Rosacea Research Articles

The associations between gut microbiota and inflammatory skin diseases: a bi-directional two-sample Mendelian randomization study.

Accumulating evidence shows that dysregulation of intestinal flora is associated with inflammatory skin diseases, specifically atopic dermatitis (AD), psoriasis (PSO), and rosacea (ROS). However, the causality is still unclear. To study the underlying causality between gut microbiota (GM) and AD, PSO, and ROS, a bi-directional two-sample Mendelian randomization (2SMR) analysis was conducted. Summary statistics of gut microbiota, AD, PSO, and ROS were extracted from large-scale genome-wide association studies (GWASs). In 2SMR analysis, in addition to the inverse variance weighted as the principal method for evaluating causal association, four different methods were also used. Sensitivity analysis and reverse 2SMR study were implemented to evaluate the robustness of 2SMR results or reverse causal relationship, respectively. A total of 24 specific gut microbiota species related to AD, PSO, and ROS were identified by 2SMR analysis. After using the Bonferroni method for multiple testing correction, family FamilyXIII (ID: 1957) [OR = 1.28 (1.13, 1.45), p = 9.26e-05] and genus Eubacteriumfissicatenagroup (ID: 14373) [OR = 1.20 (1.09, 1.33), p = 1.65e-04] were associated with an increased risk for AD and PSO, respectively. The genus Dialister showed a negative association, suggesting a protective role against both atopic dermatitis and rosacea. Our reverse 2SMR analysis indicated no reverse causality between these inflammatory skin diseases and the identified gut microbiota. In summary, this study provided evidence for the causality between GM and inflammatory skin diseases. These findings suggested that supplementing specific bacterial taxa may be an effective therapy for AD, PSO, and ROS.

Granulomatous Rosacea Aggregatively Occurring on the Nose

Granulomatous Rosacea Aggregatively Occurring on the Nose

Efficacy of Topical Dapsone 5% Gel for the Treatment of Erythematotelangiectatic Rosacea: New Treatment Option With Old Drug.

Many topical drugs are used in the treatment of erythematotelangiectatic rosacea (ETR). However, dapsone 5% gel has never been used in ETR to date. To evaluate the efficacy of dapsone 5% gel as a new treatment option for ETR. Thirty-five patients with ETR were included in the study. Diagnosis was made with National Rosacea Society criteria. Dapsone 5% gel was used topically twice a day for 12 weeks. Investigator Global Assessment (IGA) 4-point scale ( 0 → Clean, 1 → mild, 2 → moderate, 3 → severe, 4 → very severe), Visual Analogue Scale (VAS) and Dermatology Life Quality Index (DLQI) were used for evaluation (at baseline, 2nd, 6th, and 12th weeks). IGA scores among baseline (2 → 62.9%, 3 → 34.3%, 4 → 2.9%) and 2nd (1 → 14.3%, 2 → 77, 1%, 3 → 8.6%), 6th (1 → 45, 7%, 2 → 54.3%) and 12th weeks (1 → 62.9%, 2 → 37.1%) were found to be statistically significant (P < 0.001). Median VAS scores among baseline (median = 7 [5-9]) and 2nd (median=5 [3-8]), 6th (median=5 [3-6]) and 12th weeks (median = 4 [2-6]) were statistically significant (P < 0.001). Median DLQI scores among baseline (median = 8 [6-14]) and 2nd (median = 5 [3-11]), 6th (median = 5 [3-11]) and 12th weeks (median = 4 [2-9]) were statistically significant (p<0.001). Concurrent systemic disease was a risk factor for poor treatment response (P = 0.034). Mild irritation was observed in 3 patients (8.5%) during treatment. Dapsone 5% gel was effective and well tolerated in ETR treatment.

