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DERMAGIC/EXPRESS(14)
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LA ROSÁCEA /THE ROSACEA

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1.) Rosaceous lymphedema: a rare variant of a common disorder. 
2.) Comparison of the long-pulse dye (590-595 nm) and KTP (532 nm) lasers in the treatment of facial and leg telangiectasias. 
3.) Rhinophyma: treatment with CO2 laser. 
4.) [Rosacea with ocular involvement in a child] 
5.) Rosacea: recognition and management for the primary care provider. 
6.) The significance of Demodex folliculorum density in rosacea. 
7.) A study of the prevalence of Helicobacter pylori infection and other markers of upper gastrointestinal tract disease in patients with rosacea. 
8.) Inflammatory cytokines in the tears of patients with ocular rosacea. 
9.) Rosacea: how to recognize and treat an age-related skin disease. 
10.) Topical metronidazole maintains remissions of rosacea. JUNIO 1.998
11.) Effective sunscreen ingredients and cutaneous irritation in patients with rosacea. 
12.) Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. 
13.) Ocular rosacea: patient characteristics and follow-up. 
14.) Cutaneous angiosarcoma of the face: clinicopathologic and immunohistochemical study of a case resembling rosacea clinically. 
15.) A study on Demodex folliculorum in rosacea. 
16.) A double-blind, multicenter clinical trial comparing efficacy of once-daily metronidazole 1 percent cream to vehicle in patients with rosacea. 
17.) The Demodex mite population in rosacea [see comments]
18.) Treatment of rosacea: topical clindamycin versus oral tetracycline.
19.) [Double-blind study versus excipient of 0.75% metronidazole gel in the treatment of rosacea]
20.) Oral spironolactone therapy in male patients with rosacea.
21.) Childhood rosacea.
22.) A clinical and histopathologic study of granulomatous rosacea.
23.) Flash lamp pumped dye laser for rosacea-associated telangiectasia and erythema.
24.) Topical metronidazole for severe and recalcitrant rosacea: a prospective open trial.
25.) An epidemiological study of rosacea.
26.) Isotretinoin treatment of rosacea.
27.) May Helicobacter pylori be important for dermatologists?
28.) Efficacy and safety of topical azelaic acid (20 percent cream): an overview of results from European clinical trials and experimental reports. (rosacea and acne)
29.) Ocular rosacea. Signs, symptoms, and tear studies before and after treatment with doxycycline [see comments]
30.) [Dapsone in granulomatous rosacea] Dapson bei granulomatoser Rosazea.
31.) ROSÁCEA EN LA WEB: Noritate Available For Treatment Of Rosacea 
32.) ROSÁCEA EN LA WEB: Lotion Proven Safe, Effective For Rosacea 
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1.) Rosaceous lymphedema: a rare variant of a common disorder. 
====================================================
Author 
Harvey DT; Fenske NA; Glass LF 
Address 
Division of Dermatology and Cutaneous Surgery, University of South
Florida College of
Medicine 33612, USA. 
Source 
Cutis, 61(5):321-4 1998 Jun 
Abstract 

Rosaceous lymphedema is considered to be a rare and disfiguring variant of acne rosacea. Cases remain difficult to treat and can challenge afflicted patients both cosmetically and psychologically. We describe an unusual presentation of rosaceous lymphedema and review the differential diagnosis of persistent facial edema. 

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2.) Comparison of the long-pulse dye (590-595 nm) and KTP (532 nm) lasers in the treatment of facial and leg telangiectasias. 
====================================================
Author 
West TB; Alster TS 
Address 
Washington Institute of Dermatologic Laser Surgery, Washington, DC, USA. 
Source 
Dermatol Surg, 24(2):221-6 1998 Feb 

Abstract 

BACKGROUND: Telangiectasias develop on the face secondary to genetic predisposition, chronic actinic damage, collagen vascular disease, topical steroid application, and disorders of vascular regulation including acne rosacea. Linear and "spider" telangiectasias develop on the legs, especially in women beginning in the second to third decade, secondary to multiple factors including genetic predisposition, gravity, pregnancy, and trauma.

OBJECTIVE: The purpose of this investigation was to compare the 590- and 595-nm long-pulse (1.5 msec) dye laser and KTP (532 nm) laser in the treatment of facial and leg telangiectasias.

RESULTS: For both facial and lower extremity telangiectasias, the difference in improvement ratings between the two lasers following both one and two treatment sessions was statistically significant.

CONCLUSION: Both the flashlamp-pumped long-pulse dye laser and the KTP laser may play a role in the treatment of facial and leg telangiectasias. However, when used to treat vessels on the lower extremities, both of these laser systems are probably best used in conjunction with sclerotherapy of the larger "feeding" reticular veins. While long-pulse dye laser irradiation achieves superior vessel clearance, patients may prefer multiple treatments with the KTP laser due to its low side effect profile and decreased associated pain. 

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3.) Rhinophyma: treatment with CO2 laser. 
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Author 
Lomeo P; McDonald J; Finneman J 
Address 
Department of Otolaryngology--Head and Neck, Mercy/General Health
Partners,
Muskegon, Michigan, USA. 
Source 
Ear Nose Throat J, 76(10):740-3 1997 Oct 

Abstract 

Rhinophyma is an acne rosacea which primarily affects the midface of elderly men, and causes disfigurement as well as obstruction. There are numerous ways of treating this condition and, in our institution, a CO2 laser is the treatment of choice. 

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4.) [Rosacea with ocular involvement in a child] 
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Author 
Bourrat E; Rybojad M; Deplus S; Morel P 
Address 
Service de Dermatologie, H^opital Saint-Louis, Paris. 
Source 
Ann Dermatol Venereol, 123(10):664-5 1996 


Abstract 

INTRODUCTION: Rosacea ia an uncommon facial eruption in children. We report a case of rosacea associated with a specific episcleritis.

CASE REPORT: A 10-year-old girl consulted for an erythematous papular and pustular eruption of the mid face of 1 month duration. The child complained that she had had a red painful right eye for 6 months. There was no argument for acne, periorificial granulomatous dermititis or for sarcoidosis. The ophthalmological examination gave the diagnosis of ocular and cutaneous rosacea. Oral antibiotics followed by erythromycin gave favorable results for both skin and ocular lesions.

