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  2. Related Articles Role of serum 25-hydroxyvitamin D levels and vitamin D receptor gene polymorphisms in patients with rosacea: a case-control study. Clin Exp Dermatol. 2018 Sep 23;: Authors: Akdogan N, Alli N, Incel Uysal P, Candar T Abstract BACKGROUND: Vitamin D has significant effects on the immune system and thereby on the pathogenesis of rosacea. However, there is a lack of information on the vitamin D status and vitamin D receptors (VDRs) of patients with rosacea. AIM: To evaluate the role of vitamin D in rosacea susceptibility. METHODS: A case-control study was conducted, enrolling patients with rosacea and healthy controls (HCs). Five VDR gene single nucleotide polymorphisms (SNPs) (Cdx2, FokI, ApaI, BsmI and TaqI) and serum 25-hydroxyvitamin D3 [25(OH)D3 ] levels were compared between patients and HCs. RESULTS: The study enrolled 60 patients (M/F: 14/46) and 60 age- and sex-matched HCs (M/F: 14/46). Age (mean ± SD) was 48 ± 11 years for both groups. The serum 25(OH)D3 levels (median ± interquartile range) were higher in patients with rosacea (12.9 ± 6.8 ng/mL) than in HCs (10.5 ± 3.7 ng/mL) (P < 0.001). Subjects with high serum 25(OH)D3 levels had a 1.36-fold increased risk of rosacea (95% CI 1.17-1.58). Heterozygous and mutant ApaI polymorphisms increased rosacea risk by 5.26-fold (95% CI 1.51-18.35) and 3.69-fold (95% CI 1.19-11.48), respectively, whereas mutant TaqI polymorphisms decreased the risk by 4.69 times (95% CI 1.37-16.67). Heterozygosity for Cdx2 alleles increased rosacea risk, whereas wildtype ApaI and mutant TaqI alleles decreased it. CONCLUSIONS: The present study suggests that an increase in vitamin D levels may contribute to the development of rosacea. ApaI and TaqI polymorphisms, and heterozygous Cdx2, wildtype ApaI and mutant TaqI alleles were significantly associated with rosacea. These results indicate a possible role of vitamin D and VDR pathways in the pathogenesis of rosacea, although causality could not be assessed. PMID: 30246390 [PubMed - as supplied by publisher] {url} = URL to article
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  4. Global Epidemiology and Clinical Spectrum of Rosacea, Highlighting Skin of Color: Review and Clinical Practice Experience. J Am Acad Dermatol. 2018 Sep 18;: Authors: Alexis AF, Callender VD, Baldwin HE, Desai SR, Rendon MI, Taylor SC Abstract Among individuals with skin of color, rosacea has been reported less frequently than in those with white skin, but it is not a rare disease. In fact, rosacea may be underreported and underdiagnosed in populations with skin of color because of the difficulty of discerning erythema and telangiectasia in dark skin, as well as underestimation of the susceptibility of more highly pigmented skin to dermatologic conditions like rosacea whose triggers include sun exposure. Many people with skin of color who have rosacea may experience delayed diagnosis leading to inappropriate or inadequate treatment, greater morbidity, and uncontrolled, progressive disease with disfiguring manifestations, including phymatous rosacea. This paper reviews the epidemiology of rosacea in skin of color and highlights variations in the clinical presentation of rosacea across the diverse spectrum of patient populations affected. It presents strategies to aid in the timely diagnosis and effective treatment of rosacea in patients with skin of color, with an aim of promoting increased awareness of rosacea in these patients and reducing disparities in the management of their disease. PMID: 30240779 [PubMed - as supplied by publisher] {url} = URL to article
  5. Full Text The four components of this treatment are: (1) Dextran sulfate is an anionic polymer of sulfated glucose [1] Dextran sulfate contains approximately 17% sulfur which is equivalent to approximately 2.3 sulfate groups per glucosyl residue. [2] (2) 4-t-butylcyclohexanol [BCH; TRP-regulin ®] [3] (3) pongamia oil [4] (4) hesperidin methyl chalcone [HMC] [5] Some of the products mentioned in the above post, "Avène redness-relief cosmetic products for sensitive skin prone to redness" are: Eau Thermale Avène Antirougeurs Clean Redness-Relief Refreshing Cleansing Lotion Eau Thermale Avène Tolérance Extrême Emulsion Eau Thermale Avène Antirougeurs Calm Soothing Repair Mask Eau Thermale Avène Xeracalm A.D Lipid-Replenishing Cleansing Oil Eau Thermale Avène Skin Recovery Cream Eau Thermale Avène Cicalfate Restorative Skin Cream Eau Thermale Avène Extremely Gentle Cleanser Lotion Eau Thermale Avène Antirougeurs Dermo Cleansing Milk Eau Thermale Avène Antirougeurs Day Redness Relief Soothing SPF 25 Cream Eau Thermale Avène Antirougeurs Fort Relief Concentrate End Notes [1] Dextran Sulfate, Sodium Salt (CAS 9011-18-1), Santa Cruz Biotechnology [2] Dextran Sulfate, Sigma Aldrich, Millipore Sigma [3] PubChem, Sigma Aldrich, ChemSpider, Paula's Choice, Safety Data Sheet, Effective treatment for sensitive skin: 4-t-butylcyclohexanol and licochalcone A [4] derived from the seeds of the Millettia pinnata tree [5] Paula's Choice, Truth in Aging, Douglas Laboratories,
