given this a great deal of thought.  We hope you agree this is how a non profit organization with members should have choices regarding their anonymity as well as having transparency when it comes to the organization they join.  Posting How You Can Remain Anonymous while Posting in the RRDi Member Forum? Follow these directions.  As mentioned above about Sign in with Apple, you can remain totally anonymous and completely private using your Apple ID when registering and hide behind a cryptic display name and also hide your email address totally.   Change Your Profile You can completely remain anonymous when you post in our member forum. You can change your display name to something cryptic or clever. Only the staff at the RRDi has your membership information. The RRDi will NEVER display or disclose to anyone your profile and contact information without your permission. Our Privacy Policy is solid. And if you join only with your email address, the staff has no idea who you are. Your email address is your only ID, so, how much more anonymous can you get?  Change Your Display Name The steps to change your display name are the following:  1. Login to your member account by looking for Existing User? Sign in (Top Right Corner of your screen) (if you are having issues logging in please contact us, giving your first and last name, your email address used when registering your account as a voting member and we will assist you in being able to login to your member account. If you registered only with your email address just contact us with your email address and we will be happy to assist ) 2. Once logged in you will see your display name in the top right corner. Click on the toggle and select ACCOUNT SETTINGS. In the left column of the account settings page look for DISPLAY NAME. In the column to the right of display name type in the field box under CHANGE DISPLAY NAME (to the left of the field box it says NEW DISPLAY NAME) change to whatever new display name you want to remain anonymous.  3. Click the SAVE button. Voila!  You are now anonymous. No one knows who you are.  Hide Your Online Status You may also want to hide your online status.  Sign in with Apple The ultimate privacy is using Sign in with Apple. Private Tapatalk Member Forum We have now sponsored a private Rosaceans Tapatalk member forum which you can join. For more information.  Guests Allowed to Post No More We in the past have allowed guests to post here without registering. Effective at the end of June 2022 we have not allowed guests this privilege anymore and guest must subscribe to post.  Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post.    Mahalo We also now have a mobile app for your device (currently this project has been paused). Why not join now since you have a better understanding of our privacy policy. 
    • Volunteer Benefits Volunteering has benefits not only in helping others but for the volunteer.  Watch the three videos on this page! An Active Member is one who has posted within the last thirty days and has full access to the RRDi website. An Inactive Member is one who has not posted in the last thirty days and is therefore restricted to guest privlieges of access to the site until such time as the member becomes active again and full access to the site is restored. Any SUBSCRIBED member is not restricted to post within thirty days. Volunteer Active Members may waive the subscription fee. If you want to have your membership as a volunteer active member and have the subscription fee waived use the fill out this form.  Volunteering Reduction From 1998 through 2005 there was an incredible volunteer spirit that drove the formation of the RRDi. Since 2005 the force that motivated so many to bring together rosacea sufferers into a grassroots non profit organization has dwindled to just a flickering wick. Why is it that rosaceans (rosacea sufferers) don't volunteer anymore?  Rosaceans have moved on to rosacea social media platforms.  Andy Seth, an entrepreneur, has a blog post, The Way We Think About Volunteering Is Dead Wrong, states, "research shows that the happiest volunteers are those who give 2 hours per week. That’s it. 2 hours."   Two Hours a Week If the RRDi could get any rosacean to volunteer 2 hours a weeks, that would be greatly appreciated, but also a miracle. Are there volunteers who actually volunteer two hours a week? There must be, otherwise the study is bogus. If we could get any RRDi member to just post their thought or experience with rosacea for 15 minutes a week that would be incredible. Volunteer to Post for 15 minutes We have dotted the RRDi forum with requests to RRDi members to simply post anything and the 1300 plus members as of this date are simply miniscule when it comes to posting. Getting our members to post is a challenge. If you have some insight how to get our members to post, we are all ears. You can reply to this post and comment to your heart's content. Of course, that is the issue, the RRDi members' hearts are not content to post. Why is that?  Feedback suggests that the Invision Community platform which we have been using since 2004 is not easy to use and rosaceans prefer social media platforms. Our answer to this is simple, watch this short video asking for volunteers to post on the RRDi social media accounts.  Win a Free Jar of the ZZ cream Demodex Solutions, one of our sponsors, has graciously allowed us to choose the best poster in a month and award the winning poster a free jar fo the ZZ cream. You want a free jar?  Follow these instructions.  Live Long and Prosper The research Mr. Seth referred to may have been the study commented on by the American Psychological Association that reports, "Volunteers lived longer than people who didn't volunteer if they reported altruistic values or a desire for social connections as the main reasons for wanting to volunteer, according to the study." This same study, Andrea Fuhrel-Forbis, the co-author concludes:  "It is reasonable for people to volunteer in part because of benefits to the self; however, our research implies that should these benefits to the self become the main motive for volunteering, they may not see those benefits."  Helper's High One of the benefits is what is called 'helper's high' which has been scientifically confirmed. [1] Of course, if a RRDi member who has rosacea helps another rosacea sufferer that would be the basis for receiving the 'helper's high.' Rosaceans helping rosaceans.  In trying to understand why volunteering amongst rosaceans has continued on this downward course, and googling this for an answer, The Guardian has an article about this subject and concluded, "But while the benefits of volunteering are clear, there is worrying evidence that the people who could benefit most from giving their time are precisely those least likely to be involved." The Current State of Volunteering Volunteer Match (which the RRDi has joined) has an article on this subject and states that the Bureau of Labor Statistics Report shows "that volunteer rates have been steadily declining for over a decade," [2] and comments, "There’s an endless supply of reasons that could explain why volunteer rates are falling. Last year, upon seeing the results, VolunteerMatch President Greg Baldwin argued that volunteer rates are falling because we as a nation don’t invest enough resources in the nonprofit sector. Without resources, nonprofits simply don’t have the capacity to effectively engage volunteers. Someone in the comments of that post argued that the falling rates can be attributed to the fact that more people are overworked with less time on their hands. Others say people are simply lazier than they used to be. I personally think it could be attributed to a shifting trend away from community involvement, due to the emergence of online communities, young people moving more often, and other factors." [3] In the above article mentioned [3] there are a number of comments and I think Ron from Florida's [April 16, 2016] comment is insightful:  "When I was younger, volunteering and giving back was part of life. It was something that we did and didn’t think twice about it. I don’t see that same philosophy these days. It’s to the point that schools here require some level of community service to complete your graduation requirements." Stem Learning reports, "It is suggested that stagnating volunteer numbers and in some areas, reducing numbers of volunteers, along with cuts made by local authorities falling disproportionately upon the volunteering sector funding, suggests a potential fall in people volunteering per se. Furthermore the 2015/16 Community Life survey, highlighted 14.2 million people formally volunteered at least once a month in 2014/15 and although rates are mostly unchanged, it appears irregular volunteering appear to show a 5% drop!" Carey Nieuwhof lists 6 REASONS YOU'RE LOSING HIGH CAPACITY VOLUNTEERS. I don't see how those six reasons are related to the RRDi, but I am all ears to anyone who can point out to me what the RRDi isn't doing or doing with regard to Carey's six reasons that we could improve. Our page on volunteering covers most of what Carey is discussing.  Without a doubt this explains the situation. Any thoughts on this subject would be much appreciated.  