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    • rss
      PubMed RSS Feed - -Exploring the association between skin microbiota and inflammatory skin diseases: a two-sample Mendelian randomization analysis

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      Arch Dermatol Res. 2024 Oct 14;316(10):677. doi: 10.1007/s00403-024-03433-y. ABSTRACT Dysbiosis in the skin microbiome is closely associated with various inflammatory skin diseases. However, current research on the causal relationship between the skin microbiome and inflammatory skin diseases lacks comprehensive and detailed investigation. We used a two-sample Mendelian randomization (MR) approach to explore associations between the skin microbiome and seven inflammatory skin diseases, including acne, atopic dermatitis, erysipelas, vitiligo, psoriasis, rosacea, and urticaria. The GWAS summary data for the skin microbiome was derived from 647 participants in two German population-based cohorts, and for the inflammatory skin diseases, they were sourced from the FinnGen consortium. Our primary MR analysis method was the inverse variance weighted (IVW) method, complemented by alternatives like MR-Egger regression, weighted median estimation, and constrained maximum likelihood. Sensitivity analyses, including Cochran's Q test, MR-Egger intercept test, and MR-PRESSO outlier detection, were conducted to validate and stabilize our findings. We identified significant causal relationships between the skin microbiome and seven inflammatory skin diseases: acne, atopic dermatitis, erysipelas, vitiligo, psoriasis, rosacea, and urticaria, with 7, 6, 9, 1, 7, 4, and 7 respective causal relationships for each disease. These relationships comprise 20 protective and 14 risk causal relationships. We applied the false discovery rate correction to these results. Sensitivity analysis revealed no significant pleiotropy or heterogeneity. Our study revealed both beneficial and detrimental causal relationships between diverse skin microbiota and inflammatory skin diseases. Additionally, the ecological niche of the skin microbiome was crucial to its functional impact. This research provided new insights into how skin microbiota impacted skin diseases and the development of therapeutic strategies. PMID:39400597 | DOI:10.1007/s00403-024-03433-y {url} = URL to article
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      PubMed RSS Feed - -Skin-permeable gold nanoparticles with modifications azelamide monoethanolamine ameliorate inflammatory skin diseases

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      Biomark Res. 2024 Oct 9;12(1):118. doi: 10.1186/s40364-024-00663-0. ABSTRACT BACKGROUND: Traditional topical drug delivery for treating inflammatory skin diseases suffers from poor skin penetration and long-term side effects. Metal nanoparticles show promising application in topical drug delivery for inflammatory skin diseases. METHODS: Here, we synthesized a new type of nanoparticles, azelamide monoethanolamine-functionalized gold nanoparticles (Au-MEA NPs), based on citrate-capped gold nanoparticles (Au-CA NPs) via the ligand exchange method. The physical and chemical properties of Au-CA NPs and Au-MEA NPs were characterized. In vivo studies were performed using imiquimod-induced psoriasis and LL37-induced rosacea animal models, respectively. For in vitro studies, a model of cellular inflammation was established using HaCaT cells stimulated with TNF-α. In addition, proteomics, gelatin zymography, and other techniques were used to investigate the possible therapeutic mechanisms of the Au-MEA NPs. RESULTS: We found that Au-MEA NPs exhibited better stability and permeation properties compared to conventional Au-CA NPs. Transcutaneously administered Au-MEA NPs exerted potent therapeutic efficacy against both rosacea-like and psoriasiform skin dermatitis in vivo without overt signs of toxicity. Mechanistically, Au-MEA NPs reduced the production of pro-inflammatory mediators in keratinocytes by promoting SOD activity and inhibiting the activity of MMP9. CONCLUSION: Au-MEA NPs have the potential to be a topical nanomedicine for the effective and safe treatment of inflammatory skin diseases. PMID:39385245 | PMC:PMC11465885 | DOI:10.1186/s40364-024-00663-0 {url} = URL to article
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      PubMed RSS Feed - -Scalp Rosacea Treated with Topical Ivermectin

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      Skin Appendage Disord. 2024 Oct;10(5):429-432. doi: 10.1159/000537807. Epub 2024 May 15. ABSTRACT INTRODUCTION: Scalp rosacea is often misdiagnosed or overlooked, and few reports deal with this peculiar localization. Furthermore, the pharmacological approach to scalp rosacea remains a therapeutic challenge, as no topical and/or systemic drugs have been approved for this specific area so far. CASE PRESENTATION: A series of 5 adult patients affected by inflammatory rosacea and concurrent scalp involvement, confirmed by dermoscopy and histopathology with negative microbiologic swabs, and effectively treated with ivermectin 1% cream once daily for 12 weeks is presented. CONCLUSION: Our experience, although limited, suggests that evaluation of rosacea subjects should also include the scalp and that the treatment with ivermectin 1% cream may be effective on scalp rosacea. PMID:39386311 | PMC:PMC11460844 | DOI:10.1159/000537807 {url} = URL to article
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      PubMed RSS Feed - -Evaluation of Benzene Presence and Formation in Benzoyl Peroxide Drug Products

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      J Invest Dermatol. 2024 Sep 27:S0022-202X(24)02155-9. doi: 10.1016/j.jid.2024.09.009. Online ahead of print. ABSTRACT The potent carcinogen, benzene, is a known degradation product of benzoyl peroxide (BPO) and was recently reported to form when BPO drug products, used for acne and rosacea treatment, are incubated at body temperature and elevated temperatures expected during storage and transportation. This study provides evidence for a wide range of benzene concentrations (0.16 ppm to 35.30 ppm) detected by GC-MS in 111 over-the-counter BPO drug products tested and maintained at room temperature. A prescription encapsulated BPO drug product was stability tested at cold (2°C) and elevated temperature (50°C), resulting in no apparent benzene formation at 2°C, and high levels of benzene formation at 50°C, suggesting that encapsulation technology may not stabilize BPO drug products but cold storage may greatly reduce benzene formation. Face model experiments where BPO drug product was applied to PolyMethyl MethAcrylate (PMMA) photoprotection test skin plates and benzene was detected in surrounding air by SIFT-MS, showed detectable benzene through evaporation and substantial benzene formation when exposed to UV light at levels below peak sunlight. Results suggest that potential benzene exposure from formation during BPO drug product use poses significant risks independent of the starting benzene concentration. PMID:39384016 | DOI:10.1016/j.jid.2024.09.009 {url} = URL to article
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      PubMed RSS Feed - -Single-cell transcriptomics reveals aberrant skin-resident cell populations and identifies fibroblasts as a determinant in rosacea

