"Rosacea is a common inflammatory skin disorder mediated by the dysregulation of both keratinocytes and T cells. Here, we report that aquaporin 3 (AQP3), a channel protein that mediates the transport of water/glycerol, was highly expressed in the epidermis and CD4+ T cells of both rosacea patients and experimental mice....Our findings reveal that AQP3-mediated activation of NF-κB in keratinocytes and activation of STAT3 in CD4+ T cells acted synergistically and contributed to the inflammation in rosacea." [1] "Aquaporin 3 (AQP-3) is the protein product of the human AQP3 gene." [2] "Aquaporins (AQPs) are water channels that facilitate transepithelial water transport across plasma membranes following an osmotic gradient [3]. AQPs are glycosylated integral membrane proteins and widely expressed in bacteria (for review [4]), yeast [5], plants [6] (for review [7]), and mammals..." [3] Obviously we need more rosacea research on this subject. Do you want to support such targeted research? Join the RRDi and post in this thread. A Graphical abstract of AQP3 [4] End Notes [1] PubMed RSS Feed - -Targeting Aquaporin-3 Attenuates Skin Inflammation in Rosacea  [2] Aquaporin-3, Wikipedia [3] Aquaporin-3 in Cancer Saw Marlar, Helene H. Jensen, Frédéric H. Login, and Lene N. Nejsum Int J Mol Sci. 2017 Oct; 18(10): 2106. Published online 2017 Oct 7. doi: 10.3390/ijms18102106 [4] Biochimica et Biophysica Acta (BBA) - Biomembranes Volume 1861, Issue 4, 1 April 2019, Pages 768-775 Single-channel permeability and glycerol affinity of human aquaglyceroporin AQP3 Roberto A. Rodriguez, Huiyun Liang, Liao Y. Chen, Germán Plascencia-Villa, George Perry 

"In fact, rosacea might be underreported and underdiagnosed in populations with skin of color because of the difficulty of discerning erythema and telangiectasia in dark skin. The susceptibility of persons with highly pigmented skin to dermatologic conditions like rosacea, whose triggers include sun exposure, is probably underestimated. Many people with skin of color who have rosacea might experience delayed diagnosis, leading to inappropriate or inadequate treatment; greater morbidity; and uncontrolled, progressive disease with disfiguring manifestations, including phymatous rosacea." Global epidemiology and clinical spectrum of rosacea, highlighting skin of color: Review and clinical practice experience Andrew F. Alexis MD, MPH, Valerie D. Callender MD, Hilary E. Baldwin MD, Seemal R. Desai MD, Marta I. Rendon MD, Susan C. Taylor MD  Journal of the American Academy of Dermatology Volume 80, Issue 6, June 2019, Pages 1722-1729.e7

In  2004, it has been stated that "The economic burden of skin disease on the US healthcare was approximately $96 billion in 2004. [1] "In 2013, more than 85 million Americans were seen by a medical professional for skin diseases. The United States healthcare system alone is estimated to spend approximately 75 billion dollars annually to treat skin diseases. Additionally, the prevalence of skin disease increases to almost 50% in Americans 65 years of age or older). Moreover, it is estimated that the population over the age of 65 will almost double in the United States in the next 30 years, leading to an inevitable increase in annual healthcare costs for skin disease treatment." [2] This expenditure is on all skin conditions. A "Data Bridge Market Research analyses that the rosacea treatment market, which was USD 1.8 billion in 2022, would rocket up to USD 2.6 billion by 2030 and is expected to undergo a CAGR of 6.1% during the forecast period of 2023 to 2030." - Global Rosacea Treatment Market, DBMR  How much is spent on rosacea in the USA?  Rosacea How many of those billions are spent on rosacea? As the above figures shows it is in the millions of dollars.  "In 2013, the costs associated with the treatment and lost productivity among those who sought medical care for rosacea was $243 million." [2] Between 2002 and 2005, for an individual patient, "Of the total healthcare costs, annual rosacea-related expenditures were $276; approximately 70% of rosacea-related expenditures were due to prescription drugs. [3]  In 2013, "The treatment of rosacea incurred primarily pharmacy rather than medical costs. The median annual pharmacy costs, by type of therapy, were: $285 for combination therapy $142 for a topical medication $63 for an oral antibiotic agent." [4] In 2014, the NRS states, "The lack of health insurance or the amount of the required co-pay kept 47 percent of the survey respondents from obtaining medical care for their rosacea at some point.  And 56 percent reported they had paid out-of-pocket for a rosacea-related medication or procedure not covered by their insurance policy.  Of those answering the survey, the amount paid out of pocket was less than $100 for 33 percent, between $100 and $500 for 35 percent, between $500 and $1,000 for 12 percent and greater than $1,000 for 11 percent." [6] End Notes [1] Bickers DR, Lim HW, Margolis D, et al; for the American Academy of Dermatology Association, and the Society for Investigative Dermatology. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol. 2006;55: 490-500. [2] Aquaporin-3 in the epidermis: more than skin deep Wendy B. Bollag, Lorry Aitkens, Joseph White, and Kelly A. Hyndman Am J Physiol Cell Physiol. 2020 Jun 1; 318(6): C1144–C1153. Published online 2020 Apr 8. doi: 10.1152/ajpcell.00075.2020 [3] SKIN CONDITIONS BY THE NUMBERS, AAD [4] Healthcare utilization and costs of patients with rosacea in an insured population Michael Romanowicz, Judith J Stephenson, James Q Del Rosso, Greg Lenhart Dermatol. 2008 Jan;7(1):41-9. Healthcare utilization and costs of patients with rosacea in an insured population [5] Cost and Drug Utilization Patterns Associated with the Management of Rosacea Caroline Helwick, Medical Writer Am Health Drug Benefits. 2013 Nov-Dec; 6(9): 583–584. [6] New Survey Shows Insurance Covers Medication For Most, NRS

Int J Dermatol. 2023 Nov 29. doi: 10.1111/ijd.16950. Online ahead of print. NO ABSTRACT PMID:38031285 | DOI:10.1111/ijd.16950 {url} = URL to article

PubMed RSS Feed - -Successful Treatment of Granulomatous Rosacea by JAK Inhibitor Abrocitinib: A Case Report If you are taking vandetanib read this:  PubMed RSS Feed - -Dark perifollicular macules and granulomatous rosacea secondary to vandetanib

"Trichoscopy is a method of hair and scalp evaluation and is used for diagnosing hair and scalp diseases. The method is based on dermoscopy." [1] "In many cases the combination of clinical examination and trichoscopy is sufficient for establishing the correct diagnosis....The most characteristic features of scalp rosacea are perifollicular scaling and arborizing vessels." [2] Why I like trichoscopy? Professor Lidia Rudnicka End Notes [1] Trichoscopy, Wikipedia [2] PubMed RSS Feed - -Differential diagnosis of red scalp. The importance of trichoscopy image courtesy of Wikipedia Commons

Clin Cosmet Investig Dermatol. 2023 Nov 20;16:3369-3374. doi: 10.2147/CCID.S440138. eCollection 2023. ABSTRACT Granulomatous rosacea (GR) is a rare inflammatory skin disease characterized by persistent, hard, yellow, brown, red, or flesh-colored papules, plaques, or nodules on the face. Limited data are available on patients treated for GR, with only case reports and case series published. Herein, we describe the case of a 53-year-old woman who presented to the hospital with persistent red to brown and pink patches on both cheeks accompanied by a burning sensation for one month. Histopathological examination of a cutaneous biopsy revealed granulomatous inflammation in focal areas. Both acid-fast and Periodic acid-Schiff staining were negative. The patient was diagnosed with GR based on her clinical presentation and laboratory test results. She was treated with abrocitinib, a JAK-1 inhibitor, for 20 weeks. This resulted in substantial improvement in her rash and the associated burning sensation. Subsequent follow-up visits indicated no adverse effects or relapses. Additionally, a literature review was conducted to compare with the current case, which concluded that abrocitinib is a viable treatment option for GR, exhibiting a relatively high safety profile with minimal side effects. PMID:38021428 | PMC:PMC10674708 | DOI:10.2147/CCID.S440138 {url} = URL to article