Online Volunteering Dr. Natalie Hruska says that the studies indicating a drop in volunteering over the past decade "do not factor in kinds of volunteerism today, like virtual volunteering" and writes there is "a necessity to redefine what volunteerism is and how we understand it today." [4] Volunteering Statistics "About 25 percent of Americans volunteered in 2015, according to federal data, compared to a global average of just 10 percent." [5] "The volunteering rate has declined slightly from 27 percent in 2002 despite the efforts of many American leaders..." [5] A Long and Winding Road Volunteering for the RRDi to help fellow rosaceans is a long and winding road that leads to your door, which is without a doubt, the most difficult door to open. Can you open that door and join us to find the cure for rosacea?   Volunteering for a Non Profit Organization You may want to read up on these subjects:     Social Media Posters or Moderators Needed Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post. End Notes [1] Helper's High: The Benefits (and Risks) of Altruism, Psychology Today [2] According to the 2015 report, 24.9% of the U.S. population over the age of 16 volunteered at least once in the past year. In 2011, this percentage was 26.8%, and in 2005 it was 28.8%.  "The volunteer rate declined by 0.4 percentage point to 24.9 percent for the year ending in September 2015..." VOLUNTEERING IN THE UNITED STATES — 2015, U.S. Bureau of Labor Statistics, Thursday, February 25, 2016 [3] The U.S. Volunteer Rate Is Still Dropping. Why?, Tess Srebro | March 25, 2016 | Industry Research | Engaging Volunteers, Volunteer Match [4] Dr. Natalie Hruska, April 12, 2016 POST to the article in end note 2. Dr. Hruska had a YouTube video that discussed online volunteering but it is no longer available. Dr. Hruska has written a book on this subject, Managing the First Global Technology: Reflections on a relevant application of the Internet, in Kindle or Paperback.  [5] How to get more Americans to volunteer, The Conversation Civil society organization workforce as a share of the economically active population, by country, 1995-2000, John Hopkins Center for Civil Society Studies
    • Ann Agric Environ Med. 2022 Jun 24;29(2):169-184. doi: 10.26444/aaem/141324. Epub 2021 Aug 31. ABSTRACT Despite a significant increase in reported cases of frontal fibrosing alopecia (FFA) in literature, discussion about the possible role of environmental factors, instruction for diagnosis and guideline for treatment, are limited. The review aims to provide a detailed synthesis of this condition that could be used by clinicians in their practise. Whether single-centre or multi-centre, studies of more than 60 cases less than 5 years old were mainly taken into consideration. Results obtained were that FFA affects mainly postmenopausal Caucasian women; the most common comorbidities are hyperlipidaemia, arterial hypertension, osteoporosis, hypothyroidism, depression, alongside dermatological disorders such as atopic dermatitis, rosacea, seborrheic dermatitis and androgenetic alopecia. Autoimmune, genetic, hormonal (e.g. estrogen deficiency, pregnancy, lactation, HRT and raloxifene) and environmental (e.g. daily use of facial sunscreens and less frequent use of hair dyes and shampoo) hypotheses were proposed for pathogenesis, as well as association with various predisposing factors (patient's health-social profile, disease's history and comorbidities). Clinical presentation of FFA can be divided into 3 specific patterns, each with a different prognosis. Diagnosis is usually made clinically with the use of trichoscopy; however, scalp biopsy remains the gold standard. The condition is regarded as a variant of lichen planopilaris (LPP) due to the similarity of the prominent histopathological findings, but the clinical image is distinct and therapeutic options vary. 5α-reductase inhibitors, intralesional steroids, and hydroxychloroquine provide the highest level of evidence for the treatment of FFA. The conclusion is that a better understanding of the disease is crucial for proper disease management. PMID:35767748 | DOI:10.26444/aaem/141324 {url} = URL to article
    • J Cosmet Dermatol. 2022 Jun 28. doi: 10.1111/jocd.15189. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin condition of varying severity that can significantly impact patient quality of life. Intense pulsed light (IPL) is an established treatment for rosacea-associated telangiectasia, inflammation, and erythema. This study assessed whether application of a phyto-corrective mask, gel, and resveratrol antioxidant serum after IPL treatment can improve outcomes and reduce procedure-related adverse effects. METHODS: In a prospective, open-label, split-face, 3-month study, 10 subjects with moderate to severe facial rosacea underwent IPL treatment on both sides of the face. The following were applied to the right side of the face only: phyto corrective mask once weekly starting immediately after IPL; phyto corrective gel twice daily; and resveratrol antioxidant treatment at night. Both sides of the face were treated with sunscreen. Subjects were assessed on Day 1, 1 and 3 months after IPL by three, independent evaluators using the 5-point Global Aesthetic Improvement Scale (GAIS). All subjects rated skin redness, hydration and overall improvement on Day 1 and completed a patient satisfaction questionnaire at the 1- and 3-month visits. RESULTS: Ten women were enrolled, aged 44-72 years old, with moderate (n=6) to severe (n=4) rosacea. IPL was effective at reducing symptoms with rosacea classified as absent in 5 women and mild in 5 at the final 3-month visit. GAIS scores also revealed improvements on both sides of the face, but the skincare treated side showed continuous improvement over 3 months with all patients remaining at least 'Improved', whereas there appeared to be a waning effect after 1 month following with IPL alone. On Day 1 after IPL, all women reported less redness, improved hydration and improved skin appearance on the right side of the face. Patient satisfaction was consistently rated higher on the right side of the face. CONCLUSION: Application of a phyto-corrective mask, gel, and resveratrol antioxidant serum may complement IPL treatment for rosacea by enhancing treatment outcomes and reducing procedure-related symptoms. PMID:35765796 | DOI:10.1111/jocd.15189 {url} = URL to article
    • Antibiotics (Basel). 2022 May 27;11(6):722. doi: 10.3390/antibiotics11060722. ABSTRACT Tetracycline class antibiotics are widely used for multiple skin diseases, including acne vulgaris, acne rosacea, cutaneous infections, inflammatory dermatoses, and autoimmune blistering disorders. Concerns about antibiotic resistance and protecting the human/host microbiome beg the question whether broad-spectrum tetracyclines such as doxycycline and minocycline should be prescribed at such a high rate by dermatologists when a narrow-spectrum tetracycline derivative, sarecycline, exists. We evaluated the clinical effectiveness of oral sarecycline against cutaneous staphylococcal infections, eyelid stye, and mucous membrane pemphigoid to determine whether sarecycline is a viable option for clinicians to practice improved antibiotic stewardship. We observed significant improvement in staphylococcal infections and inflammatory dermatoses with courses of oral sarecycline as short as 9 days, with no reported adverse events. These clinical findings are consistent with in vitro microbiological data and anti-inflammatory properties of sarecycline. Our data provides a strong rationale for clinicians to use narrow-spectrum sarecycline rather than broad-spectrum tetracyclines as a first-line agent in treating staphylococcal skin infections and inflammatory skin diseases for which tetracyclines are currently commonly employed. Such advancement in the practice paradigm in dermatology will enhance antibiotic stewardship, reduce risk of antibiotic resistance, protect the human microbiome, and provide patients with precision medicine care. PMID:35740129 | PMC:PMC9220064 | DOI:10.3390/antibiotics11060722 {url} = URL to article More Information on Sarecycline (requires subscription)
    • Actas Dermosifiliogr. 2022 Jun;113(6):T550-T554. doi: 10.1016/j.ad.2022.05.008. Epub 2022 May 10. ABSTRACT BACKGROUND AND OBJECTIVE: Rosacea is a chronic acneiform skin disorder in which impaired skin barrier function can lead to sensitization to allergens. We aimed to analyze contact allergies in our patients with rosacea. MATERIAL AND METHODS: Retrospective cohort study of all patients who underwent patch testing in our skin allergy clinic between May 1991 and May 2019. RESULTS: A total of 200 patients with rosacea were referred to our clinic for patch testing during the study period; they represented 2.1% of all patch tested patients in the period. Eighty-one percent were women (mean age, 44.7years). At least 1 positive patch test was recorded for 46.5%; 15% were of current relevance. The most frequent positive reaction was to nickel (26%), followed by cobalt chloride (6.5%), isothiazolinones (6%), p-phenylenediamine (5.5%), fragrance mix II (5%), and thimerosal (3.5%). The most common currently relevant patch test reactions were to isothiazolinones in 10 of the 200 patients (5%); to phenylenediamine, fragrance mix II, and toluensulfonamide formaldehyde resin in 4 patients (2%) each; and to tixocortol and fragrance mix I in 2 patients (1%) each. The allergen groups most often implicated were metals (of current relevance in 12.6%) and drugs (of current relevance in 25.8%). Preservatives and fragrances were the next most common allergen groups, and 70.8% and 43.7% of the positive reactions in these groups, respectively, were of current relevance. Cosmetics were the most frequent source of sensitization, followed by topical medications-notably corticosteroids and antifungal agents. CONCLUSIONS: We emphasize the high prevalence of allergic contact dermatitis in patients with rosacea, a finding which supports patch testing, especially if eruptions worsen when these patients use cosmetics and topical medications. PMID:35748000 | DOI:10.1016/j.ad.2022.05.008 {url} = URL to article More information on Sensitive Skin and Rosacea (requires subscription)
