Rosacea is a chronic inflammatory skin disease, affecting commonly patients with fair skin. It is characterized by persistent facial erythema that could cause cosmetic disfigurement, psychosocial burden and significant impact on patients' quality of life. 1 The updated classification of the National Rosacea Society defines diagnostic phenotypes, with the fixed centrofacial erythema being a characteristic clinical phenotype. 1 Treatment of erythematotelangiectatic rosacea (ETR) is challenging. 2 Current treatment options include energy-based devices (such as laser, intense pulsed light, and electrocoagulation) 3 and brimonidine gel. The latter was recently introduced. Its effect is transient with frequent treatment escape within 24 h. 2 The therapeutic benefit of repeated botulinum toxin mesotherapy sessions in ETR was also reported, probably through acetylcholine blocking effects. 4 Nevertheless, this therapeutic modality is considered so costly.Tranexamic acid (TXA) is an antifibrinolytic drug that reduces the risk of excessive bleeding in menorrhagia, hemophilia, as well as major surgery. TXA has been used for the treatment of several skin diseases such as angioedema and melasma. 5,6 To date, only few studies described the use of TXA in the treatment of rosacea, topically or by microneedling, with encouraging results. 6,7,8,9 None of these studies evaluated intralesional microinjection of TXA for the

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Background Rickets is a common disease worldwide. In the developed world, its prevalence dramatically decreased but still diagnosed in at‐risk populations. The skin plays a critical role in vitamin D synthesis. Therefore, several skin diseases, especially keratinization disorders, could lead to impaired vitamin D metabolism and vitamin D deficient rickets. Objective The article aimed to summarize the current knowledge of skin diseases and conditions associated with rickets. Methods To examine the association between rickets and skin diseases, we performed a systematic review of the literature using PubMed database. The search included studies published from the database inception to August 2019. Results A total number of 75 articles were included. Identified conditions associated with rickets were ichthyosis being a more common skin diseases, alopecia, epidermal and melanocytic nevi, xeroderma pigmentosum, mastocytosis, psoriasis, and atopic dermatitis. Three types of rickets were identified: vitamin D‐dependent rickets, hypocalcemic vitamin D‐dependent rickets type 2, and hypophosphatemic rickets. Cutaneous skeletal hypophosphatemia syndrome is a newly described and under‐recognized condition. It is defined by the association of epidermal or melanocytic nevi, hypophosphatemic rickets, and elevated levels of fibroblast growth factor 23. Rickets in patients with ichthyosis was mainly due to impaired ability of ichthyotic skin to synthesize vitamin D, poor UV penetration of the skin caused by keratinocyte proliferation, and dark phototype. The latter may be considered a risk factor for rickets in patients with ichthyosis. Conclusion Despite its rarity, these associations should be properly recognized by dermatologists. Early diagnosis of rickets is important to prevent growth retardation and skeletal deformities.