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  1. Dr. Randy Shuck, answers a question about rosacea on a Florida television station. Click here
  2. David Pascoe has announced that a company in Germany is starting a chemical trial with a new product called Rossoseq. For more info click here.
  3. You may want to verbally ask your dermatologist to volunteer for the RRDi MAC. You may also provide the following link to your dermatologist to fill out an online application request form: http://irosacea.org/macapplication.php If you prefer to write a letter to your doctor about this you may use the following sample letter: http://irosacea.org/sample.php
  4. Image courtesy of sodahead.com Whenever the subject of demodex mites (demodectic rosacea) comes up there is the age old quandary, which came first the demodex or the rosacea? This question was first proposed by Frank Powell, M.D., in an article, Something to Blush About, in the Ivanhoe Newswire. [1] The NRS published an article in July 2012 that states, “now there may be some evidence that the “chicken” —Demodex mites — and not the “egg” comes first, according to a recent scientific report.” [2] This article comments on the work of “researcher Dr. F.M.N. Forton [who] has championed the mite as a key culprit behind the development of the condition, noting it may be the missing link in understanding the onset of subtype 2 (papulopustular) rosacea.” David Pascoe published an editorial on this subject where he states under the subheading, Dreaming, that “this theory is pretty far fetched.” [3] While neither Powell or Forton dogmatically say whether the demodex or the rosacea is first, both are saying the evidence points to the demodex mites as coming first. No one really knows for sure. The articles written about demodex and rosacea are prolific. [4] There doesn’t seem to be any end to researchers writing about demodectic rosacea which, without a doubt, more will be coming down the pipeline for us to read about and comment on. For example, there is a report that two proteins from B.oleronius found on demodex mites may cause an inflammatory response in rosacea patients. [5] So which comes first the bacteria or the mites? Does it really make any difference? Apparently to some which comes first is very important. Now there is evidence of at least five types of bacteria associated with demodex. A paper in 2017 continues to explain the quandary. "Many studies have shown higher density of the parasites in diseased inflammatory skin than in normal skin, but whether it is the cause or result of the inflammation remains unclear." [6] A paper in 2018 may help to resolve this issue because for the first time it has been discovered that Demodex mites secrete bioactive molecules that reduced TLR2 expression in sebocytes. [7] So while the jury is still out on this subject, What do you think? Which comes first, the demodex or the rosacea? Does it even matter? The point is that there is evidence that demodectic rosacea needs to be ruled out, especially when you consider the gold standard of rosacea treatment is now Soolantra, which the active ingredient is ivermectin, an insecticide, and Oracea. So if you make a choice, which comes first, be careful. Being dogmatic on this subject might get some egg on your face. End Notes [1] Powell is quoted as saying: “In other words, which came first: the mites or the rosacea?” study author Frank Powell, M.D., consultant dermatologist at Mater Misericordiae Hospital in Dublin, Ireland, was quoted as saying. “And now there is evidence that it might be the mites.” Something to Blush About, Medical Breakthoughs, Ivanhoe Newswire, December 11, 2007 [2] The Chicken, not the Egg? National Rosacea Society, Thursday, July 5, 2012 [3] More Demodex Dreaming: Mites are the Chicken? by David Pascoe, July 24th, 2012 [4] For a partial list of papers on demodex and rosacea click here [5] Positive correlation between serum immuno-reactivity to Demodex-associated Bacillus proteins and Erythematotelangiectic Rosacea. O’Reilly N, Menezes N, Kavanagh K. Br J Dermatol. 2012 Jun 18. doi: 10.1111/j.1365-2133.2012.11114.x. [6] Iran J Parasitol. 2017 Jan-Mar; 12(1): 12–21. PMCID: PMC5522688 Human Permanent Ectoparasites; Recent Advances on Biology and Clinical Significance of Demodex Mites: Narrative Review Article Dorota LITWIN, WenChieh CHEN, Ewa DZIKA, and Joanna KORYCIŃSKA [7] Demodex TLR2 Expression in Sebocytes Demodex Density Count - What are the Numbers?
