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    The RRDi Medical Advisory Consultants list (46 RRDi MAC Members) is in alphabetical order by last name. For more information.

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    • Cornea. 2024 Jul 5. doi: 10.1097/ICO.0000000000003627. Online ahead of print. ABSTRACT PURPOSE: The purpose of this study was to report the outcomes of quantum molecular resonance (QMR) electrotherapy in the management of refractory pediatric ocular rosacea. METHODS: This is a retrospective case series on 3 female pediatric patients (ages 12, 15, 14 years) with ocular rosacea. Two patients presented with corneal stromal neovascularization and punctate epithelial erosions while 1 patient presented with corneal scarring and paracentral stromal thinning. After failing conservative management, the patients were treated with 4 consecutive QMR electrotherapy sessions with the intensity set at 5 corresponding on average to a power of 12 W, with 60 V voltage and 200 mA current. Informed consent was obtained for off-label use. Patients were assessed for changes in vision, foreign body sensation, tearing, photophobia, and redness at each visit to determine symptomatic improvement. Outcome measures include best-corrected visual acuity, use of supplemental therapies (eg topical steroids) for symptom relief, extent of corneal neovascularization via serial slitlamp photography, and corneal scar remodeling via high resolution anterior segment optical coherence tomography (OCT). RESULTS: Two of the 3 patients experienced improvement in visual acuity after QMR electrotherapy. Corneal neovascularization and scarring regressed significantly in all 3 patients. Two months post-QMR electrotherapy, corneal remodeling was evident on optical coherence tomography in 2 patients. All 3 patients were able to discontinue topical immunosuppressants and remain symptom-free at 1.5 years of follow-up. CONCLUSIONS: QMR electrotherapy is a promising alternative in the treatment of refractory ocular rosacea in childhood and puberty, and it may potentiate corneal remodeling. PMID:38967538 | DOI:10.1097/ICO.0000000000003627 {url} = URL to article
    • J Alzheimers Dis. 2024 Jun 28. doi: 10.3233/JAD-240198. Online ahead of print. ABSTRACT This manuscript reviews the significant skin manifestations of Lewy body disease, including Parkinson's disease and dementia with Lewy bodies, and the diagnostic utility of skin biopsy. Besides classic motor and cognitive symptoms, non-motor manifestations, particularly dermatologic disorders, can play a crucial role in disease presentation and diagnosis. This review explores the intricate relationship between the skin and Lewy body disease. Seborrheic dermatitis, autoimmune blistering diseases (bullous pemphigoid and pemphigus), rosacea, and melanoma are scrutinized for their unique associations with Parkinson's disease, revealing potential links through shared pathophysiological mechanisms. Advances in diagnostic techniques allow the identification of promising biomarkers such as α-synuclein in samples obtained by skin punch biopsy. Understanding the dermatologic aspects of Lewy body disease not only contributes to its holistic characterization but also holds implications for innovative diagnostic approaches. PMID:38968048 | DOI:10.3233/JAD-240198 {url} = URL to article
    • JAAD Int. 2024 May 6;16:112-118. doi: 10.1016/j.jdin.2024.04.009. eCollection 2024 Sep. ABSTRACT PMID:38957837 | PMC:PMC11217679 | DOI:10.1016/j.jdin.2024.04.009 {url} = URL to article
    • Clin Cosmet Investig Dermatol. 2024 Jun 26;17:1551-1552. doi: 10.2147/CCID.S484236. eCollection 2024. ABSTRACT [This corrects the article DOI: 10.2147/CCID.S473598.]. PMID:38952412 | PMC:PMC11215658 | DOI:10.2147/CCID.S484236 {url} = URL to article
    • Heliyon. 2024 Jun 1;10(11):e32275. doi: 10.1016/j.heliyon.2024.e32275. eCollection 2024 Jun 15. ABSTRACT A combination of benzoyl peroxide (BPO) and tretinoin is recommended for treating acne; however, concurrent administration can be irritating, and coformulation is prevented by BPO-mediated oxidation of tretinoin. In rosacea, benzoyl peroxide has been shown to be efficacious; however, its use has been limited by poor tolerability. To overcome these limitations, the active ingredients can be encapsulated within silica microcapsules. The US Food and Drug Administration has approved 2 products using this technology, a combination of encapsulated benzoyl peroxide and encapsulated tretinoin product for acne vulgaris and encapsulated benzoyl peroxide to treat inflammatory lesions in rosacea. The active ingredients are released through small channels in the silica shell, gradually releasing the active ingredients to the skin. This study describes the stability and release profiles of encapsulated tretinoin and encapsulated benzoyl peroxide from the silica shell in physiologically relevant conditions and provides differentiation from traditional formulations. PMID:38947450 | PMC:PMC11214359 | DOI:10.1016/j.heliyon.2024.e32275 {url} = URL to article