Rosacea is More than Just a Red Face: Microbotox's Role in Minimizing Enlarged Facial Pores for a Rosacea Patient

Enlarged facial pores are a cosmetic concern and a prominent feature of skin aging that impacts patient quality of life. Microbotox has emerged in multiple studies as a solution for reducing pore size and improving skin texture. A case of 29 years old female with papulopustular rosacea and enlarged skin pores was reported. From the patient's anamnesis, it was found that the patient has been complaining of a reddish patch with pimples on the nose and both cheeks for the past 4 years. The patient has also had enlarged pores on both cheeks for the past 3 years. On dermatologic state there were erythematous macule, erythematous papules and enlarged pores on both of the cheek. Global Flushing Severity Score (GFSS) was 3, Investigator’s Global Assessment (IGA) of Rosacea Severity for papules and pustules is grade 2 and erythema grade 2. Visual Assessment for Pore was 6. Patient received a single session of microbotox. Dermoscopy examination showed linear vessels (telangiectasia), a pustule, and also follicles filled with sebum. Follow up of the patient was done for 6 weeks. Patients reported a decrease in issues such as flushing, papules, pustules, and erythema. A noticeable improvement in pore size was also observed. This action can be repeated every 3 months to maintain clinical improvement and good skin texture. Botulinum toxin exhibits a satisfying level of efficacy and safety in rosacea treatment. A single microbotox session proves to be a safe and effective approach for reducing facial pore size, along with notable improvements in skin texture.

Rosacea treatment with mussel adhesive protein delivered via microneedling: Invivo and clinical studies.

Rosacea is a prevalent chronic dermatological condition marked by facial inflammation and erythema, significantly compromising the quality of life for affected individuals. Current treatment methods for rosacea are not considered ideal because of the complex etiology of the disease. Mussel adhesive protein (MAP) is a glycoprotein derived from the foot gland of mussels. The protein exhibits anti-inflammatory properties, relieves skin itching, and promotes wound healing. We aimed to explore the feasibility of using MAP administered via microneedle delivery for treating rosacea and the potential molecular mechanism involved. The therapeutic effect and mechanism of MAP microneedle delivery in an LL-37-induced rosacea-like mouse model were observed using morphological and histological methods. Twenty-seven patients with erythematotelangiectatic rosacea (ETR) underwent treatment once every 1 month, with three treatments constituting one treatment course. The therapeutic effect was evaluated by comparing the clinical images taken at baseline, after the first treatment course, and after the second treatment course. The red value, CEA, and GFSS score were also calculated. In response to the microneedle delivery of MAP, innate immunity, inflammatory infiltration, and abnormal neurovascular regulation improved significantly in rosacea-like mice. In the clinical experiments, the microneedle delivery of MAP significantly improved the symptoms of erythema, flushing, and telangiectasia in patients with ETR, and no obvious adverse reactions were observed. MAP delivered by microneedling is effective and safe for treating ETR.

Advances in the Pathogenesis and Treatment of Rosacea: A Phenotype-Based Therapeutic Approach

Rosacea is a common chronic inflammatory skin disorder that mainly affects the central face. It is primarily characterized by recurrent episodes of flushing, persistent erythema, inflammatory papules, telangiectasias, phymatous changes, and ocular symptoms. Its pathogenesis is complex and still not completely understood. It encompasses innate and adaptive immune system dysregulation, neurovascular dysfunction, and genetic and environmental factors. To date, four subtypes of rosacea have been identified, based on the predominant clinical features: erythemato-teleangiectatic, papulopustular, pyhomatous, and ocular rosacea. New insights into this condition have led to several pharmacological treatments, including topical medications, spanning from the conventional azelaic acid, metronidazole, benzoyl peroxide, clindamycin, and erythromycin to new ones including not only brimonidine, oxymetazoline, ivermectine, and minocycline but also systemic drugs such as oral antibiotics, isotretinoin, non-selective β-blockers or α2-adrenergic agonists, and laser- or light-based therapies, together with new therapeutic approaches. The aim of this study was to review the current literature on the pathophysiology of rosacea and to provide an overview of therapeutic approaches that specifically address each clinical subtype.