  6. 0_purchase.png.90e351976c60ab1694dd926e4
    Purchase. Description. More information
    Gentle soothing formula comforts skin while cleansing. Visibly reduces the appearance of redness, heat, irritation and tightness. Gentle, soothing formula reduces heat, tightness and irritation and comforts skin while cleansing. This gentle, calming and soothing cleansing lotion is formulated with carefully selected ingredients to gently reduce heat, tightness and irritation while cleansing even the most redness-prone skin. Gel-texture offers immediate relief to the skin upon application. Can be used as a post-vascular laser treatment. Rooted in dermatology and hydrotherapy, Avène has over 270 years of expertise in caring for sensitive skin and is trusted by millions. Its core ingredient, Avène

    $24.00 NOTE: Our shopping cart is disabled. We are using it to display affiliate items which if you click on PURCHASE in the PRODUCT INFORMATION by scrolling below or click on the Amazon banner the RRDi receives a small affiliate fee upon completion of your purchase. Mahalo.

  7. Effects of dextran sulfate, 4-t-butylcyclohexanol, pongamia oil and hesperidin methyl chalcone on inflammatory and vascular responses implicated in rosacea. Clin Cosmet Investig Dermatol. 2018;11:421-429 Authors: Hernandez-Pigeon H, Garidou L, Galliano MF, Delga H, Aries MF, Duplan H, Bessou-Touya S, Castex-Rizzi N Abstract Background: Rosacea is a chronic facial skin disorder characterized by inflammation and vascular abnormalities. The pathophysiology of rosacea involves increased activation of the capsaicin receptor, TRPV1, the vascular endothelial growth factor (VEGF) pathway, and cathelicidin LL-37, MMP-9, and KLKs. We evaluated the activity of four compounds (dextran sulfate, 4-t-butylcyclohexanol [BCH; TRP-regulin®], pongamia oil, and hesperidin methyl chalcone [HMC]) on inflammatory and vascular responses implicated in rosacea. Materials and methods: The anti-inflammatory activity of dextran sulfate was evaluated on PGE2 production after PMA stimulation of NCTC-2544 keratinocytes, and on normal human epidermal keratinocytes (NHEKs) after proinflammatory stimulation to mimic a rosacea environment. The anti-angiogenic activity of dextran sulfate was measured by analyzing pseudotube formation in co-cultured human microvascular endothelial cells/normal human dermal fibroblasts. HMC modulation of vascular responses and IL-8 cytokine production after SP stimulation was evaluated in human skin explants. We also assessed the effect of BCH on TRPV1 activation, and the effect of combined BCH and pongamia oil on the inflammatory response of NHEKs. Results: Dextran sulfate strongly and significantly inhibited PMA-induced PGE2 production, inhibited KLK5 and MMP-9 mRNA expression, and IL-8, IL-1α and VEGF production, and displayed a highly significant inhibitory effect on VEGF-induced pseudotube formation. In SP-stimulated human skin explants, HMC significantly decreased the proportion of dilated vessels, total vessel area, and IL-8 production. BCH significantly and dose-dependently inhibited TRPV1 activation, and BCH and pongamia oil inhibited CXCL1 and CXCL6 mRNA expression and IL-8 production in NHEKs. Combined BCH/pongamia oil inhibited IL-8 production synergistically. Conclusion: These in vitro results showed that dextran sulfate, BCH, pongamia oil and HMC, possess complementary soothing and anti-redness properties, supporting their combination in Avène redness-relief cosmetic products for sensitive skin prone to redness, and for topical adjunctive rosacea treatment. PMID: 30233225 [PubMed] {url} = URL to article
  8. Admin

    Candida Albicans And Rosacea

    One paper links Fungal keratitis associated with ocular rosacea
  9. 0_purchase.png.90e351976c60ab1694dd926e4
    Purchase. About the product
    - Worried about Retin - A drying out your facial skin? Our advanced, anti aging formula is designed for daily use (day and night)with maximum prescription strength effectiveness without flaking,peeling or dry skin. Loaded with the best organic ingredients for your face such as Hyaluronic Acid, Vitamin E, Green Tea, Shae Butter and Jojoba Oil. For men and women and all skin types.
