tetracycline and Rosacea

Rosacea is one of the most common conditions affecting the ocular surface. The purpose of this review is to provide an update on the pathogenesis and treatment of rosacea based on the dermatology and ophthalmology literatures.. Literature searches were conducted for rosacea and ocular rosacea. Preference was given to systematic reviews, meta-analysis, case-controlled studies, and documented case reports while excluding poorly documented case studies and commentaries. The data were examined and independently analyzed by more than two of the authors.. Rosacea is a complex inflammatory condition involving the pilosebaceous unit. Its underlying mechanism involves an interplay of the microbiome, innate immunity, adaptive immunity, environmental triggers, and neurovascular sensitivity. The latest classification of rosacea includes three dermatologic subgroups and a fourth subgroup, ocular rosacea. Ocular rosacea clinically displays many features that are analogous to the cutaneous disease, such as lid margin telangiectasia and phlyctenulosis. The role of environmental triggers in the exacerbation of ocular rosacea appears to be understudied. While lid hygiene and systemic treatment with tetracycline drugs remain the mainstay of treatment for ocular rosacea, newer dermatologic targets and therapies may have potential application for the eye disease.. Ocular rosacea appears to embody many of the manifestation of the dermatologic disease. Hence, the basic pathophysiologic mechanisms of the ocular and cutaneous disease are likely to be shared. Better understanding of the ocular surface microbiome and the immunologic mechanisms, may lead to novel approaches in the management of ocular rosacea.

Topics: Anti-Bacterial Agents; Antimicrobial Cationic Peptides; Cathelicidins; Dermatologic Agents; Eye Diseases; Humans; Risk Factors; Rosacea; Tetracycline

Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations. The objective of these guidelines is to offer evidence-based recommendations to assist Canadian health care providers in the diagnosis and management of rosacea. These guidelines were developed by an expert panel of Canadian dermatologists taking into consideration the balance of desirable and undesirable outcomes, the quality of supporting evidence, the values and preferences of patients, and the costs of treatment. The 2015 Cochrane review "Interventions in Rosacea" was used as a source of clinical trial evidence on which to base the recommendations.

Topics: Anti-Infective Agents; Consensus; Dermatologic Agents; Dicarboxylic Acids; Doxycycline; Eye Diseases; Humans; Intense Pulsed Light Therapy; Isotretinoin; Ivermectin; Laser Therapy; Metronidazole; Outliers, DRG; Practice Guidelines as Topic; Rosacea; Tetracycline

Rosacea is a common chronic skin condition affecting the face, characterised by flushing, redness, pimples, pustules and dilated blood vessels. The eyes are often involved and thickening of the skin with enlargement (phymas), especially of the nose, can occur in some people. A range of treatment options are available but it is unclear which are most effective.. To assess the efficacy and safety of treatments for rosacea.. We updated our searches, to July 2014, of: the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library (2014, Issue 6), MEDLINE (from 1946), EMBASE (from 1974) and Science Citation Index (from 1988). We searched five trials registers and checked reference lists for further relevant studies.. Randomised controlled trials in people with moderate to severe rosacea.. Study selection, data extraction, risk of bias assessment and analyses were carried out independently by two authors.. We included 106 studies, comprising 13,631 participants. Sample sizes of 30-100 and study duration of two to three months were most common. More women than men were included, mean age of 48.6 years, and the majority had papulopustular rosacea, followed by erythematotelangiectatic rosacea.A wide range of comparisons (67) were evaluated. Topical interventions: metronidazole, azelaic acid, ivermectin, brimonidine or other topical treatments. Systemic interventions: oral antibiotics, combinations with topical treatments or other systemic treatments, i.e. isotretinoin. Several studies evaluated laser or light-based treatment.The majority of studies (57/106) were assessed as 'unclear risk of bias', 37 'high risk ' and 12 'low risk'. Twenty-two studies provided no usable or retrievable data i.e. none of our outcomes were addressed, no separate data reported for rosacea or limited data in abstracts.Eleven studies assessed our primary outcome 'change in quality of life', 52 studies participant-assessed changes in rosacea severity and almost all studies addressed adverse events, although often only limited data were provided. In most comparisons there were no statistically significant differences in number of adverse events, most were mild and transient. Physician assessments including investigators' global assessments, lesion counts and erythema were evaluated in three-quarters of the studies, but time needed for improvement and duration of remission were incompletely or not reported.The quality of the body of evidence was rated moderate to high for most outcomes, but for some outcomes low to very low.Data for several outcomes could only be pooled for topical metronidazole and azelaic acid. Both were shown to be more effective than placebo in papulopustular rosacea (moderate quality evidence for metronidazole and high for azelaic acid). Pooled data from physician assessments in three trials demonstrated that metronidazole was more effective compared to placebo (risk ratio (RR) 1.98, 95% confidence interval (CI) 1.29 to 3.02). Four trials provided data on participants' assessments, illustrating that azelaic acid was more effective than placebo (RR 1.46, 95% CI 1.30 to 1.63). The results from three studies were contradictory on which of these two treatments was most effective.Two studies showed a statistically significant and clinically important improvement in favour of topical ivermectin when compared to placebo (high quality evidence). Participants' assessments i. There was high quality evidence to support the effectiveness of topical azelaic acid, topical ivermectin, brimonidine, doxycycline and isotretinoin for rosacea. Moderate quality evidence was available for topical metronidazole and oral tetracycline. There was low quality evidence for low dose minocycline, laser and intense pulsed light therapy and ciclosporin ophthalmic emulsion for ocular rosacea. Time needed to response and response duration should be addressed more completely, with more rigorous reporting of adverse events. Further studies on treatment of ocular rosacea are warranted.

Topics: Anti-Infective Agents; Brimonidine Tartrate; Cyclosporine; Dermatologic Agents; Dicarboxylic Acids; Doxycycline; Female; Humans; Ivermectin; Male; Metronidazole; Middle Aged; Ophthalmic Solutions; Quinoxalines; Randomized Controlled Trials as Topic; Rosacea; Tetracycline

Topics: Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents; Dermatologic Agents; Dicarboxylic Acids; Doxycycline; Evidence-Based Medicine; Humans; Metronidazole; Practice Guidelines as Topic; Randomized Controlled Trials as Topic; Rosacea; Tetracycline; Treatment Outcome

Rosacea is a chronic facial inflammatory disease. The pathogenesis, diagnosis and treatment are reviewed.