A Review of the Diagnostic and Therapeutic Gaps in Rosacea Management: Consensus Opinion.

Rosacea is a common, chronic inflammatory disease characterized by both fluctuating and fixed heterogeneous signs such as facial erythema, papules/pustules, telangiectasia, acute vasodilation (flushing), and phymatous changes, and symptoms such as cutaneous stinging and burning. The shift to a phenotype-based approach to rosacea management has improved the consistency of recommendations across recent published guidelines. Consistent and thorough guidance for the classification, diagnosis, and management of the disease is difficult, as the mechanisms underlying the development of rosacea are still not completely understood nor universally accepted. Here, we provide a critical review of current published guidance, and gaps in the knowledge and management of rosacea. We present the recently approved microencapsulated benzoyl peroxide as an effective topical treatment option for papulopustular rosacea. Benzoyl peroxide (BPO) has been used in acne management for many years; however, many clinicians perceive treatment of rosacea with any BPO formulation to be counterintuitive because of concerns of potential skin irritation, while the lack of an accepted mechanism of action on rosacea pathophysiology means that others may be hesitant to use BPO as a treatment. Minocycline foam 1.5% is also an option for the treatment of inflammatory lesions in rosacea, with a decreased risk of systemic adverse events compared with oral minocycline.

Exploring the efficacy of laser speckle contrast imaging in the stratified diagnosis of rosacea: a quantitative analysis of facial blood flow dynamics across varied regions.

Rosacea has a high incidence, significantly impacts quality of life, and lacks sufficient diagnostic techniques. This study aimed to investigate the feasibility of laser speckle contrast imaging (LSCI) for measuring facial blood perfusion in patients with rosacea and to identify differences in blood flow among various facial regions associated with different rosacea subtypes. From June to December 2023, 45 patients were recruited, with 9 excluded, leaving 36 subjects: 12 with erythematotelangiectatic rosacea (ETR), 12 with papulopustular rosacea (PPR), and 12 healthy controls. The Think View multispectral imaging analyzer assessed inflammation via gray reading values across the full face and five facial areas: forehead, nose, cheeks, and chin. LSCI measured and analyzed blood perfusion in the same areas. Plasma biomarkers interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α) were tested in different groups. Both ETR and PPR groups showed increased average blood perfusion and facial inflammation intensity by gray values compared to controls, with statistically significant differences. Average blood perfusion of ETR and PPR groups showed increased values in the forehead, cheeks, and nose, compared to controls, and the values in the cheeks were statistically different between ETR and PPR. The facial inflammation intensity of the ETR group showed increased values in the forehead and cheeks, and the PPR group showed increased gray values in the forehead, cheeks, nose, and chin compared to controls, and the values for the cheeks, nose, and chin were statistically significantly different between ETR and PPR. Plasma biomarkers IL-6, IL-1β, and TNF-α were significantly elevated in both ETR and PPR groups compared to controls. LSCI is a valuable, non-invasive tool for assessing blood flow dynamics in rosacea, providing a data foundation for clinical research. Different rosacea subtypes exhibit distinct lesion distribution and blood flow patterns, and both ETR and PPR could affect all facial areas, particularly the cheeks in ETR and the forehead, nose, and chin in PPR.

Assessing the Efficacy and Safety of Intradermal Injection of Different Doses of Botulinum Toxin Type A: A Randomized, Double‐Blind, Placebo‐Controlled, Split‐Face Pilot Study in Rosacea Patients with Erythematic Telangiectasia