      By rss · Posted

      Nat Commun. 2024 Oct 9;15(1):8737. doi: 10.1038/s41467-024-52946-7. ABSTRACT Rosacea is a chronic inflammatory skin disorder, whose underlying cellular and molecular mechanisms remain obscure. Here, we generate a single-cell atlas of facial skin from female rosacea patients and healthy individuals. Among keratinocytes, a subpopulation characterized by IFNγ-mediated barrier function damage is found to be unique to rosacea lesions. Blocking IFNγ signaling alleviates rosacea-like phenotypes and skin barrier damage in mice. The papulopustular rosacea is featured by expansion of pro-inflammatory fibroblasts, Schwann, endothelial and macrophage/dendritic cells. The frequencies of type 1/17 and skin-resident memory T cells are increased, and vascular mural cells are characterized by activation of inflammatory pathways and impaired muscle contraction function in rosacea. Most importantly, fibroblasts are identified as the leading cell type producing pro-inflammatory and vasodilative signals in rosacea. Depletion of fibroblasts or knockdown of PTGDS, a gene specifically upregulated in fibroblasts, blocks rosacea development in mice. Our study provides a comprehensive understanding of the aberrant alterations of skin-resident cell populations and identifies fibroblasts as a key determinant in rosacea development. PMID:39384741 | PMC:PMC11464544 | DOI:10.1038/s41467-024-52946-7 {url} = URL to article
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      PubMed RSS Feed - -IL-17A-neutralizing antibody ameliorates inflammation and fibrosis in rosacea by antagonizing the CXCL5/CXCR2 axis

      By rss · Posted

      FASEB J. 2024 Oct 15;38(19):e70096. doi: 10.1096/fj.202400006R. ABSTRACT Rosacea is a chronic inflammatory skin disorder that can lead to fibrosis. However, the mechanisms underlying fibrosis in the later stages of rosacea have been less thoroughly investigated. Interleukin-17A (IL-17A) has been implicated in both inflammation and organ fibrosis; however, the effectiveness and mechanism of IL-17A-neutralizing antibodies in the later stages of rosacea-related fibrosis remain unclear. In this study, we induced rosacea-like lesions in mice using LL-37 and administered IL-17A-neutralizing antibodies. The results indicated that the IL-17A-neutralizing antibodies alleviated skin damage, reduced skin thickness, and decreased the secretion of inflammatory factors (TNF-α, CAMP, TLR4, P-NF-kB), angiogenesis-related factors (CD31, VEGF), and the TGF-β1 signaling pathway, along with factors associated with epithelial-mesenchymal transition and the deposition of fibrosis-related proteins (COL1) in the rosacea-like mouse models. Furthermore, the IL-17A-neutralizing antibodies effectively diminished the expression of IL-17, IL-17R, CXCL5, and CXCR2 in the skin. Our findings demonstrate that IL-17A-neutralizing antibodies inhibit the activation of the CXCL5/CXCR2 axis in rosacea-like skin tissue, thereby ameliorating inflammation and fibrosis associated with the condition. PMID:39370827 | DOI:10.1096/fj.202400006R {url} = URL to article
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      PubMed RSS Feed - -Usability evaluation and reporting for mobile health apps targeting patients with skin diseases: a systematic review

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      Clin Exp Dermatol. 2024 Oct 7:llae378. doi: 10.1093/ced/llae378. Online ahead of print. ABSTRACT BACKGROUND: Usability is an important method for evaluating mobile health apps from a user perspective. Yet, many publicly available apps lack adequate attention to their design, development, and evaluation. OBJECTIVES: To assess usability evaluation and reporting for mobile health apps targeting patients with skin diseases. METHODS: The protocol was registered with PROSPERO (CRD42022347184). A search strategy combined terms for usability evaluation, user experience, skin disease and mobile health apps (search date from 2012 to 2023). Six databases (Embase, Medline, CINAHL, Cochrane CENTRAL, Cochrane Database of Systematic Reviews, Scopus) were searched, identifying 18052 results. Nine studies (comprising 9 apps) were included in the final analysis. RESULTS: Skin conditions/issues targeted included skin cancer (n=3), sun protection (n=3), and one study identified for each of the following: chronic pruritus/acne/psoriasis/rosacea/laser treatments/actinic damage/monitoring benign moles/alopecia/inflammatory rash/cutaneous leishmaniasis/spina bifida. All studies assessed app usability and feasibility, with the majority concluding that the apps were deemed useful and easy to use. Qualitative methods, such as usability questionnaires and semi-structured interviews, were predominantly employed. Common emerging themes included ease of use and navigation, comprehensibility, security/privacy concerns, data sharing issues, customizability, costs, and the ability to track progress or self-monitor. CONCLUSIONS: While smartphone applications for skin disorders show promising usability across diverse diseases, the limited literature compared to the rapid app development highlights the need for meticulous user-centered design and rigorous evaluation. The study emphasises the importance of evaluating and reporting usability findings to optimize the long-term adoption of mobile health apps, particularly those targeting skin diseases. PMID:39373121 | DOI:10.1093/ced/llae378 {url} = URL to article
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      PubMed RSS Feed - -Differences in the Clinical Characteristics of Male Patients With Different Ages of Rosacea: A Retrospective Study of 215 Male Outpatients

      By rss · Posted

      J Cosmet Dermatol. 2024 Oct 7. doi: 10.1111/jocd.16620. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is more common in women and Caucasians, leading to little research on rosacea in Asian men. Additionally, there is limited research on the patients across different age groups. AIMS: The aim of this study is to analyze and compare the characteristics of male patients of rosacea among different age groups. METHODS: A retrospective analysis was conducted on 215 male patients with rosacea, investigating their characteristics, clinical symptoms, exacerbating factors, complications, psychological status, and treatment, as well as exploring factors influencing the early onset of male rosacea. RESULTS: The patients were divided into three age groups (≤ 30 years, 31-44 years, and ≥ 45 years), with the study revealing an average age of 38.59 ± 13.13 years among the patients. The most common subtype of rosacea in men was erythematotelangiectatic rosacea (ETR), followed by phymatous rosacea (PhR). The main reported features included persistent erythema (87.4%) and telangiectasia (71.2%), predominantly affecting the nose (58.6%) and cheeks (56.3%). Twenty-six percent of patients reported concurrent skin diseases, with 14.0% reporting systemic diseases. Significant differences were observed among different age groups regarding family history, clinical features, lesion distribution, symptom severity, aggravating factors, presence of systemic diseases, and treatment preferences. Subjective skin typing, Fitzpatrick phototype, and positive family history were identified as factors influencing the age of onset of rosacea in men. CONCLUSION: Male patients with rosacea exhibit distinct clinical characteristics, with a greater prevalence of nasal involvement and nasal lesions among male patients. Clinical features vary among different age groups, with patients aged ≥ 45 experiencing more complex and severe symptoms. Patients aged ≤ 30 may be more influenced by genetic factors and have higher treatment expectations. PMID:39373316 | DOI:10.1111/jocd.16620 {url} = URL to article
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      PubMed RSS Feed - -Investigation of Factors Associated with Gut Microbiota in <em>Demodex</em>-associated Skin Conditions

