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  2. Related Articles Spotlight on brimonidine topical gel 0.33% for facial erythema of rosacea: safety, efficacy, and patient acceptability. Patient Prefer Adherence. 2017;11:1143-1150 Authors: Anderson MS, Nadkarni A, Cardwell LA, Alinia H, Feldman SR Abstract BACKGROUND: Brimonidine tartrate is a highly selective alpha 2 agonist that induces direct vasoconstriction of small arteries and veins, thereby reducing vasodilation and edema. OBJECTIVE: To review the current literature regarding the safety, efficacy, and patient acceptability of brimonidine 0.33% gel. METHODS: A PubMed search was performed using the terms brimonidine 0.33% gel, rosacea, safety, efficacy, and acceptability. Peer-reviewed clinical trials and case reports from 2012 to 2016 were screened for inclusion of safety, efficacy, and/or patient acceptability data. RESULTS: Brimonidine topical gel 0.33% is associated with mild, transient skin-related adverse reactions. Efficacy may be achieved within 30 minutes of administration with maximal reductions in erythema 3-6 hours after administration. Patient satisfaction with use of brimonidine topical gel is superior to vehicle gel for facial appearance, treatment effect, facial redness, and daily control of facial redness. LIMITATIONS: Studies were typically limited to 1-year follow-up. Only one study has examined the use of brimonidine topical gel in combination with other rosacea and acne medications. DISCUSSION: Brimonidine topical gel 0.33% is a safe, effective, and patient-accepted treatment for facial erythema of rosacea. PMID: 28740369 [PubMed] {url} = URL to article
  3. Yesterday
  4. Related Articles Late onset asymptomatic pancreatic neuroendocrine tumor - A case report on the phenotypic expansion for MEN1. Hered Cancer Clin Pract. 2017;15:10 Authors: Kaiwar C, Macklin SK, Gass JM, Jackson J, Klee EW, Hines SL, Stauffer JA, Atwal PS Abstract BACKGROUND: Multiple endocrine neoplasia type 1 (MEN1) is a hereditary cancer syndrome associated with several endocrine as well as non-endocrine tumors and is caused by mutations in the MEN1 gene. Primary hyperparathyroidism affects the majority of MEN1 individuals by age 50 years. Additionally, MEN1 mutations trigger familial isolated hyperparathyroidism. We describe a seemingly unaffected 76-year-old female who presented to our Genetics Clinic with a family history of primary hyperparathyroidism and the identification of a pathogenic MEN1 variant. CASE PRESENTATION: The patient was a 76 year-old woman who appeared to be unaffected. She had a family history of a known MEN1 pathogenic variant. Molecular testing for the known MEN1 mutation c.1A > G, as well as, biochemical testing, MRI of the brain and abdomen were all performed using standard methods. Molecular testing revealed our patient possessed the MEN1 pathogenic variant previously identified in her two offspring. Physical exam revealed red facial papules with onset in her seventies, involving her cheeks, nose and upper lip. Formerly, she was diagnosed with rosacea by a dermatologist and noted no improvement with treatment. Clinically, these lesions appeared to be facial angiofibromas. Brain MRI was normal. However, an MRI of her abdomen revealed a 1.5 cm lesion at the tail of the pancreas with normal adrenal glands. Glucagon was mildly elevated and pancreatic polypeptide was nearly seven times the upper limit of the normal range. The patient underwent spleen sparing distal pancreatectomy and subsequent pathology was consistent with a well-differentiated pancreatic neuroendocrine tumor (pNET). CONCLUSIONS: Age-related penetrance and variable expressivity are well documented in families with MEN1. It is thought that nearly all individuals with MEN1 manifest disease by age 40. We present a case of late-onset MEN1 in the absence of the most common feature, primary hyperparathyroidism, but with the presence of a pNET and cutaneous findings. This family expands the phenotype associated with the c.1A > G pathogenic variant and highlights the importance of providing comprehensive assessment of MEN1 mutation carriers in families that at first blush may appear to have isolated hyperparathyroidism. PMID: 28736585 [PubMed] {url} = URL to article
  5. The Healthy Geezer: Red, bumpy nose is rosacea, not booze, By Fred Cicetti, Times Herald-Record
  6. Last week
  7. Related Articles Improvement of Rosacea During Acyclovir Treatment: A Case Report. Am J Clin Dermatol. 2017 Jul 21;: Authors: Badieyan ZS, Hoseini SS PMID: 28733947 [PubMed - as supplied by publisher] {url} = URL to article
  8. Treatment for Phenotype 5

