So, I have suffered from rosacea for 7 years that came on overnight when I moved into a new house at university. The last 2 years, the condition has regressed quite dramatically and have tried to control the issue with Vbeam with varying degrees of success. My symtoms are burning on the cheeks, nose, temples, ranging from moderate to severe, moderate redness at baseline and no pastules and pustules. I recently got a skin biopsy test done which has apparently now confirmed rosacea. However, the main reason I wanted to get tested was because I wanted to test the levels of demodex to see whether they may have been contributing or causing my rosacea. Frustratingly the results that came back confirmed demodex, but didn't test for levels, which was pointless in my eyes, as everyone has demodex and would test postive for Demodex.

What is confusing to me is that I travelled to Cornwall for 4 days last week and my condition improved overnight. There was no change in my diet, weather, etc, but my skin drastically improved (redness and burning way down). I came back to London on Sunday and the last 3 days its gotten worse and worse by the day. How can this be with no change but environment. Could this potentially be linked to Demodex or not?

I have attached my biopsy results if anyone might be able to decode them. The dermatologist I saw to follow up on these results didn't really offer up much in way of explaining the results to me.

I read a scientific article which stated the following;

PVI with lymphohistiocytic infiltrate
This is the most confusing type of PVI. Conditions that are associated with a lymphohistiocytic inflammatory cell infiltrate include drug reactions, viral infections and post-viral reactions, HIV dermatoses, and leprosy24,25 (fig 6​6).). Ziel-Neelsen, acid fast bacilli, Gomori methenamine silver, PAS, and Fite stains should be performed on all inflammatory dermatoses with a prominent lymphohistiocytic infiltrate to exclude the presence of microorganisms.


With that information, should I be looking at getting the stain tests done to see whether my rosacea could be caused by the presence of microorganisms?

I am very confused by it all and at my wits end!

Thanks,

Screenshot 2019-10-23 at 17.07.23.jpg