Clin Cosmet Investig Dermatol. 2023 Nov 18;16:3363-3368. doi: 10.2147/CCID.S441581. eCollection 2023. ABSTRACT An abnormal density of Demodex mites can trigger many skin disorders known as demodicosis. Clinical manifestations of demodicosis may resemble other skin diseases and can coexist with other skin disorders, resulting in underdiagnosis and a more challenging diagnosis. Here, we report three cases of demodicosis in acne vulgaris patients. These case series have discussed their clinical features along with optimal strategies for diagnosis and treatment. PMID:38021431 | PMC:PMC10664713 | DOI:10.2147/CCID.S441581 {url} = URL to article

Postepy Dermatol Alergol. 2023 Oct;40(5):642-646. doi: 10.5114/ada.2023.130523. Epub 2023 Aug 22. ABSTRACT INTRODUCTION: The relationship between rosacea and basal cell carcinoma (BCC) is still not known. Almost all reports questioning the relation between BCC and rosacea are focused on rhinophyma. AIM: To examine the possible connection of BCC and rosacea. MATERIAL AND METHODS: 110 patients with BCC located on the face treated surgically in the Dermatosurgery Unit in 2020-2021 were included in the study. A trained dermatologist assessed the presence or absence of concomitant rosacea and assessed its severity according to the Investigator's Global Assessment (IGA). RESULTS: Fifty-one (46.4%) subjects with BCC and concomitant clinically diagnosed rosacea were found. In our group 35.5% of women had BCC located on the cheeks, while in men most cancers were located on the nose (55%, n = 11), however this difference has not reached statistical significance. CONCLUSIONS: The incidence of rosacea in our population was undoubtedly higher, comparing to the normative population. Both rosacea and BCC share the same risk factors - UV exposure, the potential association should not be neglected. PMID:38028413 | PMC:PMC10646708 | DOI:10.5114/ada.2023.130523 {url} = URL to article

"Conclusions Patients with rosacea seem to have increased risk for depressive and anxiety symptoms also in general population. Physicians treating patients with rosacea should pay more attention to the psychosocial health of patients." Association of rosacea with depressive and anxiety symptoms: a general population study  

Int J Dermatol. 2023 Nov 28. doi: 10.1111/ijd.16920. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory dermatosis characterized by remissions and flares. Although the rosacea active treatment phase is well established, the long-term maintenance phase is still challenging. OBJECTIVE: To discuss and make recommendations on how to treat patients during the long-term maintenance phase for the main rosacea phenotypes. METHODS: A panel of six board-certified Brazilian dermatologists and one American dermatologist gathered to compose a consensus based upon an initial statement on how to treat rosacea during the long-term maintenance phase based on the methodology Nominal Group Technique. The experts discussed each factor based upon an initial statement on how to treat rosacea patients in the long-term maintenance phase. A sequence of comprehensive narrative reviews was performed; a questionnaire preparation about the definition of the maintenance phase and its management was presented; an interpersonal discussion and ranking of the ideas were conducted. Recommendations were made if the specialists had 75% agreement. RESULTS: The maintenance treatment phase, which starts by achieving IGA 0 or 1 grades at the active phase, should be considered at least during the 9-month period after remission. The recommendations of all treatments target this period. Daily skincare regimen and sunscreen are crucial. Active treatment phase should be recommended if signs or symptoms reappear or worsen. CONCLUSION: Maintenance phase success depends on patient's adherence to daily skin care, appropriate treatments, continued follow-up with dermatologist, and self-assessment to identify new signs and symptoms indicating disease relapse. PMID:38013632 | DOI:10.1111/ijd.16920 {url} = URL to article

Res Sq. 2023 Nov 17:rs.3.rs-3611240. doi: 10.21203/rs.3.rs-3611240/v1. Preprint. ABSTRACT More than 20% of the population across the world is affected by non-communicable inflammatory skin diseases including psoriasis, atopic dermatitis, hidradenitis suppurativa, rosacea, etc. Many of these chronic diseases are painful and debilitating with limited effective therapeutic interventions. However, recent advances in psoriasis treatment have improved the effectiveness and provide better management of the disease. This study aims to identify common regulatory pathways and master regulators that regulate molecular pathogenesis. We designed an integrative systems biology framework to identify the significant regulators across several inflammatory skin diseases. With conventional transcriptome analysis, we identified 55 shared genes, which are enriched in several immune-associated pathways in eight inflammatory skin diseases. Next, we exploited the gene co-expression-, and protein-protein interaction-based networks to identify shared genes and protein components in different diseases with relevant functional implications. Additionally, the network analytics unravels 55 high-value proteins as significant regulators in molecular pathogenesis. We believe that these significant regulators should be explored with critical experimental approaches to identify the putative drug targets for more effective treatments. As an example, we identified IKZF1 as a shared significant master regulator in three inflammatory skin diseases, which can serve as a putative drug target with known disease-derived molecules for developing efficacious combinatorial treatments for hidradenitis suppurativa, atopic dermatitis, and rosacea. The proposed framework is very modular, which can indicate a significant path of molecular mechanism-based drug development from complex transcriptomics data and other multi-omics data. PMID:38014119 | PMC:PMC10680929 | DOI:10.21203/rs.3.rs-3611240/v1 {url} = URL to article

Skin Res Technol. 2023 Nov;29(11):e13525. doi: 10.1111/srt.13525. NO ABSTRACT PMID:38009046 | DOI:10.1111/srt.13525 {url} = URL to article

J Dermatol. 2023 Nov 27. doi: 10.1111/1346-8138.17051. Online ahead of print. ABSTRACT Granulomatous rosacea (GR) is a rare and distinct variant of rosacea. We report three cases of recalcitrant GR successfully treated with pulsed-dye laser (PDL) and provide experimental evidence supporting its potential as a treatment option. PDL treatment demonstrated remarkable efficacy in the three clinical cases, despite their resistance to conventional therapies. Chemokine ligand 9 (CXCL9), a key chemokine involved in inflammation and granuloma formation, was found to be increased in skin sections from all three patients. In vitro experiments using human monocytes and dermal fibroblasts demonstrated that PDL treatment significantly reduced CXCL9 expression in fibroblasts. These findings suggest that PDL may modulate CXCL9 secretion in fibroblasts, potentially limiting the recruitment of immune cells to the lesion. Although further research is needed to fully understand the precise mechanisms underlying the role of CXCL9 in GR, PDL may be a promising therapeutic approach for refractory GR. PMID:38009832 | DOI:10.1111/1346-8138.17051 {url} = URL to article

Clin Exp Dermatol. 2023 Nov 27:llad417. doi: 10.1093/ced/llad417. Online ahead of print. NO ABSTRACT PMID:38011317 | DOI:10.1093/ced/llad417 {url} = URL to article

Dermatology. 2023 Nov 26. doi: 10.1159/000535034. Online ahead of print. ABSTRACT Background The association between rosacea and psychiatric comorbidity has been reported previously. However, there is a lack of general population studies about this subject area. Objectives To study the association between rosacea with depressive and anxiety symptoms at population level. Methods A clinical whole-body examination was performed by dermatologists for 1,932 subjects belonging to the Northern Finland Birth Cohort 1966 Study during the 46-year follow-up survey. The presence of depressive and anxiety symptoms was gathered by using validated Hopkins Symptom Checklist-25 (HSCL-25) included into the self-administered questionnaires. Binary logistic regression analysis was used to identify associations between rosacea and psychological symptoms. Results Rosacea was found in dermatological evaluation in 15.1% of the study subject (n=292). In logistic regression analyses, after adjusting for confounding factors, those with rosacea had 1.6-fold (OR 1.55, 95% CI 1.02-2.32) risk for psychiatric symptoms according to HSCL-25 when compared with controls. In separate analyses of HSCL-25 depression subscale, the risk was increased especially for depressive symptoms OR 1.56 (95% CI 1.10-2.18). Conclusions Patients with rosacea seem to have increased risk for depressive and anxiety symptoms also in general population. Physicians treating patients with rosacea should pay more attention to the psychosocial health of patients. PMID:38008081 | DOI:10.1159/000535034 {url} = URL to article