DISCUSSION: Ocular involvement is a frequent complication of rosacea in adults. It is exceptional in children in whom rosacea is in itself rare. The presence of blepharitis, keratoconjunctivitis or episcleritis may suggest the diagnosis in a child with a mid facial eruption. As in the adult, skin and ocular rosacea responds well to prolonged oral antibiotics. The choice of the antibiotic depends on the age of the child. Cyclins are not authorized in children under the age of 8 years. 
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5.) Rosacea: recognition and management for the primary care provider. 
====================================================
Author 
Chalmers DA 
Address 
Integrated Cardiovascular Therapeutics, Woodbury, N.Y., USA. 
Source 
Nurse Pract, 22(10):18, 23-8, 30 1997 Oct 

Abstract 
Rosacea is a common facial dermatitis that currently affects an estimated 13 million Americans. It is a chronic and progressive cutaneous vascular disorder, primarily involving the malar and nasal areas of the face. Rosacea is characterized by flushing, erythema, papules, pustules, telanglectasia, facial edema, ocular lesions, and, in its most advanced and severe form, rhinophyma. Ocular lesions are common, including mild conjunctivitis, burning, and grittiness.

Blepharitis, the most common ocular manifestation, is a nonulcerative condition of the lid margins. Rosacea most commonly occurs between the ages of 30 to 60, and may be seen in women experiencing hormonal changes associated with menopause.

Women are more frequently affected than men; the most severe cases, however, are seen in men. Fair complexioned individuals of Northern European descent are most likely to be at risk for rosacea; most appear to be pre-disposed to flushing and blushing. Alcohol, stress, spicy foods, and extremes of temperature have all been implicated, but have not been found to actually cause rosacea.

Early diagnosis by the primary care practitioner, management with systemic antibiotics such as tetracycline, and topical agents such as metronidazole, in conjunction with patient education and lifestyle modifications, can achieve remission in most instances. 

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6.) The significance of Demodex folliculorum density in rosacea. 
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Author 
Erba¨gci Z; Ozg¨ozta¸si O 
Address 
Department of Dermatology, Faculty of Medicine, Gaziantep University,
Turkey. 
Source 
Int J Dermatol, 37(6):421-5 1998 Jun 

Abstract 

BACKGROUND: Demodex folliculorum has been reported in rosacea in a number of clinical studies. As the Demodex mite is also present in many healthy individuals, it has been suggested that the mite may have a pathogenic role only when it is present in high densities. Moreover, some authors have proposed that a mite density above 5/cm2 may be a criterion for the diagnosis of inflammatory rosacea. In this study, the possible role of D. folliculorum and the importance of mite density in rosacea were investigated using a skin surface biopsy technique.

METHODS: Thirty-eight patients with rosacea and 38 age-and-sex-matched healthy subjects entered the study. With the skin surface biopsy technique, we obtained samples from three facial sites. We then determined the mite positivities, the mean mite counts in both study groups, the mean mite densities at each facial site and in the rosacea subgroups, and the mite densities above 5/cm2.

RESULTS: The mean mite count in the rosacea group (6,684) was significantly higher than that in controls (2,868; p < 0.05). The cheek was the most frequently and heavily infested facial region. Ten rosacea patients and five normal subjects had mite densities over 5/cm2; the difference was not statistically significant (p > 0.05).

CONCLUSIONS: Rosacea is a disease of multifactorial origin, and individual properties may modify the severity of the inflammatory response to Demodex. We suggest that a certain mite density is not an appropriate criterion in the diagnosis of the disease; nevertheless, large numbers of D. folliculorum may have an important role in the pathogenesis of rosacea, together with other triggering factors. 

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7.) A study of the prevalence of Helicobacter pylori infection and other markers of upper gastrointestinal tract disease in patients with rosacea. 
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Author 
Sharma VK; Lynn A; Kaminski M; Vasudeva R; Howden CW 
Address 
Department of Internal Medicine, University of South Carolina School of Medicine, Columbia, USA. 
Source 
Am J Gastroenterol, 93(2):220-2 1998 Feb 

Abstract 

OBJECTIVE: Recent reports have suggested that patients with rosacea, a chronic inflammatory skin disorder of unknown etiology, have an increased prevalence of Helicobacter pylori infection. However, no causal relation has been identified. This study was designed to determine the prevalence of H. pylori infection and upper gastrointestinal symptoms in rosacea patients and in subjects without chronic skin disorders.

METHODS: Forty-five patients with rosacea and 43 healthy subjects underwent serological testing for H. pylori infection. Demographics, gastrointestinal symptoms, and medication use were recorded using a structured questionnaire.


RESULTS: There was no significant difference in the seroprevalence of H. pylori infection between rosacea patients and healthy subjects (26.7% vs 34.9%; p = 0.40). Significantly more patients with rosacea complained of indigestion (66.7% vs 32.6%; p = 0.001) and used antacids (60% vs 32.6; p = 0.01). There was no significant difference in the prevalence of H. pylori infection between symptomatic and asymptomatic rosacea patients, or in those using antacids. There were no differences in the frequency of heartburn, history of peptic ulcer disease, family history of peptic ulcer disease, use of H2-receptor antagonists, or use of nonsteroidal antiinflammatory drugs.

CONCLUSIONS: Patients with rosacea have similar rates of H. pylori infection as healthy subjects. Rosacea patients complain significantly more frequently of "indigestion" and use more antacids unrelated to H. pylori infection. 

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8.) Inflammatory cytokines in the tears of patients with ocular rosacea. 
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Author 
Barton K; Monroy DC; Nava A; Pflugfelder SC 
Address 
Ocular Surface and Tear Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida, USA. 
Source 
Ophthalmology, 104(11):1868-74 1997 Nov 

Abstract 

OBJECTIVE: The purpose of the study is to compare tear fluid concentrations of interleukin-1alpha (IL-1alpha), tumor necrosis factor-alpha (TNF-alpha), and epidermal growth factor (EGF) in ocular rosacea with those in control subjects and to examine the relation between tear functions, such as production and clearance rate, and the concentrations of cytokines in tear fluid.

PARTICIPANTS AND INTERVENTION: Fourteen patients with severe meibomian gland disease, facial rosacea, and symptoms of ocular irritation were examined for ocular surface disease, tear production, and tear clearance rate (TCR). Twelve control subjects, frequency-matched for age, and 15 ideal normal subjects with no ocular symptoms and normal tear function were assessed using the same parameters. Minimally stimulated tear samples (20 microl) were drawn from each subject and analyzed using a sandwich enzyme-linked immunosorbent assay to detect IL-1alpha, TNF-alpha, and EGF.