Topics: Administration, Cutaneous; Administration, Oral; Anti-Bacterial Agents; Dermatologic Agents; Humans; Rhinophyma; Risk Factors; Rosacea; Tetracycline; Treatment Outcome; United States

Rosacea is a common chronic inflammatory disease of the skin and is associated with a number of etiological causes and inciting factors. It is characterized by erythematous changes of the facial skin, and commonly presents with papules, pustules, or telangiectasias. The 4 subtypes of rosacea are categorized according to secondary symptoms, such as pain, erythema, dryness, and edema. A number of therapies are available to treat rosacea, some of which can be used in combination. The mainstays of therapy are topical metronidazole, topical azelaic acid, and oral tetracyclines. Other pharmacotherapeutic interventions have been shown to improve the signs and symptoms of rosacea, although many of these have not yet received approval by the US Food and Drug Administration for this indication.

Topics: Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Anti-Infective Agents; Dermatologic Agents; Diagnosis, Differential; Dicarboxylic Acids; Humans; Laser Therapy; Metronidazole; Phytotherapy; Rosacea; Sunscreening Agents; Tetracycline

There is a great deal of evidence to support the use of tetracycline and doxycycline in the treatment of papulopustular rosacea. Nevertheless, these agents have shared and unique adverse effects and relative contraindications. Recently, subantimicrobial-dose doxycycline was demonstrated to be an effective treatment for rosacea, due to its inherent anti-inflammatory properties. Furthermore, subantimicrobial-dose doxycycline has a more preferable tolerability profile and a lower occurrence of bacterial resistance than traditional-dose doxycycline. To further elucidate the role of tetracycline agents in rosacea, clinical trials that compare these agents with each other as well as with other effective rosacea treatments are called for. Adherence studies comparing oral tetracycline treatment with topical metronidazole treatment may also enhance clinical decision making.

Topics: Anti-Bacterial Agents; Clinical Trials as Topic; Doxycycline; Humans; Rosacea; Tetracycline

Topics: Administration, Oral; Biopsy, Needle; Dermoscopy; Diagnosis, Differential; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Immunohistochemistry; Male; Middle Aged; Risk Assessment; Rosacea; Scalp Dermatoses; Severity of Illness Index; Tetracycline; Treatment Outcome

Rosacea is an extremely common chronic dermatosis affecting an estimated 14 million Americans. Rosacea is most commonly managed with topical metronidazole, sometimes in combination with oral antibiotics.. To review published studies about topical metronidazole therapy for rosacea, both as a monotherapy and in conjunction with oral antibiotics.. Medline searches were conducted for clinical trials using metronidazole, tetracycline, and doxycycline for rosacea.. Topical metronidazole has been well studied as a rosacea therapy. Twice-daily dosing of metronidazole 1.0% cream is as effective as 250 mg tetracycline twice daily. Metronidazole 1.0% gel used once daily is as effective as azelaic acid 15% gel dosed twice daily. When dosed at subantimicrobial levels, doxycycline 20 mg taken twice daily is effective in decreasing inflammatory lesions and erythema associated with rosacea. Metronidazole 0.75% lotion is more effective when used in combination with doxycycline 20 mg dosed twice daily.. Metronidazole in 0.75% strength lotion, cream, and gel and 1.0% metronidazole cream and gel are all efficacious in treating rosacea. Combination treatment with oral antibiotics at both antimicrobial and subantimicrobial doses is an efficacious means of treating rosacea. Maintenance treatment with topical metronidazole decreases relapses and allows for longer intervals between flares.

Topics: Anti-Bacterial Agents; Clinical Trials as Topic; Dermatologic Agents; Dicarboxylic Acids; Doxycycline; Drug Administration Routes; Drug Administration Schedule; Drug Therapy, Combination; Humans; Metronidazole; Rosacea; Tetracycline

Despite its prevalence, rosacea has not received the same attention of researchers as other dermatologic disorders. Nevertheless, new pharmacologic and nonpharmacologic therapies for the condition continue to be developed. The future of rosacea treatment will probably involve a combination of drugs and devices. Certain core therapies (i.e., topical metronidazole, topical azelaic acid, oral tetracyclines, and topical sulfur/sodium sulfacetamide) are validated by the greatest amount of high-order clinical evidence and will undoubtedly remain first-line therapeutic choices. However, more research is necessary to validate the efficacy and safety of newer pharmacologic agents and light-based therapy. Because rosacea is a chronic condition, pharmacologic maintenance therapy is necessary to maintain remission.

Topics: Anti-Infective Agents; Biomedical Research; Chronic Disease; Dermatologic Agents; Dicarboxylic Acids; Forecasting; Humans; Metronidazole; Rosacea; Tetracycline

The Cochrane Collaboration is an international nonprofit organization that conducts systematic reviews of healthcare interventions. The organization has recently reviewed all studies meeting designated criteria on interventions for rosacea. To be included in the review, trials had to be randomized controlled trials (RCTs) that met the methodological criteria of the reviewers and that were conducted in an adult patient population with moderate to severe rosacea. The electronic databases searched included The Cochrane Skin Group Specialised Trials Register, The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, BIOSIS, and Science Citation Index. The reviewers tried to obtain details of unpublished and ongoing RCTs through correspondence with authors and pharmaceutical companies. After evaluating the included studies, the reviewers concluded there is evidence that topical metronidazole in 1% cream and 0.75% gel formulations and azelaic acid in 20% cream formulation are effective and safe. Furthermore, there is some evidence that oral metronidazole and tetracycline are effective. The reviewers also made suggestions about future rosacea research.