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      Turkiye Parazitol Derg. 2024 Oct 7;48(3):171-177. doi: 10.4274/tpd.galenos.2024.93064. ABSTRACT OBJECTIVE: This study describes the relationships of factors related to gut microbiota and skin conditions associated with Demodex, including demodicosis, rosacea, and perioral dermatitis. METHODS: A total of 113 patients from Dokuz Eylül University Hospital Dermatology Department answered a cross-sectional questionnaire. They consisted of 42 cases of Demodex-related skin diseases and 71 healthy controls. Demographic data and medical history, dietary and lifestyle habits, and gastrointestinal symptoms were recorded. Statistical analysis included descriptive statistics, chi-square tests, Fisher's Exact tests, independent samples t-tests, and logistic regression methods. RESULTS: Our findings identified alcohol consumption [odds ratio (OR)=11.13, 95% confidence interval (CI): 4.11-17.22, p<0.01] and smoking (OR=10.32, 95% CI: 2.47-21.57, p<0.01) as strong risk factors for Demodex-related conditions. Low water intake (0-1 liter per day) (OR=3.39, 95% CI: 2.08-5.57, p=0.03) and infrequent exercise (less than 1 hour per week) (OR=4.87, 95% CI: 2.70-12.54, p=0.02) were also significant risk factors. Additional factors associated with increased Demodex risk included reduced bowel movements (OR=2.71, 95% CI: 1.45-4.06, p=0.01) and higher pet ownership (OR=2.85, 95% CI: 2.13-4.27, p=0.03). Although vegetarian and high-fat diets showed some associations, they were not independently significant. CONCLUSION: This study demonstrates key environmental and lifestyle factors, such as low water intake, infrequent exercise, reduced bowel movements, higher pet ownership, alcohol consumption, and smoking, that are significantly associated with Demodex-related skin conditions. These factors, related to gut microbiota, may provide valuable insights for managing these skin conditions and suggest promising directions for future research. PMID:39373592 | DOI:10.4274/tpd.galenos.2024.93064 {url} = URL to article
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      PubMed RSS Feed - -A case of Morbihan disease treated with ivermectin

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      Int J Dermatol. 2024 Oct 4. doi: 10.1111/ijd.17510. Online ahead of print. NO ABSTRACT PMID:39367516 | DOI:10.1111/ijd.17510 {url} = URL to article
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      PubMed RSS Feed - -Optimizing Dermatological Care Triage in a Safety-Net Hospital: Retrospective Analysis of Diagnoses and In-Person Referrals

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      South Med J. 2024 Oct;117(10):577-581. doi: 10.14423/SMJ.0000000000001737. ABSTRACT OBJECTIVES: Teledermatology is a cost-effective and efficient approach to delivering care and is particularly beneficial for patients with limited access to specialized services. Considering the rapid expansion of telehealth, it is crucial to focus on optimization. The purpose of our study was to evaluate the triaging of dermatologic care in an electronic consultation (e-consultation) service in a safety-net hospital. METHODS: This was a 2-year retrospective review of a dermatology asynchronous store-and-forward e-consultation service. RESULTS: A total of 1425 patients completed 1502 e-consultation. Of these e-consultations, 46% of the patients had Medicaid and 44% were Black or African American. The top three diagnoses were dermatitis unspecified, neoplasm of uncertain behavior, and acne/rosacea. Most (68%) were managed via e-consultation and did not require an in-person appointment. Children and adolescents were more likely to require an in-person appointment (74%) compared with adults (30%, P < 0.0001). Patients with a chief complaint of hair loss or skin lesion were more likely to require in-person evaluation (58% and 41%, respectively) compared with rash (24%) and acne (18%) (P < 0.0001). There was no difference found in recommendations for in-person evaluation based on race, non-English-language preference, or insurance status. CONCLUSIONS: E-consultation services seem well suited for certain concerns, and underserved populations can be evaluated by teledermatology. PMID:39366681 | DOI:10.14423/SMJ.0000000000001737 {url} = URL to article
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      PubMed RSS Feed - -Development of Indian Council of Medical Research (ICMR) Standard Treatment Workflows for Skin Diseases: A Step Toward Universal Health Coverage

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      Indian Dermatol Online J. 2024 Jul 15;15(5):794-800. doi: 10.4103/idoj.idoj_741_23. eCollection 2024 Sep-Oct. ABSTRACT BACKGROUND: Skin conditions form a major bulk of diseases in the community. With a disproportionately low number of dermatologists in the country, and a greatly unequal distribution between urban versus rural areas, ineffective treatment and mismanagement of skin conditions are, however, commonplace. OBJECTIVE: To develop standard treatment workflows (STWs) for certain skin diseases for use by clinicians at primary, secondary, and tertiary care centers. METHODOLOGY: Seven members, from various academic institutes across the country, were selected for formulation of the STWs. They were provided logistic and technical support by the ICMR, Department of Health Research (DHR), and WHO India office. Multiple rounds of online and physical discussions were performed to identify topics that would be most useful in the management of skin diseases for the health care personnel (HCP) and subsequently to frame the STW content. RESULTS: The selected diseases included acne and rosacea, alopecia, bacterial skin infections, cutaneous adverse drug reactions, dermatophytosis, eczema/dermatitis, immunobullous dermatoses, psoriasis, scabies, varicella and herpes, vitiligo, and urticaria. There was one separate module on rational use of topical corticosteroids. The STWs for these conditions have been finalised and are available as physical posters in health centers and can also be accessed online and through mobile applications. CONCLUSION: Thirteen STW modules have been prepared with a view to optimize management of skin diseases at various levels of health care system of the country. PMID:39359295 | PMC:PMC11444446 | DOI:10.4103/idoj.idoj_741_23 {url} = URL to article
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      PubMed RSS Feed - -HArmonyCa™ hybrid filler to restore connective tissue: An Italian real-life retrospective study