    Phymatous (Rhinophyma) [aka Subtype 3] This phenotype responds to treatment very well. Phymatous rosacea is uncommon. The most frequent phymatous manifestation is rhinophyma (known familiarly as "whiskey nose" "brandy nose" or "rum blossom"). In its severe forms, rhinophyma is a disfiguring condition of the nose resulting from hyperplasia of both the sebaceous glands and the connective tissue. Rhinophyma occurs much more often in men than in women (approximate ratio, 20:1), [1] and a number of clinicopathologic variants have been described. [2] Although rhinophyma is often referred to as "end-stage rosacea," it may occur in patients with few or no other features of rosacea. The diagnosis is usually made on a clinical basis, but a biopsy may be necessary to distinguish atypical, or nodular, rhinophyma from lupus pernio (sarcoidosis of the nose); basal-cell, squamous-cell, and sebaceous carcinomas; angiosarcoma; and even nasal lymphoma. [3] Older papers usually mention how rosacea progresses in stages and ends up in subtype 3, but recent studies indicate that this is not necessarily true. One can develop phenotype 5 without going through any 'stages.' [read this post] One report says, "It can affect nose (rhinophyma), chin (gnatophyma), forehead (metophyma), ears (otophyma) and eyelids (blepharophyma). Rhinophyma is the most frequent location..." [15] For images of phenotype 5 (formerly Subtype 3) click below: http://goo.gl/BI2lf; 28 Images of Rhinophyma A classic example of Subtype 3 is WC Fields (the rosacea poster boy): Another classic example is this painting in the Louvre, "The Old Man and His Grandson" by Ghirlandiao around the year 1480. There are Five Variants of Rhinophyma: Glandular Fibrous FibroangiomatousActinic Rhinophymous leishmaniasis This is a great thread to read about Subtype 3. Treatment There are a number of different treatments for rhinophyma, including surgery, but it is better to treat the rosacea before it reaches the advance stage of rhinophyma. However, once rhinophyma has developed it can usually be corrected by surgery using either laser, scapel, or dermabrasion. The good thing about rhinophyma is that though this condition is generally regarded as a severe form of rosacea it is a relatively rare disorder involving thickening of the skin on the nose and the presence of many oil glands and this condition can usually can be corrected. Accutane is usually the drug of choice, but your physician may use other prescription drugs such as antibiotics if you have this skin disorder. Other treatment may involve cryosurgery, dermashaving and electrosurgery. "Coblation of rhinophyma is an effective treatment with few side effects." [4] ""...Initially, the mass was thought to be rhinophyma, but biopsy of the mass revealed noncaseating granulomata consistent with sarcoidosis. The mass resolved following several steroid injections..." [5] Radiofrequency is used to treat rhinophyma. [6]Rhinophyma treated with kilovoltage photons {7]Treatment of rhinophyma with ultrasonic scalpel: case report [8] Radiosurgical excision of rhinophyma. [9] "Surgery is indisputably the treatment of choice for rhinophyma." [10] This report said, "Despite many advances in fundamental understanding, surgical techniques, and related technologies, no single method has been universally embraced and employed as the "gold standard." " [11] Smoothbeam laser [13] Surgical Management [14] Another report says, "Both tangential excision and carbon dioxide laser are well-established, reliable procedures for rhinophymaplasty that preserve the underlying sebaceous gland fundi allowing spontaneous re-epithelialization without scarring with similar outcomes and high patient satisfaction. The original nose shape and nearly normal skin surface texture are preserved by quickly removal of the hypertrophic tissue sparing the pilosebaceous tissue. The CO(2) laser is more capital intensive and results in higher fees compared with the simpler cold blade tangential excision. In our experience the ease of use, accuracy and precision of the lasers offer is not justified by the increased costs." [16] Another report, which says, "a surgical "gold standard" for treating the distorting phymatous skin alterations has not yet been established," it goes on to state, "the combination of a bovine collagen-elastin with simultaneous autologous non-meshed split-thickness skin grafting" was used in a surgery, and "may ultimately avoid the recurrence of rhinophyma and contribute to a full skin repair leading to satisfactory functional and aesthetic outcome." [17] "This report describes a simple, safe, efficient, and cost-effective approach to the treatment of severe rhinophyma using a scalpel and the electroscalpel, instruments readily available in every operating room." [18] Scalpel Excision and Wire Loop Tip Electrosurgery [19] One reports says, "The CO2 