    • PLoS One. 2022 Jun 23;17(6):e0270268. doi: 10.1371/journal.pone.0270268. eCollection 2022. ABSTRACT PURPOSE: To compare the safety and efficacy of intense pulsed light (IPL) followed by meibomian gland expression (MGX), against monotherapy of MGX. METHODS: Patients with moderate to severe meibomian gland dysfunction (MGD) were 1:1 randomized to 4 sessions of intense pulse light + MGX at 2-week intervals, or 4 sessions of Sham + MGX at 2-week intervals. Both patients and examiners were blinded to the allocation. Outcome measures, evaluated at the baseline (BL) and at a follow-up (FU) conducted 4 weeks after the last IPL session, included fluorescein tear breakup time (TBUT) as the primary outcome measure, OSDI (Ocular Surface Disease Index) questionnaire, Eye Dryness Score (EDS, a visual analog scale (VAS)-based questionnaire), Meibomian gland score (MGS, a score of meibum expressibility and quality in 15 glands on the lower eyelid), daily use of artificial tears, and daily use of warm compresses. In addition, during each treatment session, the number of expressible glands was counted in both eyelids, the predominant quality of meibum was estimated in both eyelids, and the level of pain/discomfort due to MGX and IPL was recorded. RESULTS: TBUT increased from 3.8±0.2 (μ±standard error of mean (SEM)) to 4.5±0.3 seconds in the control arm, and from 4.0±0.2 to 6.0±0.3 in the study arm. The difference between arms was statistically significant (P < .01). Other signs/symptoms which improved in both arms but were greater in the study arm included MGS (P < .001), EDS (P < .01), the number of expressible glands in the lower eyelids (P < .0001) and upper eyelid (P < .0001), the predominant meibum quality in the lower eyelid (P < .0001) and upper eyelid (P < .0001), and the level of pain due to MGX (P < .0001). Outcome measures which improved in both arms with no significant differences between the two were OSDI (P = .9984), and the daily use of artificial tears (P = .8216). Meibography, daily use of warm compresses, and severity of skin rosacea did not show statistically significant changes in either arm. No serious adverse events were observed. There was a slight tendency for more adverse events in the control group (P = 0.06). CONCLUSIONS: The results of this study suggest that, in patients with moderate to severe symptoms, combination therapy of intense pulse light (IPL) and meibomian gland expression (MGX) could be a safe and useful approach for improving signs of dry eye disease (DED) due to meibomian gland dysfunction (MGD). Future studies are needed to elucidate if and how such improvements can be generalized to different severity levels of MGD. PMID:35737696 | PMC:PMC9223330 | DOI:10.1371/journal.pone.0270268 {url} = URL to article More information on Dry Eye Disease (requires subscription)
    • Dermatology: how to manage rosacea in skin of colour Drugs Context. 2022 May 31; Khalad Maliyar, Sonya J Abdulla
    • Dermatology: how to manage rosacea in skin of colour Drugs Context. 2022 May 31; Khalad Maliyar, Sonya J Abdulla
    • Rosacea in skin of color: A comprehensive review. Indian J Dermatol Venereol Leprol. 2020 Oct 27;: Authors: Sarkar R, Podder I, Jagadeesan S
    • Global Epidemiology and Clinical Spectrum of Rosacea, Highlighting Skin of Color: Review and Clinical Practice Experience. J Am Acad Dermatol. 2018 Sep 18;: Authors: Alexis AF, Callender VD, Baldwin HE, Desai SR, Rendon MI, Taylor SC
    • Drugs Context. 2022 May 31;11:2021-11-1. doi: 10.7573/dic.2021-11-1. eCollection 2022. ABSTRACT Rosacea is a common inflammatory skin disorder affecting the face. Common cutaneous symptoms include papules, pustules, persistent centrofacial erythema, telangiectasias, recurrent flushing, phymatous changes and a variety of ocular manifestations. Previous epidemiological studies have demonstrated that the incidence of rosacea is much lower in people with darker Fitzpatrick phototypes compared to fair-skinned individuals. In patients with darker skin, the centrofacial erythema can be masked and difficult to appreciate, impacting the ability for providers to make diagnoses and leading to misdiagnoses. Thus, it is difficult to say with certainty that the disparities in prevalence in rosacea amongst fair-skinned and darker individuals are true. The primary aim of this article is to raise awareness that rosacea is a global disease and to provide healthcare professionals with strategies to identify and manage rosacea amongst individuals with skin of colour. PMID:35720055 | PMC:PMC9165629 | DOI:10.7573/dic.2021-11-1 {url} = URL to article Global Epidemiology and Clinical Spectrum of Rosacea, Highlighting Skin of Color: Review and Clinical Practice Experience.    
    • Biomed Pharmacother. 2022 Jun 16;153:113292. doi: 10.1016/j.biopha.2022.113292. Online ahead of print. ABSTRACT Rosacea is a common chronic facial inflammatory disease that affects millions of people worldwide. Due to the unclear etiology of rosacea, effective treatments are limited. Celastrol, a plant-derived triterpene, has been reported to alleviate inflammation in various diseases. However, whether celastrol exerts protective effects in rosacea remains to be elucidated. In this study, weighted gene co-expression network analyses (WGCNA) were performed. Hub modules closely related to rosacea clinical characteristics were identified and found to be involved in inflammation- and angiogenesis-related signaling pathways. Then, the pharmacological targets of celastrol were predicted using the TargetNet and Swiss Target Prediction databases. A GO analysis indicated that the biological process regulated by celastrol highly overlapped with the pathogenic biological processes in rosacea. Next, we showed that celastrol ameliorated erythema, skin thickness and inflammatory cell infiltration in the dermis of LL37-treated mice. Celastrol suppressed the expression of rosacea-related inflammatory cytokines and inhibited the Th17 immune response and cutaneous angiogenesis in LL37-induced rosacea-like mice. We further demonstrated that celastrol attenuated LL37-induced inflammation by inhibiting intracellular-free calcium ([Ca2+]i)-mediated mTOR signaling in keratinocytes. Chelating intracellular Ca2+ with BAPTA/AM potentiated celastrol-induced repression of LL37-induced p-S6 elevation. The mTOR agonist MHY1485 dramatically reinforced LL37-induced rosacea-like characteristics, while celastrol attenuated these outcomes. Moreover, celastrol inhibited LL37-activated NF-κB in a mTOR signaling-dependent manner. In conclusion, our findings underscore that celastrol may be a rosacea protective agent by inhibiting the LL37-activated Ca2+/CaMKII-mTOR-NF-κB pathway associated with skin inflammation disorders. PMID:35717785 | DOI:10.1016/j.biopha.2022.113292 {url} = URL to article
    • Pediatr Dermatol. 2022 Jun 14. doi: 10.1111/pde.15036. Online ahead of print. ABSTRACT BACKGROUND/OBJECTIVES: We observed isolated cases of perialar intertrigo in children and teenagers that did not appear to correspond to any known clinical entity. The objective of this study was to describe the clinical features of this dermatosis and the clinical characteristics of the patients. METHODS: We conducted a prospective, multicenter cohort study in France from August 2017 to November 2019. All the patients under 18 years of age with chronic perinasal intertrigo were included. A standardized questionnaire detailing the clinical characteristics of the patients and the description of the intertrigo. If possible, a Wood's lamp examination of the intertrigo was done. RESULTS: Forty-one patients were included (25 boys and 16 girls, average age: 12.1 years). Intertrigo was bilateral in 38 patients (93%). The majority of patients had no symptoms (54%). Pruritus was present in 39% of cases. Orange red follicular fluorescence was present in the perialar region on Wood's light examination in 78% of cases with active fluorescence. The presumptive diagnoses suggested by the investigators were acne (24.4%), seborrheic dermatitis (19.5%), rosacea (9.8%), psoriasis (9.8%) and perioral dermatitis (7.3%). No diagnosis was proposed in 22% of the cases. CONCLUSIONS: We describe a previously undescribed clinical sign which is characterized by a chronic bilateral erythematous intertrigo located in the perialar region. It can be isolated or associated with various facial dermatoses. PMID:35699273 | DOI:10.1111/pde.15036 {url} = URL to article
    • Watch the full version • Dr. Tara 
    • If you can donate one dollar a month by subscribing to the RRDi for one yea as an active member this should be enough to keep the RRDi going. Please seriously consider this. Thanks.  If you can only donate for one month we request $2 since that helps with the PayPal fee. 