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      J Cosmet Dermatol. 2024 Oct 3. doi: 10.1111/jocd.16503. Online ahead of print. ABSTRACT BACKGROUND: Facial aging and dermal conditions may negatively influence the quality of life, leading patients to seek aesthetic procedures to restore a more satisfying appearance. HArmonyCa™ is a recently developed hybrid filler that combines the actions of the most common dermal fillers, hyaluronic acid (HA) and calcium hydroxylapatite (CaHA). AIMS: This study investigates the efficacy and safety of HArmonyCa™ in patients affected by chrono- and photoaging and several facial skin conditions. PATIENTS/METHODS: One hundred and twenty-nine patients, affected by chrono- and photoaging, and skin conditions such as oily and acne-prone skin, rosacea, or scarring, were treated with HArmonyCa™. Injections followed the retrograde linear fanning technique. A physicians' consensus identified five optimal entry points. The physician and patients assessed treatment outcomes using the Global Aesthetic Improvement Scale (GAIS) 9 months after treatment (including immediate lift effect, skin firmness, and elasticity), and 3D images were taken for documentation. Adverse events (AEs) were evaluated immediately after the procedure and after 9 months. RESULTS: According to the physician's assessments, all patients displayed an improvement in facial appearance, particularly during movement, with the patients' evaluation showing agreement. Only minor AEs were reporte, which resolved spontaneously. Moreover, HArmonyCa™ treatment proved compatible with different medications and aesthetic procedures. CONCLUSIONS: This study shows that one treatment with HArmonyCa™ yields highly satisfactory outcomes in patients affected by skin conditions. For the first time, we show that HArmonyCa™ is a dynamic filler that improves facial laxity during movement. The treatment proved to be safe and fully compatible with other cosmetic procedures and medications. PMID:39360597 | DOI:10.1111/jocd.16503 {url} = URL to article
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      PubMed RSS Feed - -Efficacy and Tolerance of a Polymeric Surfactant Technology-Based Cleanser for Clinically Diagnosed Sensitive Skin

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      J Drugs Dermatol. 2024 Oct 1;23(10):889-893. doi: 10.36849/JDD.2024.8510. ABSTRACT BACKGROUND: Cleansing is an important hygiene activity, necessary to prevent bacterial, fungal, yeast, and viral infection. However, in the presence of skin disease, cleansing can take on a new challenge: removing the sebum, sweat, externally applied substances, environmental debris, and organisms from the face without damaging the skin barrier. Since cleansers cannot easily distinguish between sebum and the intercellular lipids required to maintain skin integrity, unique cleansing technologies are necessary to provide mild cleansing for the many manifestations of sensitive skin. OBJECTIVE: This 4-week clinical study aimed to evaluate the appropriateness of a cosmetic facial foaming gel cleanser with a polymeric surfactant technology in a diverse sensitive skin population. METHOD: 85 subjects with sensitive skin due to eczema/atopic dermatitis, rosacea, acne, or cosmetic intolerance syndrome were evaluated via investigator grading, self-assessment questionnaire, noninvasive measurements, and digital photography. RESULTS: The foaming gel cleanser was well tolerated showing no significant increases in investigator-graded irritation endpoints. Sensitive skin subjects saw considerable reduction (P&lt;0.05) in stinging, itching, burning, tightness, and overall sensitivity at 2 and 4 weeks. Improvements in smoothness, softness, clarity, radiance, and overall skin appearance, were observed by both the investigator and patients (P&lt;0.05) at 2 and 4 weeks. CONCLUSION: The polymeric surfactant technology-based foaming gel cleanser provided a rich, foaming lather that felt gentle and left skin feeling comfortable. J Drugs Dermatol. 2024;23(10):889-893. doi:10.36849/JDD.8510. PMID:39361686 | DOI:10.36849/JDD.2024.8510 {url} = URL to article
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      PubMed RSS Feed - -Tranexamic Acid for the Treatment of Hyperpigmentation and Telangiectatic Disorders Other Than Melasma: An Update

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      Clin Cosmet Investig Dermatol. 2024 Sep 25;17:2151-2163. doi: 10.2147/CCID.S479411. eCollection 2024. ABSTRACT Tranexamic acid (TXA), a synthetic lysine analog, is a commonly used antifibrinolytic and procoagulant agent. Based on its good hemostatic efficacy, it is mainly used clinically for bleeding in trauma, various types of surgical and dental procedures and prevention of bleeding in patients with hemophilia. In recent years, studies have shown that TXA has the effects of anti-melanogenesis, anti-inflammation, anti-angiogenesis and promotes the recovery of the skin barrier, so it has been tried to be used as a treatment for hyperpigmentation and telangiectatic diseases. Oral, topical, intradermal injections and microneedling are all commonly used modes of administration. TXA for melasma is the most studied and has achieved indications in some countries, whereas it is still an off-label drug for many other dyschromia. We review the clinical use of TXA in hyperpigmentation and telangiectatic disorders other than melasma, such as post-inflammatory hyperpigmentation, Riehl's melanosis, rosacea, and post-acne erythema, to provide more evidence for the use of TXA in these disorders, and to provide safer and more cost-effective alternatives for the treatment of these diseases. PMID:39350932 | PMC:PMC11439988 | DOI:10.2147/CCID.S479411 {url} = URL to article
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      PubMed RSS Feed - -Signaling pathways and targeted therapy for rosacea