Topics: Anti-Infective Agents; Dermatologic Agents; Dicarboxylic Acids; Gels; Humans; Metronidazole; Randomized Controlled Trials as Topic; Rosacea; Tetracycline

Topics: Anti-Infective Agents; Anti-Inflammatory Agents; Dermatologic Agents; Diagnosis, Differential; Dicarboxylic Acids; Doxycycline; Humans; Laser Therapy; Life Style; Metronidazole; Minocycline; Patient Education as Topic; Referral and Consultation; Risk Factors; Rosacea; Tetracycline

Corticosteroids were first introduced for topical use in dermatology in 1951. Since then uncontrolled use (abuse) has caused many different reactions, often with manifestations resembling those of rosacea.. The prolonged use of local corticosteroids (usually 2-6 months) may lead to a clinical picture of severe dermatitis with erythema, papules and pustules that are classified according their localization to three types. The treatment of choice is tetracycline in combination with local application of neutral ointments.. Trivial skin dermatoses, especially on the face, should not be treated with local corticosteroids.

Topics: Administration, Topical; Adrenal Cortex Hormones; Adult; Aged; Dermatologic Agents; Diagnosis, Differential; Drug Eruptions; Facial Dermatoses; Female; Humans; Male; Middle Aged; Prognosis; Risk Assessment; Rosacea; Severity of Illness Index; Tetracycline

Although potentially significant adverse reactions and drug interactions have been reported in association with erythromycin, oral tetracyclines, and trimethoprim-sulfamethoxazole, overall these agents are associated with excellent safety profiles, especially considering their widespread use over many years. It must be considered that when these antibiotics are used for the treatment of rosacea and also for acne vulgaris, their use is on a long-term basis rather than their typical short-course regimens for most infectious diseases. As a result, dermatologists prescribing these agents may feel assured that most patients will not encounter any significant problems, but they do need to be aware of potential adverse reactions to allow for early recognition and discontinuation of the offending drug when needed. Early recognition also allows for favorable management of adverse reactions. In addition, potentially significant drug interactions may be recognized by obtaining a thorough medical history and avoiding combinations of drugs that may interact unfavorably. Fortunately, there are several choices that allow us to individually select a treatment regimen that is optimal for the individual patient, allowing for effective control of rosacea.

Topics: Administration, Oral; Anti-Bacterial Agents; Doxycycline; Erythromycin; Female; Humans; Male; Minocycline; Prognosis; Rosacea; Secondary Prevention; Severity of Illness Index; Tetracycline; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Administration, Topical; Anti-Infective Agents; Humans; Metronidazole; Rosacea; Skin; Tetracycline

Topics: Adrenal Cortex Hormones; Adult; Aged; Child; Dermatitis; Diagnosis, Differential; Facial Dermatoses; Female; Humans; Male; Metronidazole; Middle Aged; Mouth; Prognosis; Risk Factors; Rosacea; Sex Distribution; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Age Factors; Child; Child, Preschool; Contraceptives, Oral; Dermatitis; Dermatitis, Contact; Diagnosis, Differential; Drug Eruptions; Environmental Exposure; Facial Dermatoses; Female; Humans; Infant; Infant, Newborn; Light; Lipid Metabolism; Lupus Erythematosus, Systemic; Male; Middle Aged; Pyridoxine; Rosacea; Sebaceous Glands; Sex Factors; Skin; Skin Manifestations; Tetracycline

Topics: Acne Vulgaris; Alopecia Areata; Dermatitis, Contact; Humans; Lupus Erythematosus, Systemic; Lymphatic Diseases; Methotrexate; Ointments; Photosensitivity Disorders; Porphyrias; Psoriasis; Rosacea; Skin Diseases; Steroids; Sunscreening Agents; Tetracycline; Tinea; Trichophyton; Urea; Vitiligo

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.. To determine if the use of topical metronidazole gel (Metrogel) could prevent relapse of moderate to severe rosacea.. 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).. Subjects were enrolled at 6 separate sites in large cities at sites associated with major medical centers.. 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.. Subjects were evaluated monthly for up to 6 months to determine relapse rates.. 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.. 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%).. 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.

Topics: Administration, Cutaneous; Adult; Aged; Anti-Bacterial Agents; Dermatologic Agents; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Metronidazole; Middle Aged; Recurrence; Rosacea; Tetracycline; Treatment Outcome

In order to determine the relationship between meibomian gland dysfunction and tear film abnormalities in rosacea, tear film flow and stability and meibomian gland function were assessed in 43 consecutive patients. Schirmer, tear film break-up time, and meibomian gland function values in patients with ocular rosacea (n = 28) were found to be significantly decreased as compared with those of the patients with only cutaneous involvement and control patients (p > 0.05). In patients with dermatologic rosacea (n = 15) these values were not different from those of the age- and sex-matched controls (p > 0.05). The effects of tetracycline and meibomian gland expression therapy also were investigated in patients with ocular rosacea. Neither meibomian gland expression therapy nor tetracycline administration had beneficial effects on decreased tear secretion, but tetracycline improved the break-up time values. Our findings showed a positive relationship between tear film abnormalities and meibomian gland dysfunction in patients with rosacea. Decreased tear secretion in patients with ocular rosacea would seem to be a result of structural changes secondary to meibomian gland dysfunction, and short break-up time might be due to an abnormal meibum composition.

Topics: Adult; Eyelid Diseases; Female; Humans; Lacrimal Apparatus Diseases; Male; Meibomian Glands; Rosacea; Tears; Tetracycline

We compared the effects of doxycycline and tetracycline hydrochloride on the subjective symptoms in ocular rosacea. Twenty-four patients with symptomatic ocular rosacea were randomly assigned to two groups and treated with doxycycline 100 mg/day (group 1, 16 patients) or tetracycline hydrochloride 1 g/day (group 2, eight patients). The dosages of each drug were gradually tapered and discontinued according to symptomatic response. At each examination all the manifesting symptoms were scored by the patients. Patients were followed up from six weeks to three years. After six weeks of drug treatment, all patients except one had symptomatic improvement. Although most of the scores of the symptoms were significantly decreased in both groups, greater symptomatic relief occurred in the tetracycline hydrochloride-treated patients (P = .041). However, after three months of treatment there was no significant difference in symptoms between the two groups. Gastrointestinal tract complications occurred in two of the 16 patients (12.5%) in group 1 and in three of the eight patients (37.5%) in group 2. Both tetracycline hydrochloride and doxycycline can control the symptoms of ocular rosacea.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Doxycycline; Drug Tolerance; Eye Diseases; Female; Follow-Up Studies; Gastrointestinal Diseases; Humans; Male; Middle Aged; Prospective Studies; Random Allocation; Rosacea; Tetracycline

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

Topics: Administration, Cutaneous; Administration, Oral; Adult; Aged; Clindamycin; Double-Blind Method; Follow-Up Studies; Humans; Middle Aged; Rosacea; Tetracycline

One percent metronidazole in an emollient cream base was compared with 250 mg oral tetracycline taken twice daily for the treatment of seventy-five patients with rosacea. After eight weeks of treatment there was no statistically significant difference between the results of the two treatments. Tetracycline did have a more rapid onset of effect on papules and pustules. Both treatments were well tolerated.