    • Clin Cosmet Investig Dermatol. 2022 Jun 2;15:1029-1036. doi: 10.2147/CCID.S367545. eCollection 2022. ABSTRACT BACKGROUND: The biomarker to predict the depression in patients with rosacea was absent. OBJECTIVE: We aimed to explore the potential association between BDNF and depression in patients with rosacea, and also to determine whether serum BDNF level is a potential biomarker for identifying depression in patients with rosacea. METHODS: The patients with rosacea, rosacea with depression and healthy control were included, clinical evaluation (DLQI, RSSs, BDI-II) and serum BDNF levels detection were performed on subjects, the comparisons and correlation analysis of the obtained data were performed. RESULTS: In clinical evaluation, whether DLQI or RSSs, rosacea with depression group was significantly higher compared to rosacea group. Besides, we found the serum BDNF levels were lower in patients with rosacea and rosacea with depression compared to healthy controls, also in the rosacea with depression group, serum BDNF levels were lower than in rosacea patients. Whatever in rosacea or rosacea with depression group, the statistical significance of serum BDNF levels between the different subtypes like the ETR and PPR was not found. In further correlation analysis, we found no correlation between serum BDNF and RSSs in patients with rosacea whatever the subtype of ETR or PPR. Interestingly, we found a negative correlation between serum BDNF levels and BDI-II in rosacea with depression group, the decreased serum BDNF levels were associated with the increased BDI-II, also the ROC confirmed it can evaluate the depression in patients with rosacea. CONCLUSION: Serum BDNF level is a potential biomarker for identifying depression in patients with rosacea. PMID:35677222 | PMC:PMC9170175 | DOI:10.2147/CCID.S367545 {url} = URL to article
    • JAMA Dermatol. 2022 Jun 8:e221891. doi: 10.1001/jamadermatol.2022.1891. Online ahead of print. ABSTRACT IMPORTANCE: Topical formulations of tretinoin precursors (retinol and its ester derivatives) are widely available over the counter and may offer similar clinical benefits to those of tretinoin for treatment of photoaging. However, which of the many purported molecular effects of retinoids most strongly drives clinical improvements in tretinoin-treated skin remains unclear. OBJECTIVES: To evaluate the clinical efficacy of topical tretinoin precursors (TTP) vs tretinoin (RA) in treating moderate to severe facial photodamage and to identify potential biomarkers that correlate with clinical efficacy. DESIGN, SETTING, AND PARTICIPANTS: This randomized, double-blind, single-center, parallel-arm study of 24 patients with moderate to severe facial photodamage was conducted at an academic referral center from November 2010 to December 2011, with data analysis performed from January 2012 to December 2021. INTERVENTIONS: Daily topical application of 0.02% RA or 1.1% TTP formulation containing retinol, retinyl acetate, and retinyl palmitate for 24 weeks. MAIN OUTCOMES AND MEASURES: Photoaging and tolerability were assessed by dermatologist evaluations and patient-reported outcomes. Target gene expression was assessed by real-time quantitative polymerase chain reaction of biopsied tissue from treated areas. RESULTS: A total of 20 White women were ultimately analyzed (9 randomized to TTP, 11 randomized to RA). At week 24, there was no significant difference in Griffiths photoaging scores among patients receiving TTP vs RA (median, 4 vs 5) (TTP - RA difference: -1; 95% CI, -2 to 1; P = .27). Treatment with TTP was associated with erythema 6 times less frequently than RA (11% vs 64%) (TTP - RA difference: -0.53; 95% CI, -0.88 to -0.17; P = .01). Target gene analysis showed significant CRABP2 messenger RNA (mRNA) induction (confirming retinoic acid receptor signaling) but no significant changes in procollagen I or MMP1/3/9 mRNA in TTP-treated samples. Instead, MMP2 mRNA, which encodes a type IV collagenase, was significantly reduced in TTP-treated samples (week 24 - baseline mRNA difference: -5; 96% CI, -33 to 1.6; P = .02), and changes in MMP2 were strongly correlated with changes in fine wrinkles (r = 0.54; 95% CI, 0.12 to 0.80; P = .01). Interestingly, patients with severe baseline wrinkles exhibited greater improvements (r = -0.74; 95% CI, -0.89 to -0.43; P < .001). This trend was mirrored in MMP2 mRNA, with initial expression strongly predicting subsequent changes (r = -0.78; 95% CI, -0.89 to -0.43; P < .001). CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, there was no significant difference in efficacy between this particular formulation of TTP and tretinoin 0.02%. However, the results of these mechanistic studies highlight MMP2 as a possible mediator of retinoid efficacy in photoaging. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01283464. PMID:35675051 | PMC:PMC9178500 | DOI:10.1001/jamadermatol.2022.1891 {url} = URL to article
    • J Drugs Dermatol. 2022 Jun 1;21(6):574-580. doi: 10.36849/JDD.6838. ABSTRACT BACKGROUND: While rosacea is a common inflammatory condition that affects diverse populations, published data in skin of color (SOC) are limited. This review explored nuances in clinical presentation and treatment considerations in SOC patients with rosacea and the role of cleansers and moisturizers in the management of rosacea in these populations. METHODS: A panel reviewed and discussed aspects of rosacea in SOC and possible implications for treatment and maintenance. The outcome of these discussions, coupled with the panel's expert opinion and experience was used to define draft statements. After group discussions and an online review process, the panel agreed on the inclusion and wording of five statements. RESULTS: Studies and anecdotal clinical experience suggest that rosacea is more common in SOC populations than previously reported. The clinical presentation of rosacea across diverse skin types includes the spectrum of clinical subtypes observed in other populations; however, clinical features may be less conspicuous in individuals with higher skin phototypes and the index of suspicion may be lower in SOC populations. To avoid underdiagnosis, dermatologists should consider rosacea in the differential diagnosis of any patient presenting with a history of skin sensitivity, central facial erythema, papules, and pustules. The compromised barrier in rosacea contributes to skin sensitivity. Studies including Chinese rosacea patients showed that using a moisturizer and sunscreen negatively correlated with rosacea development. CONCLUSIONS: The use of skincare could improve rosacea symptomatology. These products are recommended before and during prescription therapy and as part of a maintenance regimen as adjuncts. J Drugs Dermatol. 2022;21(6):574-580. doi:10.36849/JDD.6838. PMID:35674765 | DOI:10.36849/JDD.6838 {url} = URL to article
    • A report indicates the following about the 'choice of vehicle' in treating rosacea:  "The choice of vehicle is an important consideration in the treatment of acne and rosacea." [1] For example, some report irritation using the Cetaphil 'Basis for Vehicle' using Soolantra. [2] Some treatment vehicles cause not only irritability but also dryness or other issues that are termed 'adverse events' (AEs). This same report puts it succinctly:  "Although topical therapy should avoid AEs associated with systemic medication administration, the efficacy, safety, and tolerability of topical therapy is influenced by percutaneous penetration, retention at the target for a sufficient time to obtain the desired therapeutic effect, and avoidance of adverse local reactions that may affect adherence. It has been noted that the drug product is only one of multiple components that determine the efficacy and tolerability of topically applied therapies such that the performance of a topical medication is also influenced by characteristics of the vehicle formulation that may influence penetration, permeation, irritancy, and patient preference." [1] The report "summarizes drug delivery systems that have been developed with the aim of improving outcomes for patients being treated for either acne or rosacea." [1] "In liquid and gel formulations, the bulk excipient that serves as a medium for conveying the active ingredient is usually called the vehicle. Petrolatum, dimethyl sulfoxide and mineral oil are common vehicles." [3] End Notes  [1] J Clin Aesthet Dermatol. 2022 May; 15(5): 36–40. Enhancing Topical Pharmacotherapy for Acne and Rosacea: Vehicle Choices and Outcomes Lawrence J. Green, MD and Edward Lain, MD [2] Soolantra Mechanism of Action & Basis for the Vehicle (requires subscription) [3] Excipient, Vehicles - Wikipedia
    • Eur J Dermatol. 2022 Jan 1;32(1):138-139. doi: 10.1684/ejd.2022.4236. NO ABSTRACT PMID:35653084 | DOI:10.1684/ejd.2022.4236 {url} = URL to article
    • J Dermatolog Treat. 2022 Jun 2:1-13. doi: 10.1080/09546634.2022.2079598. Online ahead of print. ABSTRACT Background: Since medication absorption through the skin and eye tissue seems similar, commercially available eye-drops could be used to treat skin diseases when topical therapies are unavailable or unaffordable. The FDA-approved and off-label applications of various eye drops used as topical treatments in dermatological clinical practice were highlighted in this review.Methodology: A thorough PubMed and Google Scholar library search using various combinations of the keywords (Eye drop, ocular solution, conjunctival installation, and skin diseases, topical, local, beta-blockers, prostaglandin, cyclosporin, apraclonidine, atropine, oxymetazoline).Results and conclusions: Based on the findings of the studies reviewed, timolol is highly recommended for infantile hemangioma and other vascular skin conditions such as angiomas, Kaposi sarcoma, acne, rosacea, and wound healing. Bimatoprost is a drug that can be used to treat hypotrichosis of any kind, as well as mild localized alopecia areata and leukoderma. Oxymetazoline ispromising for treating facial erythema. We recommend apraclonidine for mild upper eyelid ptosis induced botulinum neurotoxin. We don't recommend atropine for hyperhidrosis, although it can help with hydrocystomas and pruritis produced by syringomas. Tobramycin will need to be tested in RCTs before it can be confirmed as a viable alternative to systemic treatments for treating green nail syndrome. PMID:35652324 | DOI:10.1080/09546634.2022.2079598 {url} = URL to article