RESULTS: Tear IL-1alpha concentration was significantly higher in patients with rosacea than in age-matched (P = 0.003) and ideal control subjects (P < 0.001). Tumor necrosis factor-alpha was not detected in patients or control subjects, indicating levels of less than 10 pg/ml. Epidermal growth factor was not significantly higher in patients with rosacea than in age-matched control subjects. Tear turnover LN(TCR) was lower in patients with rosacea than in both age-matched (P = 0.048) and ideal control subjects (P = 0.002). Schirmer I scores were statistically lower in patients with rosacea than in ideal control subjects (P = 0.013), but not age-matched control subjects. Interleukin-1alpha was correlated inversely with LN(TCR) (r= -0.58, P < 0.0001) and Schirmer I (r = -0.39, P = 0.012).

CONCLUSIONS: Concentrations of IL-1alpha are present in normal tears but are elevated in ocular rosacea, whereas TNF-alpha is not present in either case. The reduced tear turnover, LN(TCR), its inverse correlation with IL-1alpha, and the absence of TNF-alpha in the tears of these patients suggest that the increased concentration of IL-1alpha observed may be largely because of clearance failure of cytokine normally produced at the ocular surface. 

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9.) Rosacea: how to recognize and treat an age-related skin disease. 
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Author 
Litt JZ 
Address 
Case Western Reserve University School of Medicine, Cleveland, OH, USA. 
Source 
Geriatrics, 52(11):39-40, 42, 45-7 1997 Nov 

Abstract 

Rosacea is an age-related disorder of the central portion of the facial skin whose peak onset occurs in persons in their 40s and 50s. A chronic and progressive condition of flare-ups and remissions, rosacea can be disfiguring if left untreated. Rosacea can be characterized as having three stages. Target areas for all symptoms include the cheeks, nose, chin, or forehead. Rosacea resembles a number of other dermatologic conditions, particularly acne vulgaris. The combination of oral and topical antibiotic therapy usually brings about remission. The key is to recognize the early signs and clinical picture so that accurate diagnosis can be made and therapy and counseling instituted. 

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10.) Topical metronidazole maintains remissions of rosacea. 
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Author 
Dahl MV; Katz HI; Krueger GG; Millikan LE; Odom RB; Parker F; Wolf JE Jr; Aly R; Bayles C; Reusser B; Weidner M; Coleman E; Patrignelli R; Tuley MR; Baker MO; Herndon JH Jr; Czernielewski JM 
Address 
Department of Dermatology, University of Minnesota, Minneapolis, USA. 
Source 
Arch Dermatol, 134(6):679-83 1998 Jun 

Abstract 

BACKGROUND: Rosacea is a chronic skin disease that requires long-term therapy. Oral antibiotics and topical metronidazole successfully treat rosacea. Because long-term use of systemic antibiotics carries risks for systemic complications and adverse reactions, topical treatments are preferred.

OBJECTIVE: To determine if the use of topical metronidazole gel (Metrogel) could prevent relapse of moderate to severe rosacea.

DESIGN: A combination of oral tetracycline and topical metronidazole gel was used to treat 113 subjects with rosacea (open portion of the study). Successfully treated subjects (n = 88) entered a randomized, double-blind, placebo-controlled study applying either 0.75% topical metronidazole gel (active agent) or topical metronidazole vehicle gel (placebo) twice daily (blinded portion of the study).

SETTING: Subjects were enrolled at 6 separate sites in large cities at sites associated with major medical centers.

SUBJECTS: One hundred thirteen subjects with at least 6 inflammatory papules and pustules, moderate to severe facial erythema and telangiectasia entered the open phase of the study. Eighty-eight subjects responded to treatment with systemic tetracycline and topical metronidazole gel as measured by at least a 70% reduction in the number of inflammatory lesions. These subjects were randomized to receive 1 of 2 treatments: either 0.75% metronidazole gel or placebo gel.

INTERVENTIONS: Subjects were evaluated monthly for up to 6 months to determine relapse rates. MAIN OUTCOME

MEASURES: Inflammatory papules and pustules were counted at each visit. Relapse was determined by the appearance of a clinically significant increase in the number of papules and pustules. Prominence of telangiectases and dryness (roughness and scaling) were also observed.

RESULTS: In the open phase, treatment with tetracycline and metronidazole gel eliminated all papules and pustules in 67 subjects (59%). The faces of 104 subjects (92%) displayed fewer papules and pustules after treatment, and 82 subjects (73%) exhibited less erythema. In the randomized double-blind phase, the use of topical metronidazole significantly prolonged the disease-free interval and minimized recurrence compared with subjects treated with the vehicle. Eighteen (42%) of 43 subjects applying the vehicle experienced relapse, compared with 9 (23%) of 39 subjects applying metronidazole gel (P<.05). The metronidazole group had fewer papules and/or pustules after 6 months of treatment (P<.01). Relapse of erythema also occurred less often in subjects treated with metronidazole (74% vs 55%).

CONCLUSION: In a majority of subjects studied, continued treatment with metronidazole gel alone maintains remission of moderate to severe rosacea induced by treatment with oral tetracycline and topical metronidazole gel. 

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11.) Effective sunscreen ingredients and cutaneous irritation in patients with rosacea. 
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Author 
Nichols K; Desai N; Lebwohl MG 
Address 
Department of Dermatology, Mount Sinai School of Medicine, New York,New York,
USA. 
Source 
Cutis, 61(5):344-6 1998 Jun 

Abstract 

Patients with rosacea are particularly susceptible to the irritation caused by sunscreen ingredients. The purpose of this bilateral comparison study was to examine the effects of different ingredients found in sunscreen on facial cutaneous irritancy in patients with rosacea. patients clinically diagnosed with rosacea were asked to test different preparations of common sunscreens on their faces. The results show that the presence or absence of appropriate protective ingredients, such as dimethicone and cyclomethicone in the vehicle, may prevent irritation from other sunscreen ingredients in patients with inflammatory conditions such as rosacea. 
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12.) Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. 
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Author 
Neumann E; Frithz A 
Address 
Department of Dermatology, S¨odersjukhuset, Stockholm, Sweden. 
Source 
Int J Dermatol, 37(4):263-6 1998 Apr 

Abstract 

BACKGROUND: Dilatation of vascular vessels in rosacea has generally been attributed to yielding to deranged connective tissue. In contrast, in a previous study a degrading effect of insufficient vascular vessels in connective tissue has been demonstrated in connection with diabetic microangiopathy. In yet another paper, it was demonstrated that the fusing of damaged capillaries, which had lost part of their adjacent walls due to functional inadequacy, led to the formation of dilated vessels. These pathogenetic patterns are the main subjects of this study of rosacea.

