Objectives: 1. Suggest the possible concept of ‘Rosacea’ as a cutaneous expression of a systemic chronic inflammatory state

2. Present the combined treatment protocol for rosacea, based on my inside-out anti-inflammatory approach based on functional medicine.

Introduction: Rosacea is a common chronic inflammatory skin disorder but causes of the disease are not yet clear. Many articles have been published about an increased risk of systemic diseases such as cardiovascular disease, gastrointestinal disease and nervous system disease in patients of rosacea. Those results show the possibility that rosacea may be a skin expression of systemic chronic low-grade inflammation. Therefore, assessment and treatment of rosacea should be based on a systemic and holistic approach, not just be focused on the symptom of the skin itself.

Materials / method: After the assessment with various types of questionnaire, food diary, lab test, HRV, etc., patients with rosacea have been approached and treated with combined systemic personalized anti-inflammatory modality.

Results: Objective findings and subjective symptoms of patients are improved with the treatment protocol of considering rosacea as a skin expression of systemic low-grade inflammation with the concept of ‘gut-brain-skin axis’,

Conclusion: When rosacea patients are approached by systemic anti-inflammatory combined modality, not only the skin condition but also the general condition of patients have been improved. Most of the cases, the skin condition of patients has been well maintained without recurrence after the treatment.

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Objectives: Learn more details of rosacea classification and holistic management

Introduction: Rosacea is a highly prevalent, chronic inflammatory disease, presented with persistent condition in which the skin on a person’s cheeks, nose, chin, eyelids, or forehead becomes inflamed and red, often producing small pimples and noticeable blood vessels. The treatment of rosacea remains a challenge to dermatologists.

Conclusion: Therapies include medications, IPLs, lasers, cosmeceuticals, nutraceuticals, LLLTs, mesotherapy and various combinations of these modalities. The appropriate treatment depends on clinical types and patient's various clinical symptoms. We generally rely on medical treatments for rosacea. But if we want to achieve better and longer efficacy of disease control, lifestyle change, emotion regulation, diet modification, trigger avoidance and skin care regimen adjustment all play important roles in holistic rosacea management.

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Objectives: good treatment response of topical pimecrolimus 1% for Rosacea

Introduction: Background: Rosacea is an inflammatory skin disease characterized by erythema, papulopustules and telangectasia. Rosacea is a common condition, which is often resistant to treatment.

Materials / method: case report

Results: Observation: A 28 years old woman visited to the dermatovenereology polyclinic Sanglah Hospital Denpasar in 28thFebruary 2008. Clinical feature showed persistent erythema macules on cheeks, and some papules and pustules which have been present for 9 years. She was given oral and topical anti-acne but had not responded to treatment especially for erythema and flushing. The diagnosis was based on clinical finding, the feature showed persistent erythema macules on cheeks, and some papules and pustules. On histopathologic examination revealed, telangiectasis and limphoplasmacytic infiltration on

Conclusion: The treatment response with pimecrolimus 1% was seen within two weeks, further evaluation was needed to see the final result.

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