Clin Geriatr Med. 2024 Feb;40(1):11-23. doi: 10.1016/j.cger.2023.09.007. Epub 2023 Oct 20. ABSTRACT Inflammatory skin conditions affect people of all ages, genders, and races. These common conditions are frequent causes of visits to the dermatologist. The geriatric population is often afflicted by these conditions because many are chronic and relapsing diseases. These inflammatory conditions include but are not limited to psoriasis, atopic dermatitis, contact dermatitis, seborrheic dermatitis, rosacea, and Grover disease. Chronic inflammatory skin conditions place a large burden on the health care system in the United States and have many associated comorbidities. This article discusses these inflammatory dermatoses that affect the geriatric population and common therapeutic options. PMID:38000855 | DOI:10.1016/j.cger.2023.09.007 {url} = URL to article

J Cosmet Dermatol. 2023 Nov 22. doi: 10.1111/jocd.16094. Online ahead of print. ABSTRACT BACKGROUND: The link between rosacea and various systemic conditions has been growing in prominence, even though the relationship between rosacea and cardiovascular disease remains a subject of debate in current research. AIMS: Detecting the connection between rosacea and subclinical atherosclerosis using laboratory and ultrasonographic parameters. METHODS: Fifty rosacea patients and 49 control were included in the study. Demographic, clinical, and laboratory data, including serum high sensitivity C-reactive protein (hs-CRP), fetuin-A (FA), and matrix gla protein levels were assessed. Carotid intima-media thickness (CIMT) was measured by carotid ultrasonography. RESULTS: Serum hs-CRP levels (p = 0.009) and mean CIMT (p = 0.001) were significantly higher, while serum FA levels were significantly lower (p < 0.001) in the rosacea patients compared with control. The number of patients with mean CIMT>75th percentile according to age and sex were significantly higher in the rosacea group (p = 0.001). Rosacea patients with ocular involvement exhibited significantly higher hs-CRP values in comparison to those without ocular involvement (p = 0.008). No significant correlation was detected between disease duration, severity, subtype and the study parameters. CONCLUSIONS: This study results suggest that rosacea poses an independent risk for subclinical atherosclerosis regardless of its severity, duration, or subtype. Therefore, individuals diagnosed with rosacea should receive careful evaluation and monitoring to detect possible cardiovascular complications promptly. Furthermore, our study hints at a potential elevated risk of subclinical inflammation in rosacea patients with ocular involvement, warranting additional attention and further investigation. PMID:37994275 | DOI:10.1111/jocd.16094 {url} = URL to article

Drugs Aging. 2023 Nov 22. doi: 10.1007/s40266-023-01079-5. Online ahead of print. ABSTRACT Though more common earlier in life, increasing attention is being focused on the development of cutaneous lupus erythematosus (CLE) in patients with advancing age. Studies show that CLE is more common in older populations than previously thought, and all CLE subtypes are possible in this group. Just like patients in the third or fourth decade of life, CLE may appear alongside or independent of systemic lupus erythematosus. Older populations manifesting CLE for the first time seem to have a lower risk of progression to systemic disease than younger peers, and are more commonly White. CLE must be carefully distinguished from other skin conditions that have a predilection for presentation in older populations, including rosacea, lichen planus, and other autoimmune conditions such as dermatomyositis or pemphigus/pemphigoid. It is thought that most CLE in older populations is drug-induced, with drug-induced subacute cutaneous lupus erythematosus being the most common subtype. Management of CLE in older patients focuses on eliminating unnecessary medications known to induce CLE, and otherwise treatment proceeds similarly to that in younger patients, with a few special considerations. PMID:37991658 | DOI:10.1007/s40266-023-01079-5 {url} = URL to article

Dermatol Pract Concept. 2023 Oct 1;13(4):e2023230. doi: 10.5826/dpc.1304a230. ABSTRACT INTRODUCTION: During the COVID-19 pandemic, personal protective equipment, particularly face masks, became an essential requirement to engage in various activities. Several articles reported an increase of recurrences of dermatologic facial diseases (ie, acne, rosacea) related to mask use. OBJECTIVES: To evaluate the number of recurrences of rosacea related to face mask use. METHODS: This prospective study was conducted on adult patients with a pre-pandemic diagnosis of mild and moderate papulopustular rosacea. All patients had previously achieved either partial or complete remission after a 4-month treatment with topical ivermectin in 2019. We collected data in two different phases characterized by different intensity of mask use during the pandemic and post-pandemic period. We collected data through clinical assessment of the disease, questionnaires on personal habits and standardized skin surface biopsy to study the Demodex mites count. RESULTS: We enrolled a total of 30 patients. In the pandemic period, 5/30 patients had a relapse of mild papulopustular rosacea; the Demodex sample resulted positive in 4/5 relapsed patients. In the post-pandemic period, 4/30 patients reported a relapse of mild rosacea (3 patients) and moderate papulopustular rosacea (1 patient). At the Demodex exam, 1/4 relapsed patients resulted positive. CONCLUSIONS: We did not find a significant increase in relapses of papulopustular rosacea during the pandemic. An appropriate anti-parasitic treatment may reduce the number of recurrences due to mask use. PMID:37992377 | PMC:PMC10656128 | DOI:10.5826/dpc.1304a230 {url} = URL to article

Adv Skin Wound Care. 2023 Dec 1;36(12):626-634. doi: 10.1097/ASW.0000000000000065. ABSTRACT GENERAL PURPOSE: To review the clinical presentation and treatment of rosacea. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After participating in this educational activity, the participant will:1. Distinguish the clinical manifestations of rosacea subtypes.2. Identify pharmacologic and nonpharmacologic treatment options for patients who have rosacea. PMID:37983575 | DOI:10.1097/ASW.0000000000000065 {url} = URL to article

Adv Skin Wound Care. 2023 Dec 1;36(12):1. doi: 10.1097/ASW.0000000000000073. NO ABSTRACT PMID:37983581 | DOI:10.1097/ASW.0000000000000073 {url} = URL to article

Mol Med Rep. 2024 Jan;29(1):4. doi: 10.3892/mmr.2023.13127. Epub 2023 Nov 17. ABSTRACT Following the publication of this paper, it was drawn to the Editor's attention by a concerned reader that the GAPDH control western blotting data shown in Fig. 4A were strikingly similar to data appearing in different form in another article written by different authors at different research institutes. Owing to the fact that the contentious data in the above article had already been published prior to its submission to Molecular Medicine Reports, the Editor has decided that this paper should be retracted from the Journal. The authors were asked for an explanation to account for these concerns, but the Editorial Office did not receive a reply. The Editor apologizes to the readership for any inconvenience caused. [Molecular Medicine Reports 17: 8385‑8390, 2018; DOI: 10.3892/mmr.2018.8887]. PMID:37975263 | DOI:10.3892/mmr.2023.13127 {url} = URL to article

Clin Cosmet Investig Dermatol. 2023 Nov 9;16:3221-3228. doi: 10.2147/CCID.S436368. eCollection 2023. ABSTRACT BACKGROUND AND AIM: Clinical manifestations of rosacea include transient or persistent facial erythema, telangiectasia, papules, and pustules. The existing assessment tools primarily evaluate the facial area to assess the severity of rosacea. However, in addition to the face, telangiectasia, erythema, and flushing can occur in the ear. Here, we investigated the correlation between the dermoscopic characteristics of capillaries in the earlobe and auricle and the types and severity of rosacea. MATERIALS AND METHODS: Experienced dermatologists evaluated the clinical type, medical history, severity, and distribution pattern of facial erythema. The clinical severity of rosacea was assessed using the standard grading system (SGS), clinician's erythema assessment (CEA), and investigator's global assessment (IGA). Relationships of the clinical types and severity with the dermoscopic characteristics of capillaries in the earlobe and auricle were further analyzed. RESULTS: In total, 145 patients with rosacea were enrolled in this study. We found that SGS, CEA, and IGA correlated well with the dermoscopic features of capillaries in the earlobe (R = 0.357, 0.357, and 0.314, respectively) (p < 0.001) and auricle (R = 0.423, 0.443, and 0.374, respectively) (p < 0.001). However, there was no significant correlation between the features and types of rosacea. CONCLUSION: The dermoscopic characteristics of capillaries in the earlobe and auricle can be used as indicators of the clinical severity of rosacea, regardless of the clinical subtype. PMID:37965100 | PMC:PMC10642572 | DOI:10.2147/CCID.S436368 {url} = URL to article