  5. IPS Version 4.0 Click here to access.
  6. We welcome articles on any aspect of rosacea for the second edition of the RRDi Journal. Health professionals and researchers are invited to submit research articles, clinical trial reports, case studies, review papers and opinion pieces, which will be subject to peer review. We also welcome personal statements from rosacea patients, news bulletins, and other relevant short pieces for inclusion in the journal. Please direct all enquiries to: Citations should be numbered in superscript in the text, and references listed numerically. Figures should be greyscale in 300 dpi tiff format. For colour figures, please inquire. Deadline for the next edition indefinite.
  7. http://www.standard.co.uk/lifestyle/health/save-your-blushes--how-to-avoid-skin-redness-8014899.html
  8. Steps to remove notification emails (1) Sign in to your account (2) In upper right corner of your browser look for your user name which in this case is Canarygirl and click to show the following popup window and then click on ACCOUNT SETTINGS (notice Account Settings is below Manage Followed Content): (3) In the next window which is Account Settings look toward the right column and look for OTHER SETTINGS and click on NOTIFICATION SETTINGS: (4) In the next window which is NOTIFICATION SETTINGS, be sure all the selections are UNCHECKED except one (be sure DO NOT SEND ME NOTIFICATIONS is selected) and in the far right column that you have NOT Subscribed to the newsletter: ------------------------------------- How to unsubscribe if the above steps don't work ------------------------------------- Use our contact form and request to be removed from the Newsletter or other notifications describing in detail why the above steps do not work for you, please. If you want to be removed just from the Newsletter only, there is an unsubscribe link always in our newsletter which you simply click on.
  9. Tapatalk is a forum app on the iPhone,Android, webOS, Windows Phone 7 and BlackBerry. Tapatalk Forum App provides super fast on-the-go forum access to majority of the discussion forums that has activated the Tapatalk plugin. Check out http://www.tapatalk.com for more information!
  10. Thanks for the post. I will look into this and get back to you.
  11. While rosacea is not mentioned in the case of Brandon Thomas, age 20, blushing drove this young man to suicide. This case demonstrates how serious psychologically flushing can become. Flushing, which includes blushing, is usually the chief differentiator in diagnosing rosacea. http://vitals.msnbc.msn.com/_news/2012/07/09/12644071-unbearable-blushing-parents-speak-out-about-sons-suicide?lite
  12. There is debate among authorities whether Perioral Dermatitis is a rosacea variant or not or should be classified as a disease of its own. While PD can be a rosacea mimic, on its own, the RRDi has classified Rosacea Perioral Dermatitis as a rosacea variant. PD can also be a co-existing condition. For more info on PD click here.
  13. Rosaacea Perioral Dermatitis [RPD] There are authoritative sources who classify Perioral Dermatitis as a rosacea variant. The RRDi recognizes Rosacea Periorial Dermatitis [RPD] as a rosacea variant. <begin Excerpt from Rosacea 101: Includes the Rosacea Diet, pages 10, 11 by Brady Barrows, with permission from the author> Perioral Dermatitis [POD] “Perioral dermatitis (POD) is a chronic papulopustular and eczematous facial dermatitis. It mostly occurs in women, although a distinct papular variant occurs in children. The clinical and histologic features of the lesions resemble those of rosacea. Patients require systemic and/or topical treatment, an evaluation of the underlying factors, and reassurance.