Patient case (clinical description): A 41-year-old woman comes to the dermatology clinic complaining of facial redness, especially on her forehead and cheeks. She noticed that the redness gets worse in the summer and after sun exposure. She is otherwise healthy. On physical examination, she has multiple papules and pustules present on her forehead, cheeks, and nose on a background of erythema and telangiectasias. There are no other lesions or nodules. The patient is married and has 2 children who are 5 and 9 years old. She has IUD and doesn't wish to have more kids. She does not smoke or drink alcohol. Her vital signs are normal, and BMI is 21.

Patient's own account: I'm 41, married with 2 lovely kids who are 5 and 9 years old. I have an IUD and I don't want to have more kids. I don't smoke or drink alcohol. I had to go to the dermatology clinic because I had terrible redness on my face, especially on my forehead and cheeks. It got worse in the summer and after being under the sun. I'm usually healthy. They conducted a physical exam and they found several lesions and pustules on my forehead, cheeks and nose and they also found some signs of erythema and telangiectasia. My vitals were normal, and my BMI is 21.

Clinical trial: Analysis of the Microbiome in Rosacea

Eligibility criteria:
Inclusion Criteria:

          -  Participants must be over the age of 18 years old.

          -  Participants must have a current diagnosis of moderate-to-severe
             erythematotelangiectatic or papulopustular rosacea or free of rosacea to serve as
             control.

          -  Participants must have the ability to understand and communicate with the
             investigator.

          -  Participants must be willing and comply with the requirements of the protocol.

          -  Participants must provide written informed consent

        Exclusion Criteria:

          -  Subjects unable to provide informed consent.

          -  Subjects with significant medical history or concurrent illness that the investigator
             feels are not safe for study participation.

          -  Recently treated (4 weeks for topical antibiotics/steroids/other anti- inflammatory
             medications on the face, 8 weeks for systemic antibiotics/steroids/other
             immunosuppressive agents) or current (skin) diseases that would affect clinical
             evaluation and skin sampling.

          -  Subjects with a history of facial surgeries and cosmetic procedures (i.e. laser
             therapy, resurfacing, dermal fillers, and deep chemical peels) within 6 months.

          -  Subjects with facial features (i.e. significant hair growth) that would affect
             clinical evaluation and skin sampling.

          -  Participants with a history of chronic gastrointestinal disease, diabetes mellitus,
             cardiac disease or immunodeficiency disease.

          -  Intake of proton pump inhibitors, H2 receptor antagonists, laxatives, or antidiarrheal
             medication, NSAIDs, or antacids within 2 weeks prior to enrollment.

          -  Participants with a history of major surgery of the GI tract (5 years).

          -  Participants with a known hypersensitivity to tetracyclines or doxycycline or topical
             ivermectin

          -  Subjects unwilling to avoid facial washing for 24 hours prior to sampling and to come
             to sampling visit without make-up.

          -  Subjects with known allergy to lidocaine and epinephrine.

          -  Subjects with known bleeding disorders.

          -  Subjects with a history of keloids or excessive scarring.

          -  Pregnant subjects. Self-reporting will be used to determine whether a patient is
             pregnant
No condition on gender to be admitted to the trial.
Accepts Healthy Volunteers
Subject must be at least 18 Years old.


Eligibility (NLI label): Entailment