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I am not sure what caused it by my wife Barbara is on Permax and suffered from edema which in turn led to cellulitis which she has been trying to clear up since last April. Four different antibiotics and continuung dressing changes have improved the cellulitis but still not 100% done with it. Meanwhile Permax had done nothing for her and she is weaning of it and ready to try Mirapex when she gets down to zero. Allan