… The etiology of perioral dermatitis is unknown; however, the uncritical use of topical steroids for minor skin alterations of the face often precedes the manifestation of the disease” [47] “Histologically, it is indistinguishable from rosacea …” [48] “PD is characterized by a skin barrier disorder of facial skin. It differs from rosacea in that it involves a significantly increased TEWL and features of an atopic diathesis. However, it remains disputed as to whether PD is an individual skin disease or a subtype of rosacea in atopic patients.” [49] “Ackerman has stated his belief that, histologically, this condition is the same as rosacea. He says that ‘like rosacea, perioral dermatitis is fundamentally an inflammatory process involving hair follicles. Initially, both conditions are folliculitis that progresses to granulomatous folliculitis and dermatitis.’” [50] “Perioral dermatitis is a red, bumpy rash around the mouth and on the chin that resembles acne or rosacea … Perioral dermatitis can be hard to separate from rosacea, but symptoms including tiny blisters and skin scaling can help make the distinction. Other symptoms of rosacea must be present for that diagnosis to be made instead of perioral dermatitis.” [51] “Perioral dermatitis (POD) is a chronic papulopustular and eczematous facial dermatitis. It mostly occurs in women, although a distinct papular variant occurs in children. The clinical and histologic features of the lesions resemble those of rosacea … Histologic findings are similar to those of rosacea …” [52] “You won’t see comedones (whiteheads and blackheads), cysts (boil-like lesions), or scarring, as you would if you have acne, nor will you see the typical flushing of rosacea.” [53] “The cause of perioral dermatitis is unknown. But some dermatologists believe it is a form of rosacea…” [54] “Perioral dermatitis (POD) is a chronic papulopustular facial dermatitis found in younger women and children. It appears to be a juvenile form of granulomatous rosacea.” [55] “Some authorities consider that perioral dermatitis is a circumscribed variant of rosacea.” [56] “Some experts consider this disorder to be a variant of rosacea.” [57] “Perioral dermatitis is a distinct entity and not a variant of seborrhoeic dermatitis or rosacea …” [58] “Although rosacea papules may appear in the perioral area, as noted earlier, perioral dermatitis without rosacea symptoms cannot be classified as a variant of rosacea. Perioral dermatitis is characterized by such stigmata as microvesicles, scaling, and peeling.” [59] “Sodium sulfacetamide, penetrating antibacterial, in combination with hydrocortisone and sulfur, has enjoyed twenty years of remarkable safety, with outstanding efficacy and patient acceptance, in the prescription treatment of pustular acne and severe, refractory seborrheic dermatitis. Recently, this combination has been reported to be highly effective concomitant therapy for perioral dermatitis. Almost paradoxically, it achieves these desired goals without the excessive erythema and discomforting irritation associated with retinoic acid and benzoyl peroxide.” [60] As already mention some clinicians consider perioral dermatitis to be a variant of rosacea. [61] It usually effects young females and results from topical steroid use. My gut feelings nominate perioral dermatitis as a rosacea variant but because of the controversy about this I am listing it also as a rosacea mimic. This is another example of the confusion in rosacea among dermatologists. There is no general consensus and much debating. End notes 47 thru 61 are located in the book, Rosacea 101: Includes the Rosacea Diet, pages 10, 11 by Brady Barrows <end excerpt from Rosacea 101> Periorol Dermatitis is a rosacea mimic and is considered in a differential diagnosis of rosacea. "Perioral” refers to the area around the mouth, and “dermatitis” indicates a rash or irritation of the skin. Usually Periorol Dermatitis is characterized by tiny red papules (bumps) around the mouth. The areas most affected by perioral dermatitis are the facial lines from the nose to the sides and borders of the lips, and the chin. The areas around the nose, eyes, and cheeks can also be affected. There are small red bumps, mild peeling, mild itching, and sometimes burning associated with perioral dermatitis. When the bumps are the most obvious feature, the disease can look like acne. Compare