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    • Antibiotics (Basel). 2024 Mar 17;13(3):270. doi: 10.3390/antibiotics13030270. ABSTRACT Clindamycin is a highly effective antibiotic of the lincosamide class. It has been widely used for decades to treat a range of skin and soft tissue infections in dermatology and medicine. Clindamycin is commonly prescribed for acne vulgaris, with current practice standards utilizing fixed-combination topicals containing clindamycin that prevent Cutibacterium acnes growth and reduce inflammation associated with acne lesion formation. Certain clinical presentations of folliculitis, rosacea, staphylococcal infections, and hidradenitis suppurativa are also responsive to clindamycin, demonstrating its suitability and versatility as a treatment option. This review describes the use of clindamycin in dermatological practice, the mechanism of protein synthesis inhibition by clindamycin at the level of the bacterial ribosome, and clindamycin's anti-inflammatory properties with a focus on its ability to ameliorate inflammation in acne. A comparison of the dermatologic indications for similarly utilized antibiotics, like the tetracycline class antibiotics, is also presented. Finally, this review addresses both the trends and mechanisms for clindamycin and antibiotic resistance, as well as the current clinical evidence in support of the continued, targeted use of clindamycin in dermatology. PMID:38534705 | DOI:10.3390/antibiotics13030270 {url} = URL to article
    • Rev Soc Bras Med Trop. 2024 Mar 25;57:e008042024. doi: 10.1590/0037-8682-0605-2023. eCollection 2024. ABSTRACT Cutaneous involvement in paracoccidioidomycosis (PCM) can exhibit a highly polymorphic spectrum. The infiltrative pattern corresponds to up to 26.6% of observed skin lesions, including sarcoid-like plaques, a rare presentation of cutaneous lesions in PCM. This clinical expression is almost exclusively cutaneous, and its histology reveals a tuberculoid granuloma with a scarcity of fungi, leading to misdiagnosis as other granulomatous diseases. Here, we report a rare form of chronic multifocal paracoccidioidomycosis manifesting as sarcoid-like skin lesions misdiagnosed as granulomatous rosacea in a patient with severe systemic disease. PMID:38537002 | DOI:10.1590/0037-8682-0605-2023 {url} = URL to article
    • Get free samples of Roversol for rosacea while supplies last. 
    • Otol Neurotol Open. 2023 Nov 22;3(4):e043. doi: 10.1097/ONO.0000000000000043. eCollection 2023 Dec. ABSTRACT BACKGROUND: Pulsatile tinnitus (PT) is increasingly recognized as a cardinal symptom of idiopathic intracranial hypertension (IIH). However, clinicians should remain aware of other causes of nonidiopathic or secondary intracranial hypertension manifesting as PT. We present 2 patients with isolated PT (without accompanying headache, blurred vision, and papilledema) thought to be secondary to tetracycline-induced intracranial hypertension. To our knowledge, these are the first cases of PT as the presenting symptom of this condition. CASES: A 41-year-old female (body mass index [BMI] 29 kg/m2) with ocular rosacea was initially treated with minocycline. Shortly after transitioning to oral doxycycline and erythromycin eye ointment, she noted left-sided PT. Her PT resolved after discontinuing doxycycline. In a second case, a 39-year-old female (BMI 19 kg/m2) with acne presented with a three-year history of left-sided PT while on long-term oral doxycycline for many years. She denied visual or auditory changes and atypical headaches. MRI findings were concerning for intracranial hypertension. Three months later, the patient was seen by neuro-ophthalmology, with findings suggesting prior papilledema. The patient reported PT improvement after discontinuing doxycycline. CONCLUSIONS: This case series highlights 2 cases of isolated PT as the sole symptom of intracranial hypertension that resolved with tetracycline cessation. The presentation and unexpected improvement following tetracycline discontinuation are atypical compared with previous reports of tetracycline-induced intracranial hypertension. Clinicians should maintain a high index of suspicion for all types of intracranial hypertension (idiopathic and secondary), even in patients with a lower BMI. Current and prior medications should be reviewed when considering the etiology of intracranial hypertension. PMID:38516546 | PMC:PMC10950181 | DOI:10.1097/ONO.0000000000000043 {url} = URL to article
    • Ocul Immunol Inflamm. 2024 Mar 21:1-8. doi: 10.1080/09273948.2024.2328791. Online ahead of print. ABSTRACT PURPOSE: The objective of this study was to illustrate the changes in ocular findings, meibography, and tear break-up time (TBUT) values in pediatric patients with ocular rosacea following a standardized treatment. METHODS: The study included consecutive patients diagnosed with ocular rosacea, referred to a tertiary hospital between 2021 and 2023. Each patient underwent biomicroscopic examinations, non-invasive TBUT assessments, corneal fluorescein staining (evaluated using the Oxford scoring system), and meibography. The standard treatment protocol involved warm compresses, eyelid hygiene, preservative-free sodium hyaluronate eye drops (administered four times daily), topical azithromycin 1.5% (twice daily for 3 days), topical steroids (loteprednol 0.5%, four times daily for 2 weeks), and either doxycycline 100 mg/day for 14 days or oral suspension of azithromycin 10 mg/kg for 3 days followed by an additional three-day course of treatment administered 10 days later (for patients above and below 14 years of age, respectively). RESULTS: The study included 18 patients, with 10 (55.5%) being female and 8 (44.4%) being male, with a mean age of 9.7 ± 4.5 years (range: 3-18). Four patients displayed cutaneous involvement. The treatments resulted in significant improvements in the Oxford scores, reduction in corneal neovascularization, and increased TBUT (p < 0.001, p = 0.016, p < 0.001, respectively). Meibomian gland loss area also significantly improved post-treatment (27.4 ± 6.7% vs 39.2 ± 13.4%, p = 0.001). CONCLUSION: This study demonstrated that pediatric ocular rosacea patients may exhibit improved meibomian gland function, regression of corneal neovascularization, and enhanced tear film parameters following a standardized treatment protocol that includes both topical and systemic approaches. PMID:38512290 | DOI:10.1080/09273948.2024.2328791 {url} = URL to article
    • JAAD Case Rep. 2024 Feb 19;46:18-22. doi: 10.1016/j.jdcr.2024.02.005. eCollection 2024 Apr. NO ABSTRACT PMID:38496728 | PMC:PMC10943928 | DOI:10.1016/j.jdcr.2024.02.005 {url} = URL to article
    • This topic has been researched a lot. There are many, many published articles on this subject. We even have our own extensive post on this subject.   Think about it, is this what you as a rosacea sufferer want clinical studies and scientific medical journals to spend money on? The above article was published by the Dermatology Online Journal. 