    • Clin Ophthalmol. 2024 Jun 24;18:1801-1810. doi: 10.2147/OPTH.S440199. eCollection 2024. ABSTRACT Demodex represents the most frequent ectoparasite found in humans. Although Demodex mites are considered commensals of human pilosebaceous units, an abnormally high mite density can cause several ocular and cutaneous symptoms and signs, sometimes to a severe degree. Both Demodex spp. (folliculorum and brevis) play a significant part in eye pathology and facial dermatoses. These mites have been related to blepharitis, ocular rosacea, meibomian gland dysfunction and various skin diseases, including rosacea, demodicosis and seborrheic dermatitis. Understanding the importance of Demodex in both eye and skin conditions is crucial for accurate diagnosis and appropriate management strategies, which may involve targeted treatments to control the mite population and reduce associated symptoms. PMID:38948346 | PMC:PMC11213710 | DOI:10.2147/OPTH.S440199 {url} = URL to article
    • J Cosmet Dermatol. 2024 Jun 28. doi: 10.1111/jocd.16354. Online ahead of print. ABSTRACT OBJECTIVE: To assess the effectiveness and safety of treating erythematotelangiectatic rosacea using fractional radiofrequency (FRF). METHODS: Twenty patients with a confirmed diagnosis of erythema capillaris rosacea were selected, and one side of each patient's face was randomly assigned to receive FRF treatments for three to six times, with an interval of 2 weeks between each treatment. VISIA, dermoscopy, and the Clinician's Erythema Evaluation Scale (CEA) were applied to evaluate the efficacy of the treatment before and after the treatment, to record the VAS scores and adverse reactions, and to conduct a patient satisfaction survey. RESULTS: The characteristic counts and scores of red zone and porphyrin as assessed by VISIA test were significantly decreased, and the difference between the treated side and the pretreatment side was statistically significant (p < 0.05), and the efficacy of the treatment was statistically insignificant compared with the control side, except for the red zone and porphyrin which were statistically significant before and after the treatment (p > 0.05). By CEA score, the difference between the treated side after treatment and the control side was statistically significant (p < 0.05), and the difference between the treated side before and after treatment was statistically significant (p < 0.05); the difference between the control side before and after treatment was not statistically significant (p > 0.05). Dermatoscopic observation showed reduction in pore size, reduction of yellowish-white and black horn plugs within the pores, lightening of the red background and thinning and blurring of the capillary structure on the treated side of the skin compared to the control side, and the skin on the treated side showed the above mentioned changes before and after the treatment as well. The mean pain score of the subjects was obtained by VAS score 3.67 ± 0.90. Adverse effects included mild edema, erythema, and microscopic crusting; no long-term adverse effects were seen in all patients. The efficacy of FRF treatment was evaluated 1 month after the final treatment, and 85% of the subjects rated it as satisfactory, very satisfactory, and very satisfactory. CONCLUSION: FRF for the treatment of erythematous capillary dilatation rosacea is effective, safe, and suitable for clinical promotion. PMID:38943266 | DOI:10.1111/jocd.16354 {url} = URL to article
    • Skin Res Technol. 2024 Jul;30(7):e13782. doi: 10.1111/srt.13782. ABSTRACT INTRODUCTION: Prior research has explored the relationship between inflammatory skin disorders and breast cancer (BC), yet the causality of this association remains uncertain. METHODS: Utilizing a bidirectional two-sample Mendelian randomization (MR) approach, this study aimed to elucidate the causal dynamics between various inflammatory skin conditions-namely acne, atopic dermatitis, psoriasis vulgaris, urticaria, and rosacea-and BC. Genetic variants implicated in these disorders were sourced from comprehensive genome-wide association studies representative of European ancestry. In the forward MR, BC was posited as the exposure, while the reverse MR treated each inflammatory skin disease as the exposure. A suite of analytical methodologies, including random effects inverse variance weighted (IVW), weighted median (WME), and MR-Egger, were employed to probe the causative links between inflammatory skin diseases and BC. Sensitivity analyses, alongside evaluations for heterogeneity and pleiotropy, were conducted to substantiate the findings. RESULTS: The MR analysis revealed an increased risk of acne associated with BC (IVW: OR = 1.063, 95% CI = 1.011-1.117, p = 0.016), while noting a decreased risk of atopic dermatitis (AD) in BC patients (IVW: OR = 0.941, 95% CI = 0.886-0.999, p = 0.047). No significant associations were observed between BC and psoriasis vulgaris, urticaria, or rosacea. Conversely, reverse MR analyses detected no effect of BC on the incidence of inflammatory skin diseases. The absence of pleiotropy and the consistency of these outcomes strengthen the study's conclusions. CONCLUSION: Findings indicate an elevated incidence of acne and a reduced incidence of AD in individuals with BC within the European population. PMID:38937884 | PMC:PMC11211090 | DOI:10.1111/srt.13782 {url} = URL to article