METHODS: Punch biopsies from rosacea lesions were examined by light microscopy and immunochemistry in order to identify structural changes leading to the formation of telangiectasias.

RESULTS: Deranged connective tissue is secondary to damaged capillaries. The primary damage may be evoked mostly by environmental influences, mainly the sun.

CONCLUSIONS: Infections, infestations, and granulomatous formations are not primary in the development of rosacea. 

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13.) Ocular rosacea: patient characteristics and follow-up. 
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Author 
Akpek EK; Merchant A; Pinar V; Foster CS 
Address 
Department of Immunology, Massachusetts Eye and Ear Infirmary, Boston 02114, USA. 
Source 
Ophthalmology, 104(11):1863-7 1997 Nov 

Abstract 

PURPOSE: The purpose of this report is to review the presenting symptoms and signs, treatment regimens used, complications encountered, and outcome in a cohort of patients with ocular rosacea.

METHODS: The medical records of 131 patients with a diagnosis of ocular rosacea were reviewed retrospectively. Data were entered in a tabulated form, and a descriptive analysis was performed.

RESULTS: The age range at presentation was between 23 and 85 years (mean, 56 years). Cutaneous manifestations of rosacea were present in 112 of the patients at their first visit. The most common presenting symptoms were foreign body sensation and burning, and the most common signs were telangiectasia and irregularity of lid margins, and meibomian gland dysfunction. Thirteen patients had decreased visual acuity at the time of presentation due to corneal complications. Six of these patients required penetrating keratoplasty during the course of their disease. Seven patients had severe cicatrizing conjunctivitis at the time of referral. One hundred thirteen patients were treated with oral tetracycline derivatives. Seven patients were left with visual acuity less than 20/400, and one patient underwent enucleation for corneal perforation and endophthalmitis.

CONCLUSIONS: Ocular rosacea is a common disease involving the skin and the eyes. It is widely underdiagnosed by many ophthalmologists despite the blinding potential. Successful therapy requires a multidisciplinary approach. 

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14.) Cutaneous angiosarcoma of the face: clinicopathologic and immunohistochemical study of a case resembling rosacea clinically. 
====================================================
Author 
Mentzel T; Kutzner H; Wollina U 
Address 
Institute of Pathology, University of Jena, Germany. 
Source 
J Am Acad Dermatol, 38(5 Pt 2):837-40 1998 May 


Abstract 


An unusual cutaneous angiosarcoma resembling rosacea clinically is described. A 66-year-old man presented with a red discoloration and a diffuse swelling on his nose over a 2-year period that was diagnosed as rosacea. Despite antiinflammatory treatment, the infiltration increased and, after repeated skin biopsies, the diagnosis of a well-differentiated cutaneous angiosarcoma associated with a prominent inflammatory infiltrate was considered. The neoplasm was treated by surgery. The described case emphasizes that diffuse swelling and rosacea-like clinical features should be added to the variably clinical features of cutaneous angiosarcoma. 

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15.) A study on Demodex folliculorum in rosacea. 
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Author 
Abd-El-Al AM; Bayoumy AM; Abou Salem EA 
Address 
Department of Dermatology, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo. 
Source 
J Egypt Soc Parasitol, 27(1):183-95 1997 Apr 

Abstract 

A random sample of 16 female patients suffering from papulopustular rosacea (PPR) as well as (16) normal female healthy subjects as control group were adopted in this study to assess of Demodex folliculorum pathogenesis. It was done through determination of mite density using a standard skin surface biopsy 10.5 cm2 from different designated 6 areas on the face, and scanning electron microscopic study (SEM) as well as total IgE estimation.

A trial of treatment using Crotamiton 10% cream with special program was also attempted. All subjects ranged between 35-55 years old. All patients with rosacea and 15 of the control group i.e. 75.93% were found to harbour mites. The mean mite counts by site distribution were 28.6 & 6.9 on the cheeks, followed by 14.5 & 3.0 on the forehead and lastly 6.8 & 0.8 on the chin in PPR and control groups respectively.

The total mean mite count in patients was 49.9 initially and 7.9 after treatment. In the control group it was 10.7 & 10.6 respectively. The mean total IgE was 169.4 & 168.4 and 96.3 & 98.4 in PPR and control groups respectively Light and scanning electron microscopy revealed that all mites were pointing in one direction. Some of them were containing bacteria inside their gut and on their skin. After treatment 3 cases (18.75%) were completely cured, 10 cases (62.5%) gave moderate response while 3 cases (18.75) have no response.

In conclusion, this study supports the pathogenic role of D. folliculorum in rosacea

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16.) A double-blind, multicenter clinical trial comparing efficacy of once-daily metronidazole 1 percent cream to vehicle in patients with rosacea. 
====================================================
Author 
Breneman DL; Stewart D; Hevia O; Hino PD; Drake LA 
Address 
Dermik Laboratories, Inc., Collegeville, Pennsylvania 19426-1200, USA. 
Source 
Cutis, 61(1):44-7 1998 Jan 

Abstract 

The efficacy and safety of a new formulation of metronidazole 1 percent cream applied once daily was compared to vehicle cream in a double-blind, randomized, parallel group, ten-week clinical study. The results showed that metronidazole 1 percent cream was significantly better than vehicle in reducing the lesions of rosacea, improving erythema, and physician's global rosacea scores. The incidence of adverse events related to the skin was low. 

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17.) The Demodex mite population in rosacea [see comments]
====================================================
CM - Comment in: J Am Acad Dermatol 1994 May; 30(5 Pt 1):812-3
SO - J Am Acad Dermatol 1993 Mar;28(3):443-8
AU - Bonnar E; Eustace P; Powell FC
AD - University Department of Ophthalmology, Mater Misercordiae Hospital, Dublin, Ireland.
MJ - Acne Rosacea [parasitology]; Mites; Skin [parasitology]
MN - Acne Rosacea [drug therapy]; Adult; Aged, 80 and over; Aged; Face; Middle Age; Tetracycline [therapeutic use]
MT - Animal; Female; Human; Male
PT - JOURNAL ARTICLE

AB - BACKGROUND: The cause of rosacea is unknown; among other factors a causative role has been postulated for the hair follicle mites Demodex folliculorum and Demodex brevis.