    • Front Immunol. 2024 Feb 29;15:1382092. doi: 10.3389/fimmu.2024.1382092. eCollection 2024. ABSTRACT [This corrects the article DOI: 10.3389/fimmu.2023.1285951.]. PMID:38487539 | PMC:PMC10938264 | DOI:10.3389/fimmu.2024.1382092 {url} = URL to article
    • Another study on bacteria and rosacea which adds cutibacterium acens being LOWER and substantiating other papers that staphylococcus epidermis is higher in the 17  in the case group who had rosacea. No mention of other microbes, which is generally what western medicine focuses on including studies on rosacea. There are three other bacteria that are mentioned in rosacea studies which we list in this category Wouldn't it be incredible if 10,000 rosaceans got together and each one donated just one dollar and sponsored through a legal non profit organization for rosacea to investigate microbes other than bacteria, i.e., virus, archea, or for that matter whatever the 10,000 rosaceans wanted investigated by a show of hands? Could rosaceans actually come together and do their own rosacea research?  
    • Dermatol Online J. 2023 Oct 15;29(5). doi: 10.5070/D329562420. NO ABSTRACT PMID:38478655 | DOI:10.5070/D329562420 {url} = URL to article
    • Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329662989. ABSTRACT Research in dermatology education highlights the lack of skin of color (SOC) instruction for medical students, leading to concerning healthcare outcomes. Because of the already limited opportunity for students to have dedicated teaching in pathophysiology, management, and treatment of dermatologic diseases in medical school, we developed an educational module that addresses these gaps. We created a one-hour virtual lecture for medical students focused on common skin diseases tested on the United States Medical Licensing Examination with visual images across all skin types. A questionnaire was administered before and after the educational module to assess outcomes comparing disease identification in lighter (Fitzpatrick scale I-III) versus darker (Fitzpatrick scale IV-VI) skin tones and to determine medical school student attitudes. An analysis of 43 examination scores before, and after attending the educational module determined rosacea, psoriasis, and basal cell carcinoma to be conditions in SOC patients that demonstrated the most significant improvement (47.3%, 54.9%, and 30.8%, respectively). Our results also highlighted worse performance outcomes for diseases in SOC in the pre-examination questionnaire. Thus, our study indicates that a concise education module focused on disease presentations inclusive of all skin types may efficiently increase students' ability to identify diseases commonly misdiagnosed in the clinical setting. PMID:38478660 | DOI:10.5070/D329662989 {url} = URL to article
    • The conclusion of this study is mind boggling. Just think about it for a few seconds. So much for WC Fields as the rosacea poster boy. 
    • We have tried over the last twenty years to figure out how to get rosacea sufferers to come together into a patient advocacy non profit organization, to fulfill our MISSION STATEMENT. Currently we are only allowing subscribed members to post. We have a few active members but so far, as of this date, March 12. 2024, none of our few active members post.  If you have an idea on how we can get members to post, why not find the reply to this topic button (only subscribed members can post) and tell us what you think? So if you only post on social media rosacea websites, why do you feel comfortable doing this? What is it about our forum style website that makes you feel uncomfortable to post?   We could use some young rosacea blood to stimulate posts and keep our non profit going.  You want to run this non profit?  Post and tell us what you think. Post. 
    • J Eur Acad Dermatol Venereol. 2024 Mar 12. doi: 10.1111/jdv.19913. Online ahead of print. ABSTRACT BACKGROUND: Itch as the most common symptom in dermatology has been shown to be related to psychological factors such as stress, anxiety and depression. Moreover, associations were found between perceived stigmatization and itch. However, studies investigating the differences between patients with dermatoses with and without itch regarding perceived stress, stigmatization, anxiety and depression are missing. Therefore, one of the aims of the second study of the European Society for Dermatology and Psychiatry (ESDaP study II) was to investigate these relationships in a large cohort of patients with different itchy dermatoses. RESULTS: 3399 patients with 14 different itchy dermatoses were recruited at 22 centres in 17 European countries. They filled in questionnaires to assess perceived stigmatization, stress, signs of clinically relevant anxiety or depression, itch-related quality of life, the overall health status, itch duration, frequency and intensity. The most significant association between the severity of itching and the perception of stress was observed among individuals with rosacea (correlation coefficient r = 0.314). Similarly, the strongest links between itch intensity and experiences of stigmatization, anxiety, and depression were found in patients with seborrheic dermatitis (correlation coefficients r = 0.317, r = 0.356, and r = 0.400, respectively). Utilizing a stepwise linear regression analysis, it was determined that within the entire patient cohort, 9.3% of the variation in itch intensity could be accounted for by factors including gender, levels of anxiety, depression, and perceived stigmatization. Females and individuals with elevated anxiety, depression, and perceived stigmatization scores reported more pronounced itch intensities compared to those with contrary attributes. CONCLUSION: This study underscores the connection between experiencing itch and its intensity and the psychological strain it places on individuals. Consequently, psychological interventions should encompass both addressing the itch itself and the interconnected psychological factors. In specific cases, it becomes imperative for dermatologists to direct individuals towards suitable healthcare resources to undergo further psychological assessment. PMID:38468596 | DOI:10.1111/jdv.19913 {url} = URL to article
    • J Clin Aesthet Dermatol. 2023 Dec;16(12 Suppl 2):S14-S15. NO ABSTRACT PMID:38464742 | PMC:PMC10919953 {url} = URL to article
    • Eur J Dermatol. 2023 Dec 1;33(6):612-617. doi: 10.1684/ejd.2023.4619. ABSTRACT Rosacea is a chronic inflammatory skin disorder that significantly impairs quality of life, however, its pathophysiology is still unclear. Previous studies have suspected that the bacterial -microbiome plays a causative role in the disease. To investigate whether there are differences in the abundance and diversity of facial bacterial microbiomes between rosacea patients and healthy controls. Samples of facial microorganisms from subjects were collected with sterile swabs, and the V3 and V4 regions of bacterial 16S rRNA were amplified and sequenced using the MiSeq platform of the Illumina system. A total of 44 samples qualified (including 17 in the case group and 27 in the control group), comprising 2,048 operational taxonomic units belonging to 40 phyla and 1,312 species that were clustered. The alpha diversity in patients with rosacea was higher than that in healthy controls, but this difference was not statistically significant. In addition, compared with healthy individuals, the mean relative abundance of Cutibacterium acens was significantly lower (61.79% vs 79.69%, p=0.014) and that of Staphylococcus epidermidis was higher (19.64% vs 6.48%, p=0.036) in rosacea patients. Changes in microbial abundance and diversity correlate with the pathogenesis of rosacea. PMID:38465541 | DOI:10.1684/ejd.2023.4619 {url} = URL to article
    • We have added Tumid lupus as a Rosacea mimic to our official list. 
