Abstract: The etiology of cutaneous dirt-adhering disease (CDAD) remains unclear, it can occur independently or secondary to diseases such as erythematous pemphigus, psoriasis, and acne, and most patients are complicated with mental and psychological disorders. This patient suffered from recurrent rosacea. In this case, the patient's cutaneous dirt-adherent disease was secondary to roseacea. The patient had vecurrent facial erythema and papules for half a year, accompanied by brown crusting for one month. which showed no significant improvement after oral administration of doxycycline hyclate and tripterygium glycosides tablets, so apremilast was given for treatment, and the skin lesions of rosacea and CDAD gradually subsided. We analyzed that in this patient, mental and psychological factors activated the hypothalamic-pituitary-adrenal axis, which promoted the release of inflammatory factors such as IL-1β and tumor necrosis factor, exacerbated the inflammatory response, and stimulated sebum secretion, thereby inducing CDAD. Apremilast can target and inhibit PDE-4, reduce the expression of inflammatory cytokines, so as to inhibit the inflammatory response and improve the symptoms of rosacea, the reduced sebum secretion further ameliorates the symptoms of CDAD.

Key words: apremilast, cutaneous dirt-adherent disease, rosacea