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    • Related Articles The Spectrum and Sequelae of Acne in Black South Africans Seen in Tertiary Institutions. Skin Appendage Disord. 2018 Oct;4(4):301-303 Authors: Dlova NC, Mosam A, Tsoka-Gwegweni J Abstract
      Introduction: Acne is a chronic disorder of the pilosebaceous unit affecting all ethnic groups. It remains in the top 5 skin conditions seen worldwide. The paucity of data characterizing acne in South African Blacks led us to the documentation of types and sequelae of acne.
      Methods: This is a cross- sectional study describing the spectrum and variants of acne in 5 tertiary hospitals in the second most populous province in South Africa over 3 months (January 1 - March 31, 2015).
      Results: Out of 3,814 patients seen in tertiary dermatology clinics, 382 (10%) had a primary diagnosis of acne or rosacea, forming the fourth most common condition seen. Acne accounted for 361 (94.5%); acne vulgaris was the commonest subtype at 273 (75.6%), followed by steroid-induced acne 46 (12.7%), middle-age acne 6 (1.7%), acne excoriée 2 (0.6%), and "undefined" 34 (9.4%).
      Conclusion: The observation of steroid-induced acne as the second most common variant in Black patients underlines the need to enquire about steroid use and education about the complications of using steroid-containing skin-lightening creams. Treatment of postinflammatory hyperpigmentation should be part of the armamentarium for holistic acne treatment in Blacks, as it remains a major concern even after active acne has resolved.
      PMID: 30410901 [PubMed] {url} = URL to article
    • Related Articles Comprehensive Diagnosis and Planning for the Difficult Rhinoplasty Patient: Applications in Ultrasonography and Treatment of the Soft-Tissue Envelope. Facial Plast Surg. 2017 Oct;33(5):509-518 Authors: Kosins AM PMID: 28962057 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Body Piercing: A National Survey in France. Dermatology. 2018 Nov 07;:1-8 Authors: Kluger N, Misery L, Seité S, Taieb C Abstract
      BACKGROUND: There are no recent data available in France regarding body piercing (BP).
      OBJECTIVE: We examined the demographics, motivations, quality of life, cutaneous conditions, and cutaneous side effects after BP within the French population.
      METHODS: A representative sample of 5,000 individuals (aged 15 and over) from the general population responded to a survey online between April and August 2017. Data regarding demographics, BP characteristics (location, age at first piercing, hesitation, regrets, motivations, cutaneous side effects), tobacco, skin conditions (acne, contact eczema, atopic eczema, rosacea, psoriasis, vitiligo), and tattoos were collected. Respondents also filled an SF-12 quality of life questionnaire.
      RESULTS: Overall, 12% of the respondents reported at least one BP (women: 19.4%, men: 8.4%, p < 0.01). The prevalence was highest among those aged between 25 and 34 years (25.8%). Individuals with BP were more likely to smoke (p < 0.01). The most common body parts for piercings were the external part of the ear (42%), the navel (24%), the tongue (15%), and the nose (11%). Gender differences included localization (belly button and nose for women, eyebrows for men) and motivations (embellishment of the body for women, individuality and sexuality for men). A total of 33.6% of the study participants reported having skin problems after BP, primarily infection (44%). Individuals with BPs were more likely to report having contact eczema, atopic dermatitis, and acne. BP was associated with a lower mental quality of life score.
      CONCLUSION: This is the largest epidemiological study on BP in France to date. It allows us to draw a precise current snapshot of French indi viduals with BP.
      PMID: 30404090 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles [Not Available]. Ugeskr Laeger. 2016 Jan 25;178(4):V66927 Authors: Carlsen BC, Larsen HK, Hædersdal M PMID: 26815717 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles The microbiome in dermatology. Clin Dermatol. 2018 May - Jun;36(3):390-398 Authors: Musthaq S, Mazuy A, Jakus J Abstract
      The skin supports a delicate ecosystem of microbial elements. Although the skin typically acts as a barrier, these microbes interact with the internal body environment and imbalances from the "healthy" state that have been linked to several dermatologic diseases. Understanding the changes in microbial flora in disease states allows for the potential to treat by restoring equilibrium. With the rising popularity of holistic and natural consumerism, prebiotics, probiotics, symbiotic, and other therapies are under study to find alternative treatments to these skin disorders through manipulation or supplementation of the microbiome.
      PMID: 29908581 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles The relationship between inflammatory bowel disease and rosacea over the lifespan: A meta-analysis. Clin Res Hepatol Gastroenterol. 2018 Oct 30;: Authors: Han J, Liu T, Zhang M, Wang A Abstract
      BACKGROUNDS AND AIMS: It has been argued that the relationship between inflammatory bowel disease (IBD) and rosacea is bi-directional, but this hypothesis has not been explicitly tested. This systematic review examines the bi-directional prospective relationships between IBD and rosacea.
      METHODS: A comprehensive search through PubMed and EMBASE was undertaken for studies investigating the association between two mainly forms of IBD [ulcerative colitis (UC) and Crohn's disease (CD)] and rosacea published in English until Jan 2018. Reviewers assessed the eligibility of each report by exposure/outcome measurement and study design. Two sets of pooled risk estimates were calculated using fixed or random effects: the direction from IBD to rosacea and rosacea to IBD.