    • The above video was made a while ago, I think in 2021. If you think you know how to run a patient advocacy non profit organization why not join and take over. If your ideas are better then serve on the board of directors and help us. Maybe you can get the skin industry to sponsor your ideas and then get paid as the NRS runs its non profit that is run by businessmen and dermatologists. Maybe you could get a dermatologist on our board. But before you do, you might want to read all our rules, mission statement, charter, privacy policy, and legal disclaimer to see what is involved. You can make a lot of money running a non profit since many non profits have salaried directors and employees. Non profits make billions of dollars and pay lot of money out for services and salaries. We could setup the RRDi in your home state or country and you run it! I can teach you what you need to know about our financial situation and how you can continue receiving donations. We did receive six thousand dollars over the hears in grants from Galderma, but getting volunteer grant writers is like pulling teeth. Maybe you know how to get grants?
    • The RRDi has stopped reviewing the NRS with regard to how it spends its donations since rosaceans could care less. The last review above is for 2020 but since rosaceans could care less, there is no point it being the lone watchdog on the NRS. Let Samuel and Andrew Huff who sit on the board of directors of this non profit keep getting around 60% of the expenditures of the NRS through their profit organizations which is legal and rosaceans keep donating to the NRS and think this is how a non profit for rosacea should be run. I imagine Sam and Andrew have nice homes, expensive vehicles and take nice vacations. Good for Sam and Andrew who know how to get rosaceans to donate to their 'non profit' for rosacea. The skin industry loves the NRS and continues to give the vast majority of the donations since the public donates about 23.58% of the total donations which means 76.42% of the donations to the NRS are sponsored by the skin industry over period from 1998 through 2020. Rosaceans love it that the NRS is run by businessmen and dermatologists and is not a patient advocacy non profit but instead a non profit supported mainly by the skin industry. It is so sad that rosaceans don't want to come together in a united non profit group that supports patient advocacy for rosacea, engaging in their own research, not relying on the skin industry. So sad. 
    • Allergol Immunopathol (Madr). 2024 Mar 1;52(2):23-31. doi: 10.15586/aei.v52i2.978. eCollection 2024. ABSTRACT Morbihan syndrome (MS) is characterized by solid facial edema, usually related to rosacea or acne vulgaris. The facial edema deforms the patient's features, can impair peripheral vision, and affects quality of life. Its pathophysiology remains unclear. The disease usually has a slow and chronic course. MS most commonly affects middle-aged Caucasian men with rosacea and is rare in people below 20 years of age. MS is a diagnosis of exclusion. There is no standard treatment for MS, though systemic isotretinoin and antihistamines are mainly used. We present the case of an adolescent girl with MS nonresponding to 19 months of isotretinoin treatment with add-on antihistamines. Therapy with monthly administration of omalizumab (anti-IgE) for 6 months was an effective therapeutic option, improving the quality of life. Our case is the second description of omalizumab use in Morbihan syndrome, the first in an adolescent. PMID:38459887 | DOI:10.15586/aei.v52i2.978 {url} = URL to article
    • JMIR Med Inform. 2024 Mar 8;12:e57654. doi: 10.2196/57654. ABSTRACT [This corrects the article DOI: 10.2196/23415.]. PMID:38457810 | DOI:10.2196/57654 {url} = URL to article url to original article
    • J Cutan Med Surg. 2024 Mar 7:12034754241229365. doi: 10.1177/12034754241229365. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory condition of which there is no cure. The pathogenesis of rosacea is likely multifactorial, involving genetic and environmental contributions. Current understanding suggests that pro-inflammatory pathways involving cathelicidins and inflammasome complexes are central to rosacea pathogenesis. Common rosacea triggers modulate these pathways in a complex manner, which may contribute to the varying severity and clinical presentations of rosacea. Established and emerging rosacea treatments may owe their efficacy to their ability to target different players in these pro-inflammatory pathways. Improving our molecular understanding of rosacea will guide the development of new therapies and the use of combination therapies. PMID:38450615 | DOI:10.1177/12034754241229365 {url} = URL to article
    • J Clin Aesthet Dermatol. 2024 Feb;17(2):47-51. ABSTRACT OBJECTIVE: Erythematotelangiectatic rosacea (ETR) is recognized by flushing, persistent centrofacial erythema, and telangiectasia. Many lines of topical treatments have been used for ETR with variable outcomes. We aimed to evaluate the efficacy of 10% topical tranexamic acid (TXA) with and without microneedling in treating ETR. METHODS: All patients received treatment on both sides of the face, the right side was treated with microneedling combined with 10% topical TXA, and the left side was treated with 10% topical TXA only. All patients received three sessions at two weeks intervals. The final evaluation was done three months after the last treatment session. RESULTS: The study included 45 females. Their age ranged between 20 and 48 years. The duration of the disease ranged from two months to five years. Both sides of the face showed improvement after treatment. There was a clinically and dermoscopic significant improvement in the side treated with microneedling + TXA compared to the side of the face treated with TXA alone. LIMITATIONS: The small sample size and the lack of long-term follow-up. CONCLUSION: This study showed that TXA is an effective and safe treatment modality for ETR. Microneedling can enhance the delivery of TXA and lead to better outcomes regarding erythema and telangiectasia. PMID:38444423 | PMC:PMC10911261 {url} = URL to article
    • J Clin Aesthet Dermatol. 2024 Feb;17(2):32-42. ABSTRACT OBJECTIVE: Our aim was to review the current and emerging dermatological applications of the novel thermomechanical fractional injury (TMFI) device, Tixel® (Novoxel, Netanya, Israel). METHODS: A systematic review of PubMed using the search terms of "Tixel", "thermomechanical fractional", ["thermomechanical ablation" and "skin"], and ["thermomechanical ablation" and "dermatology"]. RESULTS: Thirty-six articles matched our inquiry. Fifteen articles did not meet inclusion criteria. Of the remaining 21 articles, eight were related to device-assisted drug delivery, seven related to photoaging, and seven related to scientific/ preclinical exploration. Preclinical studies have shown ablative and non-ablative microchannel formation similar to that of CO₂ laser but without charring, with clinical studies demonstrating efficacy for a wide range of applications including rhytides, hypertrophic scarring, infantile hemangiomas, and acne/rosacea. The treatment is well tolerated with minimal discomfort and downtime, showing promise for pain-averse and pediatric populations. Few adverse events have been reported, with a high degree of safety demonstrated in all Fitzpatrick types. LIMITATIONS: Heterogeneous result reporting among studies. Limited number of randomized controlled trials. CONCLUSION: Tixel® is an emerging TMFI device with a wide range of current and potential applications, including device-assisted drug delivery and treatment of rhytides, photoaging, and scars among other conditions. The device has both ablative and non-ablative settings and has been safely used in all Fitzpatrick skin types. Larger and randomized controlled trials are needed to compare this device to current standard of care treatments. PMID:38444425 | PMC:PMC10911265 {url} = URL to article