laser is more capital intensive and results in higher fees compared with the simpler cold blade tangential excision. In our experience the ease of use, accuracy and precision of the lasers offer is not justified by the increased costs." [20] Salicylic acid 30% • Jojoba oil • Glycolic acid 70% • Baking Soda • Dawn Ultra Low Dose Isotretinoin Another treatment has been reported, coblation. The report says, "A hand-held coblation ‘wand’ emits a slow stream of saline solution – sterilised salt water – from the end that comes into contact with the nose. At the same time, it emits waves of radiofrequency energy to excite the molecules in the solution which ‘sands’ down the tissue. It also uses a low heat to cauterise (clot) any bleeding blood vessels." [12] Anecdotal Reports Nose Swelling, big pores, phymous tissue--please post! End Notes [1] Roberts JO, Ward CM. Rhinophyma. J R Soc Med 1985;78:678-681.[iSI] [Medline] [2] Aloi F, Tomasini C, Soro E, Pippione M. The clinicopathologic spectrum of rhinophyma. J Am Acad Dermatol 2000;42:468-472.[CrossRef][iSI] [Medline] [3] Murphy A, O'Keane JC, Blayney A, Powell FC. Cutaneous presentation of nasal lymphoma: a report of two cases. J Am Acad Dermatol 1998;38:310-313.[iSI] [Medline] [4] Coblation of rhinophyma. Timms M, Roper A, Patrick C.J Laryngol Otol. 2011 Apr 27:1-5. [5] Sarcoidosis of the external nose mimicking rhinophyma. Case report and review of the literature. Goldenberg JD, Kotler HS, Shamsai R, Gruber B.Ann Otol Rhinol Laryngol. 1998 Jun;107(6):514-8. [6] Management of mild to moderate rhinophyma with a radiofrequency. Erisir F, Isildak H, Haciyev Y.J Craniofac Surg. 2009 Mar;20(2):455-6. [7] Rhinophyma treated with kilovoltage photons. Skala M, Delaney G, Towell V, Vladica N.Australas J Dermatol. 2005 May;46(2):88-9. [8] Treatment of rhinophyma with ultrasonic scalpel: case report. Tenna S, Gigliofiorito P, Langella M, Carusi C, Persichetti P.J Plast Reconstr Aesthet Surg. 2009 Jun;62(6):e164-5. Epub 2008 Dec 12. [9] Radiosurgical excision of rhinophyma. Somogyvári K, Battyáni Z, Móricz P, Gerlinger I.Dermatol Surg. 2011 May;37(5):684-7. doi: 10.1111/j.1524-4725.2011.01965.x. Epub 2011 Apr 1. Letter: radiosurgical excision of rhinophyma. Niamtu J 3rd.Dermatol Surg. 2012 May;38(5):816-7. doi: 10.1111/j.1524-4725.2012.02383.x. [10] Rhinophyma in rosacea : What does surgery achieve? Sadick H, Riedel F, Bran G.Hautarzt. 2011 Oct 19. [11] Nuances in the management of rhinophyma. Facial Plast Surg. 2012 Apr;28(2):231-7Authors: Little SC, Stucker FJ, Compton A, Park SS [12] How salt-blasting surgery cured my disfiguring condition called 'drinker's red nose' By ROGER DOBSON Mail Online / Health PUBLISHED: 16:07 EST, 12 May 2012 | UPDATED: 17:23 EST, 12 May 2012 Read more: http://www.dailymail...l#ixzz1uvARY8Et [13] J Dermatolog Treat. 2012 Apr;23(2):153-5. Epub 2010 Oct 22. Moderate rhinophyma successfully treated with a Smoothbeam laser. Chou CL, Chiang YY [14] Conn Med. 2014 Mar;78(3):159-60. Surgical management of rhinophyma: a case report and review of literature. Ferneini EM, Banki M, Paletta F, Ferneini CM. [15] An Bras Dermatol. 2012 Dec;87(6):903-5. Gnatophyma: a rare form of rosacea. Macedo AC, Sakai FD, Vasconcelos RC, Duarte AA. [16] J Craniomaxillofac Surg. 2012 Dec 8. pii: S1010-5182(12)00248-X. doi: 10.1016/j.jcms.2012.11.009. Surgical correction of rhinophyma: Comparison of two methods in a 15-year-long experience. Lazzeri D, Larcher L, Huemer GM, Riml S, Grassetti L, Pantaloni M, Li Q, Zhang YX, Spinelli G, Agostini T. [17] Int J Surg Case Rep. 2012 Nov 10;4(2):200-203. doi: 10.1016/j.ijscr.2012.11.003. [Epub ahead of print] The surgical treatment of rhinophyma-Complete excision and single-step reconstruction by use of a collagen-elastin matrix and an autologous non-meshed split-thickness skin graft. Selig HF, Lumenta DB, Kamolz LP. Aesthetic Plast Surg. 2013 Jan 8. [Epub ahead of print] Optimizing Cosmesis with Conservative Surgical Excision in a Giant Rhinophyma. Lazzeri D, Agostini T, Spinelli G. [18] Aesthetic Plast Surg. 2013 Mar 1. [Epub ahead of print] Management of Severe Rhinophyma With Sculpting Surgical Decortication. Husein-Elahmed H, Armijo-Lozano R. [19] Dermatol Surg. 2013 Apr 5. doi: 10.1111/dsu.12193. [Epub ahead of print] Treatment of Severe Rhinophyma Using Scalpel Excision and Wire Loop Tip Electrosurgery. Prado R, Funke A, Brown M, Ramsey Mellette J. Source Northeast Dermatology Associates, Andover, Massachusetts. [20] J Craniomaxillofac Surg. 2013 Jul;41(5):429-36. doi: 10.1016/j.jcms.2012.11.009. Epub 2012 Dec 8. Surgical correction of rhinophyma: comparison of two methods in a 15-year-long experience. Lazzeri D1, Larcher L, Huemer GM, Riml S, Grassetti L, Pantaloni M, Li Q, Zhang YX, Spinelli G, Agostini T.