    • Medicine (Baltimore). 2024 Jun 28;103(26):e38705. doi: 10.1097/MD.0000000000038705. ABSTRACT Rosacea is a chronic and recurrent inflammatory skin disease affecting the center of the face that causes burning and itching sensations and changes in aesthetics. Liang Xue Wu Hua Tang (LXWHT) is a classic herbal formulation that is efficacious and has been widely used in the clinical treatment of rosacea; however, the pharmacological mechanisms remain unclear. The aim of the present study was to investigate the mechanism of action of LXWHT using network pharmacology and molecular docking. The Traditional Chinese Medicine System Pharmacology database was searched to identify the active ingredients and pharmacological targets of LXWHT, and the GeneCard, Disgenet, and Gene Expression Omnibus databases were applied to screen rosacea-related targets. Cytoscape software was used to visualize the protein-protein interaction network, and network topology analysis was used to identify core targets. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed for the core targets. Molecular docking simulations and visualization were performed using Maestro and PyMOL, respectively. A total of 43 active compounds and 28 potential targets for LXWHT treatment of rosacea were selected for analysis. The Gene Ontology/Kyoto Encyclopedia of Genes and Genomes results indicated that LXWHT may exert therapeutic effects on rosacea by intervening in immune pathways including tumor necrosis factor pathway, interleukin-17 pathways, and Toll-like receptor signaling pathways. Chemokine ligand 2, interferon-γ, interleukin-1ß, peroxisome proliferator-activated receptor-γ, and matrix metallopeptidase 9 may be the core therapeutic target. Quercetin, stigmasterol, kaempferol, beta-sitosterol, luteolin, beta-carotene, baicalein, acetin, and isorhamnetin were predicted to be the key active ingredients. LXWHT may exert therapeutic effects in the treatment of rosacea by modulating immunity and angiogenesis, laying the foundation for further research. PMID:38941423 | DOI:10.1097/MD.0000000000038705 {url} = URL to article
    • J Cosmet Dermatol. 2024 Jun 23. doi: 10.1111/jocd.16435. Online ahead of print. NO ABSTRACT PMID:38923159 | DOI:10.1111/jocd.16435 {url} = URL to article
    • Acta Derm Venereol. 2024 Jun 25;104:adv40053. doi: 10.2340/actadv.v104.40053. ABSTRACT Patients with rosacea commonly experience stigmatization, which induces stress and thereby exacerbates their symptoms. Given the strong effects of rosacea on health-related quality of life (HRQoL), addressing the physical and psychosocial aspects of rosacea is essential. To examine the effects of rosacea on HRQoL, we conducted a systematic review and meta-analysis involving real-world data. PubMed, EMBASE, and the Cochrane Library were searched, and randomized controlled trials (RCTs), cross-sectional studies, and case series evaluating the HRQoL of patients with rosacea were included. HRQoL assessment tools such as the Dermatology Life Quality Index (DLQI) and Rosacea-Specific Quality-of-Life Questionnaire (RosaQoL) were used. Data on 13,453 patients were retrieved from 52 eligible studies: 4 RCTs, 15 case series, and 33 cross-sectional studies. Compared with healthy controls, patients with rosacea had significantly lower DLQI scores (standardized mean difference [SMD] = -1.09, 95% confidence interval [CI] = -0.81 to -1.37). The DLQI scores after treatment were higher than those before treatment (SMD = -1.451, 95% CI = -1.091 to -1.810). The pooled estimates for the overall DLQI and RosaQoL scores were 8.61 and 3.06, respectively. In conclusion, patients with rosacea have lower HRQoL compared with healthy individuals, and treatment for rosacea improves their HRQoL. PMID:38916178 | PMC:PMC11218680 | DOI:10.2340/actadv.v104.40053 {url} = URL to article
    • Int Ophthalmol Clin. 2024 Jul 1;64(3):9-12. doi: 10.1097/IIO.0000000000000527. Epub 2024 Jun 24. ABSTRACT Intense pulsed light has a growing body of research supporting its use in skin rejuvenation, dermatologic conditions, as well as ocular rosacea, dry eyes and meibomian gland dysfunction. This paper will start with the conception of one protocol for treating dry eyes, blepharitis and styes using broad band light, a version of intense pulsed light, and its evolution into a life-changing in-office procedure for many patients. The approach for optimizing the settings, considerations during the consultation, the procedure in detail, after treatment care, and potential complications to avoid are all explained. Periocular and facial rejuvenation treatment protocols are discussed as well. This should be a useful guide for clinicians looking to add intense pulsed light to their in-office treatment armamentarium to significantly improve the lives of their patients. PMID:38910500 | DOI:10.1097/IIO.0000000000000527 {url} = URL to article
