Objectives: To identify and properly classify the clinical phenotypes of rosacea among patients with Fitzpatrick skin phototypes III-V . To identify primary and secondary features, aggravating factors and extracutaneous manifestations. To discuss management of medical and esthetic concerns and implications of rosacea in skin of color.

Introduction: Rosacea was once thought to be a disease of northern European origin and perceived as uncommon in darker skin types. In recent years, more cases of rosacea have been identified in African, Latino, or Asian descents.

Materials / method: This was an observational cross-sectional study conducted among patients at the De La Salle University Medical Center and in a private clinic evaluating clinical features using the rosacea clinical scorecard and the 2017 standard classification by the National Rosacea Society expert committee. The duration of the disease, the subtype, aggravating factors, ocular symptoms, comorbidities , and subtype severity were likewise identified. Appropriate medical treatment and other adjunctive modalities such lasers to address erythema and chemical peels for post-inflammatory hyperpigmentation.

Results: A total of 413 (345 F; 68 M) patients were enrolled. Forty eight percent of patients presented with persistent centrofacial erythema, validated by 3D imaging. Phymas were present in 16% of cases. Transient facial redness with papules, pustules, and nodules were present in 52% of cases. Cases of rhinophyma usually developed post-operative complications and dissatisfaction. Majority of cases responded well to appropriate skin care products and rosacea medications.

Conclusion: The clinical characteristics of rosacea among Filipinos were identified. Although previously considered as rare among Asians, the study shows that it is common among Filipinos with brown skin. This seems to be related to Spanish and Chinese racial influence, vascular and sebaceous gland hyperreactivity and natural instrinsic responses to heat and sunlight. The presence of rosacea should always be considered when contemplating on performing aesthetic procedures such as chemical peels, lasers, and facial surgery.

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Objectives: The objective was to evaluate the durability of results from
combined therapy using botulinum toxin and exosomes for
treating large pores, skin flushing, and pigmentation, up to 18
months post-treatment.

Introduction: This study tracked participants over 18 months to gauge the
efficacy of combined therapy for diverse skin issues. Initial
positive outcomes after two sessions prompted further
investigation into the sustainability of results.

Materials / method: Participants received combined botulinum toxin and exosome
therapy targeting pore size, flushing, and pigmentation.
Treatment involved two sessions: the first utilizing insulin
syringe air dissection and micro-droplet botulinum toxin, the
second employing microneedle therapy (MTS) and exosomes.
Treatment efficacy was assessed using 3D camera analysis
over the 18 months.

Results: Following two sessions, patients experienced significant
improvement in skin texture and pigmentation at the six-month
mark, indicating satisfactory outcomes. Combining botulinum
toxin and exosome therapy stimulated collagen production and
enhanced dermal tissue, resulting in lasting skin
enhancements. Analysis revealed these improvements
persisted for 18 months post-treatment, suggesting long-term
efficacy.

Conclusion: This study highlights the sustained effectiveness of combined
botulinum toxin and exosome therapy for addressing skin pore,
flushing, and pigmentation concerns. The treatment's
regenerative effects, including enhanced collagen production
and tissue improvement, led to enduring enhancements in skin
quality. These findings support the long-term use of combined
therapy for various skin issues.

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Objectives: Deepen understanding of rosacea's cyclical symptoms and impact on diverse skin types, particularly the underdiagnosis in skin of color. Explore advanced diagnostic techniques, such as Wood's lamp, to reveal subtle signs. Evaluate the effectiveness of traditional treatments like isotretinoin and the role of innovative approaches, including the use of rose-derived exosomes for their anti-inflammatory and skin barrier restoration properties. Aim to develop comprehensive, tailored treatment plans that address the unique challenges and symptoms presented by individuals with skin of color.

Introduction: Rosacea, is frequently misdiagnosed in individuals with skin of color, where its classic signs are often masked. The condition's hallmark facial redness and bumps are commonly overlooked, leading to mistaken attributions of symptoms like large pores on the nose for phymatous changes and dark circles under the eyes to mere pigmentation issues rather than underlying inflammation. This misinterpretation highlights the critical need for a refined diagnostic lens that recognizes these atypical presentations, ensuring those affected receive accurate diagnoses and appropriate management.

Materials / method: Study on two 30-year-old females with atypical rosacea symptoms in skin of color. Case 1 reported visible pores and nasal enlargement; Case 2 had dark circles and eye inflammation. Interventions included skincare for barrier repair, hydration, a rosacea diary, radio frequency micro needling, CO2 laser, and rose-derived exosomes for Case 1; Laser Genesis, exosomes microneedling, and cooling wands for Case 2.Outcomes were measured by changes in redness, phymatous alterations, dehydration, skin texture, and the severity of dark circles and inflammation.

Results: Results revealed significant improvements: Case 1 experienced a marked reduction in nasal phymatous changes and visible pores, alongside a notable decrease in facial redness and dehydration. Case 2 saw a substantial alleviation of dark circles and eye inflammation, with enhanced skin texture and hydration. Both cases demonstrated considerable symptom relief, underscoring the tailored treatment approach's effectiveness in addressing atypical rosacea manifestations in skin of color, with patients reporting high satisfaction levels.

Conclusion: The study underscores the critical importance of recognizing rosacea symptoms beyond initial visual appearances, especially in individuals with skin of color. The significant improvements observed in both cases highlight the efficacy of tailored treatments. These findings advocate for a more nuanced diagnostic approach that considers atypical presentations of rosacea, promoting better patient outcomes through personalized management strategies. This may also reduce the risk of scarring & worsening of symptoms through misdiagnosis.

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