OBJECTIVE: Our purpose was to compare the population density of Demodex mites in facial skin of defined categories of patients with rosacea with control subjects. We also assessed the impact of tetracycline therapy on the mite population.

METHODS: The population density and distribution of Demodex mites were studied in the facial skin of 42 patients with rosacea and 42 age- and sex-matched control subjects. Mites were counted in measured skin surface biopsy specimens obtained from six standard facial sites with cyanoacrylate glue.

RESULTS: The mean mite count was 49.8 (range 2 to 158) in patients with rosacea and 10.8 (range up to 97) in control subjects (p 0.001); the highest density of mites was found on the cheeks. A statistically significant increase in mites was found in all subgroups of rosacea, being most marked in those with steroid-induced rosacea. Mite counts in patients with rosacea before and after a 1-month course of oral tetracycline showed no significant difference.

CONCLUSION: Increased mites may play a part in the pathogenesis of rosacea by provoking inflammatory or allergic reactions, by mechanical blockage of follicles, or by acting as vectors for microorganisms.

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18.) Treatment of rosacea: topical clindamycin versus oral tetracycline.
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SO - Int J Dermatol 1993 Jan;32(1):65-7
AU - Wilkin JK; De Witt S
AD - Department of Medicine, Ohio State University.
MJ - Acne Rosacea [drug therapy]; Clindamycin [analogs & derivatives]; Tetracycline [therapeutic use]
MN - Administration, Cutaneous; Administration, Oral; Adult; Aged; Clindamycin [therapeutic use]; Double-Blind Method; Follow-Up Studies; Middle Age
MT - Comparative Study; Human; Support, Non-U.S. Gov't
PT - CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

AB - BACKGROUND. A new topical antibiotic preparation, clindamycin in a lotion base, was compared with oral tetracycline in the treatment of rosacea. Forty-three patients clinically diagnosed as having rosacea were examined in an investigator-blinded study.

METHODS. Patients used topical clindamycin lotion applied twice daily or the usual oral dose of tetracycline hydrochloride (250 mg four times a day for 3 weeks, then 250 mg twice a day for the remaining 9 weeks). Patients' lesions were examined clinically at 3-week intervals over a period of 12 weeks.

RESULTS. Topical clindamycin treatment produced similar clinical results to oral tetracycline and was superior in the eradication of pustules.

CONCLUSIONS. These results show topical clindamycin in a lotion base to be a safe and effective alternative to oral tetracycline therapy in the treatment of rosacea.

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19.) [Double-blind study versus excipient of 0.75% metronidazole gel in the treatment of rosacea]
====================================================
TT - [Etude en double insu contre excipient du metronidazole gel a 0.75 p. 100 dans le traitement de la rosacee.]
SO - Ann Dermatol Venereol 1993;120(2):129-33
AU - Espagne E; Guillaume JC; Archimbaud A; Baspeyras M; Boitier F; Bussiere M; Chamberlin J; Coin A; Di Crescenzo MC; Dolivo M; et al
AD - Groupe d'Essais Therapeutiques en Pratique de Ville, Hopital Henri Mondor, Creteil.
MJ - Acne Rosacea [drug therapy]; Metronidazole [therapeutic use]
MN - Administration, Topical; Adult; Double-Blind Method; Excipients; Gels; Metronidazole [administration & dosage]; Placebos
MT - Comparative Study; Female; Human; Male
MC - English Abstract
PT - CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

AB - INTRODUCTION. The proven value of tetracyclines and metronidazole administered orally in the treatment of the chronic and recurrent disease that is rosacea is tempered by the important undesirable effects observed in long-term therapy. The purpose of this study was to test the effectiveness of an 0.75 p. 100 metronidazole gel in the treatment of rosacea.

PATIENTS AND METHODS. The study involved two groups of patients: one received the metronidazole gel and the other the vehicle of the gel used as placebo. The multicentre randomized trial was conducted in the double-blind fashion by 18 private dermatologists working in the Paris region. Fifty one patients who, since more than 3 months, had been presenting with rosacea, defined as at least 4 papulopustules associated with erythema and/or telangiectasia, entered the trial. Topical treatments and systemic treatments which had shown some activity against rosacea had been interrupted for 15 days or 2 months respectively. The product (or the placebo) was applied a.m. and p.m. on the whole dry face. The patients were seen on days 0, 21 and 42. The evaluation was purely clinical, and the principal criterion of judgement was a change in the number of papulopustules between days 0 and 42.

RESULTS. The metronidazole gel reduced the number of papulopustules between day 0 and day 42, and this reduction was significantly greater than that observed with the excipient alone. The active product began to be effective during the third week and remained so during the next three weeks. Both the metronidazole gel and its excipient seemed to be poorly tolerated, with frequent complaints of dry skin, but in 5 women of the metronidazole group this dryness was alleviated by application of moisturizers.

CONCLUSION. This study has demonstrated that the 0.75 p. 100 metronidazole gel is effective in the treatment of the papulopustular component of rosacea.

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20.) Oral spironolactone therapy in male patients with rosacea.
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SO - J Dermatol 1992 May;19(5):293-7
AU - Aizawa H; Niimura M
AD - Department of Dermatology, Jikei University School of Medicine, Tokyo, Japan.
MJ - Acne Rosacea [drug therapy]; Spironolactone [administration & dosage]
MN - Acne Rosacea [blood]; Administration, Oral; Adult; Middle Age; Sebaceous Glands [drug effects]; Sex Hormones [blood]; Spironolactone [pharmacology]
MT - Human; Male
PT - JOURNAL ARTICLE

AB - Spironolactone at 50 mg/day was orally administered for four weeks to 13 male patients with rosacea in order to observe its clinical effectiveness. Serum estradiol (E2), 17OH-progesterone (17OH-P4), testosterone (T), androstenedione (delta 4 A), dihydrotestosterone (DHT), dehydro-epiandrosterone sulfate (DHEA-S) were measured prior to and after treatment. Although there were no significant changes in T, delta 4A, DHT, or DHEA-S, the serum levels of 17OH-P4 increased significantly. E2 tended to increase, although the change was not significant. Two of the 13 patients discontinued spironolactone treatment because of general malaise, but seven of the remaining eleven patients exhibited an improvement in their rosacea.