    • Dermatol Res Pract. 2024 Jun 15;2024:7714527. doi: 10.1155/2024/7714527. eCollection 2024. ABSTRACT The most prevalent skin condition is acne vulgaris. Recent clinical practice guidelines recommend oral isotretinoin to treat moderate-to-severe acne. The aim of this study is to assess the knowledge, attitude, and risk perception of oral isotretinoin for acne treatment. This is a cross-sectional descriptive study conducted in the country of Jordan. The study sample includes people resident in Jordan aged ≥14 years who have been treated with oral isotretinoin for acne. The study involved 373 participants who previously used oral isotretinoin for skin disorders. Most were Jordanian (89.3%), aged 19-25 (37.3%), and from the central region (82.8%). Mostly, they used isotretinoin for severe or mild acne (25.2% and 24.1%, respectively), rosacea (4.1%), or to alleviate acne scars. Surprisingly, 58.1% did not consult their specialist for side effects, and 20% shared their treatment. The average proper use score was 9.98 out of 16. A link was found between higher risk knowledge scores and proper use scores. Side effects such as nausea, irregular heartbeat, and pancreatitis affected some users (11.5%, 10.5%, 7.0%, and 3.2%, respectively). Knowledge about isotretinoin's risks varied, with percentages recognizing teratogenicity (57.7%), liver damage (52.6%), and lipid profile effects (37.2%), while 25% believed that they had no side effects. The study revealed partial adherence to oral isotretinoin guidelines, with gaps in monitoring and consultation. A positive correlation emerged between risk knowledge and proper usage, emphasizing the need for comprehensive education and monitoring strategies in isotretinoin therapy for skin disorders. PMID:38911019 | PMC:PMC11193596 | DOI:10.1155/2024/7714527 {url} = URL to article
    • J Adv Res. 2024 Jun 22:S2090-1232(24)00250-9. doi: 10.1016/j.jare.2024.06.013. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is an inflammatory skin disorder characterized by the release of inflammatory mediators from keratinocytes, which are thought to play a crucial role in its pathogenesis. Despite an incidence of approximately 5.5%, rosacea is associated with a poor quality of life. However, as the pathogenesis of rosacea remains enigmatic, treatment options are limited. OBJECTIVES: To investigate the pathogenesis of rosacea and explore new therapeutic strategies. METHODS: Transcriptome data from rosacea patients combined with immunohistochemical staining were used to investigate the activation of STAT3 in rosacea. The role of STAT3 activation in rosacea was subsequently explored by inhibiting STAT3 activation both in vivo and in vitro. The key molecules downstream of STAT3 activation were identified through data analysis and experiments. Dual-luciferase assay and ChIP-qPCR analysis were used to validate the direct binding of STAT3 to the IL-36G promoter. DARTS, in combination with experimental screening, was employed to identify effective drugs targeting STAT3 for rosacea treatment. RESULTS: STAT3 signaling was hyperactivated in rosacea and served as a promoter of the keratinocyte-driven inflammatory response. Mechanistically, activated STAT3 directly bind to the IL-36G promoter region to amplify downstream inflammatory signals by promoting IL-36G transcription, and treatment with a neutralizing antibody (α-IL36γ) could mitigate rosacea-like inflammation. Notably, a natural plant extract (pogostone), which can interact with STAT3 directly to inhibit its activation and affect the STAT3/IL36G signaling pathway, was screened as a promising topical medication for rosacea treatment. CONCLUSIONS: Our study revealed a pivotal role for STAT3/IL36G signaling in the development of rosacea, suggesting that targeting this pathway might be a potential strategy for rosacea treatment. PMID:38909883 | DOI:10.1016/j.jare.2024.06.013 {url} = URL to article
    • J Invest Dermatol. 2024 Jun 20:S0022-202X(24)01859-1. doi: 10.1016/j.jid.2024.05.024. Online ahead of print. NO ABSTRACT PMID:38908780 | DOI:10.1016/j.jid.2024.05.024 {url} = URL to article
    • Cureus. 2024 May 21;16(5):e60731. doi: 10.7759/cureus.60731. eCollection 2024 May. ABSTRACT Background Internalized stigma (IS) is the acceptance of unfavorable stereotypes about the disease that society has created and withdrawing from society with feelings of shame and worthlessness. Due to the visibility feature of facial skin diseases such as rosacea and acne vulgaris (AV), it is possible for them to cause IS. Objective We aimed to examine the level of IS in AV and rosacea patients and compare these patient groups as well. Methods Fifty-three AV and 46 rosacea patients aged 18-65 were included in this study. Internalized Stigma Scale (ISS) adapted for AV and rosacea were applied to all the patients. They also responded to the "Dermatology Life Quality Index" (DLQI) questionnaire. The relationship between IS levels and DLQI was investigated, and then acne and rosacea patients were compared with each other. Results Total DLQI, total ISS, and its subscales' scores of all patients were found to be positively correlated with each other. When rosacea and AV patients were compared with each other, there was no difference regarding DLQI and ISS scores. Conclusion AV and rosacea patients experience high IS, and it is significantly related to low quality of life and health status. They also have similar IS levels when compared with each other. PMID:38903377 | PMC:PMC11187619 | DOI:10.7759/cureus.60731 {url} = URL to article