images of acne, rosacea, perioral dermatitis and other similar rosacea mimics: DermIS 27 Images. A research paper in 2004 said, "However, it remains disputed as to whether PD is an individual skin disease or a subtype of rosacea in atopic patients." [1] This is because the classification of rosacea into subtypes and variants remains a controversy. [2] A dermatologist diagnoses perioral dermatitis by examination. No other tests are usually done. Sometimes, scraping or a biopsy of the skin is done. Occasionally, blood tests are ordered to eliminate other conditions that can look similar. A culture for bacteria may sometimes be needed to eliminate the possibility of infection. Perioral dermatitis is a facial rash that tends to occur around the mouth. Most often it is red and slightly scaly or bumpy. Any itching or burning is mild. It may spread up around the nose, and occasionally the eyes while avoiding the skin adjacent to the lips. It is more rare in men and children. Perioral dermatitis may come and go for months or years. One of the most common factors is prolonged use of topical steroid creams and inhaled prescription steroid sprays used in the nose and the mouth. Overuse of heavy face creams and moisturizers are another common factor. Other factors include skin irritations, fluorinated toothpastes, or other dental fluorinated products. Some dermatologists believe it is a form of rosacea or sunlight-worsened seborrheic dermatitis. Why perioral dermatitis occurs more frequently in young women is a quandary. However, it may sporadically affect men. Its exact cause is unknown. Perioral dermatitis is a difficult condition to treat effectively, often requiring several months of treatment. "...A low-potency topical steroid may also be used to suppress the inflammation and to wean off the strong steroid. Perioral dermatitis in childhood is probably a juvenile form of rosacea..." [3] One study suggests that topical steroid use increases demodex mite density in perioral dermatitis. [4] "Tacrolimus ointment is increasingly used for anti-inflammatory treatment of sensitive areas such as the face, and recent observations indicate that the treatment is effective in steroid-aggravated rosacea and perioral dermatitis." [5] "Perioral dermatitis was diagnosed in 329 patients....In 80 patients demodex was discovered....Treatment with liquid nitrogen gives good results..." [6] DermNetNZ page on PD "Out of 1032 patients, 81.5 % were diagnosed with rosacea and 18.5 % with POD." [62] Treatment Mistica at RF reported about Dawn M Lamako who posted her treatment for PD using Sugardyne (sugar as an antimicrobial) which she explains with incredible detailed references to documents and photos. Be sure to scroll all the way down to see Dawn's photos of the treatment. For more details on this read the second post in this thread. Other Sources Perioral dermatitis (rosacea-like dermatitis)--adverse effects of externally applied steroid preparations Urabe H. - 1978 The treatment of steroid-induced rosacea and perioral dermatitis. Sneddon IB. - 1976 Perioral dermatitis and rosacea-like dermatitis: clinical features and treatment. Urabe H, Koda H. 1976 End Notes [1] Epithelial barrier function and atopic diathesis in rosacea and perioral dermatitis. Dirschka T, Tronnier H, Fölster-Holst R. Br J Dermatol. 2004 Jun;150(6):1136-41. [2] Classification Of Rosacea Remains Controversial article by Brady Barrows, RRDi Director [3] Perioral dermatitis in children. Laude TA, Salvemini JN. Semin Cutan Med Surg. 1999 Sep;18(3):206-9. [4] Density of Demodex folliculorum in perioral dermatitis. Dolenc-Voljc M, Pohar M, Lunder T. Department of Dermatovenereology, University Medical Centre Ljublana, Zaloska 2, SI-1525 Ljublana, Slovenia. Acta Derm Venereol. 2005;85(3):211-5. [5] Induction of rosaceiform dermatitis during treatment of facial inflammatory dermatoses with tacrolimus ointment. Antille C, Saurat JH, Lübbe J. Arch Dermatol. 2004 Apr;140(4):457-60. [6] Perioral dermatitis--an allergic disease? Arutjunow V., Hautarzt. 