    • The RRDi used to have a sister site relationship with the Rosacea Forum (RF), since one of our board members founded RF. David Pascoe, owner of Rosacea Support(RS), took over RF a while back. For many, many years, the RRDi and RF never had any advertisements like RS has done for years. Recently, in the past month or so, David has chosen to put advertisements on RF to help pay the bills since hosting a forum like RF is an expensive endeavor. As David points out in his reasons why he did this in this thread, the RRDi is in a similar situation and need donations to keep paying the bills which as everyone has noticed their bills are inflating and price increases on hosting are also feeling the crunch. The Invision Community platform which we have chosen to use since 2006 increased their hosting price this year by over 500%. The RRDi has chosen to resolve this with switching to a subscription based website. To access 95% of our rosacea data will require a minimum of at least $2 for one month's access or $3 for three months access. We hope this is the solution. The other option is to do as David has done with RF and put advertisements all over the website while browsing for rosacea data in the hope that these advertisements generate enough revenue to keep the site going. A third option is to have some rich donor sponsor the RRDi to keep the lights on. We still allow free posting here in our guest forum, so you can post a question about rosacea or make a comment about rosacea in our guest forum without registering and can hide behind a cryptic display name and no one ever knows who you are. Or you can donate a small donation either $2 or $3 and gain access to a wealth of rosacea data as a subscribed member. The RRDi would like some feedback in our decision to switch to a subscription based member forum. Why not find the REPLY TO THE TOPIC button and hide yourself behind a cryptic display name of your choice and tell us what you think?  
    • Skin Res Technol. 2022 May 29. doi: 10.1111/srt.13171. Online ahead of print. ABSTRACT BACKGROUND: The neural basis of rosacea is not well understood. This study aimed to determine whether cerebral glucose metabolism (CGM) changes on 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography (PET)/computed tomography (CT) scans can detect functional network changes in specific brain areas in patients with rosacea. MATERIALS AND METHODS: Eight adults with rosacea and 10 age/sex-matched healthy adults (controls) were enrolled in the study. 18 F-FDG PET/CT brain images for all eight patients and whole-body images for two of the patients were analyzed qualitatively and semi-quantitatively. Differences between the study groups were examined using Fischer's exact test and a Student's t-test. A voxel-based analysis using statistical parametric mapping was performed to compare the brain metabolism of the patients with that of the controls. RESULTS: Compared with the controls, the patients with rosacea showed extensive changes in the CGM signals in the cerebral cortex and limbic system, with less CGM shown in the right superior parietal lobule, right postcentral gyrus, right parahippocampal gyrus, left superior frontal gyrus, and lateral posterior thalamic nucleus and more CGM in the right precentral gyrus, left inferior frontal gyrus, and cerebellar tonsil. No dysmetabolic lesions were found in the whole-body 18 F-FDG PET/CT images. CONCLUSION: Specific neural functional changes occur in patients with rosacea that may explain its pathogenesis. PMID:35644027 | DOI:10.1111/srt.13171 {url} = URL to article
    • J Invest Dermatol. 2022 May 26:S0022-202X(22)00403-1. doi: 10.1016/j.jid.2022.05.005. Online ahead of print. ABSTRACT Cathelicidin LL-37-mediated activation of mast cells (MCs) has been implicated in the pathogenesis of rosacea, but the receptor involved and the mechanism of its activation and regulation remain unknown. We found that skin biopsies from rosacea patients display higher frequencies of MCs expressing Mas-related G protein-coupled receptor (GPCR)-X2 (MRGPRX2; mouse counterpart MrgprB2) when compared to normal skin. Intradermal injection of LL-37 in wild-type (WT) mice resulted in MC recruitment, expression of inflammatory mediators and the development of rosacea-like inflammation. These responses were substantially reduced in MrgprB2-/- mice and abolished in MC deficient Wsh/Wsh mice. βarrestin2 is an adaptor protein that regulates GPCR function by receptor desensitization and also by activation of downstream signaling. We found that LL-37-induced rosacea-like inflammation was significantly reduced in mice with MC-specific deletion of βarrestin2 when compared to control mice. Interestingly, absence of βarrestin2 resulted in enhanced cofilin phosphorylation and substantial inhibition of LL-37-induced chemotaxis of mouse peritoneal MCs (PMCs). Furthermore, LL-37-induced ERK1/2 phosphorylation, NF-κB activation and proinflammatory cytokine/chemokine production were reduced in βarrestin2-/- PMCs when compared to WT cells. These findings suggest that MRGPRX2/B2 participates in rosacea and βarrestin2 contributes to its pathogenesis by promoting cofilin dephosphorylation, ERK1/2 and NF-κB phosphorylation, MC chemotaxis and chemokine/cytokine generation. PMID:35644498 | DOI:10.1016/j.jid.2022.05.005 {url} = URL to article
    • Actas Dermosifiliogr. 2022 Apr;113(4):435-438. doi: 10.1016/j.ad.2020.04.014. Epub 2021 Jul 26. NO ABSTRACT PMID:35644625 | DOI:10.1016/j.ad.2020.04.014 {url} = URL to article
    • Postepy Dermatol Alergol. 2022 Apr;39(2):321-326. doi: 10.5114/ada.2021.106028. Epub 2021 Jul 16. ABSTRACT INTRODUCTION: Demodex mites are common human ectoparasites found across a broad geographical range. They reside in pilosebaceous units of the skin and feed on sebum, epithelial and glandular cells. D. folliculorum is the more common mite, inhabiting the upper end of the pilosebaceous unit while D. brevis resides deeper in the skin and meibomian glands. Until now, Demodex mites have been obtained by various techniques such as skin scraping, cellophane tape, plucking eyelashes, and also by invasive biopsies. AIM: To assess whether non-invasively collected sebum samples of patients suspected of rosacea or demodicosis are suitable for NGS DNA Demodex analysis. MATERIAL AND METHODS: Suspicion of seborrheic dermatitis or rosacea was the inclusion criterion. The study group consisted of 20 males, 1 female, age: 33-83, median: 58. Nasal dorsum was moisturized and an adhesive strip was applied. DNA was isolated from the sebum and sequenced with the use of MiSeq® Reagent Kit v2 and MiSeq® System. RESULTS: Out of 7 patients who were positive by microscopy, 6 were found positive by NGS. Additional 4 patients were found positive only by NGS, adding to a total of ten. The NGS approach showed superior sensitivity compared to light microscopy (63% and 44%, respectively). In 3 patients, both Demodex species were identified by NGS. CONCLUSIONS: We believe to have proven that it is possible to study Demodex mites by NGS with sebum as the input sample. Furthermore, it is possible to identify and distinguish Demodex folliculorum from D. brevis in individual patients. PMID:35645689 | PMC:PMC9131945 | DOI:10.5114/ada.2021.106028 {url} = URL to article
    • J Clin Aesthet Dermatol. 2022 May;15(5):36-40. ABSTRACT The choice of vehicle is an important consideration in the treatment of acne and rosacea. Agents used to treat these common conditions may be limited by multiple factors, including poor stability during storage, limited residence time in the skin and follicular unit, and high potential for skin irritation. Novel drug delivery systems have been developed to address these problems, including microencapsulation, liposomal encapsulation, and the use of a variety of nanocarriers. New vehicle technologies for acne and rosacea treatments have appeared over the past 20 years and have somewhat improved stability, tolerability, and possibly efficacy. One of the latest vehicle technologies in acne and rosacea to enhance efficacy, stability, and tolerability is microencapsulation of benzoyl peroxide and tretinoin, which resulted in significant efficacy and good tolerability in patients with each of these two diseases. Other new vehicle technologies include a polymeric form of tretinoin and a microsphere product that combines tretinoin plus clindamycin. It is likely that there will be more reports of clinical success as experience with the rapidly evolving delivery technologies increases. This review summarizes drug delivery systems that have been developed with the aim of improving outcomes for patients being treated for either acne or rosacea. It also focuses, where possible, on formulations that have been evaluated in clinical studies. PMID:35642224 | PMC:PMC9122274 {url} = URL to article
    • There are simply two sub forums available to guests:  Guests or Feedback  Subscribed Members  To view the vast amount of rosacea topics you will need to subscribe. You may be having issues trying to navigate our website using a mobile device so here is a helpful tutorial to find Rosacea Topics. Watch Video. You will have to register as a member to view some of the content below.  Step one - Finding the Menu on the Home page (iOS - hopefully Android users are similar) - Look for the three bars top right corner (click):  You should then see the following menu:  Just under the HOME button find the NAVIGATOR button and click on it and you should see the following menu:  The first word 'Navigator' is simply the title of this menu (don't click on it). The menu choices are now shown below this word, 'Navigator,' and you should begin scrolling down till you see the following:  The menu button ROSACEA TOPICS is the second to the last choice. Click on ROSACEA TOPICS which brings you to the following screen:  You may want to turn your mobile device horizontally to view the videos and subforums and scroll down to see all the choices:  Now you can view the subforums but you are not allowed to enter a subforum without being a member of the RRDi. Membership requires a subscription and all you do register and then you can view over 7K posts and over 5.4K rosacea topics. Learn more. Hope this helps mobile device users on how to navigate our website. If you have questions, find the reply to this topic button and ask. 