    - You’ll see results! Premium, high potency lotion will produce visible changes with fine lines and wrinkles. Fade sun damage, spots, acne,scars and stretch marks. Improve uneven tone, skin texture and overall appearance. Repair, improve and restore life back into your skin revealing your true beauty.
    - No oily residue left behind. Our creme quickly absorbs without a heavy or sticky feel. Gentle enough for sensitive skin and to use around your eye area helping with dark circles, milia and under eye bags. Use on hands and neck for firming and crepe skin.
    - Works great for blemish prone areas. Won’t clog pores, cause breakouts, blackheads, pimples or irritate. Helps with uneven skin tone, fade scars and dark spots and even stretch marks.
    - Light, pleasant smell. Contains no artificial fragrances added and no parabens. Gluten free and not tested on animals.
    Product description
    This Vitamin A formulation delivers noticeable results without the irritation, redness and dryness. We use the highest concentration of plant based and active ingredients possible to deliver a healthier and more youthful appearance while hydrating without a greasy residue. Promote clear skin and help control breakouts so you can achieve a clearer, smoother, and more flawless complexion. Fresh scent derived from Aloe Vera and Green Tea so you can enjoy knowing no harmful chemicals were used. Add this to your skincare routine today! 100% Guarantee - If you are not completely satisfied, simply contact us and we will give you a full refund, no questions asked! This product is distributed by LilyAna Naturals. It is manufactured in small batches of 5 gallon buckets. LilyAna Naturals distributes it into 1.7 oz bottles making it convenient for use and ensuring you receive the highest quality product.

    $19.99 NOTE: Our shopping cart is disabled. We are using it to display affiliate items which if you click on PURCHASE in the PRODUCT INFORMATION by scrolling below or click on the Amazon banner the RRDi receives a small affiliate fee upon completion of your purchase. Mahalo.

  10. 0_purchase.png.90e351976c60ab1694dd926e4
    Purchase. About the product
    Keep to the original all selects the superior soil park skin of Chinese herbal medicine, Chinese medicine cream sophora, common cnidium fruit, kochia scoparia, cortex dictamni, cortex phellodendri, honeylocust thorn, unicorn, lotus, radix stemonae, Indian buead, seven swords, iron Holly plants such as soil extract refined from natural herbal essence of the new generation of skin cream preparation for external use traditional Chinese medicine.
    Scope of application : applicable to skin sterilization and bacteriostasis.Such as staphylococcus aureus (rotting aureus), candida albicans (fungus).
    Suitable for: psoriasis, eczema and all kinds of skin diseases.Topical products, the first sales volume of the whole of China, the effect is 100%.
    suggestion recommended : acute or chronic dermatitis, eczema, tinea manus (Hong Kong foot, fungal), body tinea (sweat stain), psoriasis, peeling, blister, bad feet, the feet itch, pruritus vulvae, hemorrhoids, mosquito bites, acne, prickly heat, itchy skin.
    Product description
    Description: Suitable for: psoriasis, eczema and all kinds of skin diseases.Topical products, the first sales volume of the whole of China, the effect is 100%. Keep to the original all selects the superior soil park skin of Chinese herbal medicine, Chinese medicine cream sophora, common cnidium fruit, kochia scoparia, cortex dictamni, cortex phellodendri, honeylocust thorn, unicorn, lotus, radix stemonae, Indian buead, seven swords, iron Holly plants such as soil extract refined from natural herbal essence of the new generation of skin cream preparation for external use traditional Chinese medicine.