JMA J. 2023 Oct 16;6(4):448-454. doi: 10.31662/jmaj.2023-0100. Epub 2023 Sep 20. ABSTRACT INTRODUCTION: There remains to be lacking real-world evidence for the treatment of rosacea with a topical sulfur preparation (TSP) or topical metronidazole preparation (TMP) among Japanese patients. Therefore, in this study, we examined the effects of TSP and TMP on rosacea in Japanese patients in real-world clinical settings. METHODS: This retrospective observational analysis reviewed the medical records of 47 Japanese patients who were treated with TSP or TMP for more than 8 weeks in our clinic. Disease severity was evaluated using the Investigator Global Assessment (IGA) and the visual analog scale (VAS) for itching, burning sensation, flushing, and hypersensitivity before and 8 weeks after the initiation of the intervention. RESULTS: In total, 10 erythematotelangiectatic rosacea (ETR) and 12 papulopustular rosacea (PPR) patients treated with TSP and 12 ETR and 13 PPR patients treated with TMP were analyzed. IGA and VAS scores for itching, burning sensation, flushing, and hypersensitivity were noted to significantly improve in the ETR and PPR patient groups treated with TSP and both groups treated with TMP, except for the VAS score for itching in the TSP-treated ETR group. No significant differences were observed in terms of the improvement rates of IGA, VAS scores, or the prevalence of adverse events between the TSP- and TMP-treated groups. CONCLUSIONS: As per our findings, TSP and TMP have similarly favorable effects on both ETR and PPR in Japanese patients in real-world settings. PMID:37941711 | PMC:PMC10628168 | DOI:10.31662/jmaj.2023-0100 {url} = URL to article

J Cutan Med Surg. 2023 Nov 9:12034754231211340. doi: 10.1177/12034754231211340. Online ahead of print. NO ABSTRACT PMID:37942569 | DOI:10.1177/12034754231211340 {url} = URL to article

J Drugs Dermatol. 2023 Nov 1;22(11):1095-1098. doi: 10.36849/JDD.4920. ABSTRACT BACKGROUND: Erythematotelangiectatic rosacea can be successfully treated using various laser and light-based devices. However, the use of narrow-band intense pulsed light for the treatment of erythematotelangiectatic rosacea has not been investigated in detail. This retrospective study aimed to analyze the clinical efficacy of narrow-band intense pulsed light (500-600 nm) for the treatment of erythematotelangiectatic rosacea among Chinese individuals.&nbsp; Methods: Patients with erythematotelangiectatic rosacea who had completed 3 sessions of treatment with narrow-band intense pulsed light and follow-up from July 2016 to December 2018 were retrospectively evaluated. Clinical improvement was assessed by 2 blinded dermatologists based on photographs obtained at each follow-up visit using the clinician erythema assessment scale and 5-grade scale. RESULTS: Forty-five patients with erythematotelangiectatic rosacea treated with narrow-band intense pulsed light were included in this study. The effectiveness and excellent rates after 3 treatment sessions were 68.9% and 35.6%, respectively. An average of 2 treatment sessions was required among patients who achieved good or excellent clearance of erythema and telangiectasia. Except for transient erythema and edema, no severe adverse effects were observed. CONCLUSIONS: Narrow-band intense pulsed light is a safe and effective treatment for erythematotelangiectatic rosacea. Even with a small number of treatment sessions, narrow-band intense pulsed light can deliver a significant therapeutic effect, which may be applicable in clinical practice. J Drugs Dermatol. 2023;22(11):1095-1098&nbsp; &nbsp;&nbsp; doi:10.36849/JDD.4920. PMID:37943269 | DOI:10.36849/JDD.4920 {url} = URL to article

JMIR Dermatol. 2023 Nov 8;6:e47821. doi: 10.2196/47821. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin condition that predominantly manifests as facial flushing, irritation, and acne. Rosacea and cancer are thought to be linked by the commonality of inflammatory and immune response dysfunction. Studies that have looked into this possible association have reported mixed results. OBJECTIVE: Given the conflicting literature on this topic, our study sought to evaluate the overall association between rosacea and several cancers commonly investigated in the literature. METHODS: A systematic review was conducted using the Cochrane, PubMed, Embase, and Ovid databases. Studies were screened independently for inclusion of rosacea and glioma and breast, thyroid, hepatic, or skin cancers. Using information from the articles, rosacea and each cancer were categorized as having a positive, negative, or unclear association. RESULTS: Our systematic review included 39 full-text studies that investigated the association between rosacea and various malignancies. Among the malignancies of concern, 41% (16/39) of the studies reported an association with basal cell carcinoma, with 2 cohorts revealing an adjusted risk ratio (RR) of 1.50 (95% CI 1.35-1.67) and 0.72 (95% CI 0.56-0.93). In total, 33% (13/39) of the studies reported an association with squamous cell carcinoma, with 2 cohorts revealing an adjusted RR of 1.4 (95% CI 1.02-1.93) and 1.30 (95% CI 0.90-1.88). A total of 8% (3/39) of the studies reported an association between breast cancer and melanoma, with breast cancer cohorts revealing an adjusted RR of 8.453 (95% CI 1.638-43.606), 1.03 (95% CI 0.89-1.20), and 1.36 (95% CI 1.18-1.58) and melanoma cohorts revealing an adjusted RR of 1.10 (95% CI 0.95-1.27), 0.63 (95% CI 0.47-0.85), and 0.96 (95% CI 0.57-1.62). A total of 5% (2/39) of the studies reported an association among nonmelanoma skin cancers, hepatic cancer, and thyroid carcinomas, with nonmelanoma skin cancer cohorts revealing an adjusted RR of 1.36 (95% CI 1.26-1.47) and 2.66 (95% CI 1.53-4.61), hepatic cancer cohorts revealing an adjusted RR of 1.42 (95% CI 1.06-1.90) and 1.32 (95% CI 0.89-1.95), and thyroid carcinoma cohorts revealing an adjusted RR of 1.06 (95% CI 0.68-1.65) and 1.59 (95% CI 1.07-2.36). Only 1 cohort reported an association with glioma, revealing an adjusted RR of 1.36 (95% CI 1.18-1.58). According to our review, patients with rosacea were statistically more likely to have nonmelanoma skin cancers, breast cancer, and glioma. Rosacea was not found to be substantially associated with melanoma. The associations between rosacea and hepatic and thyroid cancers were unclear because of conflicting results. CONCLUSIONS: The current literature shows that rosacea is significantly associated with increased odds of nonmelanoma skin cancers, glioma, and breast cancer. Rosacea does not appear to be associated with melanoma. Further studies should be conducted to clarify the association between thyroid and hepatic cancers and rosacea. PMID:37938876 | DOI:10.2196/47821 {url} = URL to article

Clin Exp Dermatol. 2023 Nov 3:llad366. doi: 10.1093/ced/llad366. Online ahead of print. ABSTRACT Red scalp is a common complaint which may constitute a diagnostic and therapeutic challenge in daily clinical practice. Among the numerous diseases which cause diffuse scalp erythema are psoriasis, seborrheic dermatitis, contact dermatitis, diffuse lichen planopilaris, dermatomyositis and scalp rosacea. Accurate diagnosis is crucial for optimal treatment outcomes. Histology most frequently discriminates the underlying condition, but it requires scalp biopsy. In many cases the combination of clinical examination and trichoscopy is sufficient for establishing the correct diagnosis. The main trichoscopic features of psoriasis are silver-white scaling, regular distributed dotted (glomerular) vessels or twisted red loops and punctate hemorrhages. Yellowish-white scaling and thin arborizing vessels are typical features of seborrheic dermatitis. Contact dermatitis is characterized by the presence of yellow exudate and polymorphic vessels, while perifollicular scaling and erythema with the lack of follicular openings are typical findings in lichen planopilaris. In scalp dermatomyositis, tortuous and arborizing vessels with interfollicular and perifollicular pigmentation may be detected. The most characteristic features of scalp rosacea are perifollicular scaling and arborizing vessels. This review also summarizes histologic features and therapeutic options for these conditions. PMID:37935061 | DOI:10.1093/ced/llad366 {url} = URL to article