    • Biomedicines. 2022 Apr 30;10(5):1037. doi: 10.3390/biomedicines10051037. ABSTRACT Evidence has shown that gut microbiome plays a role in modulating the development of diseases beyond the gastrointestinal tract, including skin disorders such as psoriasis. The gut-skin axis refers to the bidirectional relationship between the gut microbiome and skin health. This is regulated through several mechanisms such as inflammatory mediators and the immune system. Dysregulation of microbiota has been seen in numerous inflammatory skin conditions such as atopic dermatitis, rosacea, and psoriasis. Understanding how gut microbiome are involved in regulating skin health may lead to development of novel therapies for these skin disorders through microbiome modulation, in particularly psoriasis. In this review, we will compare the microbiota between psoriasis patients and healthy control, explain the concept of gut-skin axis and the effects of gut dysbiosis on skin physiology. We will also review the current evidence on modulating gut microbiome using probiotics in psoriasis. PMID:35625774 | DOI:10.3390/biomedicines10051037 {url} = URL to article LEARN MORE ABOUT GUT ROSACEA
    • Life (Basel). 2022 May 12;12(5):725. doi: 10.3390/life12050725. ABSTRACT For a long time, skin was thought to be no more than the barrier of our body. However, in the last few decades, studies into the idea of skin as an independent functional organ have gradually deepened our understanding of skin and its functions. In this review, we gathered evidence that presented skin as a "trinity" of neuro-endocrine-immune function. From a neuro perspective, skin communicates through nerves and receptors, releasing neurotrophins and neuropeptides; from an endocrine perspective, skin is able to receive and secrete most hormones and has the cutaneous equivalent of the hypothalamic-pituitary-adrenal (HPA) axis; from an immune perspective, skin is protected not only by its physical barrier, but also immune cells and molecules, which can also cause inflammation. Together as an organ, skin works bidirectionally by operating peripheral neuro-endocrine-immune function and being regulated by the central nervous system, endocrine system and immune system at the same time, maintaining homeostasis. Additionally, to further explain the "trinity" of cutaneous neuro-endocrine-immune function and how it works in disease pathophysiology, a disease model of rosacea is presented. PMID:35629392 | DOI:10.3390/life12050725 {url} = URL to article
    • Medicina (Kaunas). 2022 May 11;58(5):651. doi: 10.3390/medicina58050651. ABSTRACT Background and objectives: Facial telangiectasias are dilated blood vessels that can represent a cosmetic issue for patients. They may be associated with other conditions, such as rosacea. Laser and light treatments are nowadays becoming a cornerstone in the management of these lesions. Materials and Methods: In total, 68 patients seeking medical treatment for facial telangiectasias were enrolled from 1 March 2019 to 1 March 2020 at the Dermatological Unit of Magna Graecia University (Catanzaro, Italy). A protocol consisting of a 1064 Nd:YAG laser for darker blue telangiectasias and 532 nm Nd:YAG for red lesions followed by intense pulsed light with an optimized spectrum for vascular lesion 3 weeks after the first procedure was proposed. A three-month follow-up visit assessed patient's satisfaction using a visual analog scale (VAS). Two dermatologists measured clinical results using a 4-point scale, comparing pictures before treatment and at follow-up. Results: A total of 68 patients (32 males and 36 females) completed the study, performing all requested treatments. No severe side effects were reported. Patient satisfaction was very high (8.15 ± 1.05 out of a 10-point VAS scale), as well as dermatologists' clinical evaluations (2.19 ± 0.74 out of 3). Conclusions: The combination of vascular lasers and Vascular Intense Pulsed Light acting specifically on small blood vessels may help to improve the aesthetic outcome, reducing side effects. A prospective study with a larger number of participants will be necessary to confirm this study's findings. PMID:35630068 | DOI:10.3390/medicina58050651 {url} = URL to article
    • Molecules. 2022 May 13;27(10):3143. doi: 10.3390/molecules27103143. ABSTRACT Botulinum toxin (BoNT) is a neurotoxin produced by the Clostridium botulinum bacteria. Among seven different isoforms, only BoNT-A and BoNT-B are commercially used. Currently, botulinum toxin has been indicated by the U.S. Food and Drug Administration in several disorders, among others: chronic migraine, hyperhidrosis, urinary incontinence from detrusor overactivity, or cosmetics. However, there are numerous promising reports based on off-label BTX usage, indicating its potential effectiveness in other diseases, which remains unknown to many. Among them, dermatological conditions, such as rosacea, annal fissure, Raynaud phenomenon, hypertrophic scars and keloids, and also hidradenitis suppurativa, are currently being investigated. This article aims to provide a comprehensive update on the off-label use of botulinum toxin in dermatology, based on an analysis and summary of the published literature. PMID:35630620 | DOI:10.3390/molecules27103143 {url} = URL to article
    • "Meet Demodex, the face mite, a microscopic arachnid that lives on human skin. The pore is its humble abode and the waxy sebum we secrete is its meal of choice. It's hard to know for sure, but there are likely many thousands of mites living on our faces at any given time, as BBC Reel's Melissa Hogenboom explores." There are thousands of mites living on your face, BBC More Information on Demodex
    • JAAD Case Rep. 2022 Apr 23;24:59-60. doi: 10.1016/j.jdcr.2022.04.003. eCollection 2022 Jun. NO ABSTRACT PMID:35619595 | PMC:PMC9127103 | DOI:10.1016/j.jdcr.2022.04.003 {url} = URL to article
    • Ann Med. 2022 Dec;54(1):1530-1537. doi: 10.1080/07853890.2022.2077427. ABSTRACT BACKGROUND: Though the previous genome-wide association studies found the association between HLA alleles and rosacea in the European populations, the data is lacking among the Asians. Moreover, neutrophils are important in the immune-related mechanism of rosacea, and dyslipidemia is closely related to rosacea. We aimed to explore the association between HLA genes and rosacea in Chinese rosacea patients, as well as the mediation effect of neutrophils, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) on the relationship between HLA genes and rosacea. METHODS: A total of 249 rosacea and 150 controls were ranked by the international investigator global rosacea severity scores. HLA genes, neutrophils, HDL, and LDL were detected. And their mediation effects on the relationship between HLA and rosacea risk or severity were analysed. RESULTS: HLA-DQB1*03:03 allele (OR = 41.89, 95% CI: 9.80 ∼ 179.09, p = 4.7*10-7), HLA-DQB1*04:02 allele (OR = 0.16, 95% CI: 0.03 ∼ 0.81, p = 0.026) and HLA-DQB1*03:03/05:02 genotype (OR = 5.57, 95% CI: 1.13 ∼ 27.52, p = 0.0351) were significantly associated with rosacea. Moreover, HLA-DQB1*03:03 allele (b = 1.434, SE = 0.217, p = 2.0*10-10), HLA-DQB1*05:01 allele (b = 0.894, SE = 0.33520, p = 0.008) and HLA-DQB1*03:03/06:01 genotype (b = 0.998, SE = 0.472, p = 0.040) were positively associated with rosacea severity. Furthermore, we found both neutrophils and HDL, instead of LDL, have mediation effects on the relationship between HLA-DQB1*03:03 and risk or severity of rosacea. CONCLUSIONS: We discovered novel susceptible HLA alleles for rosacea in the Chinese population, and disclosed the mediation effect of neutrophils and HDL on the relationship between HLA-DQB1 and rosacea, implying a possible correlation between rosacea and inflammatory or metabolic factors, providing hints for future studies in the mechanism of rosacea. Key messagesHLA-DQB1*03:03 allele, HLA-DQB1*04:02 allele and HLA-DQB1*03:03/05:02 genotype were significantly associated with rosacea.HLA-DQB1*03:03 allele, HLA-DQB1*05:01 allele and HLA-DQB1*03:03/06:01 genotype were positively associated with rosacea severity.Neutrophils and HDL have mediation effects on the relationship between HLA-DQB1*03:03 and risk or severity of rosacea. PMID:35622385 | DOI:10.1080/07853890.2022.2077427 {url} = URL to article