  9. Related Articles [Rosacea: New data for better care]. Ann Dermatol Venereol. 2017 Jul 17;: Authors: Cribier B Abstract In the last 10 years, numerous studies have been published that throw new light on rosacea, in all areas of the disease. This overview summarises all the key developments, based on the indexed bibliography appearing in Medline between 2007 and 2017. Recent epidemiological data show that the prevalence of the disease is doubtless greater than estimated hitherto (more than 10% of adults in some countries) and that we should not overlook rosacea in subjects with skin phototypes V or VI, a condition that exists on all continents. A new classification of rosacea by phenotype comprising major and minor signs has been put forward; it provides a more rational approach to suitable management based upon symptoms, the severity of which may be graded into 5 classes. The treatments with the best-demonstrated efficacy (updated Cochrane study) are topical metronidazole, azelaic acid and ivermectin, and oral doxycycline; isotretinoin is effective against resistant forms but is off-label. In ocular rosacea, the reference treatment is doxycycline in combination with topical therapy of the eyelids. The physiopathology is complex and involves several factors: vascular (vasodilatation, vascular growth factors), neurovascular (hypersensitivity, neuropathic pain, neuropeptides), infectious (Demodex folliculorum and its microbiota) and inflammatory (abnormal production of pro-inflammatory peptides of the innate immune system). In addition, there is a genetic predisposition as demonstrated by the weight of familial history and comparison of homozygous and heterozygous twins. There is also activation of several genes involved in immunity, inflammation and lipid metabolism; the theory of hydrolipid film anomalies has been posited once more. There has thus been a tremendous leap forward in the field of rosacea research, with therapeutic progress and improved understanding of the underlying mechanisms, which should enable the future development of more targeted treatments as well as global management of this disease, which has major social and emotional consequences on the life of patients. PMID: 28728857 [PubMed - as supplied by publisher] {url} = URL to article
  10. Face flushing? You might want to look at what you’re drinking: Alcohol can raise your risk of a skin condition called rosacea, a new study published in the Journal of the American Academy of Dermatology suggests. In the study, researchers quizzed nearly 83,000 people on their alcohol intake every four years. They discovered that the more total alcohol they drank, the more likely they were to develop rosacea over the 14-year follow up. How Booze Can Make Your Face Red, Flushed, and Swollen, BY CHRISTA SGOBBA, Men's Health
  11. In an interview with Linda Stein Gold, MD, Soolantra Cream Clinical Investigator who also volunteers on the RRDi MAC, Dr. Stein Gold says, "I see topical ivermectin therapy as first line therapy for Papulopustular Rosacea." The ZZ cream is an excellent non prescription treatment to consider.
  12. Treatment for Phenotype 2

    Persistent Erythema, Phenotype 2, is the most difficult phenotype to treat. Mirvaso and Rhofade are two treatments for phenotype 2. You should read the posts about Mirvaso and Rhofade. There have been reports of rebound with both, but particularly with Mirvaso (less rebound reports with Rhofade).