    Main ingredients:
    soil park skin, sophora, common cnidium fruit, belvedere fruit, cortex dictamni, cortex phellodendri, honeylocust thorn, unicorn, lotus, radix stemonae, Indian buead, seven swords, iron Holly, white petroleum jelly, menthol, purified water, etc.
    Scope of application:
    applicable to skin sterilization and bacteriostasis. Such as staphylococcus aureus (rotting aureus), candida albicans (fungus).
    Suggestion recommended:
    acute or chronic dermatitis, eczema, tinea manus (Hong Kong foot, fungal), body tinea (sweat stain), psoriasis, peeling, blister, bad feet, the feet itch, pruritus vulvae, hemorrhoids, mosquito bites, acne, prickly heat, itchy skin.
    Usage and dosage:
    external use, the right amount of this product to put on the skin to wash affected area, 2 to 3 times a day, can be used again one to two weeks after symptoms disappear, to prevent recurrence. notes : this product is for external use only avoid is oral, not used for large area wound surface.  
    Rules: 15 g/branch, tsui medicinal tube packing.
    Shelf life: two years
    Helpful hints:
    patients should eat less all kinds of wine, seafood, spicy food.Can eat more heat cool blood, nourishing blood, skin, detoxification functions and so on food to help cure skin disease.

    $15.99 NOTE: Our shopping cart is disabled. We are using it to display affiliate items which if you click on PURCHASE in the PRODUCT INFORMATION by scrolling below or click on the Amazon banner the RRDi receives a small affiliate fee upon completion of your purchase. Mahalo.

  11. Related Articles Procedural management of rhinophyma: A comprehensive review. J Cosmet Dermatol. 2018 Sep 17;: Authors: Krausz AE, Goldberg DJ, Ciocon DH, Tinklepaugh AJ Abstract BACKGROUND: Rhinophyma is a cosmetically deforming disease characterized by nodular overgrowth of the lower 2/3 of the nose and is considered the end stage of acne rosacea. AIMS: Review the spectrum of procedural techniques for treatment of rhinophyma with a focus on the advantages and disadvantages of each modality. METHODS: A comprehensive literature search was conducted using the search terms "rhinophyma," "treatment," and "surgery" in PubMed. Case reports, case series, and small retrospective trials using procedural techniques for management of rhinophyma were included for review. Animal studies, non-English articles, and reports of medical treatment of rhinophyma were excluded. RESULTS: There are currently no prospective, randomized controlled studies evaluating procedural management of rhinophyma. The most commonly employed treatments include scalpel excision, resection with heated knives, dermabrasion, electrosurgery and lasers, specifically carbon dioxide (CO2 ) and erbium:yttrium-aluminum-garnet (Er:YAG). The main complication associated with complete excision of rhinophymatous tissue is excessive scarring. To correct for this adverse effect, partial or tangential excision with preservation of underlying adnexal structures is now the accepted technique, irrespective of the chosen modality. CONCLUSION: There is no accepted gold standard for management of rhinophyma, and each modality succeeds in maintaining hemostasis, reducing scarring and achieving satisfactory cosmesis to different degrees. There is a conflicting data on the theoretical risk of recurrence with partial excision due to incomplete removal of tissue. Further studies evaluating this risk and alternate methods of prevention are required. PMID: 30225926 [PubMed - as supplied by publisher] {url} = URL to article
  12. Diagnostic Indicators of Rosacea and Demodicosis. Acta Derm Venereol. 2018 Sep 18;: Authors: Forton FMN, De Maertelaer V Abstract Papulopustular rosacea and demodicosis are characterized by non-specific symptoms, which can make clinical diagnosis difficult. This retrospective study of 844 patients assessed the diagnostic importance of clinical signs and symptoms that are poorly recognized as being associated with these conditions. In addition to well-known signs (vascular signs (present in 80% of patients), papules (39%), pustules (22%) and ocular involvement (21%)), other signs and symptoms (discreet follicular scales (93%), scalp symptoms (pruritus, dandruff or folliculitis; 38%) and pruritus (15%)) may also suggest a diagnosis not only of demodicosis, but also of papulopustular rosacea. Facial Demodex densities (measured by 2 consecutive standardized skin biopsies) were higher when ocular or scalp involvement was present, suggesting more advanced disease, but further investigations are needed to confirm this hypothesis. Recognition of these clinical signs and symptoms should encourage dermatologists to perform a Demodex density test, thus enabling appropriate diagnosis to be made. PMID: 30226528 [PubMed - as supplied by publisher] {url} = URL to article