Photodiagnosis Photodyn Ther. 2023 Nov 5:103871. doi: 10.1016/j.pdpdt.2023.103871. Online ahead of print. ABSTRACT Rosacea is a chronic and inflammatory skin condition, with relapses being a common characteristic. Its treatments are based on cosmetics, drugs, and the application of procedures based on high-powered light. Photodynamic Cosmetic Therapy (PCT) combines light, a photosensitizer (PS), and molecular oxygen present in tissues, generating photochemical reactions capable of causing tissue and vascular destruction, stimulating tissue repair. We report a case with an adverse effect caused by applying PCT, using 2% 5-aminolevulinic acid (ALA 2%), and irradiated with amber LED light associated with infrared radiation for the control of rosacea. A patient with subtype II rosacea underwent PCT treatment of 3 sessions at 21-day intervals, being evaluated using photographic images and Wood's lamp. In the first session of the therapy, an exacerbated inflammatory process was observed. Such an adverse event is estimated to be as a result of the patient using ointment containing corticosteroids for a short period. With the use of medications, it was possible to recover the appearance of the skin thoroughly, and after 21 days, the treatment sessions were performed again. Despite the complication that affected the patient in this study, positive effects were found after the pharmacological therapeutic measures were adopted. PMID:37935343 | DOI:10.1016/j.pdpdt.2023.103871 {url} = URL to article

Int J Womens Dermatol. 2023 Nov 3;9(4):e113. doi: 10.1097/JW9.0000000000000113. eCollection 2023 Dec. NO ABSTRACT PMID:37927369 | PMC:PMC10617829 | DOI:10.1097/JW9.0000000000000113 {url} = URL to article

Int J Biol Sci. 2023 Oct 2;19(16):5160-5173. doi: 10.7150/ijbs.86207. eCollection 2023. ABSTRACT Rosacea is a common inflammatory skin disorder mediated by the dysregulation of both keratinocytes and T cells. Here, we report that aquaporin 3 (AQP3), a channel protein that mediates the transport of water/glycerol, was highly expressed in the epidermis and CD4+ T cells of both rosacea patients and experimental mice. Specifically, AQP3 deletion blocked the development of rosacea-like skin inflammation in model mice with LL37-induced rosacea-like disease. We also present mechanistic evidence showing that AQP3 was essential to the activation of NF-κB signaling and subsequent production of disease-characteristic chemokines in keratinocytes. Moreover, we show that AQP3 was upregulated during T cell differentiation and promotes helper T (Th) 17 differentiation possibly via the activation of STAT3 signaling. Our findings reveal that AQP3-mediated activation of NF-κB in keratinocytes and activation of STAT3 in CD4+ T cells acted synergistically and contributed to the inflammation in rosacea. PMID:37928265 | PMC:PMC10620828 | DOI:10.7150/ijbs.86207 {url} = URL to article

BMC Psychiatry. 2023 Nov 3;23(1):802. doi: 10.1186/s12888-023-05321-7. ABSTRACT THE AIM: was to assess the level of subjective control of emotional states among patients treated for dermatological and gastrointestinal somatic diseases compared to those with depressive and anxiety disorders. The results were related to the analyzed dimensions of emotion regulation in healthy subjects. MATERIALS AND METHODS: The reports of the conducted studies were compiled for a total of 310 people, including 120 patients diagnosed with a somatic disease (psoriasis, rosacea, irritable bowel syndrome, and gastroesophageal reflux), as well as 96 patients diagnosed with depressive disorders and 30 patients with anxiety disorders. The control group consisted of healthy subjects (64 individuals). To assess the psychological variables analyzed, the subjects completed the Emotion Regulation Questionnaire developed by J. Brzeziński. RESULTS: The study showed that the patients suffering from a chronic somatic symptom disorder, similarly to those treated for depression and anxiety disorders, differed from the healthy individuals in most aspects of emotional control. The patients with dermatological and gastrointestinal diseases differed statistically significantly from the patients with depression and the patients with anxiety disorders in relation to three dimensions of emotional control. Patients with a somatic disease are characterized by higher emotional and rational motivation, lower emotional resilience and lower emotional arousal. CONCLUSIONS: A chronic disease co-occurs with the emotional sphere of a person's daily functioning. Regardless of the diagnosis in terms of somatic disorders and mental illnesses, the way in which emotional states are controlled can be an important factor in the onset of the disease, coping with it as well as the treatment process. PMID:37924065 | DOI:10.1186/s12888-023-05321-7 {url} = URL to article

Eur J Ophthalmol. 2023 Nov 1:11206721231212087. doi: 10.1177/11206721231212087. Online ahead of print. ABSTRACT PURPOSE: To report a rare case of a 19-year-old girl who presented with spontaneous bilateral corneal perforation in a setting of ocular rosacea. METHODS: Ocular rosacea was diagnosed and treated with doxycycline. Cyanoacrylate glue was applied to treat corneal perforations. RESULTS: At six months follow up there is good healing, visual acuity has improved, anterior chamber is deep with no Seidel. CONCLUSIONS: Rosacea is a multifactorial disease with an unclear pathophysiology. The ocular manifestations of rosacea (ocular rosacea) may occur without skin involvement, are not specific and can range from mild blepharitis to sight-threatening conditions. This case shows how ocular rosacea can lead to serious vision-threatening complications with mild symptoms. Cyanoacrylate glue and systemic antibiotic treatment are effective treatments. PMID:37915114 | DOI:10.1177/11206721231212087 {url} = URL to article

J Clin Aesthet Dermatol. 2023 Oct;16(10):22-30. ABSTRACT BACKGROUND: Morbihan's disease (MD), also known as solid persistent facial edema, solid facial lymphedema or rosacea lymphedema, is a rare condition. OBJECTIVE: Despite existing case reports and literature reviews, clinical guidance for diagnosis and management is lacking. This review aims to provide comprehensive information on the etiology, differential diagnoses, diagnostics, and management of MD. METHODS: PubMed was searched up to April 2023 for relevant studies on MD with no language restriction. Furthermore, references were checked of found reports. RESULTS: A comprehensive overview of the literature and clinical guidance for MD. We found 95 studies involving 166 patients (118 male, 46 female and 2 gender unreported) evaluating management options, categorized into: isotretinoin (16 studies), isotretinoin plus antihistamines (8), isotretinoin plus corticosteroids (8), antibiotics (13), antibiotics plus corticosteroids (7), surgical debulking (10) and miscellaneous/combination treatments (43). Some studies contributed to two categories. Treatment with isotretinoin as monotherapy or combined with antihistamines, doxycycline or minocycline as well as surgical procedures demonstrated mostly satisfactory results, although recurrences were common. Longer treatment duration, of at least 6 to 12 months, is recommended for pharmacological treatments. Adding systemic or intralesional corticosteroids to previous treatments may be beneficial. Manual lymph drainage seems to contribute to satisfying result. LIMITATIONS: This is not a systematic review and randomized controlled trials are lacking. CONCLUSION: Diagnosis of MD is based on specific clinical features and excluding diseases with similar appearance. Prolonged treatment is often necessary to obtain satisfactory results, which might be limited to a partial and/or temporary response. PMID:37915334 | PMC:PMC10617896 {url} = URL to article

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Psoriasis (Auckl). 2023 Oct 26;13:71-78. doi: 10.2147/PTT.S328439. eCollection 2023. ABSTRACT The skin microbiome is made of various microorganisms, most of which have the function of protecting individuals from harmful pathogens, and they are involved in innate and adaptive immune responses. The skin acts as a physical and immunological barrier against external stimuli, including pathogens and physical damage. Changes in the composition of the skin microbiome can trigger inflammatory processes leading to inflammatory skin diseases in susceptible individuals. Psoriasis (PsO) is a chronic inflammatory disease with a multifactorial etiology, where breakdown of immune tolerance to cutaneous microorganisms is implicated in its pathogenesis. Dysregulation of the microbiome due to genetic and environmental factors plays a significant role in the development of psoriatic disease. Dermatologic conditions such as atopic dermatitis, acne, psoriasis, and rosacea have been associated with intestinal dysbiosis. The skin microbiota composition is crucial for the development of appropriate immune responses, and alterations in the skin microbiome can contribute to changes in physiology and susceptibility to skin diseases or inflammatory conditions. Understanding the microbial settlement of the skin and the network of interactions that occur throughout life is essential for comprehending the pathogenesis of skin diseases and developing innovative treatments. With this article we tried to explore the relationship between the human microbiome and psoriatic disease, shedding light on the functions of the microbiome and the inflammatory disease processes to identify additional therapeutic targets. This review aims to highlight the relationship between skin and gut microbiome functions and inflammatory processes in skin psoriasis and psoriatic arthritis (PsA). The goal is to facilitate future studies on the skin microbiome to identify potential novel therapies for patients with psoriatic disease. PMID:37908308 | PMC:PMC10614657 | DOI:10.2147/PTT.S328439 {url} = URL to article