    • J Invest Dermatol. 2024 Mar 4:S0022-202X(24)00170-2. doi: 10.1016/j.jid.2024.02.012. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory skin disorder characterized by immune response-dependent erythema and pustules. S100 calcium binding protein A9 (S100A9), a pro-inflammatory alarmin, has been associated with various inflammation-related diseases. However, the specific role of S100A9 in rosacea remains unexplored. Therefore, our objective was to unravel the role of S100A9 in the pathogenesis of rosacea and its underlying molecular mechanisms. Here, we show that expression levels of S100A9 were elevated in both the lesions and serum of PPR patients, as well as in lesions of the LL37-induced rosacea-like mouse model. Moreover, the upregulation of S100A9 was correlated with clinical severity and levels of inflammatory cytokines. Additionally, we demonstrated that S100A9 promoted the production of pro-inflammatory factors in HaCaT cells by activating TLR4/MyD88/NF-κB signaling pathways. Notably, inhibition of S100A9 suppressed the progression of rosacea-like dermatitis and inflammatory responses in the LL37-induced rosacea-like mouse model via TLR4/MyD88/NF-κB signaling pathways. In conclusion, this study illustrated that S100A9 participates in the pathogenesis of rosacea by upregulating TLR4/MyD88/NF-κB signaling pathways, thereby promoting rosacea-associated skin inflammation. These results not only expand our understanding of the potential role of S100A9 in the development of rosacea, but also offers greater insight toward targeted therapies. PMID:38447867 | DOI:10.1016/j.jid.2024.02.012 {url} = URL to article
    • Front Public Health. 2024 Feb 19;12:1320932. doi: 10.3389/fpubh.2024.1320932. eCollection 2024. ABSTRACT BACKGROUNDS: Observational studies have shown that cigarette smoking is inversely associated with risk of rosacea, However, it remains uncertain whether this association is causal or it is a result of reverse causation, and whether this association is affected by drinking behaviors. METHODS: This study utilized the summary-level data from the largest genome-wide association study (GWAS) for smoking, alcohol consumption, and rosacea. The objective was to investigate the effect of genetically predicted exposures to smoking and alcohol consumption on the risk of developing rosacea. Two-sample bidirectional Mendelian randomization (MR) was applied, accompanied by sensitive analyses to validate the robustness of findings. Furthermore, multivariable MR was conducted to evaluate the direct impact of smoking on rosacea. RESULTS: A decreased risk of rosacea was observed in individuals with genetically predicted lifetime smoking [odds ratio (OR)MR - IVW = 0.53; 95% confidence interval (CI), 0.318-0.897; P = 0.017], and number of cigarettes per day (ORMR - IVW = 0.55; 95% CI, 0.358-0.845; P = 0.006). However, no significant associations were found between initiation of regular smoking, smoking cessation, smoking initiation, alcohol consumption and rosacea. Reverse MR analysis did not show any associations between genetic liability toward rosacea and smoking or alcohol drinking. Importantly, the effect of lifetime smoking and the number of cigarettes per day on rosacea remained significant even after adjusting for alcohol consumption in multivariable MR analysis. CONCLUSION: Smoking was causally related to a lower risk of rosacea, while alcohol consumption does not appear to be associated with risk of rosacea. PMID:38439759 | PMC:PMC10909955 | DOI:10.3389/fpubh.2024.1320932 {url} = URL to article
    • J Osteopath Med. 2024 Mar 5. doi: 10.1515/jom-2023-0269. Online ahead of print. NO ABSTRACT PMID:38436596 | DOI:10.1515/jom-2023-0269 {url} = URL to article
    • As you can see, this case of a Filipino woman in her forties went through many treatments until she got a correct diagnosis of tinea faciei with steroid rosacea, it is important to get a correct diagnosis. Learn more. 
    • What about Botox for rosacea? Answer
    • Ocul Surf. 2024 Mar 1:S1542-0124(24)00028-4. doi: 10.1016/j.jtos.2024.02.006. Online ahead of print. ABSTRACT PURPOSE: Chronic inflammation is a predisposing factor for metaplastic changes and ultimately dysplasia. We describe cases of OSSN occurring in the setting of chronic ocular surface inflammation. METHODS: Sixteen eyes from 14 individuals were included from one ocular oncology clinic between 2010 and 2023. Patients presented with ocular surface squamous neoplasia (OSSN) in the setting of chronic inflammation. The diagnosis of OSSN was made using anterior segment high-resolution optical coherence tomography (HR-OCT) and confirmed by histopathological analysis in all cases. RESULTS: Median age on presentation was 61 [IQR 47.5-69.2] years. Eleven (86%) individuals were male and five (36%) identified as White Hispanic. Ten eyes were referred with ocular surface diagnoses including pannus (n = 4), scarring (n = 3), pterygium (n = 2), and herpetic keratitis (n = 1). Only six eyes were referred as possible neoplasia. All individuals had a history of ocular surface inflammation. The most common inflammatory conditions were ocular rosacea (seven individuals) and atopic keratoconjunctivitis (AKC) (five individuals). Two individuals were found to have bilateral OSSN, one in the setting of ocular rosacea and the other in the setting of AKC. All 16 eyes from 14 individuals were suspected to have OSSN based on HR-OCT findings which guided the location of the incisional biopsies that subsequently confirmed histopathological diagnosis in all cases. CONCLUSION: OSSN may arise in the setting of chronic inflammation on the ocular surface. Identification of the tumor can be challenging in these cases, and HR-OCT can be a key diagnostic tool in detecting OSSN. PMID:38432640 | DOI:10.1016/j.jtos.2024.02.006 {url} = URL to article
    • Skin Res Technol. 2024 Mar;30(3):e13616. doi: 10.1111/srt.13616. ABSTRACT OBJECTIVE: To investigate the life, sleep quality and anxiety of rosacea patients in Yunnan and the improvement of these aspects after treatment. METHODS: A total of 141 patients with rosacea and 123 healthy controls were included in our study. The quality of life, sleep quality and anxiety of patients with rosacea and healthy controls were investigated by the Rosacea Severity Scores (RSSs), the Medical Outcomes Study 36-item short-form health survey (SF-36), the Pittsburgh Sleep Quality Index (PSQI) and Self-rating Anxiety Scale (SAS). The quality of life, sleep quality and anxiety of patients with rosacea were assessed again after treatment. RESULTS: Compared with healthy controls, patients with rosacea had significantly lower physical component scores (PCS) and mental component scores (MCS) but higher PSQI and SAS scores. After treatment, rosacea patients showed significantly higher MCS but lower PSQI and SAS scores. Correlation analysis showed a significant correlation between PCS, MCS, PSQI, SAS and RSSs. CONCLUSIONS: Patients with rosacea have a lower quality of life and sleep quality and tend to be more anxious than healthy controls. In addition, the mental quality of life, sleep quality and anxiety of rosacea patients can be significantly improved after treatment. Therefore, it is important to pay attention to the psychological status of rosacea patients. Psychological counseling and intervention are necessary to better prevent and treat rosacea. PMID:38424730 | DOI:10.1111/srt.13616 {url} = URL to article
