Topically Applied Erythromycin in Rosacea

To the Editor.— Intensive study has produced no important ideas concerning the causation or the nature of rosacea. The histopathology is not as distinctive as the clinical portrait.¹It develops in adult life against a backdrop of intense and prolonged facial flushing from stimuli that cause mild erythema in ordinary persons. Though classified as an acneiform eruption, even being called acne rosacea, only rank beginners could mistake the two. Nonetheless, early onset rosacea can coexist with acne vulgaris. There is agreement that orally given antibiotics, notably tetracyclines, are the most effective means of controlling both the erythema and the follicular papulopustules.²Low doses are adequate. This is odd, because, unlike acne vulgaris, microorganisms have not been shown to participate in the disease process.³,⁴ We recently found that a 2.0% solution of erythromycin base was at least as effective as orally given antibiotics in controlling moderately severe acne.