Exp Dermatol. 2023 Nov 1. doi: 10.1111/exd.14971. Online ahead of print. ABSTRACT Atopic dermatitis (AD) is a chronic, recurrent eczematous disorder with a complex pathophysiology caused by skin barrier abnormalities. Rosacea is a common chronic immune-mediated inflammatory disorder that results in diminished skin barrier function. Reflectance confocal microscopy (RCM) is a non-invasive method for visualizing the dynamic status of epidermal and upper dermal structures. In this study, we compared skin barrier permeability among normal, AD and rosacea groups. To assess skin barrier permeability, zinc was applied to lesional skin and the RCM reflectance intensity of zinc penetration was measured. Reflectance confocal microscopy revealed that the intensity in patients with rosacea and AD was higher than that in the normal group at depths of 8-24 μm in both the face and forearm, which were considered as the stratum corneum (SC) and tight junction (TJ) level (p < 0.0001). When comparing AD and rosacea, the intensity of rosacea was higher than that of AD at a depth of 8 μm in the face (p < 0.0001). The intensity of AD was higher than that of rosacea at a depth of 24 μm (p = 0.009). This suggests that skin barrier permeability is increased in the upper epidermis of patients with AD and rosacea. On the face, patients with rosacea had more SC weakness than did those with AD, whereas patients with AD had more TJ weakness than those with rosacea. PMID:37909707 | DOI:10.1111/exd.14971 {url} = URL to article

J Dermatol. 2023 Oct 31. doi: 10.1111/1346-8138.17012. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory skin disorder linked to various mental disorders, but little is known about the impact of rosacea on sleep disorders. The aim of this study is to confirm the association of rosacea with sleep disorders using a large administrative data set. This nationwide population-based retrospective cohort study enrolled 1129 individuals with rosacea and 11 017 age- and sex-matched controls without rosacea from the Korean National Health Insurance System database from 2002 to 2015. The prevalence of sleep disorder (7.8%) was significantly higher in patients with rosacea than in controls (5.81%; p < 0.001). Rosacea was associated with an increased risk of sleep disorder (adjusted odds ratio [aOR], 1.287 [95% confidence interval (CI), 1.022-1.623]). Among a variety of sleep disorders, patients with rosacea were likely to have an increased risk of insomnia (aOR, 1.318 [95% CI, 1.002-1.743]). In subgroup analysis, female patients with rosacea (aOR, 1.297 [95% CI, 1.010-1.722]) and those with rosacea and dyslipidemia (aOR, 1.417 [95% CI, 1.062-1.891]) were at a higher risk of having a sleep disorder. Rosacea is associated with an increased risk of having sleep disorders. The management of modifiable risk factors is important for managing sleep disorders in patients with rosacea. PMID:37905567 | DOI:10.1111/1346-8138.17012 {url} = URL to article

J Eur Acad Dermatol Venereol. 2023 Oct 31. doi: 10.1111/jdv.19591. Online ahead of print. NO ABSTRACT PMID:37907276 | DOI:10.1111/jdv.19591 {url} = URL to article

Case Rep Dermatol. 2023 Sep 6;15(1):152-155. doi: 10.1159/000533516. eCollection 2023 Jan-Dec. ABSTRACT Primary cutaneous marginal zone lymphoma (PCMZL) is a rare form of B-cell lymphoma that primarily affects the skin. Chronic antigen stimulation has been implicated in its development, with cases associated with various triggers. We present a case of PCMZL following chronic inflammation caused by long-term hair dyeing. A 75-year-old woman with a history of repeated inflammation and itching after hair dyeing for 30 years presented with persistent red-to-violaceous patches and plaques on her scalp. Despite receiving topical corticosteroid treatment for 10 years, the lesions remained. Pathological examinations confirmed the diagnosis of PCMZL. The patient achieved complete remission after radiotherapy. This case underscores the potential link between chronic inflammation and the development of PCMZL. PMID:37899942 | PMC:PMC10601760 | DOI:10.1159/000533516 {url} = URL to article

J Cutan Med Surg. 2023 Oct 29:12034754231204295. doi: 10.1177/12034754231204295. Online ahead of print. ABSTRACT Psychodermatology pertains to the relationship between the skin and brain. This review aims to summarize the evidence of the mind body connection in four psychophysiological conditions: rosacea, atopic dermatitis (AD), acne vulgaris (AV), and psoriasis. A literature search was conducted using several English language databases. All four conditions share similar psychiatric co-morbidities, including but not limited to anxiety, depression, and suicidality. In rosacea, the upregulation of transient receptor potential vanilloid type 1, Toll like receptor 2, and Th17 cells releases downstream products that are simultaneously implicated in mood disorders. Stress exacerbates AV through the hypothalamic-pituitary-adrenal (HPA) system, which alters functioning of sebocytes and Cutibacterium acnes. In AD and psoriasis, the HPA axis influences Th1, Th2, Th22, and Th1, Th17 immune mediated responses, respectively. This leads to the secretion of pro-inflammatory cytokines which are also involved in the pathogenesis of anxiety and depression. Neurotransmitters implicated in mental illness, such as gamma-aminobutyric acid and serotonin, may also play a role in the development of AD and psoriasis. The management of cutaneous disease may mitigate psychological distress, and future research may show the corollary to also be true. PMID:37898903 | DOI:10.1177/12034754231204295 {url} = URL to article

Photodermatol Photoimmunol Photomed. 2023 Oct 29. doi: 10.1111/phpp.12922. Online ahead of print. ABSTRACT BACKGROUND: Differences in clinical efficacy based on the fluence of fractional picosecond laser treatment for acne scars are unknown. OBJECTIVE: To compare the efficacy and safety of low-fluence versus high-fluence fractional picosecond Nd:YAG 1064-nm laser treatment in acne scar patients. METHODS: In this 12-week, investigator-blinded, randomized, split-face study, 25 patients with moderate-to-severe acne scars received three sessions of high-fluence laser treatment (1.0 J/cm2 ) on one side of their face and low-fluence (0.3 J/cm2 ) on the other side every 4 weeks. Patients were assessed using acne scar counts, the scar global assessment (SGA), and the ECCA scar grading scale every 4 weeks. The histological analysis compared the acne scars obtained before and 4 weeks after treatment. RESULTS: At their last visit, 88.00% and 92.00% of the subjects achieved > 30% reduction in scar counts on the low- and high-fluence sides, respectively, without a significant difference between the two sides. On both sides, the scar counts, SGA, and ECCA score significantly improved 4 weeks after the last treatment. Although the high-fluence side showed a greater reduction in scar counts (-66.73%) than the low-fluence side (-62.13%), the two sides had no significant difference in the grading scores. The high-fluence side showed significantly more severe pain and higher side-effect scores immediately and 4 weeks after treatment. Histological analysis revealed a significantly increased collagen, elastin, and vimentin expression after treatment on the low-fluence side. CONCLUSIONS: The low-fluence setting demonstrated comparable efficacy and superior safety in treating acne scars compared with the high-fluence setting. PMID:37898983 | DOI:10.1111/phpp.12922 {url} = URL to article

Nutrients. 2023 Oct 17;15(20):4405. doi: 10.3390/nu15204405. ABSTRACT As the relationship between exposome factors and inflammatory skin diseases is gaining increasing attention, the objective of this study was to investigate dietary patterns among acne and rosacea patients and to establish the disease risk attributable to nutrition. In this cross-sectional, controlled study, patients' dietary habits were assessed via subjective ratings of beneficial and trigger foods, followed by standardized food frequency surveys (FFS). Scores for disease-specific risk stratification based on dietary habits were proposed. Clinical assessments, dermatologic examinations, and laboratory analyses were performed. A total of 296 patients (acne group (AG) n = 120, control group (ACG) n = 32; rosacea group (RG) n = 105, control group (RCG) n = 39) were included. The significant impact of diet on disease severity was self-reported by 80.8% of the AG and 70.5% of the RG. Leading dietary triggers were found in both groups, while beneficial food items were identified more clearly by the AG. FFS revealed significant dietary differences between the AG, RG, and control groups. Disease-specific scores showed greater precision for acne (odds ratio 14.5 AG, 5.5 RG). The AG had higher insulin-like growth factor (IGF)-1 levels correlating with dairy intake (p = 0.006). Overall, this study underlines the influence of diet on acne and rosacea, providing valuable disease-specific scores for dietary risk stratification. Consuming vegetables, legumes, oily fish, olive oil, and nuts, and limiting meat, cheese, and alcohol appear to be beneficial for both acne and rosacea. Future studies can build on these data to further improve preventive and therapeutic strategies. PMID:37892480 | DOI:10.3390/nu15204405 {url} = URL to article

