Original article—alimentary tractSmall Intestinal Bacterial Overgrowth in Rosacea: Clinical Effectiveness of Its Eradication
Section snippets
Patients and Controls
This is a prospective study involving 113 consecutive rosacea patients (82 women, 31 men; mean age, 52 ± 15 years) recruited in an academic dermatologic department and 60 healthy, sex- and age-matched controls (40 women, 20 men; mean age, 49 ± 11 years). Two patients had flushing, 27 had erythrosis, and 84 had papulopustules. Two patients with papulopustular rosacea exhibited also phymata. Most patients associated 2 or more phases (Table 1).
Dermatologic Assessment
Two independent dermatologists (F.D., A.P.) evaluated
Results
Baseline blood and stool analyses were normal in all patients and controls.
A significantly increased prevalence of SIBO was found in patients with rosacea compared with controls (52/113 vs 3/60, respectively; P < .001). In 40 of 52, both LH-BT and G-BT were positive, whereas G-BT only was positive in the remaining 12 cases.
Seven patients presented both SIBO and Hp infection. When stratified for cutaneous lesions, 42 of 98 patients with flush and/or erythrosis were SIBO-positive versus 10 who
Discussion
This study demonstrates that rosacea patients have a significantly higher SIBO prevalence than controls, and, more importantly, that the eradication of SIBO induces an almost complete regression of the cutaneous lesions in rosacea patients and maintains this excellent result for at least 9 months. In fact, in 78% of our patients, skin lesions fully cleared and in 17.7% improved greatly 1 month after interrupting rifaximin therapy. Moreover, all rosacea patients who remained unchanged with
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Prof Aurora Parodi and Prof Vincenzo Savarino are supported by the Italian Ministry of University.