Introduction. Rosacea is a common chronic inflammatory skin disease of the central facial skin with unknown origin, significantly impacting quality of patient’s life and causing various psychosocial problems. Erythematotelangiectatic rosacea (ETR) is characterized by paroxysmal flushing that occurs repeatedly and is easily resistant to therapeutic drugs. While microinjection of type A botulinum toxin (BTX) can treat ETR, there is no consensus on the injection dose, and strong evidence to verify its efficacy and safety is lacking. This randomized, double‐blind, split‐face clinical study aimed to investigate the efficacy, safety, and optimal dose of two different single‐point injection doses (0.5 U and 1 U) of BTX in the treatment of rosacea. Methods. Twenty‐six patients with ETR were randomly assigned to receive different single‐point injections of BTX (0.5 U and 1 U, respectively) every 1 cm on one half of the face. The Clinical Erythema Score (CEA), VISIA red area absolute value, Global Aesthetic Improvement Scale Score (GAIS), and recurrence at 12‐week follow‐up were evaluated at baseline, 2,4, 8, and 12 weeks after injection. Additionally, the Dermatological Quality of Life Index (DLQI) questionnaire survey and adverse reactions were also recorded. Results. All twenty‐six patients completed the follow‐up visits and were included in the analysis. Compared to the 0.5 UBTX‐treated side, the CEA score showed significantly improvement in erythema and flushing at 2, 4, and 8 weeks after injection on the 1 U BTX‐treated side (P &lt; 0.05). The mean absolute value of the red area of VISIA was ‐19.12 ± 51.91 on 1 U BTX‐treated side and 2.5 ± 42.08, on 0.5 UBTX‐treated side at 4 weeks after treatment, showing significant improvement on the 1 U side (P &lt; 0.05). GAIS and DLQI were also significantly improved from Week 4 to Week 12 and Week 2 to Week 12, respectively (P &lt; 0.05). There was no recurrence of symptoms with either 0.5 U or 1 U injection by 12 weeks. Apart from one patient who experienced facial tightness and three patients who had temporary aggravation of erythema, all of which resolved without treatment, 22 patients did not report any side effects except for injection pain during the procedure. Conclusions. BTX‐A can significantly improves symptoms and quality of life in patients with refractory rosacea with few side effects. A single‐point injection of 1 U was more effective. This trial is registered with NCT06282679.

Investigation of skincare habits and possible rosacea triggers of patients with rosacea: A prospective case-control study.

Skincare is a part of rosacea treatment; patients benefit from complementary dermo-cosmetic care as well as medical treatments. Some skincare habits are known to trigger and exacerbate rosacea, but there are very few epidemiological studies on this matter. A total of 200 people, including 100 patients with rosacea and 100 controls, were included in the study. We questioned the methods used by the participants in daily facial cleansing. Sun and heat exposure, makeup habits, the history of the use of topical steroids, and outdoor working status were noted. A dermoscopic examination, a non-invasive and valuable method to evaluate the presence and severity of Demodex, was performed. We evaluated 30% of our rosacea patients as erythematotelangiectatic rosacea, 13% as papulopustular rosacea, and 57% of our patients had mixed type, which could not be distinguished from one of these subtypes. In the case group, the proportion of people who used daily facial cleansers and daily soaps was lower than in the control group, while the proportion of those who cleaned their face with only water and those who used facial cleansers less frequently was higher (p<0.001). In the case group, while the rate of daily make-up and use of make-up products was lower (p=0.001, p<0.001, respectively), the rate of not wearing make-up was higher (p=0.001). The history of hot bath use was higher in the case group than in the control group (p=0.011). We found a significant relationship between the severity of plaque and dry appearance and the increase in Demodex density (p=0.007, p<0.001, respectively). We recommend that patients with rosacea clean their faces daily with soap or facial cleansers and not take a bath with very hot water. Patients should be evaluated for increased Demodex mites, especially if skin dryness is accompanied.

The Interplay between Helicobacter pylori and Gut Microbiota in Non-Gastrointestinal Disorders: A Special Focus on Atherosclerosis.