Microorganisms. 2023 Oct 19;11(10):2586. doi: 10.3390/microorganisms11102586. ABSTRACT Emerging research underscores the substantial link between gut flora and various inflammatory skin diseases. We hypothesize that there exists a complex gut-skin axis, possibly affecting the progression of conditions such as eczema, acne, psoriasis, and rosacea. However, the precise nature of the causal connection between gut flora and skin diseases remains unestablished. In this study, we started by compiling summary data from genome-wide association studies (GWAS) featuring 211 unique gut microbiota and four types of skin conditions. We scrutinized these data across different taxonomic strata. Subsequently, we leveraged Mendelian randomization (MR) to ascertain if there is a causal link between gut microbiota and these skin conditions. We also performed a bidirectional MR analysis to identify the causality's direction. By utilizing Mendelian randomization, we identified 26 causal connections between the gut microbiome and four recognized inflammatory skin conditions, including 9 positive and 17 negative causal directions. Additional sensitivity analyses of these results revealed no evidence of pleiotropy or heterogeneity. Our MR analysis suggests a causal connection between gut microbiota and skin diseases, potentially providing groundbreaking perspectives for future mechanistic and clinical studies on microbiota-affected skin conditions. PMID:37894244 | DOI:10.3390/microorganisms11102586 {url} = URL to article

Photodermatol Photoimmunol Photomed. 2023 Oct 27. doi: 10.1111/phpp.12921. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic skin disorder characterised by abnormal neurovasculature and inflammation in the central region of the face. The efficacy of pulsed-dye laser and intense pulsed light treatments for rosacea have been demonstrated in several clinical trials. However, there is currently no research on the efficacy of long-pulsed alexandrite laser (LPAL) therapy alone for rosacea-related facial redness and its effect on skin microbiota. AIM: To evaluate the efficacy of LPAL therapy on facial redness in rosacea and assess changes in skin microbiota composition. METHODS: Subjects with rosacea (n=21, mean age: 39.2±11.3 years) were recruited from two medical institutions and received monthly LPAL treatments (Clarity II™, Lutronic Corp.) for 3 months. At each visit, clinical photographs were taken, and erythema was measured using a spectrometer. At the initial and final visits, the Dermatology Life Quality Index (DLQI) and Skin Sensitivity Questionnaire (SSQ) were evaluated. Skin swabs were obtained at the initial and final visit, and facial microbiome composition was analysed using 16s rRNA amplicon sequencing. RESULTS: After three LPAL treatment sessions, the average facial erythema index, measured using Mexameter® decreased significantly from 360.0 ± 96.7 at baseline to 312.0 ± 94.5 at the final visit (p <0.05). The DLQI and SSQ showed significant improvement of symptoms. Skin microbiome diversity and relative abundance were altered significantly, particularly in the genera Clostridium, Lawsonella, Bacteroides, and Lactobacillus. CONCLUSIONS: LPAL therapy alone showed favourable efficacy for the treatment of facial redness in rosacea, with some impacts on the skin microbiota composition. PMID:37890996 | DOI:10.1111/phpp.12921 {url} = URL to article

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Clin Cosmet Investig Dermatol. 2023 Oct 17;16:2893-2897. doi: 10.2147/CCID.S429480. eCollection 2023. ABSTRACT BACKGROUND: Cutaneous metastasis is rare in clinical practice, especially that from primary hepatocellular carcinoma (HCC), which is even rarer. CASE PRESENTATION: This report describes a male patient with HCC with cutaneous metastases to the nasal tip. The patient developed a raised nodule at the nasal tip 5 years after surgery for HCC, with surface ulceration and crusting and no obvious symptoms. Abdominal computed tomography (CT) showed an obvious mass in the liver. The skin lesions on the nasal tip were confirmed to be cutaneous metastasis of HCC by histopathological and immunohistochemical examinations. CONCLUSION: The incidence of cutaneous metastasis of HCC is extremely low, and nasal tip cutaneous metastasis of HCC has no specific clinical manifestations; therefore, it needs to be distinguished from rosacea rhinophyma, fungal and atypical mycobacterial infections, tumours of vascular origin, and tumours of skin appendages that occur in the nasal tip and is prone to misdiagnosis and missed diagnosis, thus requiring clinical dermatologists and otolaryngologists to be aware of such metastasis. PMID:37869532 | PMC:PMC10590066 | DOI:10.2147/CCID.S429480 {url} = URL to article

J Cosmet Dermatol. 2023 Oct 21. doi: 10.1111/jocd.16041. Online ahead of print. ABSTRACT OBJECTIVE: This study aims at investigating the difference in facial skin barrier function between rosacea patients and the healthy population of different ages in the Qinghai region and its correlation with age, providing a basis for clinical nursing and treatment. METHODS: The data of 216 rosacea patients were collected, and 211 healthy testers were selected as the control group. The skin barrier characteristics of rosacea patients of different ages were evaluated by comparing transepidermal water loss (TEWL), stratum corneum hydration (SCH), sebum content (SC), and pH values between the two groups. Then, the correlation between skin barrier function and age in rosacea patients and the healthy population was analyzed. RESULTS: In all four age groups, the TEWL of the rosacea group was higher than that of the healthy control group, and the epidermal hydration was lower than the healthy control group. In the population aged over 40, the sebum content in rosacea was lower than that in the healthy control group. In the age group of 40-59, the pH value of the rosacea group was higher than the healthy control group. In both the rosacea and the control groups, TEWL was positively correlated with age, and epidermal hydration was negatively correlated with age. The sebum content in rosacea group was negatively correlated with age (p < 0.05). CONCLUSION: As age increases, the facial epidermal function of both rosacea patients and the healthy population declines. Therefore, with increasing age, attention should be paid to enhance the epidermal function to slow down the skin aging process. PMID:37864385 | DOI:10.1111/jocd.16041 {url} = URL to article

Clin Cosmet Investig Dermatol. 2023 Oct 13;16:2855-2862. doi: 10.2147/CCID.S429099. eCollection 2023. ABSTRACT INTRODUCTION: The pathogenesis of COVID-19 includes systemic immune activation and endothelial dysfunction, which is closely related to the pathogenesis of rosacea. In order to investigate the influence of COVID-19 infection on the condition of rosacea patients, we retrospectively investigated the impact of COVID-19 infection and COVID-19-related masks on rosacea patients. METHODS: We collected the basic information from rosacea patients who had a long-term follow-up at West China Hospital of Sichuan University. Between January 2023 and March 2023, we recruited 87 rosacea patients for this survey. RESULTS: Our results showed that COVID-19 infection could aggravate the condition of rosacea patients, and the change in the symptoms was not related to fever, temperature, antipyretics use, and vaccination. In addition, we observed a significant association between the type of mask worn by rosacea patients and exacerbation, while the duration of mask usage did not exhibit a similar relationship. DISCUSSION: Considering the ongoing global utilization of masks due to the COVID-19 pandemic and the possible recurrence of COVID-19 infection, dermatologists should monitor the condition of rosacea patients infected with COVID-19 and adjust the treatment regimens accordingly. PMID:37854545 | PMC:PMC10581019 | DOI:10.2147/CCID.S429099 {url} = URL to article