1978 Feb;29(2):89-91. [47] Perioral Dermatitis eMedicine, Article Last Updated: Feb 7, 2007 Hans J Kammler, MD, PhD, Head of Unit for Dermatology, ENT, Ophthalmology, and Respiratory Diseases, German Federal Institute for Drugs and Medical Devices http://www.emedicine.com/derm/topic321.htm [48] Perioral dermatitis in children. Laude TA, Salvemini JN. Semin Cutan Med Surg. 1999 Sep;18(3):206-9 [49] Epithelial barrier function and atopic diathesis in rosacea and perioral dermatitis. Dirschka T, Tronnier H,Fölster-Holst R; Br J Dermatol. 2004 Jun;150(6):1136-41 [50] Perioral Dermatitis eMedicine, Article Last Updated: Feb 7, 2007 Hans J Kammler, MD, PhD, Head of Unit for Dermatology, ENT, Ophthalmology, and Respiratory Diseases, German Federal Institute for Drugs and Medical Devices http://www.emedicine.com/derm/topic321.htm [51] Dermatitis, The Merck Manuals Online Medical Dictionary, revision December 2006 by Peter C. Schalock, MD http://www.merck.com/mmhe/sec18/ch203/ch203c.html [52] Perioral Dermatitis eMedicine, Article Last Updated: Feb 7, 2007 Hans J Kammler, MD, PhD, Head of Unit for Dermatology, ENT, Ophthalmology, and Respiratory Diseases, German Federal Institute for Drugs and Medical Devices http://www.emedicine.com/derm/topic321.htm [53] http://www.rosaceaguide.ca/basics/like_rosacea/perioral_dermatitis.html [54] Perioral Dermatitis American Academy of Dermatology Pamphlet http://www.aad.org/public/Publications/pamphlets/PerioralDermatitis.htm [55] A case of granulomatous rosacea: Sorting granulomatous rosacea from other granulomatous diseases that affect the face. Omar Khokhar MD, and Amor Khachemoune MD CWS Dermatology Online Journal 10 (1): 6 source > http://dermatology.cdlib.org/101/case_reports/rosacea/khachemoune.html [56] Perioral dermatitis with histopathologic features of granulomatous rosacea: successful treatment with isotretinoin. Cutis 1990 Nov; 46(5):413-5. Smith KW [57] Face Up to Rosacea Heather L. Roebuck MSN, RN, APRN, BC The Nurse Practitioner: The American Journal of Primary Health Care September 2005; Volume 30 Number 9, Pages 24—35 http://www.nursingcenter.com/prodev/ce_article.asp?tid=601568 [58] PERIORAL DERMATITIS: AETIOLOGY AND TREATMENT WITH TETRACYCLINE British Journal of Dermatology 87 (4), 315–319. doi:10.1111/j.1365-2133.1972.tb07416.x; ANGUS MACDONALD, MICHAEL FEIWEL (1972) http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2133.1972.tb07416.x?journalCode=bjd [59] Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea Journal of the American Academy of Dermatology April 2002 • Volume 46 • Number 4 http://www.rosacea.org/rr/2002/summer/article_1.html [60] Old drug—in a new system—revisited. Olansky S; Cutis. 1977 Jun;19(6):852-4. [61] Recognizing rosacea Could you be misdiagnosing this common skin disorder? Millikan L., Postgrad Med 1999;105:149–58. [62] J Dtsch Dermatol Ges. 2020 May 29;: Rosacea and perioral dermatitis: a single-center retrospective analysis of the clinical presentation of 1032 patients. Hoepfner A, Marsela E, Clanner-Engelshofen BM, Horvath ON, Sardy M, French LE, Reinholz M
  14. Please read this notice about Subtypes Glandular rosacea has been proposed as a phenotype of rosacea by Crawford et al., in a paper published in 2004. Whether Glandular Rosacea should be classified as a phenotype, subtype or variant of rosacea remains to be clarified but for now the RRDi lists Glandular Rosacea in the 'other subtypes' and as a variant of rosacea until a decision is made. The RRDi now recognizes Glandular Rosacea as a rosacea variant to end the confusion.
  15. Some past papers suggest that rhinophyma is the end stage of rosacea but this has been debunked. For more info click here.
  16. Botox is sometimes used to treat rosacea. David Pascoe has been following Botox treatment for sometime now and I defer to him on this. Here is the link to his reports. How much does Botox Cost?, USA Today Botox is listed as one of the Biologic Treatments for Rosacea. Please post your experience with botox for rosacea in this thread by finding the green reply button.