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  14. Related Articles FINACEA™ (Azelaic Acid) Foam, 15. Skinmed. 2016;14(6):445-447 Authors: Gupta AK, Foley KA, Abramovits W PMID: 28031132 [PubMed - indexed for MEDLINE] {url} = URL to article
  15. Subtyping, phenotyping or endotyping rosacea: how can we improve disease understanding and patient care? Br J Dermatol. 2018 Sep;179(3):551-552 Authors: Thyssen JP PMID: 30222873 [PubMed - in process] {url} = URL to article
  16. Related Articles Treatment of rhinophyma with the Versajet™ Hydrosurgery System and autologous cell suspension (ReCELL®): A case report. J Cosmet Laser Ther. 2018 Apr;20(2):114-116 Authors: K Y, B R K, T D, E G Abstract This is a case report of a 63-year-old male patient who presented with rhinophyma of 17 years duration. Several medical treatments were applied previously, with no response or poor improvement. We present our experience by combining the Versajet™ Hydrosurgery System and ReCELL® in a heavy smoker patient, which led to a good aesthetic outcome. With the combined technique, we did not encounter any difficulties either within the operation or in the follow-up period. We obtained less complications and faster wound healing, which in return led to higher patient satisfaction. PMID: 28872937 [PubMed - indexed for MEDLINE] {url} = URL to article
  17. ElaineA [post no 3] reports trying this treatment and posts on September 14, 2018, "I am still clear at 7 months post oral treatment."
  18. Related Articles Demodex blepharitis: clinical perspectives. Clin Optom (Auckl). 2018;10:57-63 Authors: Fromstein SR, Harthan JS, Patel J, Opitz DL Abstract Demodex folliculorum and Demodex brevis are two mites which infest the human eye and which may, in excess, lead to a wide range of anterior segment findings. Demodex mites have been implicated in anterior and posterior blepharitis, blepharoconjunctivitis, blepharokeratitis, and beyond. Due to significant overlap with other anterior segment conditions, Demodex infestation remains underdiagnosed and undertreated. Definitive diagnosis can be made with lash sampling, and the most common mode of treatment is with tea tree oil in varying concentrations. This article summarizes elements of pathogenesis, diagnosis, and management critical to clinical care of this common condition. PMID: 30214343 [PubMed] {url} = URL to article
  19. Oxymetazoline Hydrochloride 1% Cream (Rhofade) for Persistent Facial Erythema Associated with Rosacea. Am Fam Physician. 2018 Jun 15;97(12):808-810 Authors: Garcia C, Birch M PMID: 30216014 [PubMed - in process] {url} = URL to article
  20. Topical Steroid Damaged/Dependent Face (TSDF): A Study from a Tertiary Care Hospital in Eastern India. Indian J Dermatol. 2018 Sep-Oct;63(5):375-379 Authors: Pal D, Biswas P, Das S, De A, Sharma N, Ansari A Abstract Background: Awareness against abuse of topical corticosteroids (TC), especially over the face, has been going on for last 5 years in India. In spite of that we are getting lots of cases in our hospitals. Aims: The aims of this study were to ascertain the demographics, magnitude and clinical features of TC misuse on the face among the dermatology outpatient department (OPD) attendees and to analyze its causes. Methods: This study was conducted in a tertiary care medical center of eastern India. Patients with relevant facial dermatoses were asked about their current use of topical formulations and confirmed to be TSDF were included in the study. Results: A total of 748 patients with facial dermatoses were screened, of which 271 (36.22%) were using TC. Of them mostly young adults between 20 and 29 years (37.10%) were using TC. Average duration between starting of use of medication and the onset of symptoms was 5 months. Ninety-eight (36.16%) patients were using topical corticosteroid for the treatment of acne and 74 (27.30%) were using as depigmenting cream. About 108 (39.85%) patients bought medicine over the counter being recommended by pharmacist/shop owner. Rosacea like features with photosensitivity was the most common adverse effect found in 79 (29.15%) patients whereas comedonal acne/acne exacerbation were found in 68 (25.09%) patients. Most of them (227, 83.76%) were unaware about the side effects of steroids. Conclusions: TC misuse in patients with facial dermatoses is still quite common even after efforts to grow the awareness among population. PMID: 30210157 [PubMed] {url} = URL to article
  21. Admin

    Is Coffee A Rosacea Trigger?