These findings demonstrate that a low dose of spironolactone is effective in the treatment of rosacea in some male patients and suggest that it is possible that changes in the metabolism of sex steroid hormones such as cytochrome p-450 isozymes have some bearing on the etiology of rosacea.

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21.) Childhood rosacea.
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SO - Pediatr Dermatol 1992 Mar;9(1):22-6
AU - Drolet B; Paller AS
AD - Department of Pediatrics and Dermatology, Children's Memorial Hospital, Northwestern University Medical School, Chicago, Illinois.
MJ - Acne Rosacea
MN - Acne Rosacea [diagnosis] [drug therapy]; Antibiotics [therapeutic use]; Child
MT - Case Report; Female; Human; Male
PT - JOURNAL ARTICLE

AB - Rosacea usually occurs in adults and rarely has been noted in children. We recently observed three children with rosacea, all of whom responded dramatically to systemic and topical antibiotics. Rosacea in childhood must be distinguished from other erythematous facial disorders, most commonly acne, granulomatous perioral dermatitis, and sarcoidosis. The distribution of facial lesions; the presence of telangiectasias, flushing, and pustules; and the appearance of lesional biopsy sections and the ocular lesions, if present, allow differentiation of rosacea from other facial eruptions.

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22.) A clinical and histopathologic study of granulomatous rosacea.
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SO - J Am Acad Dermatol 1991 Dec;25(6 Pt 1):1038-43
AU - Helm KF; Menz J; Gibson LE; Dicken CH
AD - Department of Dermatology, Mayo Clinic, Rochester, MN 55905.
MJ - Acne Rosacea [pathology]
MN - Acne Rosacea [drug therapy]; Aged, 80 and over; Aged; Blister [pathology]; Elastic Tissue [pathology]; Erythema [pathology]; Folliculitis [pathology]; Granuloma [drug therapy] [pathology]; Histiocytes [pathology]; Lymphocytes [pathology]; Middle Age; Retrospective Studies; Single-Blind Method; Skin Aging [pathology]; Skin [blood supply] [pathology]; Telangiectasis [pathology]
MT - Female; Human; Male
PT - JOURNAL ARTICLE

AB - A retrospective clinical and histopathologic study of 53 patients with granulomatous rosacea was undertaken. The patients had a broad clinical spectrum of lesions that ranged from primarily erythema to papulonodular lesions. Extrafacial lesions occurred in 15% of patients. Histologic examination showed mixed lymphohistiocytic inflammation (primarily lymphocytic inflammation in 40% of patients and primarily histiocytic with a few giant cells in 34%), epithelioid granulomas in 11% of patients, and epithelioid granulomas with caseation necrosis in 11%. Most patients had a good response to oral antibiotic therapy. Granulomatous rosacea is not a distinct disease but can be regarded and treated as a subtype of rosacea.

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23.) Flash lamp pumped dye laser for rosacea-associated telangiectasia and erythema.
====================================================
SO - J Dermatol Surg Oncol 1991 Jun;17(6):522-5
AU - Lowe NJ; Behr KL; Fitzpatrick R; Goldman M; Ruiz-Esparza J
MJ - Acne Rosacea [complications]; Erythema [surgery]; Laser Surgery; Telangiectasis [surgery]
MN - Adult; Aged; Erythema [etiology]; Middle Age; Prognosis; Telangiectasis [etiology]
MT - Female; Human; Male
PT - JOURNAL ARTICLE

AB - The persistence of facial telangiectasis and erythema in patients with rosacea frequently presents a major cosmetic problem. It may also contribute to relapses of papular and pustular lesions. This study of 27 patients treated for their telangiectasia and erythema with a flash lamp pumped dye laser tuned at 585 nm is described. The laser gave good or excellent reduction of telangiectasia and erythema and overall appearance in 24 of the patients with between one and three treatments. In addition, papule and pustule activity was decreased in 59.2% of the patients, with those with the most severe pre-treatment activity having the most significant improvement. It is suggested that this is a useful additional form of treatment that may improve the telangiectasia and erythematous component of rosacea.


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24.) Topical metronidazole for severe and recalcitrant rosacea: a prospective open trial.
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SO - Cutis 1989 Mar;43(3):283-6
AU - Lowe NJ; Henderson T; Millikan LE; Smith S; Turk K; Parker F
AD - Department of Dermatology, UCLA School of Medicine.
MJ - Acne Rosacea [drug therapy]; Metronidazole [administration & dosage]
MN - Administration, Topical; Adult; Aged; Clinical Trials; Facial Dermatoses [drug therapy]; Middle Age; Prospective Studies
MT - Female; Human; Male; Support, Non-U.S. Gov't
PT - CLINICAL TRIAL; JOURNAL ARTICLE

AB - Nineteen patients with severe or recalcitrant rosacea were treated twice daily with 0.75 percent metronidazole topical gel in an open label study. Sixteen of the patients (84 percent) showed 50 percent or greater reduction in inflammatory lesions, while fifteen (79 percent) demonstrated a reduction in erythema severity and an improvement when evaluated by the investigator global assessment. No positive response was recorded for any patient prior to topical medication, whereas six of nine patients previously treated with tetracycline/minocycline demonstrated improvement. Seven of these nine patients responded to topical metronidazole treatment. One additional patient who did not respond to minocycline or desonide treatment showed a good response to topical metronidazole. Only one patient reported local irritation after using metronidazole.

These results demonstrate that topical metronidazole gel is safe and effective for the treatment of severe or recalcitrant rosacea.

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25.) An epidemiological study of rosacea.
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SO - Acta Derm Venereol 1989;69(5):419-23
AU - Berg M; Liden S
AD - Department of Dermatology, Karolinska Sjukhuset, Stockholm, Sweden.
MJ - Acne Rosacea [epidemiology]; Facial Dermatoses [epidemiology]
MN - Acne Rosacea [classification]; Adult; Facial Dermatoses [classification]; Middle Age; Sweden
MT - Female; Human; Male; Support, Non-U.S. Gov't
PT - JOURNAL ARTICLE

AB - In a non-selected population of 809 office employees (454 women and 355 men) 81 persons were diagnosed as having rosacea, giving a prevalence of 10% (women 14%, men 5%). The rosacea group was compared with the rest of the study population. Most of the cases were rather mild. The rosacea was of an erythematotelangiectatic type in 81% of the cases and of a papulopustular type in 19%. Unilateral lesions were found in 11 subjects (14%). Only 17% of those with rosacea were impaired by sunlight, whereas 26% improved. In the rosacea group, 27% were found to suffer from migraine and 42% from a tendency to flush, compared with 13% (p less than 0.001) and 16% (p less than 0.001) respectively in the comparison group. Flushing and the regulatory mechanism of the blood vessels thus seem to be of importance in the pathogenesis of rosacea. Individuals with good pigmentation ability showed a tendency to a decreased occurrence of rosacea. The frequency of eye complaints was the same in the two groups.

