The Netherlands has endorsed the new phenotype classification of rosacea, as published in the British Journal of Dermatology. For more information. 

Related Articles Rosacea treatment guideline for The Netherlands. Br J Dermatol. 2020 Jan 23;: Authors: van Zuuren EJ, van der Linden MMD, Arents BWM Abstract The classification of rosacea has evolved from a subtyping into a phenotype approach1-3 and an updated systematic review on interventions in rosacea using this approach was recently published.4 Therefore, we developed a new evidence-based guideline for all physicians and skin therapists involved in the management of patients suffering from rosacea. A patient information leaflet based on this guideline was produced. The Working Group (WG) consisted of dermatologists (4), general practitioner (1), ophthalmologist (1), plastic surgeon (1), skin therapists (2), patient (1) and staff members of the Dutch Society of Dermatology and Venereology (2). All affiliated organizations participated in external review. PMID: 31970753 [PubMed - as supplied by publisher] {url} = URL to article

An article about any conflict of interest (COI) with the authors of dermatological textbooks is an interesting read, highlighting the need for more transparency acknowledging the funding of the authors. [1] Note this paragraph:  "In recent years, dermatologists’ relationship with industry has increased immensely. The global pharmaceutical market in dermatology is projected to exceed $34 billion per year by 2023 (Prescient & Strategic Intelligence, 2018). The relationship with industry is a complicated subject. Support from industry has been important for the advancement of dermatology and has provided funding support for a range of activities, including clinical trials, educational materials, and travel support for residents and fellows. These funds are integral for the growth and maintenance of the specialty. For example, exhibit revenue from technical exhibits at large meetings helps support registration and educational costs for attendees and provides funding for other non-income-producing activities. The pervasiveness of industry is incontrovertible and spans a gamut ranging from continuing medical education programs to educational grants to advertisements in journals (Sams and Freedberg, 2000)." Here are some highlights of the study:  (1) The study was limited to eight textbooks and states about these that all eight "are listed on the American Academy of Dermatology (AAD) website as board preparation resources recommended by members of the AAD Resident and Fellows committee under the category of general dermatology textbooks."  "The most recent editions of eight commonly used books were selected and are listed as follows: Dermatology (4th edition, 2017), Andrews’ Diseases of the Skin: Clinical Dermatology (12th edition, 2015), Dermatology Secrets Plus (5th edition, 2015), Genodermatoses: A Clinical Guide to Genetic Skin Disorders (2nd edition, 2004), Comprehensive Dermatologic Drug Therapy (3rd edition, 2012), Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence (5th edition, 2015), Dermatology: Illustrated Study Guide and Comprehensive Board Review (2nd edition, 2017), and Clinical Dermatology: A Manual of Differential Diagnosis (3rd edition, 2003)." (2) "The total compensation for 381 authors in 2016 was $5,892,221....The top 10% of dermatologists who collected payments received $5,267,494, which represented 89% of the total payment amount.....The payment distribution was skewed with a minority of dermatologists receiving the majority of payments." (3) "Given the financial incentives of pharmaceutical companies, the pharmaceutical industry has a particular interest in targeting young physicians in training as they foster their own disease treatment and prescribing patterns." (4) "This study helps to further characterize the relationship between authors of general dermatology textbooks and industry. Continued discussion to foster transparency among physicians, regulators, and the public with regard to various topics, such as policies, physician behaviors, and the potential for CoI in educational resources, is important." The paper acknowledges the limitations such as only USA physicians were included and other limitations. But you do get an idea of why transparency should be acknowledged in the textbooks that dermatologists are using so that as the authors of the study put it, "Whether industry payments to authors affect the quality of information in dermatology textbooks for better or for worse remains uncertain" so that "readers can draw their own conclusions." End Notes [1] International Journal of Women's Dermatology Conflicts of interest among dermatology textbook authors  Jorge Roman, MD, David J. Elpern, MD, and John G. Zampella, MD Etcetera Related to skin industry funding of textbook authors are the following two posts:  Rosacea Research in Perspective of Funding Rosacea Research in Perspective of Idiopathic Diseases    

Interesting that Actinic Folliculitis should be considered in a differential diagnosis with rosacea. It has been suggested that photo damage may be responsible in rosacea which is one of the threories. 

Related Articles Off-label Uses of Topical Pimecrolimus. J Cutan Med Surg. 2019 Jul/Aug;23(4):442-448 Authors: Ladda M, Sandhu V, Ighani A, Yeung J Abstract Pimecrolimus is a topical calcineurin inhibitor currently approved for second-line use in the management of mild-to-moderate atopic dermatitis in patients age 2 years and older. Given the safety profile and nonsteroidal mechanism of pimecrolimus, there has been significant interest in its use in the treatment of a variety of dermatological conditions. This article reviews research that has been published on the off-label uses of topical pimecrolimus, with a focus on published RCTs. Convincing evidence exists supporting pimecrolimus' efficacy in oral lichen planus and seborrheic dermatitis. For other conditions studied to date, pimecrolimus may prove to be a useful treatment alternative when conventional agents fail. Adverse events seen with its off-label use were typically application site reactions, the most common being a transient burning sensation. In summary, pimecrolimus appears to be an effective agent in the treatment of multiple dermatological conditions and may be worth considering as a pharmacologic alternative in several conditions when first-line treatment fails, or for areas that are more susceptible to the adverse effects of topical corticosteroids. PMID: 31053034 [PubMed - indexed for MEDLINE] {url} = URL to article