  13. Rosacea Clinical Trials

    Rosacea Trial in Austin, Texas
  14. Earlier
  15. softilly's treatment for erythematotelangiectatic rosacea:
  16. Role of Demodex mite infestation in rosacea: A systematic review and meta-analysis. J Am Acad Dermatol. 2017 Jul 12;: Authors: Chang YS, Huang YC Abstract BACKGROUND: The reported prevalence and degrees of Demodex mite infestation in rosacea vary widely. OBJECTIVE: We sought to conduct an evidence-based meta-analysis of the prevalence and degrees of Demodex mite infestation in patients with rosacea. METHODS: Systematic literature review and meta-analysis were conducted. Odds ratios for prevalence of infestation and standardized mean difference (SMD) for Demodex density in patients with rosacea were pooled. Subgroup analysis for type of rosacea, control group, and sampling and examination methods were also performed. RESULTS: Twenty-three case-control studies included 1513 patients with rosacea. Compared with the control patients, patients with rosacea were more likely to be infested by Demodex mites [odds ratio, 9.039; 95% confidence interval (CI), 4.827-16.925] and had significantly higher Demodex density (SMD, 1.617; 95% CI, 1.090-2.145). Both erythematotelangiectatic rosacea (SMD, 2.686; 95% CI, 1.256-4.116) and papulopustular rosacea (SMD, 2.804; 95% CI, 1.464-4.145) had significantly higher Demodex density than did healthy control patients. LIMITATIONS: Interstudy variability was high, and a causal relationship could not be established by case-control studies. CONCLUSIONS: Patients with rosacea had significantly higher prevalence and degrees of Demodex mite infestation than did control patients. Demodex mites may play a role in both erythematotelangiectatic rosacea and papulopustular rosacea. PMID: 28711190 [PubMed - as supplied by publisher] {url} = URL to article
  17. If you’re suffering from rosacea, your doctor might simply tell you that there’s no real way to treat it and that you’ll probably have to deal with it for the rest of your life. But as with most other health conditions, the root cause of rosacea is almost certainly linked to your state of health in general, and particularly your diet and lifestyle. This article will seek to provide some simple, natural remedies to treat your rosacea to not only reduce the symptoms, but hopefully also prevent it from flaring up in the future. 5 Natural Remedies To Treat Rosacea, by Liivi Hess, The Alternative Daily
  18. Related Articles Possible role of Helicobacter pylori in diseases of dermatological interest. J Biol Regul Homeost Agents. 2017 07 13;31(2 Suppl. 2) Authors: Guarneri C, Lotti J, Fioranelli M, Roccia MG, Lotti T, Guarneri F Abstract Helicobacter pylori is a gram-negative, flagellate, microaerophilic bacterium identified for the first time about 30 years ago, as a pathogenic factor of gastritis and peptic ulcer. Soon after, it was linked to several gastrointestinal and extra-gastrointestinal diseases (hematological, cardiovascular, neurological, pulmonary and ocular diseases, obesity, diabetes mellitus, growth retardation and extragastric MALT lymphoma). Association and possible cause-effect correlation with H. pylori infection were suggested in diseases of dermatological interest such as chronic urticaria, rosacea, Henoch-Schoenleins purpura, idiopathic thrombocytopenic purpura, cutaneous and oral lichen planus, atopic dermatitis, recurrent aphthous stomatitis, systemic sclerosis, psoriasis, Sjögrens syndrome, Behçet's disease, pruritus, alopecia areata, primary cutaneous marginal zone B-cell lymphomas, vitiligo, chronic prurigo, multiformis, prurigo nodularis, leukocytoclastic vasculitis, prurigo pigmentosa, eczema nummulare, primary cutaneous MALT-type lymphoma, sublamina densa-type linear IgA bullous dermatosis, Sweet's syndrome, cutaneous T-cell pseudolymphoma and pemphigus vulgaris. A critical review of the literature up to May 2017 shows clear evidence of H. pylori involvement only for some of the above purported associations, while in the majority of cases data appear contrasting and/or obtained on a not adequately large study population. Further clinical and laboratory research, with more adequate methodological and statistical basis, is required to assess the actual existence and relevance of many purported associations, as well as the possible role of H. pylori and the underlying pathogenic mechanisms. PMID: 28702966 [PubMed - as supplied by publisher] {url} = URL to article
  19. Related Articles Light-based devices in the treatment of cutaneous vascular lesions: An updated review. J Cosmet Dermatol. 2017 Jul 13;: Authors: Garden BC, Garden JM, Goldberg DJ Abstract BACKGROUND: Light-based devices have been used to treat cutaneous vascular lesions almost since the original development of the laser. After the introduction of the initial continuous wave and pulsed laser systems, the pulsed lasers became the gold standard device. Since then, new devices and methods to treat patients have been introduced. OBJECTIVE: To review and summarize the current literature specific to treatment of cutaneous vascular lesions with light-based devices. METHODS: A review of the current literature of light-based devices used for the treatment of vascular lesions. RESULTS AND CONCLUSIONS: New systems continue to be developed to treat vascular lesions with advantages and disadvantages compared to older devices. Nonlaser sources such as intense pulsed light and radiofrequency devices can also be used in the treatment of these patients. Newer approaches may lead to even better results. PMID: 28703427 [PubMed - as supplied by publisher] {url} = URL to article
