Hi,
I am 24 and have had acne since i was 14, and have tried loads of treatments like Minocin,Tetracycline,Retin A.Nicam Gel etc.
Today i met with the dermatologist for the first time and was really hoping and expecting to be put on Roaccutane to clear up my skin,but i got worse news than that.

He said that while i do have spots(not too many) the reason for my real red cheeks,under the eyes and side of the face is because im suffering from Atrophoderma Vermiculata.
Im absolutely gutted as he says there is no real cure for it and the laser treatment will possibly improve it(imagine the cost of that).
He is going to arrange for me to go to a clinic in the hospital in the next few weeks and let a few dermatologists look at me and will ring me later with an opinion of what to do next.
But he says and hes being honest there is not much research done on AP and its not common so there mightnt be much improvement.

Im 24 and supposed to be in the prime of my life - out chasing girls,having a laugh etc, but this has always affected my confidence and now even more so.

Anyway he recommends i start on Differin gel for the time being and he says it may improve it or may irritate it so if it irritates i should stop.
Im beginning to think nothing will work.

Well any opinions/views welcome.

Thanks

Hi Dublinlad

I have Atrophoderma Vermiculata also but am in my mid 40's and the active flushing inflamed stage has now subsided - I was not diagnosed until about age 37 though. There are three important medical journal articles that show successful treatments for this condition that your derm should be aware of. Two of the articles can be found in full on the following site:

http://www.angelfire.com/journal2/sadhelp/kp.htm

The first article is about treating Keratosis pilaris atrophicans faciei - this is another name used to describe your condition. As you can see from the results multiple pulse dye laser treatments are successful. I have had two pulse dye laser treatments done with success but will still need at least one more to get to a near normal colouring.

The 2nd article is about a patient with ulerythema oprhyogenes responding to isotretinoin. I use the term UO to describe the keritinization disorder that relates to the eyebrows only but some professionals use it to include atrophoderma vermiculata also as they often go together (as in my case). You will note the lady in this artile had red cheeks. I have tried Isotretinoin at 40mg for a period of 12 months but this was not taken until around age 38 when my skin had settled down and was only red due to scarring. This made no difference to me but I believe in a person whose skin is still 'fighting' the disorder it should help

The 3rd article can be found in part on 'pubmed'. I have posted the abstract below (your derm should be able to access the article in full):

'A case of atrophoderma vermiculatum responding to isotretinoin.Weightman W.
Department of Dermatology, Queen Elizabeth Hospital, Woodville, Australia.

Atrophoderma vermiculatum (AV) is a rare disorder leading to reticular or honeycomb scarring of the face and responding poorly to treatment. A case is now presented of the successful induction of remission in the inflammatory component of the disease following a prolonged course of isotretinoin; improvement was then maintained after cessation of the treatment. In severe cases of AV with significant scarring, a trial of isotretinoin therapy is thus worthwhile in an attempt to stop progression of the disease and improve its cosmetic appearance.

PMID: 9692315 [PubMed - indexed for MEDLINE]

Again this is quite significant as the condition went into remission. With AV it is best to try and stop the inflammatory stage that leads to scarring and pitting (as it has done with me). Isotretinion would therefore be my first choice of treatment and then PDL treatment to deal with any permanent redness created by this condition.

You may have a few questions about this condition or want to talk to me direct so please feel free to email me at gogorman 'at' orcon.net.nz

regards
Anne

Anne,

Thats great thanks for all the info.
I will have a look over the weekend at those articles and websites and will message you what i think i should do.
Thanks

Hi Anne
you really seem to know your stuff.
I notice you are in NZ like me and have had some sucess with PDL treatment for the redness. Would you be willing to give me the name of your derm and the clinic? At the moment I am under the care of my GP and I would really like to find a good derm.
Thanks, Tina.

Hi Tina

Here is a link to my derms details.

http://www.dermnetnz.org/directory/strack.html

He is based in Dunedin. I live in Invercargill but travelled up there for treatment. He charged me $750 for treating my whole cheek and eyebrow area. (1st treatment was done by another derm in Auckland about 7 years ago and that cost me $2,000) so I was pleased when another laser became available closer to home at a more reasonable cost.

Dr Strack has the latest vbeam pulse dye laser and seems to know what he is doing. However you may find someone in Christchurch who also has experience with a pulse dye laser.

My skin was really red in the cheek and eyebrow area and now it is more of a dark pink. The redness was caused by KPAF and UO - I used to have KPRF but that faded a lot in my 30's (am now in mid 40's). I

How bad is your redness Tina? Is it just from the KPRF?

Let me know if I can be of any further help. It is nice to have someone living so nearby.

Anne