Re: Women, Rhino & Ocular cea

[Guest guest]

You raise a good point, Heidi. Phymatous rosacea does most definitely

occur in both sexes, though women do not typically advance to the

severe disfiguring form characteristic of men (of course not

exclusively men, but overwhelmingly so. That's probably because men

and women have a surprising number of difference in their skin.

Unless through heredity, women's sebaceous glands and pores, and

probably other skin factors, usually do not favor the development of

severe phyma.)

I don't know that mild inflammation and nose swelling constitutes

rhinophyma. Skin edema and inflammation can certainly cause an

increase or change in the shape of the nose, but that's not the same

as enlargment of sebaceous glands that I understand is the stigmata

of phyma. But I would think that edema and inflammation of the nose

is the necessary fertile environment encouraging sebaceous glands to

enlarge, potentially unreversibly.

So I wouldn't think to call any enlarged nose on a rosacean

rhinophyma. Heat applied to the eyes could encourage skin edema in

the area (such as the nose) by increasing blood flow, but I don't

understand how heat would specifically worsen sebaceous glands.

Does that all coincide with your understanding, or am I missing

something?

Of note, the Journal of the American Academy of Dermatology finally

published in its April issue the new subtypes of rosacea as developed

by the National cea Society. NRS defines four subtypes that

exists, by itself or more commonly with other subtypes:

Erythematotelangiectatic rosacea, Papulopustular rosacea, Phymatous

rosacea, and Ocular rosacea. So we now have a common language for

distinguishing one manifestation of rosacea from another, and finally

a way for researchers to test medications on specific subtypes rather

than just rosaceans in general.

I can't find the article online, or even mention of it on NRS's Web

site. The article is titled, " Standard classification of rosacea:

Report of the National cea Society Expert Committee on the

Classification and Staging of cea " from the April issue of

Journal American Academy of Dermatology.

Marjorie

Marjorie Lazoff, MD

> Women do get rhinophyma. Dr. Nase talks about this in his book as

well

> as in previous posts. There are numerous women on this board,

including

> myself, who have mild cases. It is not always the end stage of

rosacea;

> in fact, rhinophyma can exist without rosacea (my grandmother had

> rhinophyma, not rosacea). I have corresponded with several women

who

> have rhinophyma, and we all display the same symptoms: mild

> inflammation & nose swelling, especially in the morning. Some of us

> also have experienced nose shape change, if not actual

enlargement. I'm

> not talking about W.C. Fields here, but our noses have definitely

> changed -- and rather quickly at that.

>

> Most doctors will tell you that women do not get rhinophyma. I have

> heard this and read this many, many times. But this is not the

position

> of the Director of Dermatology at the Mayo Clinic or my current

derm,

> who is treating me aggressively with low-dose accutane and V-Beam.

>

> If you don't believe that women get rhinophyma, start looking around

> you. There are a lot of women out there with bulbous, bumpy, red

noses.

>

> If you think you might have rhinophyma and especially if you have a

> family history (as I do), don't mess around with a lot of products

that

> will hasten the condition (like AHA's & BHA's) or hot compresses

(which

> I used for ocular rosacea and which helped to trigger the

rhinophyma).

> In fact, don't put anything on your nose except sunscreen (I use

Oil of

> Olay Complete -- Fragrance Free). And get a good, knowledgeable

derm who

> knows something about accutane and laser.

>

> Matija just posted an article in which a leading expert on

rhinophyma

> discusses its dramatic increase.

>

> I'm not trying to scare people, but I believe that I triggered this

> disease with kickboxing, AHA's and hot compresses.

>

> I am responding well to treatment, but still have a long way to go.

>

> Heidi

[Guest guest]

> the article you are referring to quoted and the source cited at

this url:

>

> http://rosaceadiet.com/html/tip.html

>

> third article quoted....

Thanks, Barry. I didn't supply the above URL because it doesn't give

much information, and links to a pay-per-view article that looks to

be a press release type written when the NRS first announced its new

classification, not the JAAD article was just published. Or did I

misread it?

Marjorie

Marjorie Lazoff, MD

[Guest guest]

> the article you are referring to quoted and the source cited at

this url:

>

> http://rosaceadiet.com/html/tip.html

>

> third article quoted....

Thanks, Barry. I didn't supply the above URL because it doesn't give

much information, and links to a pay-per-view article that looks to

be a press release type written when the NRS first announced its new

classification, not the JAAD article was just published. Or did I

misread it?

Marjorie

Marjorie Lazoff, MD

[Guest guest]

> the article you are referring to quoted and the source cited at

this url:

>

> http://rosaceadiet.com/html/tip.html

>

> third article quoted....

Thanks, Barry. I didn't supply the above URL because it doesn't give

much information, and links to a pay-per-view article that looks to

be a press release type written when the NRS first announced its new

classification, not the JAAD article was just published. Or did I

misread it?

Marjorie

Marjorie Lazoff, MD