    • Int J Dermatol. 2024 Mar 1. doi: 10.1111/ijd.17114. Online ahead of print. NO ABSTRACT PMID:38429862 | DOI:10.1111/ijd.17114 {url} = URL to article
    • Australas J Dermatol. 2024 Feb 28. doi: 10.1111/ajd.14224. Online ahead of print. ABSTRACT BACKGROUND: Atrophic acne scarring is a common sequela of inflammatory acne, causing significant problems for affected patients. Although prolonged inflammation and subsequent aberrant tissue regeneration are considered the underlying pathogenesis, the role of epidermal stem cells, which are crucial to the regeneration of pilosebaceous units, remains unknown. OBJECTIVES: To examine the changes occurring in epidermal stem cells in atrophic acne scars. METHODS: Changes in collagen, elastic fibre and human leukocyte antigen (HLA)-DR expression were analysed in normal skin and inflammatory acne lesions at days 1, 3 and 7 after development. The expression of epidermal stem cell markers and proliferation markers was compared between normal skin and mature atrophic acne scar tissue. RESULTS: In acne lesions, inflammation had invaded into pilosebaceous units over time. Their normal structure had been destructed and replaced with a reduced amount of collagen and elastic fibre. Expression of stem cell markers including CD34, p63, leucine-rich repeat-containing G protein-coupled receptor (LGR)6 and LGR5, which are expressed in the interfollicular epidermis, isthmus and bulge of hair follicles, significantly decreased in atrophic acne scar tissue compared to normal skin. Epidermal proliferation was significantly reduced in scar tissue. CONCLUSIONS: These findings suggest that as inflammatory acne lesions progress, inflammation gradually infiltrates the pilosebaceous unit and affects the resident stem cells. This disruption impedes the normal regeneration of the interfollicular epidermis and adnexal structures, resulting in atrophic acne scars. PMID:38419202 | DOI:10.1111/ajd.14224 {url} = URL to article
    • J Dermatol. 2024 Feb 29. doi: 10.1111/1346-8138.17168. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory skin disease. Systemic inflammation plays a vital role in the pathogenesis of rosacea. Many studies have reported hematological parameters as biomarkers for diseases with inflammatory processes. However, the diagnostic value of hematological parameters in rosacea remains a puzzle. This study involved 462 patients with rosacea, including erythematotelangiectatic rosacea (ETR, n = 179), papulopustular rosacea (PPR, n = 250), and phymatous rosacea (PhR, n = 33), and 924 healthy control subjects. Demographic, clinical, and laboratory information was collected and compared between rosacea subtypes. The hematological parameters of the patients and the healthy controls were compared retrospectively. The platelet volume (MPV) and platelet crit (PCT) were significantly upregulated, and the lower red cell distribution width (RDW) was significantly downregulated in rosacea compared to healthy controls, and they were identified as the diagnostic biomarkers for rosacea with area under the curve values of 0.828, 0.742, and 0.787, respectively. Comparing the hematological parameters among the three rosacea subtypes, we found that platelet-to-lymphocyte ratio and platelet-to-neutrophil ratio values in the ETR group were significantly higher than those in the PPR and PhR groups. The correlation between hematological parameters and clinical scores showed that RDW was negatively correlated with the Clinician Erythema Assessment score. However, there was no significant correlation between the Investigator Global Assessment score and hematological parameters. In conclusion, PCT, MPV, and RDW have diagnostic value for rosacea, and RDW is correlated with the severity of rosacea erythema, implying the potential applications of PCT, MPV, and RDW in the diagnosis and monitoring of rosacea. PMID:38421898 | DOI:10.1111/1346-8138.17168 {url} = URL to article
    • Med Mycol J. 2024;65(1):23-26. doi: 10.3314/mmj.23-00014. ABSTRACT A Filipino woman in her forties had facial erythema that was being self-treated with over-the-counter (OTC) drugs purchased outside of Japan. The drugs included clobetasol propionate, antibiotic, and antifungal components. Her facial erythema symptoms were worse during summertime. KOH direct examination of annular erythema was positive for fungal hyphae and negative for Demodex folliculorum. Fungal culture revealed Trichophyton indotineae based on internal transcribed spacer sequence analysis. Minimal inhibitory concentration for terbinafine was 0.06 µg/mL. We made a diagnosis of tinea faciei with steroid rosacea. We treated the patient with oral itraconazole. Physicians should be aware of increasing T. indotineae infections and increasing self-medication using topical OTC steroids combined with antifungals and antibiotics not only in India but also among foreign people living in other countries such as Japan. PMID:38417884 | DOI:10.3314/mmj.23-00014 {url} = URL to article
    • Drugs. 2024 Feb 29. doi: 10.1007/s40265-024-02003-w. Online ahead of print. ABSTRACT Rosacea, a chronic skin condition affecting millions of people in the USA, leads to significant social and professional stigmatization. Effective management strategies are crucial to alleviate symptoms and improve patients' quality of life. Encapsulated benzoyl peroxide 5% (E-BPO 5%) is a newly FDA-approved topical treatment for rosacea that shows promise in enhancing therapeutic response and minimizing skin irritation. This review aims to assess the role of recently FDA approved E-BPO 5% in the current treatment landscape for rosacea management, as it is not yet included in clinical guidelines that predominantly rely on older approved therapies. The review focuses on randomized controlled trials conducted in English-speaking adults. It evaluates the efficacy, safety, and tolerability of various US Food and Drug Administration (FDA)-approved agents used for rosacea treatment, including E-BPO cream, metronidazole gel, azelaic acid gel and foam, ivermectin cream, minocycline foam, oral doxycycline, brimonidine gel, and oxymetazoline HCl cream. Existing therapies have been effective in reducing papulopustular lesions and erythema associated with rosacea for many years. E-BPO 5% offers a promising addition to the treatment options due to its microencapsulation technology, which prolongs drug delivery time and aims to improve therapeutic response while minimizing skin irritation. Further research is necessary to determine the exact role of E-BPO 5% in the therapeutic landscape for rosacea. However, based on available evidence, E-BPO 5% shows potential as a valuable treatment option for managing inflammatory lesions of rosacea, and it may offer benefits to patients including: rapid onset of action, demonstrated efficacy by Week 2, excellent tolerability, and sustained long-term results for up to 52 weeks of treatment. PMID:38418773 | DOI:10.1007/s40265-024-02003-w {url} = URL to article
    • This is an example of clinicians who still rely on the Subtype classification of rosacea which was abandoned several years ago. ETR is subtype 1. The new classification of rosacea into phenotypes separates this subtype into two phenotypes:  (2) Persistent Erythema (3) Telangiectasia Dapsone has been used to treat Granulomatous Rosacea [also known as Lupoid rosacea] [1] as well as PPR [2] [1] Hautarzt. 2013 Apr;64(4):226-8. doi: 10.1007/s00105-013-2556-7. Successful treatment of granulomatous rosacea with dapsone. Ehmann LM, Meller S, Homey B. Hautklinik des Universitätsklinikums Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland. PubMed RSS Feed - - Dapsone &nbsp;for Unresponsive Granulomatous Rosacea. [2] Dapsone Gel in the Treatment of Papulopustular Rosacea: A Double-Blind Randomized Clinical Trial.        