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      Front Immunol. 2024 Sep 16;15:1367994. doi: 10.3389/fimmu.2024.1367994. eCollection 2024. ABSTRACT Rosacea is a chronic skin inflammatory disease with a global prevalence ranging from 1% to 20%. It is characterized by facial erythema, telangiectasia, papules, pustules, and ocular manifestations. Its pathogenesis involves a complex interplay of genetic, environmental, immune, microbial, and neurovascular factors. Recent studies have advanced our understanding of its molecular basis, focusing on toll-like receptor (TLR) 2 pathways, LL37 expression, mammalian target of rapamycin (mTOR) activation, interleukin (IL)-17 signaling, transient receptor potential vanilloid (TRPV) functions, and the Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathways. LL37-associated signaling pathways, particularly involving TLR2 and mTORC1, are critical in the pathogenesis of rosacea. LL37 interacts with signaling molecules such as extracellular signal-regulated kinases 1 and 2 (ERK1/2), nuclear factor kappa B (NF-κB), inflammasomes, C-X-C motif chemokine ligand 8 (CXCL8), mas-related G-protein-coupled receptor X2 (MRGPRX2)-TRPV4, and vascular endothelial growth factor (VEGF). This interaction activates macrophages, neutrophils, mast cells, and vascular endothelial cells, leading to cytokine release including tumor necrosis factor-alpha (TNF-α), IL-6, IL-1β, C motif chemokine ligand (CCL) 5, CXCL9, and CXCL10. These processes contribute to immune response modulation, inflammation, and angiogenesis in rosacea pathophysiology. The IL-17 signaling pathway also plays a crucial role in rosacea, affecting angiogenesis and the production of inflammatory cytokines. In addition, recent insights into the JAK/STAT pathways have revealed their integral role in inflammatory and angiogenic mechanisms associated with rosacea. Rosacea treatment currently focuses on symptom management, with emerging insights into these molecular pathways providing more targeted and effective therapies. Biological agents targeting specific cytokines, IL-17 inhibitors, JAK inhibitors, and VEGF antagonists are promising for future rosacea therapy, aiming for enhanced efficacy and fewer side effects. This review provides a comprehensive overview of the current knowledge regarding signaling pathways in rosacea and potential targeted therapeutic strategies. PMID:39351216 | PMC:PMC11439730 | DOI:10.3389/fimmu.2024.1367994 {url} = URL to article
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      PubMed RSS Feed - -Off-Label Uses of Abrocitinib: Review of Emerging Therapeutic Applications beyond Atopic Dermatitis

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      Life (Basel). 2024 Sep 6;14(9):1127. doi: 10.3390/life14091127. ABSTRACT Abrocitinib, an oral small-molecule Janus Kinase 1 (JAK1) inhibitor, is primarily approved for treating moderate-to-severe atopic dermatitis (AD) in adults and adolescents aged 12 and older. This review examines the emerging off-label uses of Abrocitinib. We identified 37 papers reporting on the use of Abrocitinib in various conditions other than AD. The most commonly reported uses were for vitiligo, prurigo nodularis, and hand eczema, with 12 cases each. There were also 10 cases of lichen sclerosus and chronic pruritus of unknown origin and 5 cases each of pityriasis rubra pilaris alopecia areata. Additionally, erythematotelangiectatic rosacea and steroid-induced rosacea were reported in four cases each. Other conditions treated with Abrocitinib were noted, but these mostly had only one or two reported cases. Interestingly, out of the 103 patients reviewed, all studies reported favorable clinical outcomes and satisfactory results, with the exception of one isolated case where Abrocitinib was used to treat erythematotelangiectatic rosacea. PMID:39337910 | PMC:PMC11432974 | DOI:10.3390/life14091127 {url} = URL to article
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      PubMed RSS Feed - -The Prevalence of <em>Demodex</em> spp. Infestation in Dermatological Patients in Northern Poland

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      Life (Basel). 2024 Sep 21;14(9):1196. doi: 10.3390/life14091196. ABSTRACT The presence of Demodex spp. mites on the skin is a common phenomenon in the human population. In most people, it is an asymptomatic infestation, but in some patients, it can contribute to the occurrence of diseases such as demodicosis, rosacea, or blepharitis, as well as non-specific symptoms. In this study, the results of tests assessing the presence of Demodex spp. by direct microscopic examination (DME) in 2508 patients from northern Poland with the suspicion of demodicosis were retrospectively analyzed. A total of 3684 tests were performed. Among them, only 1585 (43.02%) revealed the presence of Demodex spp., while 2099 (56.98%) were negative. It was shown that in the analyzed population of patients with clinical suspicion of demodicosis, the degree of confirmation of the presence of Demodex spp. positively correlated with the patient's age (p = 0.001) and the mite was mainly found on the edges of eyelids and on the facial skin. Additionally, in men, the presence of Demodex was more often confirmed than in women (p = 0.004). In conclusion, the proper diagnosis of demodicosis still constitutes an important clinical problem due to the non-specificity of symptoms and the low confirmation of clinical suspicions of infestation by DME, especially in lower age groups. PMID:39337978 | PMC:PMC11433365 | DOI:10.3390/life14091196 {url} = URL to article
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      PubMed RSS Feed - -An Oral Botanical Supplement Improves Small Intestinal Bacterial Overgrowth (SIBO) and Facial Redness: Results of an Open-Label Clinical Study

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      Nutrients. 2024 Sep 18;16(18):3149. doi: 10.3390/nu16183149. ABSTRACT BACKGROUND: Small intestinal bacterial overgrowth (SIBO) is a common, yet underdiagnosed, gut condition caused by gut dysbiosis. A previous study has shown the potential of herbal therapy, providing equivalent results to rifaximin. OBJECTIVES: The objective of this study was to assess how the use of an oral botanical regimen may modulate the gut microbiome, facial erythema, and intestinal permeability in those with SIBO. METHODS: This was an open-label prospective study of adults that had lactulose breath test-confirmed SIBO. Participants received a 10-week oral supplementation of a Biocidin liquid tincture and GI Detox+. If participants were found to be non-responsive to treatment after 10 weeks with a persistently positive lactulose breath test, a third oral supplement, Olivirex, was administered for an additional 4 weeks. Lactulose breath tests were administered at baseline, weeks 6, 10, and 14 to assess for SIBO status. A high-resolution photographic analysis system was utilized to analyze changes in facial erythema. Stool sample collections and venipuncture were performed to analyze the gut microbiome and intestinal permeability. RESULTS: A total of 33 subjects were screened with breath testing, and 19 subjects were found to have SIBO. Three of the subjects withdrew during the screening period prior to baseline, and sixteen subjects enrolled. Four subjects dropped out after baseline. Hydrogen-dominant SIBO was the most common subtype of SIBO, followed by methane and hydrogen sulfide. The botanical regimen was most effective for hydrogen- and hydrogen sulfide-dominant SIBO, leading to negative breath test results at week 10 in 42.8% and 66.7% of participants, respectively. Compared to baseline, supplementation with the botanical regimen led to positive shifts in short-chain fatty acid-producing bacteria such as A. muciniphila, F. prausnitzii, C. eutectus, and R. faecis by 31.4%, 35.4%, 24.8%, and 48.7% percent at week 10, respectively. The mean abundance of Firmicutes decreased by 20.2%, Bacteroides increased by 30%, and the F/B ratio decreased by 25.4% at week 10 compared to baseline. At week 10, there was a trending 116% increase in plasma LPS/IgG (p = 0.08). There were no significant changes in plasma zonulin, DAO, histamine, DAO/histamine, LPS/IgG, LPS/IgA, or LPS/IgM. Facial erythema was not statistically different at week 6, but at week 10, there was a 20% decrease (p = 0.001) in redness intensity. Among the patients that extended to week 14, there was no statistical change in erythema. CONCLUSIONS: Supplementation with an antimicrobial botanical supplemental regimen may have therapeutic potential in hydrogen and hydrogen-sulfide subtypes of SIBO. Furthermore, the botanical supplemental regimen may reduce facial erythema, increase SCFA-producing bacteria, decrease the F/B ratio, and modulate markers of intestinal permeability. PMID:39339748 | PMC:PMC11435404 | DOI:10.3390/nu16183149 {url} = URL to article
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      PubMed RSS Feed - -Incidence of rosacea after placement of intrauterine devices: a retrospective analysis

