Demodex folliculorum is an obligate parasite of human pilosebaceous follicle. Though attempts to elucidate the role of demodex in rosacea have produced conflicting results but several studies have suggested that this mite play a role in rosacea.This is a comparative, descriptive cross - sectional study that carried out on 39 rosacea and 41 non rosacea patients. These patients have biopsied in Department of Dermatology of Hamadan Sina Hospital in 5 years during 1993-1998. The mean of demodex F. in the skin face of rosacea was 1.103 and for non-rosacea patients was 0.171. This difference from statistical aspect was meaningful (P<0.05). There was no difference in mean of demodex in both sexes of rosacea patients (P>0.05). The mean of demodex in patients over 40 year in comparison of below 40 years was meaningful (P<0.05). In this study the mean of demodex in rosacea was higher than that of control group. But a prospective study with normal skin as control group is needed to clarify the exact role of demodex in rosacea.

Rosacea is a chronic inflammatory disease which presents with condition with a prevalence erythema and inflammatory lesions on central face. Rosacea has significant impact on quality of life of patients hence lowering confidence and harmful for social positions Study of effective medications improves quality of life of patients. In this study we tried to review effective medical treatments for this disease.

Background: There are controversial reports about the role of Demodex mites in pathogenesis of acne rosacea. The aim of this study was to examine the relationship between the presence and number of Demodex mites and the pathogenesis of rosacea. Methods: In this case-control study, the prevalence of Demodex mites was studied in facial biopsy of 75 patients with acne rosacea as case group, and in 75 patients with discoid lupus erythematosus and 75 patients with actinic lichen planus as control groups. Results: The prevalence of Demodex mites in patients with acne rosacea (38.6%) was significantly higher than the patients with discoid lupus erythematosus (21.3%) and actinic lichen planus patients (10.6%) (P < 0.001). Conclusion: This study suggests that Demodex mites may play a role in pathogenesis of rosacea but it is not clear whether rosacea merely provides a suitable environment for multiplication of mites, or the mites play a role in the pathological changes.

Rosacea is an inflammatory, chronic and cosmetically annoying common dermatologic disorder which presents with cutaneous telangiectasia, sustained erythema with courses of flares and flushings, papulopustular lesions, ocular involvement or disfigurating phymas. Although there are many relative effective medical therapies, however there are not any promissable treatment. Due to chronic nature of disease and exhausting usage of topical or systemic therapies, we decided to review Pubmed's literature for non-medical physical therapies, looking for more effective modalities and minimal side effects, particularly in intractable cases.

Background: Helicobacter pylori (H. pylori) is one the most infectious microorganism of human disease found in half of the world’ s population. Despite intense investigations into the spread of rosacea, the precise etiology remains unclear. There are theories, which suggest H. pylori as a predisposing factor for the occurrence. This study aimed at determining the prevalence of H. pylori in patients with rosacea. Methods: This analytical-descriptive study was conducted on patients with rosacea disease attending Tabriz University of Medical Sciences Dermatology Clinics from October 2011 to January 2011. Patients, who were 18-to 65-year-olds with confirmed rosacea diagnosis, were included in the study. All patients were referred to a dermatologist and the severity of rosacea was categorized in 3 grades of mild, moderate and severe. Then H. pylori infection was investigated using H. pylori stool antigen. P values of less than 0. 05 were considered statistically significant. Results: Out of 63 patients with rosacea, 35 patients (55. 55%) were male and 28 patients (44. 44%) were female. Based on the rosacea categorization, 11 (17. 46%), 32 (50. 79%), and 20 (31. 74%) patients had respectively severe, moderate, and mild rosacea. There was no statistical significant difference regarding age and gender between different severities (P = 0. 39). Forty patients (63. 4%) out of all 63 were positive for H. pylori on stool antigen examination. There was no statistically significant association between H. pylori infection and gender (P = 0. 87) or age (P = 0. 62). There was a statistically significant difference between patients with H. pylori negative and positive test results considering severity (P = 0. 013). Conclusions: In conclusion, although no association between rosacea and H. pylori infection was seen, there was a significant association between H. pylori infection and cases of severe rosacea.