Topics: Administration, Topical; Adult; Aged; Aged, 80 and over; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Male; Metronidazole; Middle Aged; Random Allocation; Rosacea; Tetracycline

Topics: Administration, Oral; Adolescent; Adult; Aged; Chronic Disease; Clinical Trials as Topic; Drug Evaluation; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline; Time Factors

Seventy patients with rosacea were treated with systemic tetracycline for 6 months. Sixty-eight of them cleared with treatment. After withdrawal of the drug seventeen relapsed immediately and the overall relapse rate over 4 years was 69%. The serum tetracycline levels were not significantly different in two patients who failed to respond. Six patients had rosacea keratitis and responded dramatically within 1 month. Symptoms recurred as the drug was withdrawn. It is suggested that rosacea patients with keratitis should receive early and prolonged tetracycline medication.

Topics: Clinical Trials as Topic; Female; Follow-Up Studies; Humans; Keratitis; Male; Middle Aged; Recurrence; Rosacea; Tetracycline

Topics: Adult; Atrophy; Butyrates; Clinical Trials as Topic; Dermatitis; Drug Interactions; Female; Humans; Hydrocortisone; Male; Middle Aged; Rosacea; Telangiectasis; Tetracycline

Topics: Adult; Aged; Ampicillin; Female; Humans; Male; Middle Aged; Placebos; Rosacea; Tetracycline

Topics: Acne Vulgaris; Amphotericin B; Diagnosis, Differential; Humans; Placebos; Rosacea; Tetracycline

Topics: Acetates; Acne Vulgaris; Anti-Bacterial Agents; Clinical Trials as Topic; Humans; Italy; Placebos; Rosacea; Tetracycline

Topics: Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline

Rosacea is an inflammatory skin disease. Case reports have shown rosacea as a comorbidity of inflammatory bowel disease (IBD), but no epidemiologic studies have examined rosacea and risk of subsequent IBD. The association between tetracycline use and risk of IBD was assessed, but this study produced limited findings. We examined the association between rosacea, use of tetracycline, and risk of incident Crohn's disease (CD) and ulcerative colitis (UC).. We analyzed data from 96,314 participants in the Nurses' Health Study II (1991-2011). Information on IBD was confirmed by medical review. Participants were asked in 2005 about their lifetime histories of clinician-diagnosed rosacea and year of diagnosis. Information on ever use of tetracycline was collected in 1993.. During 1,856,587 person-years (1991-2011), we identified 149 cases of CD and 215 cases of UC. Rosacea was not associated with risk of UC. In contrast, rosacea was significantly associated with increased risk of subsequent CD (hazard ratio [HR], 2.20; 95% confidence interval [CI], 1.15-4.18), which appeared particularly stronger for a longer duration after a diagnosis of rosacea (Ptrend = .01). Tetracycline use was associated with increased risk of CD (HR, 1.56; 95% CI, 1.09-2.24) and UC (HR, 1.34; 95% CI, 1.00-1.80); there was a trend toward increased risk with increased duration of use (both Ptrend < .05) (1993-2011).. On the basis of an analysis of data from the Nurses' Health Study II, ever use of tetracycline at baseline is associated with an increased risk of CD and UC. Personal history of rosacea is associated with an increased risk of only CD.

Topics: Adult; Anti-Bacterial Agents; Female; Humans; Inflammatory Bowel Diseases; Risk Assessment; Rosacea; Surveys and Questionnaires; Tetracycline

The pathogenesis of rosacea is unclear, but increased matrix metalloproteinase target tissue activity appears to play an important role. Parkinson disease and other neurodegenerative disorders also display increased matrix metalloproteinase activity that contribute to neuronal loss.. To investigate the risk of incident (new-onset) Parkinson disease in patients with rosacea.. A nationwide cohort study of the Danish population was conducted using individual-level linkage of administrative registers. All Danish citizens 18 years or older from January 1, 1997, to December 31, 2011 (N = 5 472 745), were included. Data analysis was conducted from June 26 to July 27, 2015.. The main outcome was a diagnosis of Parkinson disease. Incidence rates (IRs) per 10 000 person-years were calculated, and incidence rate ratios (IRRs) adjusted for age, sex, socioeconomic status, smoking, alcohol abuse, medication, and comorbidity were estimated by Poisson regression models.. A total of 5 404 692 individuals were included in the reference population; of these, 22 387 individuals (9812 [43.8%] women; mean [SD] age at diagnosis, 75.9 [10.2] years) received a diagnosis of Parkinson disease during the study period and 68 053 individuals (45 712 [67.2%] women; mean age, 42.2 [16.5] years) were registered as having rosacea. The IRs of Parkinson disease per 10 000 person-years were 3.54 (95% CI, 3.49-3.59) in the reference population and 7.62 (95% CI, 6.78-8.57) in patients with rosacea. The adjusted IRR of Parkinson disease was 1.71 (95%, CI 1.52-1.92) in patients with rosacea compared with the reference population. There was a 2-fold increased risk of Parkinson disease in patients classified as having ocular rosacea (adjusted IRR, 2.03 [95% CI, 1.67-2.48]), and tetracycline therapy appeared to reduce the risk of Parkinson disease (adjusted IRR, 0.98 [95% CI, 0.97-0.99]).. Rosacea constitutes an independent risk factor for Parkinson disease. This association could be due to shared pathogenic mechanisms involving elevated matrix metalloproteinase activity. The clinical consequences of this association require further study.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Cohort Studies; Community Health Planning; Denmark; Female; Humans; Male; Middle Aged; Parkinson Disease; Rosacea; Severity of Illness Index; Tetracycline; Young Adult

Topical tacrolimus has been observed to induce granulomatous rosacea (GR) in prior case reports and series. In most cases, patients recover fully after withdrawing tacrolimus and initiating doxycycline or minocycline. Herein, we describe a case of severe GR, which required further therapy. Clinicians should be aware of this rare complication because of the frequent use of topical tacrolimus.