    • Arch Dermatol Res. 2024 Jun 21;316(7):428. doi: 10.1007/s00403-024-03131-9. ABSTRACT Cannabidiol (CBD), which is derived from hemp, is gaining recognition because of its anti-inflammatory and lipid-modulating properties that could be utilized to treat acne. We conducted experiments to quantitatively assess the effects of CBD on acne-related cellular pathways. SEB-1 sebocytes and HaCaT keratinocytes were exposed to various CBD concentrations. CBD exhibited a concentration-dependent impact on cell viability and notably reduced SEB-1 viability; furthermore, it induced apoptosis and a significant increase in the apoptotic area at higher concentrations. Additionally, CBD remarkably reduced pro-inflammatory cytokines, including CXCL8, IL-1α, and IL-1β. Additionally, it inhibited lipid synthesis by modulating the AMPK-SREBP-1 pathway and effectively reduced hyperkeratinization-related protein keratin 16. Simultaneously, CBD stimulated the synthesis of elastin, collagen 1, and collagen 3. These findings emphasize the potential of CBD for the management of acne because of its anti-inflammatory, apoptotic, and lipid-inhibitory effects. Notably, the modulation of the Akt/AMPK-SREBP-1 pathway revealed a novel and promising mechanism that could address the pathogenesis of acne. PMID:38904694 | PMC:PMC11192675 | DOI:10.1007/s00403-024-03131-9 {url} = URL to article
    • Am Fam Physician. 2024 Jun;109(6):533-542. ABSTRACT Rosacea is a chronic inflammatory skin disease of the central face, affecting 5% of the population. The exact etiology is unknown. A diagnosis is made based on the updated 2017 National Rosacea Society Expert Committee guidelines, including fixed erythema, phymatous changes of skin thickening due to sebaceous gland hyperplasia and fibrosis, papules, pustules, telangiectasia, and flushing. Delays in an accurate diagnosis and treatment may occur in skin of color due to difficulty visualizing erythema and telangiectasia. The daily use of sunscreen, moisturizers, and mild skin cleansers and avoidance of triggers are essential aspects of maintenance treatment. Effective topical treatment options include alpha-adrenergic receptor agonists for flushing and ivermectin, metronidazole, and azelaic acid for papules and pustules. Systemic treatments include nonselective beta blockers for flushing, low-dose doxycycline, and isotretinoin for papules and pustules. Rosacea can significantly affect a patient's emotional health and quality of life. A referral for care is recommended for fixed phymatous changes and ocular rosacea. (Am Fam Physician. 2024;109(6):533-542. PMID:38905551 {url} = URL to article
    • World J Clin Cases. 2024 Jun 16;12(17):3253-3258. doi: 10.12998/wjcc.v12.i17.3253. ABSTRACT BACKGROUND: In addition to the non-specific symptomatology of ocular rosacea, currently, there are no reliable diagnostic tests for the disease, which may lead to its misdiagnosis. Here, we report a case of ocular rosacea presenting with multiple recurrent chalazion on both eyelids. CASE SUMMARY: A 63-year-old female patient presented with multiple chalazion and dry eyes in both eyes, with no facial erythema. Initial management done were application of steroid eye ointment on both eyelids, hot compresses, and eyelid margin cleaning; noting that there was no relief of symptoms. Surgical excision of the chalazion was done on both eyes, however, bilateral recurrence occurred post-operatively. The pathological studies showed infiltration of a small amount of fibrous tissue with many chronic inflammatory cells. Immunohistochemistry studies were positive for LL-37. Resolution of the chalazion occurred after oral administration of doxycycline and azithromycin. CONCLUSION: Our findings show that ophthalmologists should recognize the ocular manifestations of skin diseases. PMID:38898849 | PMC:PMC11185401 | DOI:10.12998/wjcc.v12.i17.3253 {url} = URL to article
    • Skin Res Technol. 2024 Jun;30(6):e13735. doi: 10.1111/srt.13735. ABSTRACT INTRODUCTION: Rosacea is a chronic inflammatory skin condition associated with erythema, inflammation and skin sensitivity. OBJECTIVES: To assess the benefit of a dermocosmetic cream (DC cream) containing Sphingobioma xenophaga extract and soothing agent in adult females with rosacea-associated erythema and sensitive skin. MATERIALS AND METHODS: During phase 1, DC was applied twice daily on the randomized half-face and compared to usual-skincare (USC) for 28 days. During phase 2, DC was applied on the full face twice daily for 56 days. Clinical, instrumental and skin sensitivity assessments were performed at all visits; demodex density (standardized skin surface biopsy (SSSB) method) was performed at baseline and D28, quality of life (QoL) was assessed using the stigmatization questionnaire (SQ), Rosacea Quality of Life index (ROSAQoL) and Dermatology Life Quality Index (DLQI) at baseline and D84. RESULTS: At D28, a significant benefit of DC over USC was observed for erythema, tightness, burning and stinging (all p ≤ 0.05), erythema measured by chromameter (p < 0.01), corneometry and transepidermal water loss (p < 0.0001 and p < 0.05, respectively), skin sensitivity (p < 0.001) and significant reduction of mean demodex density (p < 0.05) on the DC side. At D84, DC significantly (all p < 0.05) improved clinical signs and symptoms on both sides of the face compared to baseline; SQ, ROSAQoL and DLQI scores improved by 40.4%, 25.0% and 55.7%, respectively compared to baseline. Tolerance was excellent. CONCLUSION: DC significantly improved erythema, skin sensitivity, demodex count, QoL and feeling of stigmatization of subjects with rosacea and is very well tolerated. PMID:38899754 | PMC:PMC11187799 | DOI:10.1111/srt.13735 {url} = URL to article
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    • Ann Dermatol Venereol. 2024 Jun 6;151(3):103244. doi: 10.1016/j.annder.2023.103244. Online ahead of print. NO ABSTRACT PMID:38848643 | DOI:10.1016/j.annder.2023.103244 {url} = URL to article
    • Indian J Dermatol. 2024 Mar-Apr;69(2):152-158. doi: 10.4103/ijd.ijd_815_22. Epub 2024 Apr 29. ABSTRACT Gluten, a polypeptide hapten, found in many cereals such as barley, wheat, rye, oats, and others, has been recently implicated in a range of cutaneous disorders ranging from chronic plaque psoriasis through psoriatic arthritis, urticaria (chronic as well as paediatric onset), and angioedema to lichen planus, vitiligo, and rosacea. The evidence for them is still not well reviewed. To generate evidence for the causal role of gluten in various dermatological disorders. The Pubmed, MedLine, and EMBASE databases were searched using the keywords "Gluten" and one of the dermatoses, namely, "Atopic Dermatitis", "Vasculitis", "Psoriasis", "Psoriatic Arthritis", "Acne", "Alopecia Areata", and "Immunobullous disorders". All articles published in English for which free full text was available were taken into consideration. The search strategy returned in a total of 1487 articles which were screened for relevance and elimination of duplicates. Ultimately, around 114 articles were deemed suitable. The data were extracted and presented in the narrative review format. A simple and cost-effective solution to many of these chronic and lifelong conditions is to restrict gluten in the diet. However, the dermatologist would do well to remember that in the vast majority of dermatological disorders including the ones listed here, gluten restriction is not warranted and can even lead to nutritional deficiencies. The evidence varied from Grade I for some disorders like psoriatic arthritis to Grade IV to most disorders like acne, vitiligo, vasculitis, and atopic dermatitis. Herein, we review the evidence for each of these conditions and make practical recommendations for gluten restriction in them. PMID:38841247 | PMC:PMC11149804 | DOI:10.4103/ijd.ijd_815_22 {url} = URL to article
    • Skin Appendage Disord. 2024 Jun;10(3):207-214. doi: 10.1159/000536246. Epub 2024 Feb 2. ABSTRACT INTRODUCTION: Rosacea is a common chronic inflammatory dermatosis characterized by erythema, telangiectasia, papules, and pustules on the central face. The frequency of contact sensitization complicating rosacea and its therapy is unknown, with only few studies published in the literature. In the present study, we aimed to evaluate contact sensitivity in patients with rosacea. METHODS: A total of 50 rosacea patients and 50 age- and sex-matched healthy controls were enrolled. Both groups were patch tested with the European Baseline Series. RESULTS: A positive reaction to at least one allergen of the European Baseline Series was observed in 15 (30%) of rosacea patients and 10 (20%) of the healthy controls. Although the rate of positive reaction in the rosacea group was higher than in the controls, no statistically significant difference was documented. In addition, the total number of positive reactions to allergens in the rosacea group was higher than the control group, namely, 26 versus 17. CONCLUSION: Contact hypersensitivity may coexist with rosacea. Its identification holds significant clinical relevance, influencing the long-term management and justifying the application of patch testing in rosacea patients. PMID:38835717 | PMC:PMC11147521 | DOI:10.1159/000536246 {url} = URL to article