      By rss · Posted

      Arch Dermatol Res. 2024 Sep 28;316(9):650. doi: 10.1007/s00403-024-03392-4. NO ABSTRACT PMID:39340643 | DOI:10.1007/s00403-024-03392-4 {url} = URL to article
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      PubMed RSS Feed - -Rosacea in East Asian populations: Clinical manifestations and pathophysiological perspectives for accurate diagnosis

      By rss · Posted

      J Dermatol. 2024 Aug 10. doi: 10.1111/1346-8138.17411. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory disorder primarily affecting the facial skin, prominently involving the cheeks, nose, chin, forehead, and periorbital area. Cutaneous manifestations encompass persistent facial erythema, phymas, papules, pustules, telangiectasia, and flushing. The pathogenesis of rosacea is associated with various exacerbating or triggering factors, including microbial infestation, temperature fluctuations, sunlight exposure, physical exertion, emotional stress, consumption of hot beverages and spicy foods, and exposure to airborne pollen. These environmental factors interact with genetic predispositions in the development of rosacea. The roles of the lipophilic microbiome, ultraviolet radiation, nociceptive responses, and vascular alterations have been proposed as significant factors in the pathogenesis. These insights contribute to understanding the anatomical specificity of facial involvement and the progressive nature of rosacea. East Asian skin, predominantly classified as Fitzpatrick skin phototypes III to IV, is characterized by relatively diminished skin barrier function and increased sensitivity to irritants. Airborne pollen exposure may particularly act as a trigger in East Asian individuals, possibly mediated through toll-like receptors. The lack of specificity in objective clinical and histopathological findings leads to diagnostic challenges for individuals with colored skin, including East Asians, particularly when erythema is the sole objective manifestation. An alternative diagnostic scheme may thus be necessary. A diagnostic approach emphasizing vascular manifestations and nociceptive symptoms potentially holds promise for individuals with darker skin tones. More research focusing on potential variations in skin physiology across different racial groups is essential to establish more effective diagnostic schemes applicable to both dark and light skin colors. PMID:39126257 | DOI:10.1111/1346-8138.17411 {url} = URL to article
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      PubMed RSS Feed - -Important Roles of Interleukin-36, Interleukin-37, and Interleukin-38 Cytokines in the Pathogenesis of Rosacea

      By rss · Posted

      Indian J Dermatol. 2024 May-Jun;69(3):232-237. doi: 10.4103/ijd.ijd_470_23. Epub 2024 Jun 26. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin disease. Previous studies have determined that IL-36, IL-37, and IL-38 may play a role in the pathogenesis of various inflammatory diseases. AIMS AND OBJECTIVES: The present study aims to evaluate the relationship of these cytokines with rosacea. MATERIALS AND METHODS: A total of 100 individuals, including 50 patients with rosacea and 50 healthy controls, were included in the study. IL-36, IL-37, and IL-38 levels were measured using the ELISA method by taking serum samples from all participants. RESULTS: The mean serum levels of IL-36, IL-37, and IL-38 in the patient group were 52.17 ± 24.07 pg/ml, 18.46 ± 8.18 pg/ml, and 25.74 ± 8.36 ng/l, respectively. The mean serum levels of IL-36, IL-37, and IL-38 in the control group were 32.99 ± 19.90 pg/ml, 44.61 ± 22.27 pg/ml, and 45.61 ± 17.32 ng/l, respectively. The difference between the serum levels of IL-36, IL-37, and IL-38 in the patient and control groups was statistically significant (P < 0.001). CONCLUSION: Based on these findings, an increase in IL-36 and a decrease in IL-37 and IL-38 may contribute to the pathogenesis of rosacea. Future rosacea treatments could target and/or interact with these possible steps in the pathogenesis of rosacea. PMID:39119329 | PMC:PMC11305503 | DOI:10.4103/ijd.ijd_470_23 {url} = URL to article
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      PubMed RSS Feed - -Antibody immune responses and causal relationships in four immune skin diseases: Evidence from Mendelian randomization and Bayesian Weighting (Antibody Responses in Skin Diseases: MR & Bayesian)

      By rss · Posted

      Skin Res Technol. 2024 Aug;30(8):e13875. doi: 10.1111/srt.13875. ABSTRACT BACKGROUND: Recent studies increasingly suggest that microbial infections and the immune responses they elicit play significant roles in the pathogenesis of chronic inflammatory skin diseases. This study uses Mendelian randomization (MR) and Bayesian weighted Mendelian randomization (BWMR) to explore the causal relationships between immune antibody responses and four common skin diseases: psoriasis, atopic dermatitis (AD), rosacea, and vitiligo. METHODS: We utilized summary statistics from genome-wide association studies (GWAS) for antibody responses to 13 infectious pathogens and four skin diseases. Single nucleotide polymorphisms (SNPs) were selected as instrumental variables (IVs) to assess causal relationships using multiple MR methods, including inverse variance weighted (IVW), MR Egger, and weighted median. BWMR was also employed to confirm findings and address potential pleiotropy. RESULTS: The IVW analysis identified significant associations between specific antibody responses and the skin diseases studied. Key findings include protective associations of anti-Epstein-Barr virus (EBV) IgG seropositivity and Helicobacter pylori UREA antibody levels with psoriasis and AD. anti-chlamydia trachomatis IgG seropositivity, anti-polyomavirus 2 IgG seropositivity, and varicella zoster virus glycoprotein E and I antibody levels were negatively associated with rosacea, while EBV Elevated levels of the early antigen (EA-D) antibody levels and HHV-6 IE1B antibody levels were positively associated with rosacea. H. pylori Catalase antibody levels were protectively associated with vitiligo, whereas anti-herpes simplex virus 2 (HSV-2) IgG seropositivity was positively associated with vitiligo. The BWMR analysis confirmed these associations. CONCLUSION: This study underscores the significant role of H. pylori and other pathogens in these skin diseases, suggesting both protective and exacerbating effects depending on the specific condition. Understanding these pathogen-immune interactions can lead to the development of more effective, personalized treatments and preventative strategies, ultimately improving patient outcomes and quality of life. PMID:39120064 | PMC:PMC11311118 | DOI:10.1111/srt.13875 {url} = URL to article
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      PubMed RSS Feed - -Adiponectin prevents skin inflammation in rosacea by suppressing S6 phosphorylation in keratinocytes