    • Pediatr Dermatol. 2024 Feb 27. doi: 10.1111/pde.15571. Online ahead of print. ABSTRACT BACKGROUND: Idiopathic aseptic facial granuloma (IAFG) is an underrecognized pediatric skin disease, currently considered within the spectrum of rosacea. It usually manifests as a solitary, reddish, asymptomatic nodule on the cheek that resolves spontaneously. METHODS: Retrospective and descriptive observational study of 43 pediatric patients with a clinical diagnosis of IAFG, followed between 2004 and 2022, at two general hospitals in Argentina. RESULTS: IAFG predominated in girls (65%) and the average age of onset was about 6 years. A single asymptomatic nodule was seen in 79% of patients. The most common localization was the cheek (58%) followed by lower eyelids (41%). Family history of rosacea was present in 16% of patients. A concomitant diagnosis of rosacea and periorificial dermatitis was made in 14% and 9% of our population, respectively. Past or present history of chalazia was detected in 42% of the children. IAFG diagnosis was mainly clinical (88% of cases). Oral antibiotics were the most common indicated treatment (84%). Complete healing was achieved by the majority, but 18% of those with eyelid compromise healed with scars. CONCLUSIONS: IAFG is a benign pediatric condition that physicians should recognize in order to manage correctly. We herein refer to a particular morphologic aspect of IAFG lesions affecting the lower eyelids, where nodules adopt a linear distribution and have a higher probability of involute leaving a scar. Also, we consider that the concomitant findings of rosacea, periorificial dermatitis and chalazia in our patients, reinforce the consideration of IAFG within the spectrum of rosacea. PMID:38413004 | DOI:10.1111/pde.15571 {url} = URL to article
    • Cesk Slov Oftalmol. 2024;80(Ahead of print):1001-1008. doi: 10.31348/2024/3. ABSTRACT OBJECTIVE: This study aims to address the issues surrounding the diagnosis of ocular rosacea and to evaluate the development of the patients' condition after treatment, as well as to distinguish between healthy and diseased patients using a glycomic analysis of tears. METHODOLOGY: A prospective study was conducted to assess a total of 68 eyes in 34 patients over a six-week period. These patients were diagnosed with ocular rosacea based on subjective symptoms and clinical examination. The study monitored the development of objective and subjective values. The difference between patients with the pathology and healthy controls was established by means of analysis of glycans in tears. RESULTS: Skin lesions were diagnosed in 94% of patients with ocular rosacea, with the most commonly observed phenotype being erythematotelangiectatic (68.8%). The mean duration of symptoms was 29.3 months (range 0.5-126 months) with a median of 12 months. Throughout the study, an improvement in all monitored parameters was observed, including Meibomian gland dysfunction, bulbar conjunctival hyperemia, telangiectasia of the eyelid margin, anterior blepharitis, uneven and reddened eyelid margins, and corneal neovascularization. The study also observed improvements in subjective manifestations of the disease, such as foreign body sensation, burning, dryness, lachrymation, itching eyes, photophobia, and morning discomfort. The analysis of glycans in tears partially separated tear samples based on their origin, which allowed for the differentiation of patients with rosacea from healthy controls. In the first sample, the pathology was determined in a total of 63 eyes (98.4%) of 32 patients, with further samples showing a change in the glycomic profile of patients' tears during treatment. CONCLUSION: The study demonstrated objective and subjective improvements in all the patients. Tear sampling and analysis could provide a means of timely diagnosis of ocular rosacea. PMID:38413227 | DOI:10.31348/2024/3 {url} = URL to article
    • This test seems to have cornered the diagnosis of different skin diseases. Gate Recurrent Unit [GRU] "introduced in 2014 by Kyunghyun Cho et al." Wikipedia Maybe we will hear more about this in diagnosing rosacea?
    • This is a new variant of demodicidosis (demodectic rosacea). The variants keep growing. 
    • The RRDi has an extensive list of non prescription treatments for rosacea including natural treatments. Click Here
    • What is a bi-directional two-sample Mendelian randomization (2SMR) analysis? Answer:  Mendelian randomisation is a statistical approach that uses genetics to provide information about the relationship between an exposure and outcome (a type of instrumental variable analysis) [1]   Additionally, bi-directional Mendelian randomisation can be used to assess in which direction causality is most likely to flow (1). In bi-directional Mendelian randomisation, Mendelian randomisation analyses are performed in both directions (exposure to outcome, and outcome to exposure). [1] The summary concludes that there is 'evidence for the causality between GM [gut microbiota] and inflammatory skin diseases.' [1] End Notes [1] Making sense of Mendelian randomisation and its use in health research A short overview Sean Harrison, Laura Howe and Alisha R. Davies      
    • This article says acne can appear on the truncal area of the body. Whether rosacea could also involve the truncal area hasn't been investigated or confirmed, however the NHS article above says rosacea can appear on the chest, so that at least confirms the chest area. Is it a big stretch to say rosacea also appears on the truncal area?  Any comments? 
    • We are careful who we put on our links page since we do not want to appear to be a commercial site or influenced in any way with the skin industry (unless the skin industry donates or sponsors our own independent rosacea research). This Korean Acne and Rosacea Society is sponsored by Galderma and the research appears to be with no conflict of interest so we are listing this society on our links page.  