    Thanks Vestpocket for your post on this subject and pointing out how tiny the population of only 24 people in the study was. Wouldn't it be a novel idea for a group of rosaceans to get together and fund their own research. For example, let's get 10,000 rosacea sufferers together in a non profit organization dedicated to find the cure for rosacea and each rosacean donates $1 to this non profit organization who when funds a rosacea double blind, placebo controlled, clinical study on a rosacea trigger, such as coffee, or for that matter, whatever the 10,000 rosacea sufferers deemed to be a clinical subject worth investigating. Certainly one of the RRDi MAC members might be interested in receiving $10,000 to conduct such a clinical study that rosaceans would like to fund rather than the current status quo studies being done now by the other two non profit rosacea organizations. As mentioned in the initial post, there is a difference between a flushing trigger and a rosacea flareup trigger. When you drink coffee (or for that matter ingest caffeine from green tea or whatever) after you flush, and eventually recover from the flush, does the flush exacerbate your rosacea seriously, or after the flush subsides, is your rosacea unchanged?
  22. Related Articles A Prunus persica genome-wide RNA-seq approach uncovers major differences in the transcriptome among chilling injury sensitive and non-sensitive varieties. Physiol Plant. 2018 Sep 11;: Authors: Nilo-Poyanco R, Vizoso P, Sanhueza D, Balic I, Meneses C, Orellana LA, Campos-Vargas R Abstract Chilling injury represents a major constrain for crops productivity. Prunus persica, one of the most relevant rosacea crops, have early season varieties that are resistant to chilling injury, in contrast to late season varieties, which display chilling symptoms such as mealiness (dry, sandy fruit mesocarp) after prolonged storage at chilling temperatures. To uncover the molecular processes related to the ability of early varieties to withstand mealiness, postharvest and genome-wide RNA-seq assessments were performed in two early and two late varieties. Differences in juice content and ethylene biosynthesis were detected among early and late season fruits that became mealy after exposed to prolonged chilling. Principal Component and Data Distribution Analysis revealed that cold stored late variety fruit displayed an exacerbated and unique transcriptome profile when compared to any other postharvest condition. A differential expression analysis performed using an empirical Bayes mixture modeling approach followed by co-expression and functional enrichment analysis uncover processes related to ethylene, lipids, cell wall, carotenoids and DNA metabolism, light response, and plastid homeostasis associated to the susceptibility or resistance of P. persica varieties to chilling stress. Several of the genes related to these processes are in QTLs associated to mealiness in P. persica. Together, these analyses exemplify how P. persica can be used as a model for studying chilling stress in plants. This article is protected by copyright. All rights reserved. PMID: 30203620 [PubMed - as supplied by publisher] {url} = URL to article
  23. Related Articles Dermatoscopy of Granulomatous Disorders. Dermatol Clin. 2018 Oct;36(4):369-375 Authors: Errichetti E, Stinco G Abstract Although diagnosis of cutaneous granulomatous disorders (CGDs) is usually suspected based on morphologic findings, localization, and anamnestic data, clinical differentiation from each other and from similar dermatoses may be challenging. Recently, dermatoscopy has been demonstrated to be a useful tool for assisting the recognition of several CGDs. This article provides a current overview of the dermatoscopic features of the main noninfectious and infectious CGDs, including sarcoidosis, necrobiosis lipoidica, granuloma annulare, rheumatoid nodules, and leishmaniasis. Other, less common, CGDs are briefly addressed, including granulomatous rosacea, acne agminata, and leprosy. PMID: 30201146 [PubMed - in process] {url} = URL to article
  24. Advances in Acne and Rosacea Therapy. Semin Cutan Med Surg. 2018 Jun;37(3S):S63-S66 Authors: Stein Gold LF, Alexis AF, Harper JC, Tan JKL Abstract New topical therapies have demonstrated efficacy in patients with moderate or severe acne who might otherwise have required therapy with systemic antibiotics or isotretinoin. Increasing knowledge about the pathogenesis of acne has facilitated the development of therapies with novel modes of action. New and investigational therapies also are available or in development for the treatment of both the papulopustular and erythematous manifestations of rosacea. Semin Cutan Med Surg 37(supp3):S63-S66 © 2018 published by Frontline Medical Communications. PMID: 30192344 [PubMed - in process] {url} = URL to article
  25. Related Articles Efficient isolation and observation of the most complex human commensal, Demodex spp. Exp Appl Acarol. 2018 Sep 06;: Authors: Clanner-Engelshofen BM, Ruzicka T, Reinholz M Abstract Demodex spp. mites are an often neglected member of the human skin microbiome. Mostly they are commensals, although their pathophysiological role in rosacea, spinulosis folliculorum, and other skin diseases is recognized. Little is known about their life cycle, biology, and physiology. Demodex mites cannot be cultivated in vitro, thereby complicating research immensely. The manual extraction from human sebum is laborious and death can only be detected by surrogate markers like ceased movement or loss of fluorescence. Here we present a new approach for the extraction of larger mite numbers and the hitherto most precise way to detect death. The extraction of mites from sebum and debris by hand can be accelerated by a factor 10 using sucrose gradient centrifugation, which is well tolerated by the mites. Staining with propidium iodide allows for easy identification of dead mites, excluding frail mites that stopped moving, and has no negative effect on overall mite survival. We anticipate our methods to be a starting point for more sophisticated research and ultimately in vitro cultivation of Demodex spp. mites. PMID: 30191497 [PubMed - as supplied by publisher] {url} = URL to article
  26. Vestpocket

    Is Coffee A Rosacea Trigger?