  17. It was surprising to me to discover that legal drugs now kill more people than illegal drugs. Legal Drug related deaths number 100,000 in the US. That's a million deaths in ten years. This is according to the FDA, the watch dog for Legal Drugs: http://www.fda.gov/Drugs/Development.../ucm114848.htm According to Natural News, "Some experts estimate it should be more like 200,000 because of underreported cases of adverse drug reactions." http://www.naturalnews.com/009278.html#ixzz1vpHUiTFM According to a report in 2007, "Deaths due to [prescription] overdoses are the most prominent cause of drug-related mortality in death certificate data." http://www.ncbi.nlm.nih.gov/pubmed/17536879 NPR: Prescription Drug Deaths Major Killer In The U.S. http://www.npr.org/2011/09/27/140849...ler-in-the-u-s According to the Office of National Drug Control Policy, "In 1997, the latest year for which death certificate data are published, there were 15,973 drug-induced deaths in America." https://www.ncjrs.gov/ondcppubs/publ.../chap2_10.html Mercola had an article with the subheading, ""Pharmageddon" is Upon Us": http://articles.mercola.com/sites/ar...ath-in-us.aspx Fox News had an article about this same subject with smaller numbers reported: http://www.foxnews.com/health/2011/1...ths-skyrocket/ Scientific American: Prescription Drug Deaths Increase Dramatically http://www.scientificamerican.com/ar...on-drug-deaths USA Today article: Prescriptions now biggest cause of fatal drug overdoses http://www.usatoday.com/news/health/...overdose_N.htm The Inquistr: Drug Use Now Kills More People Than Traffic Accidents [study] http://www.inquisitr.com/142881/drug...cidents-study/ The number of drug related deaths due to illegal drugs is far less than those caused by legal drugs. This is not only in the USA but also globally. Sources cited below show the death toll on illegal drugs at around 200,000, GLOBALLY. The above figures show that prescription drugs kill 100,000 in the USA alone. Surely the number of prescription drug related deaths globally is far higher. Finding global statistics for prescription drug related deaths due to Adverse Drug Reactions (ADRs) is difficult to find. But this is what I have found so far: According to Los Angeles times, "In 2004 the World Health Organization reported that globally there were 5.1 million deaths due to tobacco use, 2.25 million from alcohol and 250,000 from illegal drug use." http://articles.latimes.com/2012/jan...g-use-20120105 Other sources list global deaths from illegal drug use between 200,000 to 250,000 annually. http://www.myhealthnewsdaily.com/207...ug-deaths.html http://news.yahoo.com/illegal-drugs-...024206539.html http://www.who.int/healthinfo/global...eport_full.pdf The statistics on deaths due to drugs can be suspect because "vital statistics underestimate the rates of prescription and illicit drugs because the type of drug is not specified on many death certificates" according to this report by the CDC: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm
  18. This post has been promoted to an article
  19. Demodectic rosacea is recognized by the RRDi as a rosacea variant. For more info click here.
  20. While most report that they received a correct diagnosis of rosacea, there are reports of misdiagnosed rosacea and a collection of over 100 anecdotal reports of misdiagnosed rosacea (or vice versa) are available by clicking here. While misdiagnosed rosacea is not a massive issue, it nevertheless is an issue and you should be aware of this. Adding your Anecdotal Report to the List Please add to this thread by clicking on the REPLY TO THIS TOPIC [green button near the top] or the Reply to this topic link at the bottom of the last post in this thread (you will need to register an account to post a reply this thread) which is the green reply button at top (or bottom) your experience of being misdiagnosed for rosacea or other skin condition to be added to the list. Why not share your experience with other rosacea sufferers? Join the RRDi.
  21. This post has moved: Do You Have a Gut Feeling?
  22. Galderma Pharmaceuticals has announced positive results from a phase 3 trial of CD07805/47, a proprietary topical gel for rosacea. For more info. Dr. Fowler who is the principal study investigator of this phase 2B is also a member of the RRDi MAC. More info: http://www.medicalne...cles/236391.php Background info: Once-daily topical brimonidine tartrate gel 0.5% is a novel treatment of moderate to severe facial erythema of rosacea: results of two multicenter, randomized and vehicle-controlled studies. Fowler J, Jarratt M, Moore A, Meadows K, Pollack A, Steinhoff M, Liu Y, Leoni M; on behalf of the Brimonidine Phase II study group. Br J Dermatol. 2011 Nov 2. doi: 10.1111/j.1365-2133.2011.10716.x. The information on this as of September 2012. Sansrosa became known as Mirvaso. [1] End Notes [1] Mirvaso (Sansrosa, Brimonidine) Approved for Rosacea Redness, RSG
  23. A report says that those who ingest lamb's quarters [Chenopodium album] and are later exposed to the sun " developed dermatitis with edema, erythema and necrosis on the face and dorsum of the hands." Hum Exp Toxicol. 2012 Jan 12. [Epub ahead of print] Nine case series with phototoxic dermatitis related to Chenopodium album. Ozkol H, Calka O, Karadag A, Akdeniz N, Bilgili S, Behcet L.
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