Topics: Anti-Bacterial Agents; Dermatitis, Atopic; Female; Humans; Rosacea; Tacrolimus; Tetracycline; Young Adult

Millions of rosacea sufferers are not being treated, and the reasons they do not get treatment are not well characterized.. The aim of this study is to determine the main reasons for visit, providers seen and treatments used for rosacea.. We used data from the National Ambulatory Medical Care Survey for 1993-2010, tabulating the leading reasons for visit, providers seen and treatments used in rosacea visits.. There were 1 750 000 visits per year for rosacea. The leading reasons for visit were other diseases of the skin (25.3%), skin rash (19.6%), and discoloration or abnormal pigmentation (14.7%). Dermatologists managed 72.4% of visits. The most common treatments used were topical metronidazole (29.3%), tetracycline (11.0%), minocycline (8.5%), doxycycline (7.9%), and oral metronidazole (6.9%).. Some reasons for visit were too nonspecific to provide good insight on why the patient made a visit.. Dermatologists manage rosacea most commonly, but primary care physicians need the proper training to diagnose it correctly. Improved strategies to reach untreated people with rosacea are needed.

Topics: Administration, Oral; Administration, Topical; Ambulatory Care; Anti-Infective Agents; Dermatology; Doxycycline; Female; Health Care Surveys; Humans; Metronidazole; Minocycline; Rosacea; Tetracycline; United States

The absence of specific histological or serological markers, the gaps in understanding the aetiology and pathophysiology of rosacea, and the broad diversity in its clinical manifestations has made it difficult to reach international consensus on therapy guidelines.. The main objective was to highlight the global diversity in current thinking about rosacea pathophysiology, classification and medical features, under particular consideration of the relevance of the findings to optimization of therapy.. The article presents findings, proposals and conclusions reached by the ROSacea International Expert group (ROSIE), comprising European and US rosacea experts.. New findings on pathogenesis provide a rationale for the development of novel therapies. Thus, recent findings suggest a central role of the antimicrobial peptide cathelicidin and its activator kallikrein-5 by eliciting an exacerbated response of the innate immune system. Cathelicidin/kallikrein-5 also provide a rationale for the effect of tetracyclines and azelaic acid against rosacea. Clinically, the ROSIE group emphasized the need for a comprehensive therapy strategy - the triad of rosacea care - that integrates patient education including psychological and social aspects, skin care with dermo-cosmetics as well as drug- and physical therapies. Classification of rosacea into stages or subgroups, with or without progression, remained controversial. However, the ROSIE group proposed that therapy decision making should be in accordance with a treatment algorithm based on the signs and symptoms of rosacea rather than on a prior classification.. The ROSIE group reviewed rosacea pathophysiology and medical features and the impact on patients and treatment options. The group suggested a rational, evidence-based approach to treatment for the various symptoms of the condition. In daily practice this approach might be more easily handled than prior subtype classification, in particular since patients often may show clinical features of more than one subtype at the same time.

Topics: Algorithms; Cosmetics; Dicarboxylic Acids; Humans; International Cooperation; Patient Education as Topic; Rosacea; Tetracycline

A range of treatment options are available in rosacea, which include several topical (mainly metronidazole, azelaic acid, other antibiotics, sulfur, retinoids) and oral drugs (mainly tetracyclines, metronidazole, macrolides). In some cases, the first choice is a systemic therapy because patients may have sensitive skin and topical medications can be irritant. Isotretinoin can be used in resistant cases of rosacea. Unfortunately, the majority of studies on rosacea treatments are at high or unclear risk of bias. A recent Cochrane review found that only topical metronidazole, azelaic acid, and oral doxycycline (40 mg) had some evidence to support their effectiveness in moderate to severe rosacea and concluded that further well-designed, adequately-powered randomised controlled trials are required. In our practice, we evaluate our patients for the presence of two possible triggers, Helicobacter pylori infection and small intestinal bacterial overgrowth. When they are present we use adapted antibiotic protocols. If not, we use oral metronidazole or oral tetracycline to treat papulopustolar rosacea. We also look for Demodex folliculorum infestation. When Demodex concentration is higher than 5/cm(2) we use topical crotamiton 10% or metronidazole.

Topics: Adapalene; Anti-Infective Agents; Cyclosporine; Dermatologic Agents; Dicarboxylic Acids; Humans; Immunosuppressive Agents; Isotretinoin; Keratolytic Agents; Metronidazole; Mite Infestations; Naphthalenes; Rosacea; Sulfacetamide; Tacrolimus; Tetracycline; Toluidines; Tretinoin

A range of treatment options are available in rosacea, which include several topical (mainly metronidazole, azelaic acid, other antibiotics, sulfur, retinoids) and oral drugs (mainly tetracyclines, metronidazole, macrolides). In some cases, the first choice is a systemic therapy because patients may have sensitive skin and topical medications can be irritant. Isotretinoin can be used in resistant cases of rosacea. Unfortunately, the majority of studies on rosacea treatments are at high or unclear risk of bias. A recent Cochrane review found that only topical metronidazole, azelaic acid, and oral doxycycline (40 mg) had some evidence to support their effectiveness in moderate to severe rosacea and concluded that further well-designed, adequately-powered randomised controlled trials are required. In our practice, we evaluate our patients for the presence of two possible triggers, Helicobacter pylori infection and small intestinal bacterial overgrowth. When they are present we use adapted antibiotic protocols. If not, we use oral metronidazole or oral tetracycline to treat papulopustolar rosacea. We also look for Demodex folliculorum infestation. When Demodex concentration is higher than 5/cm(2) we use topical crotamiton 10% or metronidazole.