    This is also a myth based on a poorly designed study, and it is a common for someone to skim the study and come to a false conclusion. There WAS an increase in the MTCI (malar temperature circulation index) of the cold-caffeine/caffeine pill administered group(s). That's a number indicating the difference in baseline temperature of your skin vs. the temperature after the studied element was introduced. For reference, redness was seen at MTCI of 1.4 or higher. MTCI ranged from 0.8 bare minimum to 2.2 for the average high values. Since 0.8 was the bare minimum seen, all agents had an effect, even the caffeine. These are low doses of caffeine -- a single cup of coffee is 90-120 mg, and the researchers stopped at 200 mg when administering caffeine pills. The caffeine did have an effect on increased blood flow to the cheeks at this dose. In fact, the MCTI was 0.8 to 1.1 in the caffeine treated participants, where 1.4 is the flushing threshold (per the researchers.) Naturally, if 200 mg brought the skin that close to flushing they ought to have tried 300 to 400 mg, which would have likely brought the MCTI to 1.6 to 2.2 -- very visible flushing. However, they did not try any higher doses, so we can not draw a conclusion. What the study actually found is that in a tiny sample of 24 people, a 200 mg caffeine pill did increase malar skin temperature towards the flush point, but didn't cause visible flushing at a 200 mg dose. It also found that in some of the cohort, hot water alone caused a reaction just as bad as caffeine alone! More specifically, the 200 mg caffeine pill group saw MTCI of 0.8 to 1.1. Cold coffee was nearly identical. The hot water people saw 1.1 to 3.6 MTCI. So, in some of the participants, the caffeine pill WAS exactly as bad as hot water. The worst reaction was, of course, the group administered caffeine + hot water. The dose of caffeine used is very important, because the average daily caffeine intake among caffeine drinkers is much higher. Per Villanova University, "More than half of all American adults consume more 300 milligrams (mg) of caffeine every day, making it by far America's most popular drug." Let's look at the actual numbers from the study: (agent: MTCI) Hot coffee: 1.4 - 2.2 (a few were higher) Hot water: 1.1 - 2.2 (a few were higher) Cold coffee: 1.1- 2.2 200 mg caffeine.: 0.8-1.1 So, essentially, we know caffeine has an effect, and at 200 mg, it's slightly lower than what would cause visible redness. It stands to reason that doubling the caffeine would cause a more pronounced effect, but the authors did not bother to try this obvious test of their hypothesis. 24 people is a tiny sample. Caffeine allergy is uncommon, and a 24 person cohort would easily miss these people. For example, my mother, from a single cup of black coffee, becomes dizzy and violently ill. That'd be a classic example of caffeine intolerance. No such people were part of the study. If you had a 24 person study, you'd miss all sorts of genetic anomalies. You wouldn't even find a person with common peanut allergy in a group that small due to the indicience of same, so this study is only worth the fact that heat is a contributor to flushing. It does not tell us that caffeine is not. Anecdotally, my interest in this crappy study from 1981 is because my sole rosacea trigger is caffeine. I'm not a coffee drinker. I developed rosacea from a few years of strong green tea (10 minute brews, multiple tablespoons of raw leaf per day.) Hot drinks, and hot herbal teas without caffeine have absolutely no effect on my flushing. However, even a half cup of COLD white tea, or a single sip of yerba mate, or COLD green tea sends me into an immediate reaction within 30 minutes, followed by a 12 hour period of facial itching and very hot cheeks. Every single time. Caffeine reaction is very real. I know of two popular rosacea bloggers who accidentally removed caffeine from their diet (say, because of stomach upset) and had all flushing symptoms resolve after years of playing around with other factors and medications that had no effect.