  20. Botox for Rosacea

    Botox jabs could offer a long-lasting solution for those who suffer the discomfort and embarrassing ‘blushing’ of rosacea. When tiny droplets of the wrinkle-busting nerve toxin are injected in diluted form into the forehead and cheeks, they have been found to reduce the redness which is the main symptom of the incurable skin disease. The breakthrough has been shown in early-stage trials to help all forms of the condition, including those characterised by acne-like spots on the face, and the severe skin-thickening form rhinophyma. Blush like Bridget Jones? A jab of Botox could help reduce redness and cut out acne-like spots, By Sara Malm In San Diego For Mail On Sunday, Daily Mail
  21. Microbiome-based therapeutic strategies

    Rosacea has for over 60 years has been treated with antibiotics. The current strategy is that antibiotics are not targeting microbes but are used for anti-inflammatory effects. However, there are a number of microbes that have been associated with rosacea (Candida Albicans, Chlamydophila pneumoniae, Demodex Mites, Helicobacter Pylori, Propionibacterium acnes, Staphylococcus epidermidis, and list keeps growing). With demodectic rosacea there are at least two microbes associated (Bacillus oleronius and Bartonella quintana [see end note 31 and 68 in this article]). Antibiotic treatment is used for treating other diseases and it is noted that rosacea is improved in many cases as a side note. For example, patients treated with antibiotics for SIBO or IBS who also have rosacea note that rosacea is improved. A paper worth reading on the subject of gut flora discusses the 'metagenome' or the 'second genome' in the human gut which holds microbes containing more genes in the flora in the intestinal system than the rest of our bodies. The paper says, "This creates a huge dataset that has to be disentangled." [see end note 4] The paper discusses how understanding gut flora may be a key to understanding diseases.One study by Nature Publishing Group discusses how recent research suggests that humans might be divided into three types of gut bacteria: Bacteroides, Prevotella and Ruminococcus. This may lead to personalizing medical treatment based upon which type gut microbes you predominantly have. [see end note 5] "The three gut types can explain why the uptake of medicines and nutrients varies from person to person," reports Jeroen Raes, a bioinformatician at Vrije University. [see end note 6] This may develop into a new ‘biological fingerprint’ on the same level as blood types and tissue types. [see end note 7] This may lead to a 'gut type diet' (similar to the blood type diet].
  22. A recent paper on "microbiome-based therapeutic strategies' states, "designing a geographically tailored therapeutic approach would need an in-depth understanding of how population and environmental parameters can affect the microbial communities and their metabolic potentials, which, we hope, may be attained in near future through construction of pan microbiome of human populations around the globe." The five major body habitats of the human microbiome, the Gut ( has the largest number of microbes and the greatest variety of species compared to other body habitats), Oral-cavity, Respiratory Tract, Skin (Studies suggested that diseases like atopic dermatitis, psoriasis, rosacea, acne etc. are often caused not because of pathogens but due to disruption in normal skin microbiota), and Urogenital Tract (UGT) shows "a gradual transition in the gross compositional structure along with a continual decrease in diversity of the microbiome, especially of the gut microbiome, as the human populations passed through three stages of subsistence like foraging, rural farming and industrialized urban western life." Front Microbiol. 2017; 8: 1162. Published online 2017 Jun 23. doi: 10.3389/fmicb.2017.01162 PMCID: PMC5481955 Geography, Ethnicity or Subsistence-Specific Variations in Human Microbiome Composition and Diversity Vinod K. Gupta, Sandip Paul, and Chitra Dutta Rosacea has been connected to the gut microbiome, but obviously the skin microbiome is something to consider, and we need more research on this. In an article discussing an infection with the Leishmania parasite "To my knowledge, this is the first case where anyone has shown that a pre-existing skin microbiome can influence the outcome of an infection or a disease," said Elizabeth Grice, co-senior author and assistant professor in the departments of Dermatology and Microbiology in Penn's Perelman School of Medicine. "This opens the door to many other avenues of research." [1] End Notes [2] A perturbed skin microbiome can be 'contagious' and promote inflammation, Science Daily