    • J Cosmet Dermatol. 2024 Jun 3. doi: 10.1111/jocd.16372. Online ahead of print. ABSTRACT BACKGROUND & AIM: Rosacea is a chronic inflammatory, multifactorial disease for which combination therapy could be an effective treatment. In this study, we evaluate the effect of the combination therapy of brimonidine 0.33% and ivermectin 1% as a single cream for the treatment of papulopustular rosacea. METHOD: A stable and appropriate formulation was prepared by adding the aqueous phase to the lipid phase while being stirred. The stability and physicochemical properties of the formulation were evaluated under accelerated conditions. Twelve patients (36-60 years) with mild to moderate papulopustular rosacea and a Demodex count of five or more were treated with the combination of brimonidine 0.33% and ivermectin 1% cream. Clinician's Erythema Assessment (CEA), Patients Self-Assessment (PSA), skin erythema (ΔE) and lightness (ΔL), and skin biophysical parameters including transepidermal water loss (TEWL), skin hydration, pH, and sebum content, as well as erythema and melanin index and ultrasound parameters, were measured before treatment and 4 and 8 weeks after. Adverse drug reactions were also recorded. RESULTS: CEA and PSA decreased significantly from 3 to 2 after 8 weeks, respectively (p-value = 0.014 for CEA and 0.010 for PSA). ΔE and ΔL, as well as skin erythema index and TEWL improved after 8 weeks of treatment (p < 0.05). Two patients withdrew from the study in the first week because of local adverse effects; one developed flushing following treatment and left the investigation after 4 weeks and another patient withdrew from the study after 4 weeks due to deciding to become pregnant. CONCLUSION: Eight-week treatment with the combination of brimonidine 0.33% and ivermectin 1% was shown to be effective for improvement of erythema and inflammatory lesions in mild to moderate papulopustular rosacea. PMID:38831548 | DOI:10.1111/jocd.16372 {url} = URL to article
    • J Cosmet Dermatol. 2024 Jun 3. doi: 10.1111/jocd.16413. Online ahead of print. ABSTRACT OBJECTIVE: To investigate the efficacy and safety of a repairing mask as an adjunctive treatment for skin barrier maintenance of mild to moderate rosacea. METHODS: Patients with rosacea were recruited in this dual center randomized controlled trial from November 2019 to December 2021. A total of 64 patients were included and randomized into two groups at a ratio of 3:1 into a mask group (n = 47) and a control group (n = 17). Patients in the mask group received treatment with Dr. Yu Centella asiatica repairing facial mask three times weekly for a duration of 6 weeks. All participants were instructed to continue their regimen of 50 mg oral minocycline twice daily and to apply Dr. Yu Intensive Hydrating Soft Cream twice daily. The primary endpoint of this study was the Investigator Global Assessment (IGA) score. RESULTS: A total of 54 patients completed this trial, with 41 in the mask group and 13 in the control group. After using this facial mask for 3 and 6 weeks, the IGA, facial skin dryness, facial flushing, and severity of skin lesion in the mask group showed significantly improvement (p < 0.05). Moreover, the change in the delta degree of skin flushing was significantly higher than that in the control group (p = 0.037). Throughout the study, no adverse events were reported in either group of participants. CONCLUSION: The Dr. Yu Centella asiatica repairing facial mask, as an adjunctive treatment of rosacea, appears to effectively repair and protect the skin barrier, alleviate cutaneous symptoms of rosacea, and is both efficacious and safe for patient use. PMID:38831627 | DOI:10.1111/jocd.16413 {url} = URL to article
    • J Drugs Dermatol. 2024 Jun 1;23(6):446-449. doi: 10.36849/JDD.8362. ABSTRACT Acne vulgaris is a common chronic dermatological condition characterized by obstruction and inflammation of pilosebaceous units. Recent research on a different dermatologic condition has demonstrated that the use of vasodilatory medications is associated with a decreased relative risk of rosacea. This finding is significant due to the overlapping inflammatory pathways involved in rosacea and acne. Herein, a retrospective cohort study was designed to determine the correlation between vasodilator usage and the risk of developing acne within 5 years, contrasting it with thiazide diuretics, chosen as a control due to its non-vasodilatory antihypertensive mechanism and availability of data. Angiotensin-converting enzyme (ACE) inhibitors (RR, 0.775; 95% CI, 0.727-0.826; P&lt;0.05), angiotensin receptor blockers (ARBs) (RR, 0.739; 95% CI, 0.685-0.797; P&lt;0.05), beta-blockers (BB) (RR, 0.829; 95% CI, 0.777-0.885; P&lt;0.05), and calcium channel blockers (CCB) usage (RR, 0.821, 95% CI, 0.773-0.873; P&lt;0.05) were associated with a significantly lower risk of developing acne within 5 years of initiating therapy compared to thiazide diuretics. It is unclear if thiazide diuretics are more likely to cause acne within the adult population or if vasodilators are protective against the development of acne. Finding mechanisms and therapeutics that lower the risk of developing acne is of significant public health interest, and this study provides a step toward this endeavor. Further research is required to uncover the underlying mechanisms for this reduction in the development of acne.&nbsp; J Drugs Dermatol. 2024;23(6):446-449.&nbsp; &nbsp;&nbsp; doi:10.36849/JDD.8362. PMID:38834225 | DOI:10.36849/JDD.8362 {url} = URL to article