Topics: Anti-Infective Agents; Cyclosporine; Dermatologic Agents; Dicarboxylic Acids; Humans; Immunosuppressive Agents; Isotretinoin; Keratolytic Agents; Lasers, Dye; Metronidazole; Mite Infestations; Naphthalenes; Phototherapy; Rosacea; Sulfacetamide; Tacrolimus; Tetracycline; Toluidines; Tretinoin

Tetracycline is a commonly used drug for rosacea and subantimicrobial doses may resolve the disease in many cases. Although this class of antibiotics has been linked to adverse effects, tetracycline is considered a safe drug. It can be associated with hepatotoxicity, but its role in these rare cases is unclear.. To report the case of a patient with rare tetracycline-induced hepatotoxicity.. A 49-year-old female with a history of multiple prednisone and methotrexate trials for relapsing polychondritis took oral tetracycline for rosacea. She developed facial and extremity swelling, weakness, and fatigue that corresponded with liver function test (LFT) abnormalities including hypoalbuminemia, low total protein, and elevated alkaline phosphatase. Tetracycline was discontinued and rapid resolution of symptoms and LFT abnormalities occurred after cessation of the drug.. The dose-dependency of rare tetracycline hepatotoxicity and the desire to reduce antibiotic resistance may prompt safe, yet effective, subantimicrobial doses for rosacea.

Topics: Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Female; Humans; Liver; Liver Function Tests; Middle Aged; Rosacea; Tetracycline; Treatment Outcome; Withholding Treatment

Topics: Administration, Topical; Adult; Aged; Carcinoma, Basal Cell; Dermatitis, Allergic Contact; Dermatitis, Occupational; Diagnosis, Differential; Facial Dermatoses; Female; Humans; Metronidazole; Nursing; Occupational Exposure; Patch Tests; Rosacea; Skin Neoplasms; Tetracycline

Topics: Administration, Oral; Administration, Topical; Humans; Male; Metronidazole; Middle Aged; Minocycline; Rosacea; Tetracycline

Standard treatment of steroid-induced rosacea includes discontinuation of steroids and use of an oral tetracycline. A temporary decrease to a lower-potency steroid prior to discontinuation remains optional. The limitations of standard therapy include a prolonged course of treatment with exacerbations prior to permanent improvement. Our challenge was to identify a treatment regimen to resolve steroid-induced periocular rosacea quickly and with minimal rebound effect.

Topics: Administration, Oral; Administration, Topical; Drug Therapy, Combination; Humans; Immunosuppressive Agents; Male; Middle Aged; Protein Synthesis Inhibitors; Rosacea; Steroids; Tacrolimus; Tetracycline

Topics: Administration, Oral; Administration, Topical; Aged; Anti-Infective Agents; Carbon Dioxide; Female; Forehead; Humans; Keratosis; Laser Therapy; Male; Metronidazole; Middle Aged; Rosacea; Surgery, Plastic; Tetracycline

Rosacea is a common dermatosis affecting the central portion of the face. The purpose of this study is to describe the demographics of patients and the treatments prescribed. Data on rosacea visits from 1990 to 1997 were obtained from the National Ambulatory Medical Care Survey There were 1.1 million outpatient visits for rosacea annually in the United States. Most rosacea patients were Caucasian (96%). Most visits were by women (69%), and the mean age (SD) of patients was 50 +/- 17 years. Visits to dermatologists accounted for 78% of visits. Common comorbid diagnoses included actinic keratoses, acne and cysts, and seborrheic and contact dermatitis. Topical metronidazole was the most commonly prescribed treatment; tetracycline was the most commonly prescribed systemic therapy. Combination treatment with an oral and a topical agent was commonly used. Because rosacea appears most often in fair-skinned women, these patients may benefit from the textural features and safety profiles of certain topical metronidazole preparations newly available and from oral antibiotics (eg, tetracycline). People with rosacea should be aware of the experience that dermatologists have in treating this disorder.

Topics: Administration, Oral; Administration, Topical; Adult; Age Distribution; Aged; Dermatology; Drug Therapy, Combination; Female; Health Care Surveys; Humans; Incidence; Metronidazole; Middle Aged; Office Visits; Patient Acceptance of Health Care; Prognosis; Registries; Rosacea; Severity of Illness Index; Tetracycline; Treatment Outcome; United States

Rosacea is an inflammatory disease of the face and eyes. Treatment is adjusted to the site of the disease and its severity.

Topics: Administration, Oral; Administration, Topical; Benzoyl Peroxide; Humans; Metronidazole; Rosacea; Tetracycline

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Drug Therapy, Combination; Humans; Low-Level Light Therapy; Metronidazole; Rosacea; Tetracycline

Rosacea is an uncommon disease of the eye and facial skin. Ocular rosacea is often undiagnosed by the ophthalmologist especially when skin manifestations are not evident yet. Early diagnosis and treatment is important to decrease morbidity of this potentially blinding disease. A case of ocular rosacea in a 14-year-old Chinese girl is reported. Our patient presented with chronic non-specific keratoconjunctivitis. Only much later did the characteristic corneal and facial skin lesions appear. She responded to guttae prednisolone, oral and guttae tetracycline. This case illustrates the difficulty of early diagnosis when ocular manifestations precede those of the skin. We believe this is the first case of ocular rosacea reported in Singapore.

Topics: Adolescent; Anti-Bacterial Agents; Anti-Inflammatory Agents; Corneal Diseases; Female; Humans; Prednisolone; Rosacea; Tetracycline

Topics: Aged; Anti-Bacterial Agents; Diagnosis, Differential; Humans; Male; Metronidazole; Rosacea; Tetracycline

Topics: Animals; Humans; Mites; Rosacea; Tetracycline; Thiabendazole; Time Factors

To determine the clinical characteristics, possible etiologic agents, and response to oral antibiotic therapy in patients with phlyctenular keratoconjunctivitis.. The authors reviewed the medical records of the 17 patients with phlyctenular keratoconjunctivitis who were seen and treated at the Bascom Palmer Eye Institute between 1981 and 1991.. All 17 patients were younger than 18 years of age at the onset of their disease. Girls (n = 14) outnumbered boys (n = 3) 4:1. Significant incapacitating symptoms and ocular morbidity occurred frequently, including three perforated corneas. Five of ten patients who were tested for Chlamydia infection had positive test results and five patients possibly had early rosacea dermatitis. All patients experienced long-term remission of their ocular disease after a course of oral tetracycline or erythromycin. Two patients demonstrated unique linear (fascicular) corneal phlyctenules.. Oral tetracycline or erythromycin treatment produces long-lasting remission of phlyctenular keratoconjunctivitis in affected children.

