Although it is debatable whether Helicobacter pylori may play a role in the pathogenesis of rosacea, some authors suggested that the treatment of H. pylori might have a beneficial effect. The aim of this investigation was to compare the prevalence of H. pylori between rosacea patients and controls, and to evaluate an effect of H. pylori eradication on rosecea by a 2-week triple therapy that was composed of amoxicillin, clarithromycin and omeprazole. H. pylori was detected by using gastroscopic biopsy with Warthin-Starry stain. Forty-two (84%) of 50 patients with rosacea and 39 (78%) of 50 controls had H. pylori, showing no significant difference in prevalence. The cure rates of H. pylori in rosacea patients and controls were 80% (16/20) and 85% (17/20), respectively. There was no significant decrease in the intensity of erythema in active treatment and placebo groups both during and after the treatment. Temporary improvement in papulopustules exclusively during the treatment (within 2 weeks) could be independent of H. pylori eradication. Overall, no significant reduction in the number of papulopustules was observed in active treatment and placebo groups after the treatment (in 2 months). Taken together, our study found no significant lessening of rosacea lesions by treating H. pylori infection, which conclusively does not concur with a view that H. pylori may be related to rosacea.

Eosinophilic cellulitis (EC), or Wells' syndrome, was first described by Wells in 1971 (1). EC is an idiopathic rare disorder representing well-circumscribed erythematous plaques with variable appearances, for instances, papulovesicular, blistering and nodular lesions. There are two stages which comprise acute cellulitic and chronic granulomatous. Limbs are the most prevailing sites and trunk is the next. This disorder tends to be episodic and lasts from weeks to months even to years, and heals without scarring (2-4). Histopathologic picture is characterized by a dense diffuse dermal and sometimes subcutaneous infiltrate predominantly composed of eosinophils. Degranulated eosinophilic materials and nuclear fragments are focally deposited around collagen bundles, forming flame figures, which are distinctive but not solely confined to EC (5, 6). In addition, blood eosinophilia is usually present, albeit variable (2, 4). The patients with EC show variable responses to treatment regimens (2-4). Cyclosporine has been used in the management of some immune-mediated cutaneous diseases including hypereosinophilic dermatoses (7)(8)(9)(10)(11)(12)(13)(14). Thus, we were encouraged to use cyclosporine in attempts to treat recalcitrant EC. Clearance of the lesions resulted from administration of low-dose cyclosporine within 1 month. To our search, this is the first report of patients with EC successfully treated with cyclosporine. We reviewed the pathogenic role of eosinophils and the usefulness of cyclosporine in EC. CASE REPORTS Case 1A 42-yr-old Korean man presented with reddish swollen plaques, measuring 11×17 cm, on the right lower abdomen (Fig. 1). The lesions were slowly increasing in size, and became more edematous and indurated with localized heat sensation. The eruptions had appeared at the same site several times and had persisted for about 1 to 2 months each time. The patient had no specific medical and family history. He denied taking any drug before the lesions had developed. He had neither previous infection symptoms nor insect bites. He had no previous skin disorders other than chronic urticaria. On examination, there was no palpable lymph node at axillary or inguinal areas. Laboratory investigations including ESR, serum glucose, lipid, liver enzymes, BUN, creatinine, uric acid, and electrolytes were within normal limits. White