    • Cont Lens Anterior Eye. 2024 Jun 3:102247. doi: 10.1016/j.clae.2024.102247. Online ahead of print. ABSTRACT PURPOSE: To compare the efficacy of topical autologous serum and platelet-rich plasma (PRP) in patients with severe dry eye and persistent epithelial defects. METHODS: Sixty-seven eyes of 42 patients including 12 Sjogren, 11 meibomian gland dysfunction, 8 post penetrating keratoplasty, 5 acne rosacea, 5 chemical burn and 3 neurotophic keratopathy were analyzed. Best corrected visual acuity, Schirmer, Ocular Surface Disease Index (OSDI), tear break-up time, Oxford staining scores were measured before the treatment and 1 month. One month scores of two groups were compared. RESULTS: Thirty three eyes received autologous serum and 34 received PRP. There was no statistically significant differences between two groups in ocular surface parameters at baseline. Statistically significant improvements were achieved in both groups in all parameters at 1 month (p < 0.05). Schirmer score improved from 7.9 ± 7.6 to 10.6 ± 8.4 mm in autologous serum (p < 0.001) and from 10.9 ± 9.5 to 13.3 ± 10.1 in PRP (p < 0.001); BUT from 4.3 ± 2.7 to 6.7 ± 3.4 s (p < 0.001) and 4.5 ± 3.0 to 6.0 ± 3.6 (p < 0.001); OSDI from 47.7 ± 14.7 to 25.7 ± 11.0 (p < 0.001) and from 54.1 ± 17.3 to 26.8 ± 11.0 (p < 0.001); Oxford score from 4.0 ± 1.0 to 1.3 ± 1.1 in (p < 0.001) and 3.9 ± 0.9 to 1.6 ± 1.3 (p < 0.001) respectively. Significant visual improvement was achieved with PRP from 0.81 ± 0.73 LogMAR to 0.72 ± 0.63 (p = 0.025), whereas insignificant with serum from 0.60 ± 0.65 to 0.57 ± 0.67 (p = 0.147). Mean epithelial healing time was 6.7 ± 4.7 (2-14) days in serum and 3.6 ± 1.9 (2-7) in PRP (p = 0.195). CONCLUSIONS: Both treatments are equally effective in severe dry eye and persistent epithelial defects. Although, visual gain is higher in PRP, autologous serum may be preferable due to low cost. PMID:38834425 | DOI:10.1016/j.clae.2024.102247 {url} = URL to article
    • Lasers Med Sci. 2024 Jun 1;39(1):146. doi: 10.1007/s10103-024-04098-9. ABSTRACT Previous clinical studies have shown that pulsed dye laser (PDL) and intense pulsed light (IPL) are effective for treating erythematotelangiectatic rosacea(ETR). This article aims to compare the efficacy and safety of PDL and IPL at three different wavelength bands (broad-band, single-narrow-band, and dual-narrow-band) in treating ETR. Sixty subjects with ETR were randomly categorized into four groups and received one of the following laser treatments: PDL (595 nm), IPL with Delicate Pulse Light (DPL, 500-600 nm), IPL with M22 590 (590-1200 nm), or IPL with M22 vascular filter (530-650 nm and 900-1200 nm). Four treatment sessions were administered at 4-week intervals, with one follow-up session 4 weeks after the final treatment. The efficacy of the four lasers was evaluated by comparing the clinical symptom score, total effective rate, VISIA red area absolute score, and RosaQoL score before and after treatment. The safety was evaluated by comparing adverse reactions such as pain, purpura, erythematous edema, and blister. All 60 subjects completed the study. Within-group effects showed that the clinical symptom score, VISIA red area absolute score, and RosaQoL score of all four groups were significantly reduced compared to before treatment (p < 0.001). Between-group effects showed no statistically significant difference among the four laser groups. Safety analysis showed that all four lasers were safe, but the incidence of blister was higher in the M22 vascular group. Nonpurpurogenic PDL, DPL, M22 590, and M22 vascular were equally effective in treating ETR and were well-tolerated. ClinicalTrial.gov Identifier: NCT05360251. PMID:38822948 | DOI:10.1007/s10103-024-04098-9 {url} = URL to article
    • J Cosmet Dermatol. 2024 May 30. doi: 10.1111/jocd.16417. Online ahead of print. ABSTRACT BACKGROUND: The changes in the skin caused by obesity may predispose patients with rosacea to Demodex infestation (DI). Besides, identifying predisposing factors in these patients is important for initial treatment plan. AIMS: The main purpose of this study is to determine the relationship between DI and obesity in patients with rosacea. METHODS: Sociodemographic characteristics, body mass index, and clinical features of 130 rosacea patients were recorded. Demodex density was measured by noninvasive standard skin biopsy, and a determination of ≥5/cm2 mites was regarded as positive for DI. Patients with a BMI of 30 and above were categorized as the obese group, and those with a BMI below 30 were classified as the nonobese group. Moreover, patients were divided according to DI into positive and negative. These groups were compared with each other. RESULTS: Upon comparing the patients with and without obesity, it was noted that the obese patients had significantly higher rates of erythematotelangiectatic type rosacea, rosacea severity, and flushing complaints. Furthermore, results show that the DI was significantly more common in obese patients. The most determinant factors for predicting DI in rosacea patients were papulopustular type rosacea, obesity, and rosacea severity, respectively. CONCLUSIONS: In this study, DI was found to be more common in obese patients with rosacea. Besides, obesity was found to be one of the most determining factors in detecting DI in patients with rosacea. PMID:38817094 | DOI:10.1111/jocd.16417 {url} = URL to article
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