Resolution of granulomatous rosacea after eradication of Helicobacter pylori with clarithromycin, metronidazole and pantoprazole

The aetiopathogenetic role of Helicobacter pylori in rosacea remains contro versial. We report a 27-year-old man with a 4-year history of intractable r osacea. Histopathology showed epithelioid granulomas. H. pylori infection w as proven directly on gastroscopy and by serological testing. Treatment wit h clarithromycin, metronidazole and pantoprazole eradicated H. pylori. Skin changes were markedly improved by the end of this therapy and had resolved completely 2 months later. The patient has been followed up, and has remai ned free of symptoms for 3 years. We suggest that H. pylori may be involved in the aetiopathogenesis of granulomatous rosacea. (C) 2001 Lippincott Wil liams & Wilkins.