Topics: Administration, Oral; Adolescent; Adult; Child; Child, Preschool; Chlamydia Infections; Erythromycin; Female; Follow-Up Studies; Humans; Keratoconjunctivitis; Male; Rosacea; Tetracycline; Treatment Outcome; Ulcer

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.. 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.. 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.. 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.. 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.

Topics: Adult; Aged; Aged, 80 and over; Animals; Face; Female; Humans; Male; Middle Aged; Mites; Rosacea; Skin; Tetracycline

We describe the clinicopathologic features of the papular form of granulomatous acne rosacea of the eyelids. This unusual cutaneous disorder is typified by painless eruptions of reddish to yellowish brown, occasionally ulcerative papules symmetrically distributed around the eyelids, lower part of the forehead, nasolabial folds, and upper lip. Histopathologically, the lesions display caseating and noncaseating dermal granulomas that mimic those seen in tuberculosis, tuberculoid leprosy, sarcoidosis, and other diseases. The disorder responds well to systemic tetracycline therapy but may involute spontaneously during a period of months to years. The distinction of this disorder from other dermal granulomatous diseases, such as tuberculosis, leprosy, syphilis, and foreign bodies, is important because of the different therapeutic implications.

Topics: Aged; Eyelid Diseases; Female; Granuloma; Humans; Rosacea; Tetracycline

Topics: Humans; Laser Therapy; Male; Middle Aged; Rhinophyma; Rosacea; Sulfacetamide; Tetracycline

Topics: Administration, Oral; Adult; Aged; Doxycycline; Eye Diseases; Female; Humans; Male; Middle Aged; Recurrence; Rosacea; Tetracycline

Regarding treatment of acne vulgaris and rosacea, there is not much difference between hospital and practice nor among practicing dermatologists. Most of the assistants performing the important physical-manual treatment have had the same training. After analytical conversation and etiologic as well as diagnostic classification, the patients undergo the following manual treatment: cleansing, astringing, removing of comedones, massage, face pack, and covering with tinted emulsion. At home, acne: cleansing, massage, skin lotion, vitamin A acid, benzoylperoxide, antibacterial therapy; in serious male cases of acne conglobata, Roaccutan. Rosacea: antiseptic (antibiotic) treatment (topically and systemically), metronidazole (Arilin); in serious male cases, Roaccutan.

Topics: Acne Vulgaris; Benzoyl Peroxide; Combined Modality Therapy; Erythromycin; Feeding Behavior; Humans; Rosacea; Tetracycline; Tretinoin

Topics: Adult; Female; Humans; Male; Metronidazole; Prospective Studies; Rosacea; Tetracycline; Time Factors

A case of monosymptomatic photo-onycholysis due to tetracycline-hydrochloride is reported. A 40-year-old woman with rosacea had been treated with tetracycline-hydrochloride (Achromycin) 250 mg daily for 3 years. In the summer period after one month of intensive sun exposure she developed painful bullae under the nails.

Topics: Adult; Female; Humans; Nail Diseases; Photosensitivity Disorders; Rosacea; Tetracycline

Topics: Adult; Aged; Female; Follow-Up Studies; Humans; Male; Metronidazole; Middle Aged; Recurrence; Rosacea; Tetracycline

Ocular rosacea was diagnosed in 6.3% of a cornea/external disease referral practice where more than half of the patients referred are for corneal surgery. The most common signs and symptoms are also common to many patients in the general practice of ophthalmology, i.e., foreign body sensation, burning, superficial punctate erosions, chalazia and blepharitis. Less common but dangerous to the vision was corneal thinning, vascularization and infiltrates. Three new associated symptoms were described. These were map dot subepithelial opacities, recurrent erosions and moderately severe foreign body sensation, pain or burning with minimal associated signs. Oral tetracycline 250 mg q.i.d. resulted in improvement in almost all patients from 4 to 17 days after initiation of therapy. Although most of the patients have been able to taper and stop therapy, those with foreign body sensation, burning and pain have had recurrences of their symptoms with all attempts at stopping therapy.

Topics: Adult; Aged; Conjunctival Diseases; Corneal Diseases; Eyelid Diseases; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline; Time Factors

Ocular rosacea was diagnosed in 49 patients. The most common signs and symptoms were foreign body sensation, burning, superficial punctate erosions, chalazia, and belpharitis. Less common but dangerous to the vision was corneal thinning, vascularization, and infiltrates. Three new associated symptoms were found. These were mapdot subepithelial opacities, recurrent erosions, and moderately severe foreign body sensation, pain or burning with minimal associated signs. Of the 49 patients, 37 were treated with 250 mg of oral tetracycline four times a day, which resulted in improvement in almost all patients from four to 17 days after initiation of therapy. Most of the patients have been able to taper, or taper and stop therapy without recurrence of their symptoms. Those patients with foreign body sensation, burning, and pain required the most prolonged therapy in order to taper or stop treatment with tetracycline.

Topics: Adolescent; Adult; Aged; Eye Diseases; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline

The patterns of drug resistance and the frequency of conjugative R plasmids in intestinal Escherichia coli from 88 patients treated for a skin disease (acne vulgaris) with low oral doses of tetracycline are reported. The proportion of patients with resistant bacteria was progressively greater in patients who received tetracycline for 1 week, 4 weeks, or longer (from 50 to 88%). No multiply drug-resistant bacteria were detected before treatment or after 1 week of treatment. After more than 4 weeks of treatment, multiply drug-resistant E. coli were isolated from about 50% of the patients. The origin and selection of R plasmid-determined multiple drug resistance are discussed.