  23. Related Articles An observational descriptive survey of rosacea in the Chinese population: clinical features based on the affected locations. PeerJ. 2017;5:e3527 Authors: Xie HF, Huang YX, He L, Yang S, Deng YX, Jian D, Shi W, Li J Abstract BACKGROUND: There is currently no study that has evaluated the differences in epidemiological and clinical characteristics among rosacea patients according to different facial sites. METHODS: Clinical and demographic data were obtained from 586 rosacea patients. The patients were divided into four groups based on the main sites involved with the rosacea lesions (full-face, cheeks, nose, or perioral involvement). Clinical signs were measured through self-reported, dermatologist-evaluated grading of symptoms, and physiological indicators of epidermal barrier function. RESULTS: There were 471 (80.4%), 49 (8.4%), 52 (8.9%), and 14 (2.4%) cases in the full-face, cheek, nasal and perioral groups, respectively. Compared with the healthy control, the full-face group had lower water content and higher transepidermal water loss (TEWL) in the cheeks, and chin; the perioral group had lower water content and higher TEWL in the chin; while the nasal group had the normal water content and TEWL. Compared with the full-face group, the nasal group had more severe phymatous changes, less severe self-reported and dermatologist-evaluated grading of symptoms. All the patients in the perioral or the nasal group had their first rosacea lesions start and remain at the chin or on the nose. In the full-face group, 55.8% of patients had their lesions start with the full face, 40.1% on the cheek, and the rest (4.1%) on the nose. CONCLUSION: Significant differences in clinical features were observed among rosacea patients with lesions at four different sites. The lesion localization of each group was relatively stable and barely transferred to other locations. PMID: 28698821 [PubMed - in process] {url} = URL to article
  24. Related Articles Pediatric blepharokeratoconjunctivitis: is there a 'right' treatment? Curr Opin Ophthalmol. 2017 Jul 10;: Authors: Rousta ST Abstract PURPOSE OF REVIEW: This article highlights the importance of recognizing blepharokeratoconjunctivitis (BKC) in children and reviews the clinical characteristics and current therapeutic modalities. RECENT FINDINGS: The mainstay of BKC treatment remains controlling the meibomian gland inflammation and treating cobormid conditions. BKC can occur in the setting of ocular rosacea and Demodex infestation. Small studies have shown treatment benefits of topical cyclosporine A as well as oral azithromycin in pediatric BKC. SUMMARY: BKC is a cause for visual loss in children, and therefore pediatric ophthalmologists should be more vigilant about early diagnosis and long-term treatment. There is a lack of randomized controlled trials on this topic and no standardized outcome measures. Better ways to measure the clinical outcome of various treatment modalities need to be developed. PMID: 28696955 [PubMed - as supplied by publisher] {url} = URL to article
  25. Living With Rosacea, CBS Philly

    Many never touch alcohol but have rosacea. In certain people, overproduction of two inflammatory proteins and their subsequent interaction lead to the rise of a third protein that causes rosacea. Living With Rosacea, By Dr. Brian McDonough, CBSPhilly
  26. "Especially during the summer, the initial redness of rosacea can easily be confused with a sunburn that lingers or doesn't go away," said Dr. John Wolf, chairman of dermatology at Baylor College of Medicine. "It's important for anyone who suspects they may have rosacea to see a dermatologist for diagnosis and appropriate medical therapy." The 'Sunburn' That Won't Go Away: Summer Tips for Controlling Rosacea, PRWeb, benzinga
  27. The RRDi has now over 1000 charter members who have graciously joined providing contact information so that they can vote in our decision making of who serves on the board of directors every five years. We have now opened up our membership to anyone who will provide an email address and a cryptic display name without giving us all the contact information. These new members who do not provide full contact information will not be able to vote for who serves on the board of directors, but will have posting privileges in the forum. We hope to increase our membership since many are reluctant to join if they have to provide contact information. This way, only those who really want to vote will graciously provide such information if they want to. Otherwise, a new member can be totally anonymous. We are also allowing those to use their Facebook accounts to register an account with our forum, as well as Twitter.
  28. Testing New Facebook Login and Posting

    Just set up new facebook registration/login ability and testing the posting.