      By rss · Posted

      J Invest Dermatol. 2024 Aug 7:S0022-202X(24)01982-1. doi: 10.1016/j.jid.2024.07.018. Online ahead of print. ABSTRACT Numerous recent evidence highlights epidemiological connections between rosacea and metabolic disorders. However, the precise path through which metabolic factors impact rosacea risk is still unclear. Therefore, this study aims to investigate the role of adiponectin, a crucial adipokine that regulates metabolic homeostasis, in the pathogenesis of rosacea. We elucidated a detrimental feedback loop between rosacea-like skin inflammation and decreased levels of skin adiponectin. To elaborate, rosacea lesional skin exhibits diminished adiponectin expression compared to non-lesional areas in the same patients. Induction of rosacea-like inflammation reduced adiponectin levels in the skin by generating inflammatory cytokines that suppress adiponectin production from subcutaneous adipocytes. Conversely, complete depletion of adiponectin exacerbated rosacea-like features in the mouse model. Mechanistically, adiponectin deficiency led to heightened S6 phosphorylation, a marker of the mTORC1 signaling pathway, in the epidermis. Adiponectin significantly inhibited S6 phosphorylation in cultured keratinocytes. Notably, replenishing adiponectin whole protein or topically applying an agonist for adiponectin receptor 1 successfully improved rosacea-like features in mice. This study contributes to understanding the role of adiponectin in skin inflammation associated with rosacea pathophysiology, suggesting that restoring adiponectin function in the skin could be a potential therapeutic strategy. PMID:39122145 | DOI:10.1016/j.jid.2024.07.018 {url} = URL to article
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      PubMed RSS Feed - -Bisphenol-A and pentachlorophenol sodium levels in patients with rosacea

      By rss · Posted

      Cutan Ocul Toxicol. 2024 Aug 8:1-5. doi: 10.1080/15569527.2024.2383242. Online ahead of print. ABSTRACT BACKGROUND/ OBJECTIVES: Rosacea is a common chronic inflammatory skin disorder. Endocrinedisrupting chemicals (EDC) are toxic substances, that may gain entry through the skin and subsequently interfere with hormonal and immune functions. Bisphenol A (BPA) and pentachlorophenol sodium (PCS) are two of these EDCs, incriminated in the pathogenesis of certain inflammatory skin disorders. We aimed to test the hypothesis that exposure to BPA and PCS might be involved in the pathogenesis of rosacea. METHODS: This prospective cross-sectional study involved 34 patients with rosacea (18F/16 M; mean age 48.5 ± 11 years) and 34 age and sex-matched healthy controls (20 F/14 M; mean age 48.2 ± 10.2 years). Main anthropometric measures, fasting plasma glucose (FPG), insulin, HOMA-IR, lipids, C-reactive protein (CRP), BPA, and PCS levels were quantified and recorded. RESULTS: Serum CRP (9.6 ± 3.4 vs. 3.7 ± 1.6 mg/L, respectively, p0.05 for all). Serum BPA levels were 55.8 ± 14.4 and 51.9 ± 19.2 ng/mL, and PCS levels were 63.3 ± 45.9 ng/mL and 68.6 ± 40.8 ng/mL for patients and healthy controls, respectively. There was no significant difference in BPA and PCS levels between the two groups (p > 0.05 for both). No significant association was found among HOMAIR, CRP, BPA, and PCS levels (p > 0.05 for all). CONCLUSIONS: Although the present study fails to provide presumptive evidence for the role of BPA and PCS in rosacea, the question as to other EDCs might be involved in its etiopathogenesis remains. This hypothesis requires confirmation in large-scale future prospective trials. PMID:39113570 | DOI:10.1080/15569527.2024.2383242 {url} = URL to article
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      PubMed RSS Feed - -Validación transcultural al idioma español de la escala RosaQoL

      By rss · Posted

      Actas Dermosifiliogr. 2024 Aug 5:S0001-7310(24)00647-1. doi: 10.1016/j.ad.2024.02.035. Online ahead of print. ABSTRACT INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea. PMID:39111573 | DOI:10.1016/j.ad.2024.02.035 {url} = URL to article
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      PubMed RSS Feed - -Screening of Diagnostic Biomarkers and Immune Infiltration Characteristics Linking Rheumatoid Arthritis and Rosacea Based on Bioinformatics Analysis

      By rss · Posted

      J Inflamm Res. 2024 Aug 1;17:5177-5195. doi: 10.2147/JIR.S467760. eCollection 2024. ABSTRACT INTRODUCTION: Both rheumatoid arthritis (RA) and rosacea represent common chronic systemic autoimmune conditions. Recent research indicates a heightened RA risk among individuals with rosacea. However, the molecular mechanisms linking these diseases remain largely unknown. This study aims to uncover shared molecular regulatory networks and immune cell infiltration patterns in both rosacea and RA. METHODS: The gene expression profiles of RA (GSE12021, GSE55457), and the rosacea gene expression profile (GSE6591), were downloaded from Gene Expression Omnibus (GEO) databases, and obtained to screen differentially expressed genes (DEGs) by using "limma" package in R software. Various analyses including GO, KEGG, protein-protein interaction (PPI) network, and weighted gene co-expression network analyses (WGCNA) were conducted to explore potential biological functions and signaling pathways. CIBERSORT was used to assess the abundance of immune cells. Pearson coefficients were used to calculate the correlations between overlapped genes and the leukocyte gene signature matrix. Flow cytometry (FCM) analysis confirmed the most abundant immune cells detected in rheumatoid arthritis and rosacea. Receiver operator characteristic (ROC) analysis, enzyme-linked immunosorbent assay (ELISA), and qRT-PCR were used to confirm biomarkers and functions. RESULTS: Two hundred seventy-seven co-expressed DEGs were identified from these datasets. Functional enrichment analysis indicated that these DEGs were associated with immune processes and chemokine-mediated signaling pathways. Fourteen and 17 hub genes overlapped between cytoHubba and WGCNA were identified in RA and rosacea, respectively. Macrophages and dendritic cells were RA and rosacea's most abundant immune cells, respectively. The ROC curves demonstrated potential diagnostic values of CXCL10 and CCL27, showing higher levels in the serum of patients with RA or rosacea, and suggesting possible regulation in the densities and functions of macrophages and dendritic cells from RA and rosacea, which were validated by FCM and qRT-PCR. CONCLUSION: Importantly, our findings may contribute to the scientific basis for biomarkers and therapeutic targets for patients with RA and rosacea in the future. PMID:39104909 | PMC:PMC11299729 | DOI:10.2147/JIR.S467760 {url} = URL to article
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      PubMed RSS Feed - -Successful Rhinophyma Treatment Utilizing the Versajet II Hydrosurgery System: A Case Report and Systematic Review of the Literature