The discovery of Helicobacter pylori (H. pylori) in the early 1980s by Nobel Prize winners in medicine Robin Warren and Barry Marshall led to a revolution in physiopathology and consequently in the treatment of peptic ulcer disease. Subsequently, H. pylori has also been linked to non-gastrointestinal diseases, such as autoimmune thrombocytopenia, acne rosacea, and Raynaud's syndrome. In addition, several studies have shown an association with cardiovascular disease and atherosclerosis. Our narrative review aims to investigate the connection between H. pylori infection, gut microbiota, and extra-gastric diseases, with a particular emphasis on atherosclerosis. We conducted an extensive search on PubMed, Google Scholar, and Scopus, using the keywords "H. pylori", "dysbiosis", "microbiota", "atherosclerosis", "cardiovascular disease" in the last ten years. Atherosclerosis is a complex condition in which the arteries thicken or harden due to plaque deposits in the inner lining of an artery and is associated with several cardiovascular diseases. Recent research has highlighted the role of the microbiota in the pathogenesis of this group of diseases. H. pylori is able to both directly influence the onset of atherosclerosis and negatively modulate the microbiota. H. pylori is an important factor in promoting atherosclerosis. Progress is being made in understanding the underlying mechanisms, which could open the way to interesting new therapeutic perspectives.

Case Series: Infrared Energy Device for the Treatment of Erythematotelangiectatic Rosacea

Rosacea is a common chronic dermatosis which occurs mainly in middle-aged patients. The etiology of the disease remains unknown but immune and vascular factors are seen to play a crucial role. Diagnosis is established based on clinical manifestation. We present four case reports of rosacea therapy using a medical device emitting near-infrared light.

Rhinophyma in a Patient with Multibacterial Indeterminate Leprosy

INTRODUCTION: According to the clinical recommendations, the primacy in diagnosis of leprosy still remains with the laboratory methods, but the disease can also be suspected by the external pathological alterations in the face and limbs. This article presents a case report of one of leprosy masks commonly observed in lepromatous form of multibacterial leprosy (facies leonine), and also shows a combination of leprosy and acne rosacea in the form of rhinophyma.&#x0D; CONCLUSION: Differential diagnosis did not permit the authors to rest only on the diagnosis of leprosy, because too many details indicated the simultaneous presence of vascular and fibrous alterations of the soft nose tissues uncharacteristic of leprosy, which were diagnosed as a concomitant rhinophyma. The case is indicative as an example of a possible combination of vivid clinical manifestations of two diseases of different nature, which can both hide and imitate each other.

Comparative Bioavailability of DFD-29 (Minocycline Hydrochloride Modified Release Capsules, 40 mg) Vs. Minocycline Hydrochloride Extended Release 105-mg tablets After a Single Oral Dose: A Randomized, 3-way Crossover Study

Background: A low-dose formulation (DFD-29) of minocycline hydrochloride (HCl) is under evaluation for the treatment of moderate-to-severe papulopustular rosacea. The objective of this phase 1 study is to compare the bioavailability of DFD-29 to that of the currently available Solodyn® (minocycline HCl extended release) 105-mg formulation. Methods: This single-center, randomized, open-label, laboratory-blinded, 3-way, 6-sequence crossover study compared the pharmacokinetics of a single dose of DFD-29 40 mg after an overnight fast, DFD-29 40 mg after a high-fat meal, and minocycline HCl extended release 105-mg tablet (minocycline HCl ER 105 mg) after an overnight fast in healthy adult volunteers. Blood samples were collected for PK assessments prior to and up to 72 hours after each drug dose, with a washout period of 7 calendar days between doses. Safety was evaluated by monitoring adverse events (AEs), vital signs, and laboratory tests. Results: A total of 24 subjects were randomized and 23 subjects completed the study. Mean plasma minocycline Cmax levels were 243.9 ng/mL for DFD-29 (fasting), 225.0 ng/mL for DFD-29 (fed), and 497.3 ng/mL for minocycline HCl ER 105 mg (fasting). The geometric least squares (LS) mean ratios for Cmax, AUC0-T, and AUC0-∞ of DFD-29 to minocycline HCl ER 105 mg when administered after fasting were 47.97%, 36.55%, and 38.35%, respectively. When comparing fasting vs fed administration of DFD-29, geometric LS mean ratios for Cmax, AUC0-T, and AUC0-∞ were 97.48%, 116.84%, and 115.26% respectively. Tmax was 1.5 h for DFD-29 (fasting), 4.5 h for DFD-29 (fed), and 4.0 h for minocycline HCl ER 105 mg (fasting). Treatment-emergent AEs (TEAEs) were reported in 17.4%, 13.0%, and 21.7% after administration of DFD-29 (fasting), DFD-29 (fed), and minocycline HCl ER 105 mg, respectively. Most TEAEs were mild in severity (21/22; 95.5%). Conclusion: Bioavailability was significantly lower after a single dose of DFD-29 40 mg vs minocycline HCl ER 105 mg following a single dose under fasting and fed conditions. Food intake had no impact on Cmax but may delay absorption and may slightly increase exposure. Overall, single oral doses of DFD-29 40 mg and minocycline HCl ER 105 mg were generally safe and well tolerated. This study and abstract are funded by Journey Medical Corporation.