    • Toxins (Basel). 2022 May 4;14(5):329. doi: 10.3390/toxins14050329. ABSTRACT The efficacy and safety of botulinum toxin injection have made it a popular aesthetic procedure worldwide. A cross-sectional survey was performed in order to determine the pattern of type A botulinum toxin injections in cosmetic practice, for which an 18-item questionnaire was distributed to dermatologists. A total of 469 Korean board-certified dermatologists participated in the survey, with the following results: the main candidates for type A botulinum toxin injection were individuals in their 40-50 years (46.1%), followed by those in their 20-30 years (33.4%), and people over 60 years of age (20.5%). Overall, the upper face (the glabella, forehead, and crow's line, in decreasing order) was the most favored area of injection (51%). In contrast, body contouring (i.e., shoulder, calf) and treatment for benign masseter hypertrophy were significantly more popular in the 20-30 years age group than their older counterparts. For wrinkle effacement, the most preferred dilution was 100 units/2.5 mL with isotonic sodium chloride injection (51.2%), and the most often used interval was six months (43.6%). About half (46.3%) of the dermatologists reported the experience of clinical cases which were suspicious of botulinum toxin resistance. Despite this, regarding the choice of the product, type A botulinum toxin products with greater cost-effectiveness were favored over products with a lower risk of antibody formation. Other than its cosmetic usage, botulinum toxin is applied for a variety of skin conditions. Further studies are suggested in order to identify the practice pattern of type A botulinum toxin for therapeutic uses in dermatology, such as hyperhidrosis and rosacea. PMID:35622575 | DOI:10.3390/toxins14050329 {url} = URL to article
    • This is just a helpful tip for those of you with an iPhone using the Photos app so you can show a history of your rosacea to your dermatologist by simply creating an album that shows a history of selfie photos of your rosacea flareups over a period of time.  Follow the directions from Apple on how to do this. You could name the album MyRosacea and designate which photos in the album to easily find it and show these images to your dermatologist.  Android users probably have a similar way to do this. If you really care about helping your fellow rosaceans and have an Android, wouldn't it be helpful to explain in this thread how Android users could similarly have an easy way to show a history of photos of all the selfies taken to record rosacea flareups on an Android?   It is important to have a record of your rosacea flareups for your dermatologist to review to show if your rosacea is progressing worse. You should know about the stages of rosacea. (requires subscription to view)
    • The Rosacea Diet has been around for sometime now. Dr. Ken Berry explains it below:  LEARN MORE Forum Home > Forums > Member Forum > Rosacea Topics > Trigger Avoidance > Diet Triggers (Requires Subscription)
    • If you are not aware of Dr. Zach Bush you should be. Watch this video regarding how inflammatory diseases such as rosacea are on the rise and his insight into this and what to do about it. This is also related to GUT Rosacea. 
    • Int J Dermatol. 2022 May 17. doi: 10.1111/ijd.16235. Online ahead of print. ABSTRACT BACKGROUND AND OBJECTIVES: Ocular rosacea is a special manifestation of rosacea with unknown etiology. Eye involvement in rosacea patients is surprisingly common; however, it is often underdiagnosed, resulting in inappropriate treatment. We aimed to provide an updated epidemiologic perspective on ocular rosacea in Germany to improve patient care. PATIENTS AND METHODS: Data of 777 rosacea patients were assessed using a detailed online questionnaire regarding ocular and skin symptoms, previous dermatological and ophthalmological consults, presence of type 1 hypersensitivities, and Demodex testing. All data were statistically analyzed. RESULTS: Most patients reported ocular symptoms (399/777, 51.4%), including red eyes (179/399, 44.9%), itching (187/399, 46.9%), sty or chalazion (309/399, 77.4%), and dryness (108/399, 27.1%). Ocular rosacea was confirmed in 149/309 cases who consulted an ophthalmologist (45.3%). A total of 159/399 (39.8%) had no pre-existing allergies. Eye involvement was significantly associated with the presence of skin symptoms (P < 0.05), impacting patients' general well-being and overall treatment satisfaction. About half of Demodex-positive patients (21/45, 46.7%) showed ocular symptoms. CONCLUSIONS: Eye involvement in rosacea patients was common, often presenting with unspecific symptoms. PMID:35579395 | DOI:10.1111/ijd.16235 {url} = URL to article
    • Just an update on the previous announcement mentioned above, consider this Version 2.  As the treasurer I have been trying to keep the RRDi non profit organization going with over a hundred videos and keeping the website going switching over to a subscription service (watch Rosacea Episodes S3:E1 and announcement) as well as sending out our latest newsletter to members (read the last newsletter dated 5/12/22). Yesterday, I went to a family reunion with my siblings and in-laws and had a short discussion with my sister-in-law who happens to be an editor for a prestigious journal in the scientific world and she explained to me that calling our ‘magazine’ a ‘journal’ is what is the issue since the title ‘journal’ implies it is a scientific journal with peer reviews and since we don’t have the funds to accomplish this since we have no rich donors, nothing to sell, and our income is derived solely from affiliate links from our store and now subscriptions to our website, we should simply use our newsletter tool we purchase through Invision Community as the medium to provide not only pro bono articles from the RRDi MAC but also from our members who may want to publish an article on rosacea. So instead of any article you wish to submit for our newsletter please follow the instructions mentioned in our previous post if you are a subscribed member of the RRDi. From henceforth, the Newsletter of the RRDi will only be available to subscribed members and we will be asking for a donation from those who do not subscribe to read the newsletter.  Then, if we can obtain the funds through donations we may be able to resume publishing the Journal of the Rosacea Research and Development Institute again properly with a peer review process.  We will mention any featured posts from RRDi members who post in the category of their choice in our member forum with a link to your post. So login to your RRDi member account and post your thoughts on rosacea. It may be considered as worthy of mentioning in a blurb mentioned in the next edition of the Newsletter of the RRDi. 