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      Cureus. 2024 Jul 5;16(7):e63921. doi: 10.7759/cureus.63921. eCollection 2024 Jul. ABSTRACT Rhinophyma, characterized by hypertrophy of sebaceous glands, often necessitates surgical intervention. This is the second case report of the off-label use of the Versajet II Hydrosurgery System (VJHS) (Smith & Nephew, London, UK) in the United States for the treatment of rhinophyma and the first systematic review of the literature, emphasizing its efficacy and safety for this indication. A surgical debulking and resurfacing was performed on a patient with rhinophyma. The patient underwent general anesthesia along with bilateral infraorbital blocks and local infiltration of lidocaine 1% with epinephrine. The VJHS was utilized for progressive debulking followed by debridement using sharp instruments until the desired nasal form and contour were achieved. Hemostasis was obtained through monopolar electrocautery and topical hemostatic agents. The patient exhibited excellent nasal shape and healing following VJHS debulking and without perioperative complications, suggesting both the effectiveness and safety of the VJHS in rhinophyma treatment. A literature review was conducted using the PubMed Central database. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, employing inclusion and exclusion criteria, were utilized to narrow down results to include original studies discussing rhinophyma surgical debridement with the VJHS. Six articles were included in the review for results analysis. This case report aligns with findings from international literature, emphasizing the versatility of the VJHS in rhinophyma treatment. Notably, this report marks the second documented off-label use of the VJHS in the United States for rhinophyma. The success of this case reinforces the potential of the VJHS in treating rhinophyma. This innovative approach yielded promising outcomes in several international reports. Further research is warranted to establish a standardized protocol to validate the long-term benefits of this technology applied to rhinophyma patients. PMID:39104983 | PMC:PMC11298325 | DOI:10.7759/cureus.63921 {url} = URL to article
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      PubMed RSS Feed - -Rosacea Epidemiological Investigation and Etiology Exploration in the Plateau Area

      By rss · Posted

      Ann Plast Surg. 2024 Aug 1;93(2S Suppl 1):S55-S58. doi: 10.1097/SAP.0000000000003999. ABSTRACT BACKGROUND: The epidemiology of 2 neighboring cities of differing altitude in Northwest China is unknown. The present study investigated the prevalence of rosacea in a high-altitude city and a low-altitude city. METHODS: The prevalence study was conducted via clinical examination of male and female participants in the following age groups: 5-17, 18-30, 31-50, and 51-70 years. Rosacea subtype was also determined as erythematotelangiectatic rosacea (ETTR) or papulopustular rosacea (PPR). RESULTS: The rosacea prevalence (RP) in the low-altitude city was 33.8% ± 1.2% (95% CI, ETTR = 1794, PPR = 174, n = 5794). RP in the high-altitude city has a notably higher reading of 47.7% ± 1.4% (95% CI, ETTR = 2090, PPR = 219, n = 4796). In both cities, the ETTR subtype predominated, and there was marked increase in RP among females. RP in low-altitude city females was steady across all age groups, while RP in low-altitude city males showed a declining trend with age. RP in high-altitude city females indicated a slightly increasing trend with age, while RP in males again showed a declining trend with age. Based on the results of this high-altitude city and low-altitude city study, there are an estimated 2.1 million people with rosacea, from 2 cities with a total population of 5.4 million. CONCLUSIONS: Due to the high altitude and accompanying increased UV radiation, cold climate, and reduced oxygen density, the greater northwest region of China is expected to experience high RP rates. PMID:39101850 | DOI:10.1097/SAP.0000000000003999 {url} = URL to article
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      PubMed RSS Feed - -A comparative exploration of immunohistochemical markers in patients with papulopustular rosacea undergoing treatment with oral isotretinoin versus doxycycline

      By rss · Posted

      Int J Dermatol. 2024 Aug 4. doi: 10.1111/ijd.17420. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory disease, and doxycycline is a widely recommended treatment for it due to its anti-inflammatory action. Oral isotretinoin reduces sebaceous gland activity and modulates toll-like receptors, reducing inflammation. Our aim was to investigate the effect of these two drugs on the expression of cutaneous immunohistochemical biomarkers related to etiopathogenic factors involved in rosacea. METHODS: We conducted a randomized, comparative, and evaluator-blinded trial, including 40 participants with moderate and severe papulopustular and ocular rosacea. Participants were treated with doxycycline (DOXY) 100 mg or isotretinoin (ISO) 0.3 mg/kg daily. Immunohistochemistry at baseline and after 4 months was used to demonstrate the expression of the biomarker on the affected skin. RESULTS: The following changes were detected: a reduction in the vessel count after using VEGF with DOXY (P = 0.010); a decrease in VEGF intensity with ISO (P < 0.001) and DOXY (P = 0.020); a reduction of nitric oxide synthase enzyme with both drugs in the inflammatory infiltrate (ISO P < 0.001; DOXY P = 0.003); however, only with ISO was there a significant (P = 0.030) decrease at the level of the sebaceous glands, indicating a reduction of nitric oxide synthesis; a reduction of TRPV-1 expression at the level of the sebaceous glands was observed only with DOXY (P = 0.041); a decrease of cathelicidin LL37 expression, a key antimicrobial peptide in the etiopathogenesis of rosacea, was noted with both drugs, although at the level of sebaceous glands, only with DOXY (P = 0.007). CONCLUSIONS: Oral isotretinoin and doxycycline have modified the expression of cutaneous biomarkers related to rosacea etiopathogenesis, demonstrating their role in controlling inflammatory and vascular processes. PMID:39097930 | DOI:10.1111/ijd.17420 {url} = URL to article

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