  29. Is Rosacea Contagious?

    There are no known articles that have actually studied whether rosacea is contagious but any papers published about this question says that rosacea is not contagious. "Rosacea is not catching." [1] There are some communicable skin conditions and here is a list. A recent paper published by Cell Host & Microbe states, "In a new study, researchers at the University of Pennsylvania have shown for the first time that, not only can infection with the Leishmania parasite alter the skin microbiome of affected mice, but this altered microbial community can be passed to uninfected mice that share a cage with the infected animals." An article discussing this paper says, "To my knowledge, this is the first case where anyone has shown that a pre-existing skin microbiome can influence the outcome of an infection or a disease," said Elizabeth Grice, co-senior author and assistant professor in the departments of Dermatology and Microbiology in Penn's Perelman School of Medicine. "This opens the door to many other avenues of research." " Obviously we need better understanding of Microbiome-based therapeutic strategies. Demodectic Rosacea May Be Contagious Danners points out in post #10, "This question has been asked several times on this forum, with similar experiences described by the person posing the question. Doctors and online medical articles say these are not communicable diseases, however there are several, if not hundreds of anecdotal posts on acne.org, reddit and this forum that say otherwise." Are we discussing demodectic rosacea now? A point worth mentioning is that babies do not have demodex mites. So how do most humans have demodex mites on their skin if they are not transferred? So therefore, isn't it possible to 'catch' demodectic rosacea, which is a variant of rosacea? One paper on this subject states, "The transfer of Demodex mites between individuals appears to happen less frequently than the transfer of lice (Pediculus humanus), another human-associated arthropod species, as would be expected considering the more external habitat of lice in comparison with these pore-dwelling mites." [2] Another paper explains, "Conversely, if Demodex lack strong geographic structure, it suggests the movement of mites among humans must occur very frequently (perhaps even with social greeting rituals) and across large geographic distances." [3] This same source states the following about transmission of mites between humans: "Little is known about the transmission of mites among humans. Recent studies find that many symbiotic microbes are passed directly from mother to offspring during breast-feeding or during birth (especially if birth is vaginal), and dogs acquire their Demodex mites as nursing pups. In light of this, the same means of mite transmission seems possible in humans, supported by the fact that in one study, Demodex mites were found in 77% of nipple tissue from mastectomies. Yet that we found mites on all adults but only 70% of 18 year olds, suggests that perhaps mite colonization does not strictly occur vertically, from parent to child. These results are in line with earlier morphological (largely postmortem) studies in which mites were found to be more prevalent on adults than on children. Mites could be more ubiquitous on children than noted in postmortem studies or herein but at levels or in locations that make the mites difficult to detect even with the use of molecular approaches. One study of Demodex mites on Tokelau islanders found that mites were present on a greater number of children than on adults. These conflicting findings highlight our limited understanding of how and when mites move onto and among human bodies." [3] "Presumably, Demodex passes to newborns through close physical contact after birth; however, due to low sebum production, infants and children lack significant Demodex colonization....Infestation of both species is more common in males than in females, with males more heavily colonizing than females (23% vs 13%) and harboring more D. brevis than females (23% vs 9%)....The mites are transferred between hosts through contact of hair, eyebrows, and sebaceous glands on the nose." [4] Logic concludes that demodectic rosacea may be contagious. However, why does one human (a) with rosacea who cohabits and consorts with another human (b) for many years not pass on rosacea to human (b) ? Obviously in such cases rosacea is not infecting human (b). So how can we prove beyond any doubt that demodectic rosacea may be contagious? A peer reviewed, double blind, placebo controlled clinical study should suffice to answer this question. How can this be done? Conclusion So, wouldn't it be nice if say ten thousand rosacea sufferers got together and each donated a dollar and then paid a physician to study this subject and write an article that nails the coffin on this? That brings us to a different subject, 'how do you bring together 10,000 rosacea sufferers together who can publish their own research on rosacea?' Can the RRDi do this? End Notes [1] British Skin Foundation, Rosacea [2] PNAS | December 29, 2015 | vol. 112 | no. 52 | 15963 Global divergence of the human follicle mite Demodex folliculorum: Persistent associations between hostancestry and mite lineages Michael F. Palopolia,, Daniel J. Fergusb, Samuel Minota, Dorothy T. Peia, W. Brian Simisond, Iria Fernandez-Silvad, Megan S. Thoemmesc, Robert R. Dunnc, and Michelle Trautweind [3] PLoS ONE 9(8): e106265 Ubiquity and Diversity of Human-Associated Demodex Mites Megan S. Thoemmes , Daniel J. Fergus, Julie Urban, Michelle Trautwein, Robert R. Dunn https://doi.org/10.1371/journal.pone.0106265 [4] Indian J Dermatol. 2014 Jan-Feb; 59(1): 60–66.doi: 10.4103/0019-5154.123498 PMCID: PMC3884930 Human Demodex Mite: The Versatile Mite of Dermatological Importance Parvaiz Anwar Rather and Iffat Hassan For more information on the study of demodex mites, read Megan Thoemmes, PhD Student | Dunn Lab
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