Rosacea, vinegar and lemon, dysuria and Helicobacter pylori

A 52 year old male consulted his clinician because of dysuria, difficulty i n voiding and cutaneous lesions that were cured with high daily ingestion o f acid substances (vinegar and lemon). For the last 20 years he had made se veral consultations without finding any solution to his problem. The patien t was advised to stop acid ingestion after which he presented disuria and s kin lesions compatible with rosacea. Due to the known association between t his skin disorder and gastric colonization with H. pylori an upper gastroin testinal endoscopy was performed and the presence of the bacteria was confi rmed. The patient received specific treatment with permanent resolution of the symptoms. We repeated the endoscopy with biopsy that did not show the p resence of H. pylon. It is suggested that gastric colonization with H. pylo ri could be related to irritative symptoms of the lower urinary tract that are not due to other disease processes.