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26.) Isotretinoin treatment of rosacea.
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SO - Acta Derm Venereol 1987;67(1):89-91
AU - Turjanmaa K; Reunala T
MJ - Acne Rosacea [drug therapy]; Tretinoin [therapeutic use]
MN - Adult; Aged; Follow-Up Studies; Isomerism; Middle Age; Nasal Mucosa [drug effects]; Recurrence; Time Factors; Tretinoin [adverse effects]; Xerostomia [chemically induced]
MT - Female; Human; Male
PT - JOURNAL ARTICLE


AB - Twenty patients with severe rosacea were treated with isotretinoin for 3-6 months. Six patients initially received 1.0 mg/kg and 14 patients 0.5 mg/kg of isotretinoin. The response was good or excellent in all patients and the papulopustular lesions in particular cleared promptly. Patients receiving 1.0 mg/kg of isotretinoin experienced more side-effects and the dose had to be lowered in five of the six patients. Seventeen of the 20 patients had no relapses during a follow-up of one year showing that isotretinoin has a long-lasting favourable effect in rosacea.

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27.) May Helicobacter pylori be important for dermatologists?
====================================================
AU: Rebora-A; Drago-F; Parodi-A
AD: Department of Dermatology, University of Genoa, Italy.
SO: Dermatology. 1995; 191(1): 6-8
ISSN: 1018-8665
PY: 1995
LA: ENGLISH
CP: SWITZERLAND

AB: Helicobacter pylori, a microaerophilic gram-negative bacterium, is the major cause of gastritis, plays a key role in the etiology of peptic ulcer and is a risk factor for gastric cancer. Although 50% of the population is affected, dermatologist seem to be unaware of the impact H. pylori may have on cutaneous pathology. Among skin diseases, H. pylori has been related so far only with chronic urticaria and rosacea. In rosacea, histology of the stomach mucosa revealed tht 84% of 31 patients were H. pylori positive.

Twenty percent of them were serologically negative, but, overall, 100% of the 20 patients with both histology and serology were H. pylori positive with either test. The consistency between clinical success with metronidazole and abatement of H. pylori isolates and serology after treatment was an additional evidence suggesting an etiologic relationship between rosacea and H. pylori infection.

Rosacea has often been linked with gastrointestinal disturbances. H. pylori, therefore, may link them to the well-known beneficial activity of metronidazole on rosacea lesions. The role of H. pylori is more probable in erythrotic rosacea than in its papulopustular and granulomatous stages. As in Bacillus subtilis intoxication, a flush-inducing toxin cannot be excluded.

Despite the difficulty to find patients accepting bioptic gastroscopies, large case-control studies should be done before a causal relationship with urticaria and rosacea is firmly established.

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28.) Efficacy and safety of topical azelaic acid (20 percent cream): an overview of 
results from European clinical trials and experimental reports.
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AU: Graupe-K; Cunliffe-WJ; Gollnick-HP; Zaumseil-RP
AD: Department of Clinical Development, Schering AG, Berlin, Germany.
SO: Cutis. 1996 Jan; 57(1 Suppl): 20-35
ISSN: 0011-4162
PY: 1996
LA: ENGLISH
CP: UNITED-STATES

AB: Azelaic acid cream (20 percent) is a new topical treatment for acne with an additional therapeutic potential in rosacea and hyperpigmentation disorders. Azelaic acid (AzA; HOOC-(CH2)7-COOH) is a naturally occurring compound that interferes with acne pathogenesis by virtue of its antikeratinizing, antibacterial, and anti-inflammatory properties. Vehicle-controlled studies have verified that AzA exercises a significant and clinically relevant effect on both non-inflammatory and inflammatory acne lesions.

Comparisons with clinically proven therapies have shown that 20 percent AzA cream is an effective monotherapy in mild to moderate forms of acne, with an overall efficacy comparable to that of tretinoin (0.05 percent), benzoyl peroxide (5 percent), and topical erythromycin (2 percent). In the treatment of moderate to severe acne, 20 percent AzA cream may be favorably combined with minocycline (90 percent good and excellent results), and may contribute towards reducing recurrences following discontinuation of systemic therapy (maintenance therapy with AzA cream).

Particular advantages of AzA therapy include its favorable safety and side effect profile. It is non-teratogenic, is not associated with systemic adverse events or photodynamic reactions, exhibits excellent local tolerability, and does not induce resistance in Propionibacterium acnes.

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29.) Ocular rosacea. Signs, symptoms, and tear studies before and after treatment with 
doxycycline [see comments]
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Quarterman MJ; Johnson DW; Abele DC; Lesher JL Jr; Hull DS; Davis LS
Department of Medicine, Medical College of Georgia, Augusta, USA.
Arch Dermatol (UNITED STATES) Jan 1997 133 (1) p49-54 ISSN: 0003-987X
Note: Comment in: Arch Dermatol 1997 Jan;133(1 ):89-90
Language: ENGLISH
Document Type: CLINICAL TRIAL; JOURNAL ARTICLE 
Journal Announcement: 9705
Subfile: AIM; INDEX MEDICUS

OBJECTIVE: To examine ocular signs, symptoms, and results of tear analysis in  patients with cutaneous rosacea before, during, and after doxycycline therapy.  DESIGN: Before-after trial.

SETTING: General community.

PATIENTS OR OTHER  PARTICIPANTS: Thirty-nine patients with cutaneous rosacea underwent dermatologic and  ocular examinations, testing of tear break-up time, and Schirmer testing at baseline  and 4, 8, and 12 weeks. Six patients did not complete the study. Baseline tear  break-up time and results of Schirmer test were compared with those of 13 patients  without rosacea who were matched for age and sex. I

INTERVENTION: Patients with  rosacea were given doxycycline, 100 mg daily for 12 weeks.

MAIN OUTCOME MEASURE:  Statistically significant (P, .05) improvement in tear break-up time.