    • This article is some good research since rosacea is an ISD (Inflammatory Skin Diseases). I have always known that the human microbiome is important to understanding rosacea. Since the skin comprises the largest organ it makes sense that the different microbes existing in this organ would interact and be important to understanding why an inflammatory response is indicated in rosacea. Could rosacea actually be the result of various microbes interplaying or could it actually be just one microbe that is triggering it? In normal skin without rosacea, these various microbes seem to live together without an inflammatory response or initiating an immune system response. There may be other factors that would contribute to upsetting the skin microbiome, i.e., age, diet and exercise, lifestyle, stress, cormobidities, co-existing conditions, medications, etc., which complicates the issue, but nevertheless, rosacea is a skin disease and microbes may play a part in triggering it. The classic example proving this point is that antibiotics have been used to treat rosacea for decades and more recently treatment for the eradication of demodex mites are just two microbes worth considering, bacteria and demodex, which the vast majority of rosacea research has focused on. There is little, if any, research done on rosacea involving other microbes, i.e., virus, archaea, fungi, protozoa, helminths, parasites, etc., and the list of microbes on the skin microbiome could include other microbes not yet considered since the bias in rosacea research has mainly focused on bacteria as the culprit. since antibiotic treatment does indeed clears rosacea, but overtime complicates the issue with side effects worse than the actual disease.  If you note, the research in this article is Chinese and apparently no conflict of interest is involved, for example, the skin industry in western medicine probably didn't give these researchers a dime. Bravo for such research. If only the RRDi could engage in such novel research. The following reveals who funded this research:  "This work was supported by the Chengdu University of Traditional Chinese Medicine “Xinglin Scholars” Discipline Talent Research Improvement Program, Project Number: QJJJ2021001; Chengdu University of Traditional Chinese Medicine “Foundation Thickening” Action Plan (2023-42); Chengdu University of Traditional Chinese Medicine Hospital’s “Hundred Person Plan” (21-L03 and 22-B09). “Young Qihuang” Scholars of the State Administration of Traditional Chinese Medicine (2022-256)" Read the full article. Furthermore, we also know that Gut Rosacea is related to this subject. For example, this research paper states, "Accumulating evidence shows that dysregulation of intestinal flora is associated with inflammatory skin diseases, specifically atopic dermatitis (AD), psoriasis (PSO), and rosacea (ROS). However, the causality is still unclear." [1] This same article notes that "A total of 24 specific gut microbiota species related to AD, PSO, and ROS were identified by 2SMR analysis." [1]  Can you see we need more research and that rosaceans could be involved with such novel research rather than letting the skin industry in western medicine sponsor the vast amount of rosacea research? Could rosaceans actually be united into sponsoring their own rosacea research? End Notes [1] PubMed RSS Feed - -The associations between gut microbiota and inflammatory skin diseases: a bi-directional two-sample Mendelian randomization study &nbsp;
    • J Clin Med. 2024 Feb 16;13(4):1126. doi: 10.3390/jcm13041126. ABSTRACT Childhood rosacea is a lesser known, yet significant, skin condition presenting diagnostic and treatment challenges. Although often underdiagnosed due to unclear diagnostic criteria, it manifests similarly to adult rosacea, with features such as papulopustular, telangiectasia, granulomatous, idiopathic facial aseptic granuloma, and ocular rosacea. The complex pathophysiology involves genetic, immunological, and environmental factors. Distinguishing childhood rosacea from conditions like acne, steroid rosacea, sarcoidosis, and lupus vulgaris is crucial but complicated by the lack of established criteria. Treatment strategies, mainly extrapolated from adult management protocols, include topical therapies, systemic medications, and laser treatments, adapted for pediatric patients. Special attention is given to ocular rosacea, often preceding skin manifestations, necessitating multidisciplinary care. The review underscores the urgent need for clear diagnostic guidelines, increased awareness, and tailored pediatric treatment protocols to improve patient outcomes and mitigate the condition's evolution into adulthood. PMID:38398439 | DOI:10.3390/jcm13041126 {url} = URL to article
    • Pharmaceutics. 2024 Jan 26;16(2):176. doi: 10.3390/pharmaceutics16020176. ABSTRACT Dexamethasone has a high anti-inflammatory efficacy in treating skin inflammation. However, its use is related to the rebound effect, rosacea, purple, and increased blood glucose levels. Nanotechnology approaches have emerged as strategies for drug delivery due to their advantages in improving therapeutic effects. To reduce dexamethasone-related adverse effects and improve the anti-inflammatory efficacy of treatments, we developed nanocarriers containing this corticosteroid and oleic acid. Nanocapsules and nanoemulsion presented dexamethasone content close to the theoretical value and controlled dexamethasone release in an in vitro assay. Gellan gum-based hydrogels were successfully prepared to employ the nanostructured systems. A permeation study employing porcine skin showed that hydrogels containing non-nanoencapsulated dexamethasone (0.025%) plus oleic acid (3%) or oleic acid (3%) plus dexamethasone (0.025%)-loaded nanocapsules provided a higher amount of dexamethasone in the epidermis compared to non-nanoencapsulated dexamethasone (0.5%). Hydrogels containing oleic acid plus dexamethasone-loaded nanocapsules effectively inhibited mice ear edema (with inhibitions of 89.26 ± 3.77% and 85.11 ± 2.88%, respectively) and inflammatory cell infiltration (with inhibitions of 49.58 ± 4.29% and 27.60 ± 11.70%, respectively). Importantly, the dexamethasone dose employed in hydrogels containing the nanocapsules that effectively inhibited ear edema and cell infiltration was 20-fold lower (0.025%) than that of non-nanoencapsulated dexamethasone (0.5%). Additionally, no adverse effects were observed in preliminary toxicity tests. Our study suggests that nanostructured hydrogel containing a reduced effective dose of dexamethasone could be a promising therapeutic alternative to treat inflammatory disorders with reduced or absent adverse effects. Additionally, testing our formulation in a clinical study on patients with skin inflammatory diseases would be very important to validate our study. PMID:38399236 | DOI:10.3390/pharmaceutics16020176 {url} = URL to article
    • Pharmaceuticals (Basel). 2024 Feb 6;17(2):212. doi: 10.3390/ph17020212. ABSTRACT Rosacea is a chronic skin disorder that affects more than 5% of the world's population, with the number increasing every year. Moreover, studies show that one-third of those suffering from rosacea report a degree of depression and are less compliant with treatment. Despite being the subject of prolonged studies, the pathogenesis of rosacea remains controversial and elusive. Since most medications used for the management of this pathology have side effects or simply do not yield the necessary results, many patients lose trust in the treatment and drop it altogether. Thus, dermato-cosmetic products with natural ingredients are gaining more and more notoriety in front of synthetic ones, due to the multiple benefits and the reduced number and intensity of side effects. This review is a comprehensive up-to-date report of studies that managed to prove the beneficial effects of different botanicals that may be useful in the short and long-term management of rosacea-affected skin. Based on recent preclinical and clinical studies, this review describes the mechanisms of action of a large array of phytochemicals responsible for alleviating the clinical symptomatology of the disease. This is useful in further aiding and better comprehending the way plant-based products may help in managing this complex condition, paving the way for research in this area of study. PMID:38399428 | DOI:10.3390/ph17020212 {url} = URL to article