Topics: Acne Vulgaris; Drug Resistance, Microbial; Escherichia coli; Extrachromosomal Inheritance; Feces; Humans; Plasmids; R Factors; Rosacea; Tetracycline; Time Factors

Topics: Humans; Liver; Rosacea; Tetracycline

Skin surface lipid composition was measured in thirty-one patients with rosacea and their age-matched controls. Patients with rosacea had normal lipid composition, and there was no correlation between the lipid composition and the severity of the disease. Tetracycline therapy produced no measurable change in lipid composition.

Topics: Adult; Aged; Cholesterol; Chromatography, Thin Layer; Female; Humans; Lipid Metabolism; Male; Middle Aged; Rosacea; Sebum; Skin; Squalene; Tetracycline

Results of blood chemistry studies using an automated multiple analysis system and blood cell counts for 325 patients receiving long-term low-dosage tetracycline hydrochloride therapy continuously for three years or longer revealed minimal changes in all but one patient. This patient developed a transient hyperbilirubinemia with mild juandice while taking 500 mg of tetracycline daily.

Topics: Acne Vulgaris; Adolescent; Adult; Aged; Blood Cell Count; Blood Chemical Analysis; Cellulitis; Child; Female; Folliculitis; Furunculosis; Humans; Male; Rosacea; Tetracycline; Time Factors

Topics: Acne Vulgaris; Adult; Aged; Facial Dermatoses; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Ascorbic Acid; Humans; Niacinamide; Pyridoxine; Riboflavin; Rosacea; Tetracycline

Topics: Humans; Keratitis; Rosacea; Tetracycline

Topics: Acne Vulgaris; Adolescent; Adult; Aged; Alanine Transaminase; Alkaline Phosphatase; Bilirubin; Blood Urea Nitrogen; Child; Female; Follow-Up Studies; Humans; Kidney Function Tests; Liver Function Tests; Male; Middle Aged; Rosacea; Skin Diseases; Tetracycline; Time Factors

Topics: Acne Vulgaris; Adrenal Cortex Hormones; Adult; Blister; Contraceptives, Oral; Cosmetics; Dermatologic Agents; Drug Eruptions; Eczema; Facial Dermatoses; Female; Fusobacterium; Humans; Male; Pruritus; Rosacea; Tetracycline; Vitamin B Deficiency

Topics: Blepharoptosis; Female; Humans; Middle Aged; Prednisone; Rosacea; Tetracycline; Vitamin B Complex

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Betamethasone; Biopsy; Female; Fluocinolone Acetonide; Glucocorticoids; Humans; Male; Middle Aged; Rosacea; Skin; Steroids, Fluorinated; Tetracycline; Time Factors

Topics: Adrenal Cortex Hormones; Humans; Rosacea; Tetracycline

Topics: Adolescent; Adult; Contraceptives, Oral; Dermatitis; Dermatitis, Seborrheic; Diagnosis, Differential; Facial Dermatoses; Female; Humans; Mouth; Pigmentation; Pregnancy; Recurrence; Rosacea; Tetracycline

Topics: Dermatitis; Facial Dermatoses; Female; Fusobacterium; Humans; Male; Rosacea; Staining and Labeling; Tetracycline

Topics: Administration, Oral; Adolescent; Adult; Female; Humans; Male; Rosacea; Tetracycline; Time Factors

Topics: Adult; Evaluation Studies as Topic; Female; Humans; Middle Aged; Rosacea; Tetracycline; Time Factors

Topics: Adult; Age Factors; Aged; Child, Preschool; Chin; Dermatitis; Diagnosis, Differential; Facial Dermatoses; Female; Humans; Lip Diseases; Male; Mouth Diseases; Rosacea; Sex Factors; Tetracycline

Topics: Administration, Oral; Female; Humans; Male; Rosacea; Tetracycline; Time Factors

Topics: Adult; Diagnosis, Differential; Female; Granuloma; Humans; Middle Aged; Ointments; Rosacea; Sarcoidosis; Tetracycline; Tuberculosis, Cutaneous

Topics: Glucocorticoids; Humans; Rosacea; Tetracycline

Topics: Facial Dermatoses; Female; Follow-Up Studies; Humans; Male; Rosacea; Tetracycline

Topics: Acne Vulgaris; Administration, Topical; Anti-Inflammatory Agents; Humans; Hydrocortisone; Quinolines; Rosacea; Tetracycline

Fourteen patients suffering from rosacea treated by prolonged topical applications of fluorinated steroids showed adverse effects. Aggravation and extension of telangiectasia occurred in all, and in most cessation of the treatment was followed by severe rebound inflammatory oedema and acute pustular eruption. The telangiectasia cleared or was much improved within three months of cessation of the use of fluorinated steroids. Hydrocortisone did not produce the same effect, and hence it was used, together with oral tetracycline, for treatment.

Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Betamethasone; Erythema; Facial Dermatoses; Female; Fluocinolone Acetonide; Humans; Hydrocortisone; Male; Middle Aged; Rosacea; Substance Withdrawal Syndrome; Telangiectasis; Tetracycline

Topics: Adult; Aged; Anti-Bacterial Agents; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline

Topics: Acne Vulgaris; Animals; Basement Membrane; Female; Humans; Injections, Intramuscular; Keratins; Male; Microscopy, Fluorescence; Psoriasis; Rats; Rosacea; Sebaceous Glands; Skin; Tail; Tetracycline

Topics: Ampicillin; Fever; Humans; Male; Middle Aged; Rosacea; Tetracycline

Topics: Acne Vulgaris; Adrenal Cortex Hormones; Dermatologic Agents; Estrogens; Long-Term Care; Resorcinols; Rosacea; Tetracycline

Topics: Adolescent; Adult; Aged; Amphotericin B; Drug Synergism; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline

Topics: Acne Vulgaris; Anti-Bacterial Agents; Humans; Protein Synthesis Inhibitors; Rosacea; Sulfacetamide; Sulfadiazine; Sulfamerazine; Sulfanilamide; Sulfanilamides; Sulfonamides; Tetracycline