Gut–Skin Axis: Gut Microbiota as a Link Between Rosacea and Gastrointestinal Comorbidities

Abstract: Rosacea, a prevalent dermatological condition, is characterized by the clinical manifestations of erythema, papules, and pustules. This paper delves into the emerging role of the gut-skin axis in Rosacea's pathophysiology. Convincing evidence supports the involvement of gut microbiota in orchestrating the inflammatory cutaneous response. Its multifaceted etiology is thought to be influenced by genetic susceptibility, alterations in the neurovascular and immune systems, and altered interactions with the microbiota. Strong connections broaden our understanding of Rosacea, linking it to neurological conditions like Parkinson's disease and gastrointestinal issues such as Helicobacter pylori infection and small intestinal bacterial overgrowth (SIBO), supporting the existence of an intricate brain-gut-skin connection. The interplay between these organs' homeostatic and regulatory systems is increasingly evident. While we have not fully grasped the details of immunological, neuroendocrine, and metabolic pathways, it is clear they play a part in chronic inflammatory skin conditions like Rosacea. Delving into these intricate pathways promises a nuanced comprehension of the disease's etiopathogenesis. An in-depth investigation into the roles of dysbiotic microbiota and dysregulated innate immune responses is imperative to comprehensively fathom Rosacea's pathophysiological landscape. A refined grasp of this condition and the gutskin axis holds the potential for optimizing therapeutic trajectories. The purpose of this review is to explore potential bacterial indicators of the disease and to assess whether the gut microbiome makeup of individuals with inflammatory Rosacea differs from that of healthy controls. Furthermore, it critically assesses and consolidates previously documented alterations in peripheral blood, skin, and gastrointestinal tract microbiomes within rosacea patients. This review illuminates the intricate dance of microbiota in the context of Rosacea, forging a bridge between cutting-edge insights and its implications. By synthesizing current knowledge, this review advances our understanding of microbiota-driven mechanisms in inflammatory Rosacea, paving the way for innovative therapeutic strategies.

Has the Use of the Mask Exacerbated Rosacea During the Pandemic?

During the COVID-19 pandemic, personal protective equipment, particularly face masks, became an essential requirement to engage in various activities. Several articles reported an increase of recurrences of dermatologic facial diseases (ie, acne, rosacea) related to mask use. To evaluate the number of recurrences of rosacea related to face mask use. This prospective study was conducted on adult patients with a pre-pandemic diagnosis of mild and moderate papulopustular rosacea. All patients had previously achieved either partial or complete remission after a 4-month treatment with topical ivermectin in 2019. We collected data in two different phases characterized by different intensity of mask use during the pandemic and post-pandemic period. We collected data through clinical assessment of the disease, questionnaires on personal habits and standardized skin surface biopsy to study the Demodex mites count. We enrolled a total of 30 patients. In the pandemic period, 5/30 patients had a relapse of mild papulopustular rosacea; the Demodex sample resulted positive in 4/5 relapsed patients. In the post-pandemic period, 4/30 patients reported a relapse of mild rosacea (3 patients) and moderate papulopustular rosacea (1 patient). At the Demodex exam, 1/4 relapsed patients resulted positive. We did not find a significant increase in relapses of papulopustular rosacea during the pandemic. An appropriate anti-parasitic treatment may reduce the number of recurrences due to mask use.