  27. Related Articles Thiol/disulfide homeostasis as a marker of oxidative stress in rosacea: a controlled spectrophotometric study. Cutan Ocul Toxicol. 2018 Sep 03;:1-15 Authors: Sener S, Akbas A, Kılınc F, Baran P, Erel O, Aktas A Abstract BACKGROUND: Rosacea is the chronic inflammatory disease of the facial skin. Although its etiology is not clear yet, inflammatory processes triggered by oxidative stress and oxidation of lipids have been suggested to have a role. While studies on the relationship between inflammation and oxidative stress are ongoing, thiol metabolism and its role in oxidative stress have also begun to be investigated. Thiols are among the key molecules of protein metabolism in the organism and they are firstly consumed antioxidants in case of oxidative stress. Thiols regulate intracellular redox metabolism and protect keratinocytes against the results of oxidative alterations in the stratum corneum. There is a balance known as dynamic thiol/disulfide homeostasis between thiols and their oxidized forms; disulfides. AIM: This study aimed to determine the effects of oxidative stress on protein metabolism in rosacea patients by investigating thiol/disulfide homeostasis using a newly developed and fully automated method. Determination of plasma thiol levels provides important clues regarding the extent of free radical-mediated oxidation of proteins causing damage in rosacea. METHODS: The study included 50 rosacea patients who were diagnosed clinically or histopathologically with rosacea and 42 age- and gender-matched healthy controls. Serum plasma levels of native thiol, total thiol, and disulfide were determined. The following ratios were calculated: Disulfide/native thiol ratio, disulfide/total thiol ratio, and native thiol/total thiol ratio. RESULTS: The mean age was 41.8±10.5 in the rosacea patients (35 females) and 42.5±10.3 years in the control group (33 females). The mean disulfide level was found to be significantly higher in the rosacea patients than in the control group (23.4±5.5 µM/L and 17.3±6.2µM/L, respectively; p < 0.001). The mean disulfide/native thiol ratio (0.055±0.016 vs. 0.041±0.017) and the mean disulfide/total thiol ratio (0.049±0.012 vs.0.037±0.013) were significantly higher and the mean native thiol/total thiol ratio (0.884±0.118 vs. 0.923±0.027) was significantly lower in the patients as compared with the controls (p < 0.05 for all). CONCLUSION: In rosacea patients, the thiol/disulfide balance was observed to shift towards disulfides, which could be considered an indicator of oxidative stress in rosacea. PMID: 30173569 [PubMed - as supplied by publisher] {url} = URL to article
  28. The role of nutrition in inflammatory pilosebaceous disorders: Implication of the skin-gut axis. Australas J Dermatol. 2018 Sep 03;: Authors: Maarouf M, Platto JF, Shi VY Abstract Nutrition plays a critical role in the manifestation and management of inflammatory pilosebaceous disorders. There is rich potential for insight into the impact of dietary effects on the pathophysiology of inflammatory pilosebaceous disorders including acne vulgaris, hidradenitis suppurativa, rosacea, and the closely related seborrhoeic dermatitis. Acne vulgaris and hidradenitis suppurativa are thought to have similar diet-modulating pathogenic pathways. Western diet influences Acne vulgaris and hidradenitis suppurativa by increasing insulin and modulating FOX01/mTOR, resulting in over-expression of cytokeratins, hyperproliferation of keratinocytes, and hypercornification of the follicular wall. Key receptors in rosacea are alternatively activated by UV radiation, hot beverages, spicy foods, vanilla, cinnamon, caffeine, alcohol, cold temperatures, and niacin- and formalin-containing foods, to increase oedema and flushing, resulting in erythema, telangiectasia, and warmth, characteristic features of the condition. Seborrhoeic dermatitis, while not a follicular disorder, is closely related, and can be modulated by dietary influences, such as biotin and probiotics. This overview summarizes the role that nutrition plays on these disorders, and identifies dietary modifications as potential adjunctive therapies. PMID: 30175843 [PubMed - as supplied by publisher] {url} = URL to article
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