Dermatology. 2023 Oct 17. doi: 10.1159/000534245. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory dermatological condition in humans, and its pathogenesis remains unclear. However, the development of rosacea is suspected to be related to Demodex, a microscopic commensal organism that resides in or near hair follicles and sebaceous glands. Although Demodex is known to be a host-specific, obligate commensal organism, it is currently difficult to be cultured in vitro to parasitize and infect other animal hosts. Therefore, direct evidence for a pathogenic role of Demodex in rosacea is currently lacking. SUMMARY: As circumstantial evidence, non-invasive skin-detecting techniques have shown abnormally elevated numbers of Demodex in rosacea patients. Increased cytokine levels such as IL-10, IL-8, and IL-12p70 have been observed in human sebocytes following Demodex challenge, and acaricides have been found to be effective in rosacea therapy, all point to a close relationship between Demodex and rosacea. Based on these findings, we conducted a comprehensive literature review to summarize the current state of knowledge, research insights, and clinical treatment recommendations for Demodex-associated rosacea, with the ultimate goal of improving patient outcomes. KEY MESSAGES: Rosacea appears to have a close bond with Demodex. Recent studies have implicated that Demodex mites are involved in the development of rosacea. Based on a comprehensive review of the current literature, we have cited substantial evidence supporting this relationship, proposed a possible vicious cycle between Demodex and rosacea, and illustrated the changes in immune responses during this process. In addition, we recommend that patients with both rosacea and Demodex infection be treated early with a combination of topical ivermectin and topical Th1 inhibitors to improve treatment outcomes. PMID:37848012 | DOI:10.1159/000534245 {url} = URL to article

Invest Ophthalmol Vis Sci. 2023 Oct 3;64(13):22. doi: 10.1167/iovs.64.13.22. ABSTRACT PURPOSE: To investigate oxidative stress markers in tears and serum of patients with ocular rosacea and to examine their association with both ocular surface parameters and cutaneous rosacea subtypes. METHODS: This prospective study includes rosacea patients with ocular involvement and healthy controls. We performed ophthalmological examination of all participants and collected tear breakup time (TBUT), Schirmer, Meibomian gland dysfunction (MGD) and Ocular Surface Disease Index (OSDI) scores. We quantified the total antioxidant status (TAS), total oxidant status (TOS), and arylesterase (ARE) levels from tear and serum samples, and calculated the oxidative stress index (OSI). We also classified patients into phymatous, erythematotelangiectatic, papulopustular subtypes. RESULTS: We included 90 ocular rosacea patients and 30 healthy controls. Oxidative stress (TOS, OSI) levels were significantly higher (P < 0.01) and antioxidant levels (TAS, ARE) were significantly lower (P < 0.01) in both tear and serum samples of ocular rosacea patients as compared to controls. We found a significant positive correlation between the tear and serum values regarding oxidative stress parameters (P < 0.05). Besides, OSI was negatively correlated with TBUT and positively correlated with MGD score (meiboscore) and OSDI (P < 0.05). The Schirmer score was not correlated with OSI. No difference was found between the cutaneous subtypes with respect to TAS, TOS, ARE, and OSI results. CONCLUSIONS: In this study, we identified oxidative stress markers in the serum and tears of ocular rosacea patients and showed their correlation with clinical signs of MGD, suggesting that oxidative stress contributes to ocular rosacea pathogenesis and that oxidative stress could be an indicator of MGD severity. PMID:37843493 | PMC:PMC10584021 | DOI:10.1167/iovs.64.13.22 {url} = URL to article

Int J Dermatol. 2023 Oct 12. doi: 10.1111/ijd.16881. Online ahead of print. NO ABSTRACT PMID:37828794 | DOI:10.1111/ijd.16881 {url} = URL to article

Front Immunol. 2023 Sep 27;14:1231848. doi: 10.3389/fimmu.2023.1231848. eCollection 2023. ABSTRACT BACKGROUND: Observational studies have shown that gut microbiota is closely associated with inflammatory dermatoses such as psoriasis, rosacea, and atopic dermatitis (AD). However, the causal relationship between gut microbiota and inflammatory dermatosis remains unclear. METHODS: Based on Maximum Likelihood (ML), MR-Egger regression, Inverse Variance Weighted (IVW), MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO), Weighted Mode, and Weighted Median Estimator (WME) methods, we performed a bidirectional two-sample Mendelian randomization (MR) analysis to explore the causal relationship between gut microbiota and inflammatory dermatosis. The genome-wide association study (GWAS) summary data of gut microbiota came from the MiBioGen consortium, while the GWAS summary data of inflammatory dermatosis (including psoriasis, AD, rosacea, vitiligo, acne, and eczema) came from the FinnGen consortium and IEU Open GWAS project. Cochran's IVW Q test tested the heterogeneity among instrumental variables (IVs). The horizontal pleiotropy was tested by MR-Egger regression intercept analysis and MR-PRESSO analysis. RESULTS: Eventually, the results indicated that 5, 16, 17, 11, 15, and 12 gut microbiota had significant causal effects on psoriasis, rosacea, AD, vitiligo, acne, and eczema, respectively, including 42 protective and 34 risk causal relationships. Especially, Lactobacilli and Bifidobacteria at the Family and Genus Level, as common probiotics, were identified as protective factors for the corresponding inflammatory dermatoses. The results of reverse MR analysis suggested a bidirectional causal effect between AD and genus Eubacterium brachy group, vitiligo and genus Ruminococcaceae UCG004. The causal relationship between gut microbiota and psoriasis, rosacea, acne, and eczema is unidirectional. There was no significant heterogeneity among these IVs. In conclusion, this bidirectional two-sample MR study identified 76 causal relationships between the gut microbiome and six inflammatory dermatoses, which may be helpful for the clinical prevention and treatment of inflammatory dermatoses. PMID:37828993 | PMC:PMC10565349 | DOI:10.3389/fimmu.2023.1231848 {url} = URL to article

JAAD Int. 2023 Jul 30;13:172-178. doi: 10.1016/j.jdin.2023.07.012. eCollection 2023 Dec. ABSTRACT BACKGROUND: Many patients with rosacea join online support groups to gather and disseminate information about disease management and provide emotional support for others. OBJECTIVE: To better understand rosacea patient's primary concerns for the disease as well as their disease search patterns online. METHODS: Overall, 207,038 posts by 41,400 users were collected from June 1, 2017, to June 1, 2022, in a popular online forum. We applied Latent Dirichlet Allocation (LDA), an unsupervised machine learning model, to organize the posts into topics. Keywords for each topic supplied by LDA were used to manually assign topic and category labels. RESULTS: Twenty-three significant topics of conversation were identified and organized into 4 major categories, including Management (50.33%), Clinical Presentation (24.14%), Emotion (21.97%), and Information Appraisal (3.57%). LIMITATIONS: Although we analyzed the largest forum on the internet for rosacea, generalizability is limited given the presence of other smaller forums and the skewed demographics of forum users. CONCLUSION: Social media forums play an important role for disease discussion and emotional venting. Although rosacea management was the most frequently discussed topic, emotional posting was a significantly prevalent occurrence. PMID:37823041 | PMC:PMC10562143 | DOI:10.1016/j.jdin.2023.07.012 {url} = URL to article

Eur J Dermatol. 2023 Aug 1;33(4):419-425. doi: 10.1684/ejd.2023.4534. ABSTRACT BACKGROUND: Therapeutic make-up has previously been proven to be efficacious in improving the quality of life of patients with facial dermatoses, but its efficacy has only been assessed in the short term (less than one month). OBJECTIVES: This study aimed to determine whether the effect of therapeutic make-up on patients' quality of life persists in the longer term, i.e., after one year. MATERIALS & METHODS: This study included 53 patients who benefited from a therapeutic make-up consultation in the context of various facial dermatoses (pigmentation disorders, scars, acne, rosacea, eczema, adverse events of chemotherapy, etc.). Patients were asked to complete a quality-of-life questionnaire to obtain the Skindex score at baseline, and one month (M1) and one year (M12) after the first consultation. The difference in scores between baseline and M12 was calculated and Student's t-test was used to assess the significance of the values. RESULTS: Our results showed a significant difference (p<0.001) with an improvement in quality-of-life score by more than 10% between baseline and M12, for all the dimensions of the score (Emotion, Symptoms and Functioning). Based on the subgroup analysis, this score particularly improved for patients suffering with acne or rosacea (p=0.009) and scars (p=0.43), as well as for younger patients (<30 years old) (p=0.009). CONCLUSION: This is the first study to demonstrate a persistent long-term effect of therapeutic make-up on the quality of life of patients with facial dermatoses. PMID:37823493 | DOI:10.1684/ejd.2023.4534 {url} = URL to article