    • J Cosmet Dermatol. 2022 May 16. doi: 10.1111/jocd.15089. Online ahead of print. ABSTRACT OBJECTIVES/AIMS: Rosacea is not only a skin condition but a systemic inflammatory disease that includes chronic inflammation, vascular alterations, and autoimmunity in pathogenesis. We aimed to evaluate the presence of a sensorineural hearing loss in the patients with rosacea in comparison with the healthy control group and, also to compare the audiometric results according to the severity of disease among the patient group. METHODS: Fifty-three patients with erythematelangiectatic or papulopustular type of rosacea and 105 age- and sex-matched healthy controls were included. Each participant had audiometric measurements after a complete ear-nose-throat examination by the same otorhinolaryngologist. RESULTS: The results of air and bone conduction thresholds showed statistically significant differences in particularly high frequencies between the groups in both the right and left ear (for all p <0.05). But there was no correlation between audiometric measurements and the severity or the type of rosacea (p>0.05). CONCLUSIONS: Regardless of disease severity or type, rosacea patients are likely to have sensorineural hearing loss, and it is important to refer these patients in the early period. PMID:35575907 | DOI:10.1111/jocd.15089 {url} = URL to article
    • J Adv Res. 2021 Sep 1;38:261-274. doi: 10.1016/j.jare.2021.08.012. eCollection 2022 May. ABSTRACT BACKGROUND: Endogenous gasotransmitters are small gaseous mediators that can be generated endogenously by mammalian organisms. The dysregulation of the gasotransmitter system is associated with numerous disorders ranging from inflammatory diseases to cancers. However, the relevance of these endogenous gasotransmitters, prodrug donors and inhibitors in inflammatory dermatological disorders has not yet been thoroughly reviewed and discussed. AIM OF REVIEW: This review discusses the recent progress and will provide perspectives on endogenous gasotransmitters in the context of inflammatory dermatological disorders. KEY SCIENTIFIC CONCEPTS OF REVIEW: Endogenous gasotransmitters nitric oxide (NO), carbon monoxide (CO) and hydrogen sulfide (H2S) are signaling molecules that regulate several physiological and pathological processes. In addition, sulfur dioxide (SO₂), methane (CH4), hydrogen gas (H2), ammonia (NH3), and carbon dioxide (CO2) can also be generated endogenously and may take part in physiological and pathological processes. These signaling molecules regulate inflammation, vasodilation, and oxidative stress, offering therapeutic potential and attracting interest in the field of inflammatory dermatological disorders including psoriasis, atopic dermatitis, acne, rosacea, and chronic skin ulcers. The development of effective gas donors and inhibitors is a promising alternative to treat inflammatory dermatological disorders with controllable and precise delivery in the future. PMID:35572410 | PMC:PMC9091779 | DOI:10.1016/j.jare.2021.08.012 {url} = URL to article
    • Carbohydr Res. 2022 May 6;517:108580. doi: 10.1016/j.carres.2022.108580. Online ahead of print. ABSTRACT Food allergy induced by lipid transfer proteins (LTPs) of Rosacea fruit family, such as peach, is becoming an important health problem in the Mediterranean area. Current treatments, such as allergen specific immunotherapy (AIT) with allergenic extracts show promising, but in many cases, they need an improvement in homogeneity, availability and induction of tolerant responses. Peptide-based vaccines containing adjuvants, such as carbohydrates for C-type lectin receptors (CLRs) are presented as an alternative approach. In this work, we have prepared fucosylated glycodendropeptides (GDPs) functionalized with Pru p 3 peptides via click chemistry. These GDPs, DnFuc9Prup3, induced changes in moDC maturation and lymphocyte proliferation in food allergic patients, indicating specific recognition via DC-SIGN receptor. From these data, D4Fuc9Prup3 can be considered a promising candidate for specific immunotherapy development. PMID:35561476 | DOI:10.1016/j.carres.2022.108580 {url} = URL to article
    • Actas Dermosifiliogr. 2022 May 10:S0001-7310(22)00391-X. doi: 10.1016/j.ad.2022.05.008. Online ahead of print. ABSTRACT BACKGROUND AND OBJECTIVE: Rosacea is a chronic acneiform skin disorder in which impaired skin barrier function can lead to sensitization to allergens. We aimed to analyze contact allergies in our patients with rosacea. MATERIAL AND METHODS: Retrospective cohort study of all patients who underwent patch testing in our skin allergy clinic between May 1991 and May 2019. RESULTS: A total of 200 patients with rosacea were referred to our clinic for patch testing during the study period; they represented 2.1% of all patch tested patients in the period. Eighty-one percent were women (mean age, 44.7 years). At least 1 positive patch test was recorded for 46.5%; 15% were of current relevance. The most frequent positive reaction was to nickel (26%), followed by cobalt chloride (6.5%), isothiazolinones (6%), p-phenylenediamine (5.5%), fragrance mix II (5%), and thimerosal (3.5%). The most common currently relevant patch test reactions were to isothiazolinones in 10 of the 200 patients (5%); to phenylenediamine, fragrance mix II, and toluensulfonamide formaldehyde resin in 4 patients (2%) each; and to tixocortol and fragrance mix I in 2 patients (1%) each. The allergen groups most often implicated were metals (of current relevance in 12.6%) and drugs (of current relevance in 25.8%). Preservatives and fragrances were the next most common allergen groups, and 70.8% and 43.7% of the positive reactions in these groups, respectively, were of current relevance. Cosmetics were the most frequent source of sensitization, followed by topical medications - notably corticosteroids and antifungal agents. CONCLUSIONS: We emphasize the high prevalence of allergic contact dermatitis in patients with rosacea, a finding which supports patch testing, especially if eruptions worsen when these patients use cosmetics and topical medications. PMID:35562047 | DOI:10.1016/j.ad.2022.05.008 {url} = URL to article
    • Learn More Azelaic Acid has been used to treat rosacea for many years. The brand name is Finacea, which is usually very expensive. We have information on savings card as well as generic azelaic acid prescriptions at this post. (member subscription required) There are a number of over the counter treatments using azelaic acid found in our store. Use the search tool and note the results of items found in our store.  "Azelaic acid (AzA) is an organic compound with the formula HOOC(CH2)7COOH. This saturated dicarboxylic acid exists as a white powder. It is found in wheat, rye, and barley. It is a precursor to diverse industrial products including polymers and plasticizers, as well as being a component of a number of hair and skin conditioners. AzA inhibits tyrosinase." Wikipedia
    • "Sarecycline (trade name Seysara; development code WC-3035) is a tetracycline-derived antibiotic. In the United States, it was approved by the FDA in October 2018 for the treatment of moderate to severe acne vulgaris". Wikipedia What about rosacea? Learn more below (members only😞  
    • Photodiagnosis Photodyn Ther. 2022 May 7:102897. doi: 10.1016/j.pdpdt.2022.102897. Online ahead of print. ABSTRACT A 72-year-old woman suffering from multiple actinic keratosis (AK) complicating steroid-induced rosacea received 5-aminolevulinic acid-photodynamic therapy (ALA-PDT) in our outpatient clinic. Both AKs and rosacea got remission after one session of PDT. However, adverse effect of severe acute inflammatory response emerged with lasting hyperpigmentation. We then terminated the following PDT sessions in time. After skin care and closely follow-up for a half year, most symptoms and lesions of AK and rosacea disappeared with mild hyperpigmentation left. ALA-PDT is commonly recommended for multiple AKs based on effectiveness and noninvasiveness, but has controversial efficacy and safety for rosacea. The unusual excessive inflammation in this patient after ALA-PDT may due to skin barrier destruction, vasomotor dysfunction and the immune response by dead Demodex after PDT. This case indicated that carefully evaluation before ALA-PDT is of great importance, especially for those patients with complicated skin situation. For AKs complicating rosacea, modified parameters of ALA-PDT such as less ALA incubation time or reduced light dose should be further studied to achieve the optimal efficacy and safety of ALA-PDT and offer the best benefit. PMID:35537699 | DOI:10.1016/j.pdpdt.2022.102897 {url} = URL to article
    • Skinmed. 2022 Apr 30;20(2):157-158. eCollection 2022. NO ABSTRACT PMID:35532775 {url} = URL to article
    • Skin Therapy Lett. 2022 May;27(3):5-7. ABSTRACT Tetracycline-class drugs have been used for first-line treatment of moderate-to-severe acne and rosacea for decades. Recently, a new third generation tetracycline, sarecycline, was US FDA-approved for the treatment of moderate-to-severe acne. This narrow-spectrum tetracycline-derived antibiotic has been shown to be effective with an improved safety profile. PMID:35533371 {url} = URL to article More information
    • J Cosmet Dermatol. 2022 May 9. doi: 10.1111/jocd.15066. Online ahead of print. NO ABSTRACT PMID:35534917 | DOI:10.1111/jocd.15066 {url} = URL to article Purchase
    • Actas Dermosifiliogr. 2022 Mar;113(3):326-328. doi: 10.1016/j.ad.2020.03.018. Epub 2021 Jul 26. NO ABSTRACT PMID:35527381 | DOI:10.1016/j.ad.2020.03.018 {url} = URL to article
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