    • Exp Dermatol. 2024 Feb;33(2):e15037. doi: 10.1111/exd.15037. ABSTRACT The skin is increasingly recognized as a biological active organ interacting with the immune system. Given that the epidermal skin layer actively releases various cytokines, non-invasive skin sampling methods could detect these cytokines, offering insights into clinical conditions. This study aims non-invasively measuring cytokine levels directly from the skin surface to characterize different inflammatory chronic disorders in the adult and elderly population: psoriasis, diabetes type 2, rosacea, chronic kidney disease (CKD) and aging. Cytokines IL-1β, IL-8 and IL-10 were sampled from healthy subjects and patients aged 18-80 using skin surface wash technique. A well with sterile phosphate-buffered saline solution was placed on the skin for 30 min, and the extracted solution was collected from the well for further cytokine levels analysis using ELISA assay. Results show distinct cytokine profiles in different pathological processes, healthy controls, affected and unaffected areas. Aging was associated with increased IL-1β, IL-8, and IL-10 levels in skin. In diabetes, IL-1β and IL-8 levels were elevated in lesional areas, while IL-10 levels were decreased in non-lesional skin. Psoriatic lesions showed elevated levels of IL-1β and IL-8. Rosacea patients had lower IL-10 levels in both lesional and non-lesional areas. CKD patients exhibited significantly lower IL-10 levels compared to healthy individuals. In conclusion, skin surface wash-derived cytokine profiles could serve as "alert biomarkers" for disease prediction, enabling early detection. Additionally, this method's cost-effectiveness allows pre-screening of molecules in clinical studies and holds potential as a tool for biomarkers and omics analysis, enhancing disorder characterization and disease management. PMID:38389180 | DOI:10.1111/exd.15037 {url} = URL to article
    • Actas Dermosifiliogr. 2024 Feb 19:S0001-7310(24)00155-8. doi: 10.1016/j.ad.2024.02.014. Online ahead of print. ABSTRACT INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea. PMID:38382749 | DOI:10.1016/j.ad.2024.02.014 {url} = URL to article
    • J Inflamm Res. 2024 Feb 15;17:1057-1082. doi: 10.2147/JIR.S441100. eCollection 2024. ABSTRACT As the body's largest organ, the skin harbors a highly diverse microbiota, playing a crucial role in resisting foreign pathogens, nurturing the immune system, and metabolizing natural products. The dysregulation of human skin microbiota is implicated in immune dysregulation and inflammatory responses. This review delineates the microbial alterations and immune dysregulation features in common Inflammatory Skin Diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis(AD), seborrheic dermatitis(SD), diaper dermatitis(DD), and Malassezia folliculitis(MF).The skin microbiota, a complex and evolving community, undergoes changes in composition and function that can compromise the skin microbial barrier. These alterations induce water loss and abnormal lipid metabolism, contributing to the onset of ISDs. Additionally, microorganisms release toxins, like Staphylococcus aureus secreted α toxins and proteases, which may dissolve the stratum corneum, impairing skin barrier function and allowing entry into the bloodstream. Microbes entering the bloodstream activate molecular signals, leading to immune disorders and subsequent skin inflammatory responses. For instance, Malassezia stimulates dendritic cells(DCs) to release IL-12 and IL-23, differentiating into a Th17 cell population and producing proinflammatory mediators such as IL-17, IL-22, TNF-α, and IFN-α.This review offers new insights into the role of the human skin microbiota in ISDs, paving the way for future skin microbiome-specific targeted therapies. PMID:38375021 | PMC:PMC10876011 | DOI:10.2147/JIR.S441100 {url} = URL to article
    • Curr Med Mycol. 2023 Jun;9(2):52-63. doi: 10.22034/cmm.2023.345069.1425. ABSTRACT BACKGROUND AND PURPOSE: Tinea incognita (TI), or the other equivalent tinea atypica, is a term used to declare the atypical presentation of dermatophyte infections caused by the administration of steroids or other immunosuppressive medications which modulate the local and systemic immune response. It can mimic other dermatoses; hence making diagnostic challenges for dermatologists. Tina incognita may be misdiagnosed as many dermatoses. Based on previous studies, corticosteroids may cause different clinical manifestations of dermatophytes that might be very different from those that are commonly described. MATERIALS AND METHODS: This narrative review was conducted using PubMed and Scopus databases. Search terms included "Tinea incognita" and "Atypical dermatophytosis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews, and case reports. The search was restricted to articles written in the English language from 2006 to Feb 01, 2023. Moreover, duplicate articles and non-available full-text articles were excluded. The extracted data of the search results were retrieved in this study. The morphological patterns, prevalence, sight of infection, and causative agents were also described. RESULTS: Prevalence of different patterns of TI were recorded as 50% (431 out of 862 cases) for eczema-like lesions followed by psoriasis-like and 6.61% (57 out of 862) for parapsoriasis-like pattern. Moreover, each of the rosacea-like and pyoderma-like lesions equally accounted for 4.98 % of cases (43 out of 862). In addition, the prevalence of causative agents was reported as follows: Trichophyton rubrum accounted for 247 isolates (40%) as the most prevalent, followed by Trichophyton mentagrophytes (n=152, 24%) and Microsporum canis (n=119, 19%). CONCLUSION: Tinea incognita is a great mimicker; hence, dermatologists should obtain a full medical history of the patients to make correct diagnoses. It is vital to encourage an exact identification of the etiological agent according to the internal transcribed spacer sequencing in some uncertain cases. This review highlights the importance of mycological tests and fast diagnosis of TI, especially in cases of atypical skin lesions, to choose appropriate treatment and avoid the spread of drug-resistant species. PMID:38375520 | PMC:PMC10874480 | DOI:10.22034/cmm.2023.345069.1425 {url} = URL to article
    • Front Immunol. 2024 Feb 2;15:1297240. doi: 10.3389/fimmu.2024.1297240. eCollection 2024. ABSTRACT BACKGROUND: Accumulating evidence shows that dysregulation of intestinal flora is associated with inflammatory skin diseases, specifically atopic dermatitis (AD), psoriasis (PSO), and rosacea (ROS). However, the causality is still unclear. OBJECTIVES: To study the underlying causality between gut microbiota (GM) and AD, PSO, and ROS, a bi-directional two-sample Mendelian randomization (2SMR) analysis was conducted. METHODS: Summary statistics of gut microbiota, AD, PSO, and ROS were extracted from large-scale genome-wide association studies (GWASs). In 2SMR analysis, in addition to the inverse variance weighted as the principal method for evaluating causal association, four different methods were also used. Sensitivity analysis and reverse 2SMR study were implemented to evaluate the robustness of 2SMR results or reverse causal relationship, respectively. RESULTS: A total of 24 specific gut microbiota species related to AD, PSO, and ROS were identified by 2SMR analysis. After using the Bonferroni method for multiple testing correction, family FamilyXIII (ID: 1957) [OR = 1.28 (1.13, 1.45), p = 9.26e-05] and genus Eubacteriumfissicatenagroup (ID: 14373) [OR = 1.20 (1.09, 1.33), p = 1.65e-04] were associated with an increased risk for AD and PSO, respectively. The genus Dialister showed a negative association, suggesting a protective role against both atopic dermatitis and rosacea. Our reverse 2SMR analysis indicated no reverse causality between these inflammatory skin diseases and the identified gut microbiota. CONCLUSIONS: In summary, this study provided evidence for the causality between GM and inflammatory skin diseases. These findings suggested that supplementing specific bacterial taxa may be an effective therapy for AD, PSO, and ROS. PMID:38370414 | PMC:PMC10869565 | DOI:10.3389/fimmu.2024.1297240 {url} = URL to article
    • Indian J Dermatol. 2023 Nov-Dec;68(6):727. doi: 10.4103/ijd.ijd_367_23. Epub 2024 Jan 9. NO ABSTRACT PMID:38371544 | PMC:PMC10869002 | DOI:10.4103/ijd.ijd_367_23 {url} = URL to article
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