RESULT: The  most frequent ocular symptoms were dryness, itching, blurred vision, and  photosensitivity, all of which improved significantly with treatment. All patients  had signs of ocular disease, most commonly erythema and telangiectasia, meibomian  gland dysfunction, and ciliary base injection. Significant improvement (P,.05) for  scales, erythema and telangiectasia, ciliary base injection, bulbar injection,  papillary hypertrophy, and punctate epithelial erosions was seen. Average tear break- up time for the patients with rosacea was 5.7 seconds, which improved to 10.8 seconds  after 12 weeks of treatment (P = .007). Baseline tear break-up time was  significantly lower than for the comparison group of normal subjects (P = .001).  There was no correlation between severity of cutaneous disease and ocular disease. 

CONCLUSIONS: All patients with cutaneous rosacea had some degree of ocular  involvement. Tear break-up time is abnormal in patients with rosacea. Ocular  erythema and telangiectasia, meibomian gland dysfunction, and short tear break-up  time in patients with cutaneous rosacea are indicators of ocular rosacea.  Doxycycline, 100 mg daily, will improve ocular disease and increase the tear break-up  time.


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30.) [Dapsone in granulomatous rosacea] Dapson bei granulomatoser Rosazea.
====================================================
Krause MH; Torricelli R; Kundig T; Trueb RM; Hafner J
Dermatologische Klinik und Poliklinik, Universitatsspital, Zurich. Hautarzt (GERMANY) Apr 1997 48 (4) p246-8 ISSN: 0017-8470
Language: GERMAN Summary Language: ENGLISH
Document Type: 
JOURNAL ARTICLE English Abstract
Journal Announcement: 9709
Subfile: INDEX MEDICUS

We report on two patients with granulomatous rosacea and another patient with  granulomatous perioral dermatitis who responded well to dapsone. Dapsone has a  pharmacological double function as both an antibiotic and an antiphlogistic drug.  Before the introduction of isotretinoin, dapsone had its place in the treatment of  severe acne. To date, its use in granulomatous rosacea has not been described. When  hematologic parameters are monitored, dapsone is considered a safe and cost-effective  drug, especially in countries where isotretinoin is not readily available. However,  the definite value of dapsone in granulomatous rosacea should be established by a  controlled study.

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31.) Noritate Available For Treatment Of Rosacea 
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NEW YORK, NY -- January 22, 1998 -- Dermik Laboratories, Inc., has
announced the availability of Noritate(TM) (metronidazole cream) Cream, 1%, the first prescription topical rosacea therapy cleared for once-daily dosing in the treatment of inflammatory lesions and erythema (facial redness) associated with the condition.

Cleared for marketing by the United States Food and Drug Administration (FDA), this new treatment has been shown in studies to significantly reduce inflammatory lesions of rosacea in as little as four weeks with minimal skin dryness and irritation at the site of application. Rosacea is a chronic, inflammatory skin disorder that affects an estimated 13 million Americans.

"The rapid efficacy, unique approval for once-a-day dosing and erythema indication make Noritate an exciting new therapeutic option for patients with rosacea," said Joseph Jorizzo, MD, chair of the department of dermatology, Wake Forest University School of Medicine, who conducted clinical studies on the product. "The once-daily dosage, in particular, is a major benefit that offers an exciting opportunity that may improve patient compliance."


Rosacea therapies should become part of a patient's daily routine and be consistently followed in order to manage the condition. According to Dr. Jorizzo, daily regimens that are difficult to follow, time consuming or inconvenient, may prevent patients from complying with their treatment. 

"Compliance has been a significant problem in treating rosacea," Dr. Jorizzo said. "Patients are often reluctant to commit to complex treatment programs and want a simplified routine."

Rosacea is a condition characterized by excessive redness and accompanied by papules and pustules on the cheeks, chin, nose and forehead. Often mistaken for acne, rosacea is most prevalent among fair-skinned women between the ages of 30 and 50, but tends to be more severe when present in men.

It is frequently triggered or exacerbated by extreme temperatures, spicy foods, alcoholic beverages, exercise and stress. The often embarrassing condition rarely reverses itself and cannot be cured, but it can be controlled with regular treatment.

Most of the 13 million Americans affected by rosacea are women, and many who suffer from the condition may be concerned about their appearance because of the unpredictable and unsightly flushing.
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32.) Lotion Proven Safe, Effective For Rosacea 
====================================================

LINCOLNSHIRE, Ill., June 5, 1997 -- A topical lotion used successfully for years to treat acne has recently been proven effective and safe for treating rosacea, a chronic skin disease. The study appears in the June issue of Journal of Dermatological Treatment.

Rosacea is a chronic skin disease characterized by facial redness affecting the nose, cheeks and chin. Approximately five percent of the U.S. population suffer from the disease, which has disfigured the noses of individuals such as W.C. Fields and J.P. Morgan.

"This study verifies what a growing number of dermatologists and other physicians already know," says Scott B. Phillips, M.D., principal author of the study. "The combination of sodium sulfacetamide and sulfur is a safe and effective treatment for rosacea." Dr. Phillips is a dermatologist and clinical assistant professor at the University of Chicago Hospitals.

Sodium sulfacetamide and sulfur are ingredients found in Novacet(R) Lotion (sodium sulfacetamide 10 percent and sulfur 5 percent), a prescription medication approved for the treatment of acne from GenDerm Corporation.

The vehicle controlled, double-blind study tested 103 patients suffering from rosacea. Patients who used Novacet showed significant improvement with an 83 percent reduction in erythema (facial redness) and 78 percent decrease in inflammatory lesions by the eighth week of the study.

Rosacea typically appears after age 30 and affects more women than men. In the early stages of the disease, facial flushing or blushing will appear and disappear. As the disease progresses, small red or pus-filled bumps appear. These "bumps" are often mistaken for acne. For some individuals, the nose and cheeks may appear puffy, and thick, knobby bumps may develop on the nose.

While there is no cure for rosacea, it can be controlled with early medical treatment and lifestyle modification, such as avoiding spicy foods, reducing one's stress, or not spending extended periods of time under the hot sun.

A variety of prescription medications are available for treating rosacea. These include the use of oral and topical antibiotics, topical sulfur medications, laser treatments or surgery.

For information about a free brochure called "Rosacea: The More You Know...," people can call toll-free by dialing 888-278-4545. Or write to Rosacea Help Line, 600 Knightsbridge Parkway, Lincolnshire, Illinois 60069.