Introduction: Rosacea is a centrofacial dermatosis with numerous triggers, leading to neurovascular dysregulation. Phymatous rosacea results from sebaceous hyperplasia and fibrosis, clinically presenting as irregular hypertrophy of the affected area. Medical therapies, such as photoprotection, anti-inflammatory antibiotics, and retinoids, provide suboptimal benefits in cases of phymatous rosacea. This limitation necessitates the use of surgical modalities like ablative lasers, electrosurgery, or plastic reconstruction for effective treatment. Here, we report a case of phymatous rosacea with multiple phymas over the nose, eyelids, forehead, chin, ears, and cheeks, creating a lion-like facial appearance (leonine facies) due to diffuse facial nodularity. The condition was clinically confounded with leprosy, leishmaniasis, lymphoma, and scleromyxedema. Additionally, the zygophyma (cheek) presented as a giant pedunculated tumor, which is rarely reported. It was mistaken for a soft tissue tumor, posing a diagnostic challenge. Plastic surgical excision and reconstruction proved therapeutic, and microscopic examination played a pivotal role in solving the diagnostic enigma. Case Presentation: A young male farmer with recurrent photo-exacerbated centrofacial lesions, clinically diagnosed as rosacea, later developed diffuse facial nodularity resembling leonine facies. The appearance of a progressively enlarging, globose, pedunculated tumor on his right cheek further complicated the diagnosis. Although phymatous rosacea was the leading clinical suspicion, histological analysis was deemed necessary to distinguish the combination of leonine facies and the pendulous mass from other serious conditions. Leprosy, leishmaniasis, lymphoma, and scleromyxedema are among the many causes of leonine facies, while soft tissue tumors like lipoma, fibroma, and neurofibroma can present with pedunculated morphology. The pendulous mass was surgically excised and sent for microscopic analysis, which confirmed the diagnosis of granulomatous rosacea. Cold knife excision was preferred over lasers and radiosurgery to preserve tissue architecture for histological analysis. Continued medical therapy and photoprotection contributed to further clinical regression. Conclusions: Pedunculated phymatous rosacea, mimicking a soft tissue tumor, requires histopathological distinction from more serious conditions. Cold knife plastic surgery, which preserves tissue architecture for histopathological studies, should be the recommended surgical treatment in such cases. Additionally, avoiding triggers and adhering to medical therapy are essential for better aesthetic outcomes.

Background: The prevalence of Helicobacter pylori (H.pylori) infection in patients with rosacea is reported from 50 to 90 percent, which suggests the possibility of the role of this organism in pathogenesis of rosacea. Objectives: Evaluation of relationship between H.pylori infection & rosacea. Patients and Methods: In this case-control study, 30 patients referred to skin clinics of Boo-Ali and Loghman Hakim hospitals in Tehran were compared with 30 individuals of similar sex and age who had not rosacea (control group). Serologic tests for H.pylori infection (IgG and IgA), and also urea breath test were done. The results were compared using chi-square test with 95% confidence interval and P<0.05 was considered as significant. Results: No significant differences were seen between patients with rosacea and control group in having IgA (60% in case group, 40% in control group), IgG (76.6% in case group, 53.3% in control group) and positive breath test. Conclusion: More extensive research about possible relationship between H. pylori infection and rosacea is recommended.

Background: The evidence has shown the relationship between the microbiota of the face and several skin conditions. However, for rosacea patients, the changes in the facial skin microbiota still remain unknown. Objectives: This study was performed to explore the correlation between the facial skin microbiota and rosacea and analyze and characterize the facial skin microbiota of rosacea patients in comparison to healthy controls using 16S rDNA amplicon sequencing. Methods: A total of 27 rosacea patients and 25 healthy controls were matched. TheDNAwas extracted from participants’,skin swabs taken from the nose, chin, forehead, and bilateral cheeks. The V3V4 region of the 16S rRNA gene was sequenced using Illumina MiSeq technology. The diversity of the face skin microbiota was examined using alpha and beta diversity. Utilizing linear discriminant analysis effect size (LEfSe), the quantitative study of biomarkers in the two groups was carried out. Clusters of orthologous groups and Kyoto encyclopedia of genes and genomes function predictions were made at the genus level utilizing phylogenetic investigation of communities by reconstruction of unobserved states. Results: The alpha diversity of the facial skin microbiota increased significantly in rosacea patients, and beta diversity showed substantial differences between the rosacea and healthy control groups. The facial skin microbiota community structure changed in rosacea patients,however, the dominant strains were the same as in healthy controls, both being Propionibacterium acnes and Staphylococcus epidermidis. The LEfSe demonstrated that Xanthomonas, Acinetobacter, and Pseudomonas were enriched in the rosacea patients,nevertheless, Corynebacterium, Finegoldia, and Peptoniphilus were enriched in the healthy controls. The rosacea patients showed significantly decreased expression in the pathways of membrane transport, carbohydrate metabolism, metabolic diseases, amino acid transport and metabolism, carbohydrate transport and metabolism, transcription, and inorganic ion transport and metabolism. Conclusions: The facial skin microbiota diversity and community structure changed, and the expression of several metabolic pathways was downregulated in the rosacea patients in comparison to the healthy controls, which might outline new strategic methods for the surveillance, diagnosis, and treatment of rosacea.