Silica-based microencapsulation used in topical dermatologic applications.

Microencapsulation has received extensive attention because of its various applications. Since its inception in the 1940s, this technology has been used across several areas, including the chemical, food, and pharmaceutical industries. Over-the-counter skin products often contain ingredients that readily and unevenly degrade upon contact with the skin. Enclosing these substances within a silica shell can enhance their stability and better regulate their delivery onto and into the skin. Silica microencapsulation uses silica as the matrix material into which ingredients can be embedded to form microcapsules. The FDA recognizes amorphous silica as a safe inorganic excipient and recently approved two new topical therapies for the treatment of rosacea and acne. The first approved formulation uses a novelsilica-basedcontrolled vehicle delivery technology to improve the stability of two active ingredients that are normally not able to be used in the same formulation due to potential instability and drug degradation. The formulation contains 3.0% benzoyl peroxide (BPO) and 0.1% tretinoin topical cream to treat acne vulgaris in adults and pediatric patients. The second formulation contains silica microencapsulated 5.0% BPO topical cream to treat inflammatory rosacea lesions in adults. Both formulations use the same amorphous silica sol-gel microencapsulation technology to improve formulation stability and skin compatibility parameters.

Narrow-Band Intense Pulsed Light as Treatment for Erythematotelangiectatic Rosacea: A Retrospective Study

Narrow-Band Intense Pulsed Light as Treatment for Erythematotelangiectatic Rosacea: A Retrospective Study

The role of dermatocosmetics in the management of rosacea

Rosacea is a chronic inflammatory disease that affects the facial skin. This pathology is characterized by hyperaemia, erythema, telangiectasia and other manifestations. It is also accompanied by a group of unpleasant symptoms, such as burning sensations, itching, and skin tightness. The pathogenesis of the disease has not been sufficiently studied. But it is generally accepted that it is based on abnormalities in the immune system. In addition, excessive Demodex colonization and exposure to ultraviolet radiation may play a role in the development of rosacea. The incidence rate of rosacea worldwide reaches 5%. It is emphasized that some ethnicities face a greater risk of this disease than others. It is a very difficult task to treat rosacea for a specialist. The therapeutic approach differs in different forms of the disease. There is a wide range of treatments available for papulopustular rosacea, including systemic and topical medications and even physiotherapy. However, the therapy of erythematous rosacea mainly centres around the use of dermatocosmetic care. For patients with rosacea, it is important to choose products that, first of all, can effectively reduce skin redness and discomfort and will be well tolerated. A dermo-cosmetic composition has to have an anti-inflammatory effect and the ability to repair damaged skin. This article presents our own experience of using such drug in the monotherapy of erythematous rosacea and in the complex treatment of papulopustular disease. A significant effect had been achieved at 3–4 weeks of complex therapy in patients with papulopustular rosacea. We present a clinical case report of a 46-year-old patient N. as an example of the effectiveness of therapy.

Treatment of aseptic facial granuloma as a manifestation of pediatric rosacea with oral macrolides.

Aseptic facial granuloma is a rare pediatric disease, presenting with asymptomatic facial nodules on the cheeks or the eyelids and may represent a form of granulomatous rosacea in children. In this retrospective case series, 12 children with aseptic facial granuloma were treated with oral macrolides (erythromycin or roxithromycin) resulting in a healing of the lesions within a mean treatment time of 5.25 months with no recurrences. The treatment was mainly well tolerated. Oral macrolides may be effective in the treatment of patients with aseptic facial granuloma.