The usefulness of investigating the possible underlying conditions in rosacea

The usefulness of investigating the possible underlying conditions in rosacea EditorThe paper entitled ‘Rosacea and demodicidosis with gain of function mutation in STAT1’ by Second et al. is of indubitable interest and prompted us to make some observations. The Authors described a patient with cutaneous and ocular rosacea that they related to demodicidosis as oral ivermectin improved the cutaneous lesions. However, the Authors did not demonstrate by skin scraping nor by standardized skin surface biopsy (SSSB) an excessive number of Demodex folliculorum (DF) mites in the pilosebaceous units to justify an oral antiparasitic treatment as a drug of first choice. DF is usually found in the pilosebaceous follicle with an average density <5 mites/cm2, whereas its density may increase in the skin affected by rosacea. The Authors used 200 μg/kg ivermectin without indicating the daily dosage nor the treatment duration. Furthermore, it is not clear if the relatives of the proband, who shared the same STAT1 mutation and were diagnosed as having rosacea, have been treated with oral ivermectin and, in such case, if they improved as well. Lastly, the Authors did not specify the disease‐free time after ivermectin, although the follow‐up is important to establish the long‐term efficacy of the treatment, considering the frequent relapses observed after traditional http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of the European Academy of Dermatology & Venereology Wiley

The usefulness of investigating the possible underlying conditions in rosacea

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
Copyright © 2018 European Academy of Dermatology and Venereology
ISSN
0926-9959
eISSN
1468-3083
D.O.I.
10.1111/jdv.14547
Publisher site
See Article on Publisher Site

Abstract

EditorThe paper entitled ‘Rosacea and demodicidosis with gain of function mutation in STAT1’ by Second et al. is of indubitable interest and prompted us to make some observations. The Authors described a patient with cutaneous and ocular rosacea that they related to demodicidosis as oral ivermectin improved the cutaneous lesions. However, the Authors did not demonstrate by skin scraping nor by standardized skin surface biopsy (SSSB) an excessive number of Demodex folliculorum (DF) mites in the pilosebaceous units to justify an oral antiparasitic treatment as a drug of first choice. DF is usually found in the pilosebaceous follicle with an average density <5 mites/cm2, whereas its density may increase in the skin affected by rosacea. The Authors used 200 μg/kg ivermectin without indicating the daily dosage nor the treatment duration. Furthermore, it is not clear if the relatives of the proband, who shared the same STAT1 mutation and were diagnosed as having rosacea, have been treated with oral ivermectin and, in such case, if they improved as well. Lastly, the Authors did not specify the disease‐free time after ivermectin, although the follow‐up is important to establish the long‐term efficacy of the treatment, considering the frequent relapses observed after traditional

Journal

Journal of the European Academy of Dermatology & VenereologyWiley

Published: Jan 1, 2018

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