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Robert T. Brodell, MD

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Everything posted by Robert T. Brodell, MD

  1. I am in agreement that the frustration inherent in the system decreases my participation. Ideally, a question would be emailed to me.....a link to the site.....type into the page that appears with an answer....this would only take 5 minutes and increase likelihood of participation.
  2. I am afraid that head to head comparisons between devices produced by different manufacturers and different laser and IPL devices are rare. The key concept is selecctive photothermolysis. A green light source, whether produced by a laser, or filtered to the right wavelength as in IPL has the potential for helping fade the redness of rosacea. The device used on a patient is most likely to be the device that they have in their office....the one they have experience using. I have no doubt that there is more than one way to skin this cat. Having said that, some cosmetic dermatologists have multiple devices and would develop a sense of which laser might be useful for deeper or larger vessels, etc. I am not expert in this area and will leave it to others to comment further!
  3. The word "disease" sounds ominous to most laypeople......so, I suppose that I favor the word "condition" to describe rosacea. Having said that, I have no quarrel with anyone who wants to call rosacea an "infectious disease" or an "inflammatory disease" or a hormonally mediated "disease." Most words of this type in medicine rooted in latin from thousands of years ago do not have precise definitions!
  4. Rosacea, like common acne vulgaris is caused by blocked pores, infection, and homones leading to an inflammatory response. We have a long way to go before we can talk about a cure. In my opinion, all of our efforts are directed at controlling this condition. Research dollars should be directed at basic science, epidemiology (understanding the population with rosacea), applied basic science, and clinical studies regarding particular drugs. A broad effort is required since we are not yet close to a single clear answer to this problem.
  5. Incyclinide is an altered form of tetrecycline with antiinflammatory effects, but no anti-biotic effects. The indications are that this is a very powerful and since it is not an antibiotic, it should not cause yeast infectionss or ingender resistence. It remains to be seen if there are other side effects. Indications are it will prove to be a stronger anti-inflammatory drug than the sub-antimicrobial dosing of doxycycline (oracea) I have not done any of these trials myself....and this is all second hand information!
  6. As with any new drug the issue is whether the benefits outweight the risks. Is there anywhere in the body where one wishes to have new blood vessel growth? In the setting of a heart attack....turning off new blood vessel growth might be disasterous. In preventing blindness the risk/benefit ratio is more heavily weighted to the benefit. Soooooo, since blood vessels in rosacea are worn on the outside of the body where they are easily attacked with vascular lesion lasers, the benefit here is reletively small...I would go slow on the risk side! Dr. Bob Brodell
  7. A well designed study on diet and rosacea would always be welcome...keep in mind that a large number of patients will be required....my experience with patients suggests that a "slam dunk" diet that works for a majority of patients every time...is just not likely to be found. We are looking for subtle changes...and this will require many patients to sort out. Bob Brodell
  8. Rosacea is related to blocked pores, infection/inflammation, and hormones. I never cease to be amazed how many patients can identify personal trigger factors....yet, I have never seen a patient who feels confident they can control rosacea by merely avoiding identifiable triggers. Ultimately, topical antibiotics, systemic antibiotics, and a variety of anti-inflammatory medications will be the mainstay of treatment of active disease. Vascular lesion laser remains the key to facial erythema not responsive to the above.
  9. Another new member of the advisory board...Robert T. Brodell, M.D. I am in the private practice of Dermatology and Dermatopathology in Warren, Ohio, and serve on the volunteer faculty of Northeastern Ohio Universities College of Medicine and Case Western Reserve University School of Medicine. I also serve on the committee that produces the AAD on-line rosacea website (rosacea-Net Workgroup) and serve as a director of the American Board of Dermatology. Looking forward to lending a hand!
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