      RESULTS: Five publications on 13 separate study results involving 5,051,356 participants were eligible for this meta-analysis. A total of 6 outcomes established the direction of association from IBD to rosacea, and 7 outcomes examined the direction of association from rosacea to IBD. Compared to a non-rosacea population, the pooled RR (95% CI) for overall IBD, UC and CD were 1.32 (1.18-1.49), 1.19 (1.02-1.38) and 1.52 (1.25-1.84), respectively (P < 0.05). Meanwhile, the summary RR (95% CI) of rosacea in overall IBD, UC and CD patients were 1.66 (1.50-1.84), 1.69 (1.48-1.93) and 2.08 (1.26-3.46), respectively (P < 0.05).
      CONCLUSION: Our meta-analysis confirmed a significant bi-directional association in occurrence of IBD and rosacea. Future studies should specifically investigate possible shared pathophysiological mechanisms between the two disorders.
      PMID: 30389397 [PubMed - as supplied by publisher] {url} = URL to article
    • Thanks Apurva, and also thanks for your article on co-existence. 
    • Dear Admin, Thank you for the information of posting article. I did not know about that. Next time I will copy and paste my article in the given space.
    • Hi Apurva,  I was reluctant to download a docx file since it is an odd way of posting instead of simply copying and pasting your document into the post?  I checked to see if your file contained any viruses or malware by using VirusTotal and it passed, so I opened the file and I am copying and pasting your article here for the benefit of everyone else not having to go through this process. It might be best to simply write your posts. Here is the contents of your article below:  begin article___________ Co-existence of Rosacea, Seborrheic dermatitis and Blepharitis
      There have been a lot of reports on accounting other chronic skin conditions with rosacea and it is true that you can have multiple conditions simultaneously with rosacea.
      I have experienced rosacea, seborrheic dermatitis and blepharitis together with the combination of erythema and telangiectasia. The very first time this condition appeared as a lesion on half part of nose and cheek and then covered the other part of the face with having scaly torn skin and inflamed eyes.
      After years of my experience and dealing with these conditions, the symptoms include :
      Swollen flushed skin, visible dilated blood vessels with stinging and burning sensation on face.
      SD can cause skin scaly and flaky and can burn with itch and appears mostly on front hair line,forehead and eyebrows that if you itch the flaky and crusty skin falls off like dandruff.
      Blepharitis usually involves upper eyelid and causes inflamed eyelids, teary red eyes and the most important visual aspect is greasy dandruff like scales form on eyelashes covering half of it.
      The conditions can go beyond your cheeks and nose and affect earlobes and chin area and can cause flaky and rough chin area with small bumps.
      The flare ups can last anywhere from few minutes to one day or to one month and they again come back but when it goes you can feel the temperature decrease but it can leave red bumps that looks like acne but gradually the red appearance goes with time but it waxes and wanes.
      Co-existence :
      The occurrence of other chronic inflammatory diseases like seborrheic dermatitis and blepharitis are common in patients with rosacea and the good news is, the treatment of other condition does not aggravate the signs and symptoms of rosacea and lessen the flare ups in the meantime.
      Blepharitis is an inflammation of the eyelids in which the base of the eyelids are swollen and red and flaky greasy like crusts occur around the eyelashes with frequently mildly sticking eyelids and flaky dandruff of eyebrows sometimes called seborrheic blepharitis.(1)
      It is reported that demodex can worsen the condition of rosacea but it can also aggravate the condition of seborrheic blepharitis.(2)
      SD can typically occur as rash on the face and a sheet of lesion on back and middle chest area and middle and underneath breast lines. The underlying cause of seborrhoeic dermatitis is not clear, but a type of yeast called Malassezia furfur is involved.(3) I will emphasize these conditions thoroughly in later posts but for now I will explain the treatment I had with these three conditions :
      When my doctors diagnosed these three conditions, first they prescribed me low dose oral doxycycline capsules (100mg) daily at night.
      1.    Doxycycline is an antibiotic used for treating bacterial infections.The drug is also sold under the brand names Oracea, Doryx, Monodox, Periostat, and Vibramycin. Doxycycline is in a class of medications called tetracyclines, and it's a broad-spectrum antibiotic, it works against a wide range of bacteria.This medication is used to prevent malaria and treat a wide range of infections, including: skin infection.(4,5)
           Side effects: stomach upset, constipation, nausea, heavy head.
      2.    You can apply topical metronidazole gel 0.75% on the affected skin area.  Apply a thin layer of gel once or twice daily.I used to apply once at night daily.
      It is an antibiotic and it works by decreasing redness and inflammation by stopping the growth of certain bacteria and parasites.This antibiotic treats only certain bacterial and parasitic infections. It will not work for viral infections. (6)
            Side effects : burning and eye irritation if it gets close to the eyes.
      3.     Ketoconazole 2 % and Zinc pyrithione 1 % (Shampoo) for the fungal and yeast infections of the skin. Ketoconazole an active ingredient works by interfering and weakening with the formation of the fungal cell membrane. It better works with seborrheic dermatitis and blepharitis. Thoroughly apply on wet hair and massage and leave it for 5 minutes and then rinse it out. It does not make lather like other shampoos. Take a drop on finger, rub it and apply gently on eyelashes on tightly closed eyes and rinse it properly. With 8 weeks of proper use twice in a week completely cured me with SD and blepharitis.
            Side effects : itchy and dry scalp
      4.    If you have dermatitis on your chest and breast lines and back, you can use the composition of Boric acid and  Clotrimazole cream together. It works by reducing inflammation and inhibiting the growth of fungi.
      Apply a thin layer of this base and rub until it absorbs completely twice or thrice daily. I applied this on my front              and back area for four to five days and it worked wonder and the lesions gradually disappeared.
      Note : before taking any above medication consult your doctor or physician and alcohol should not be consumed during any medication it can worsen the condition of rosacea and if you are pregnant or on breast-feeding and any other condition like diabetes or heart problem, take this medications as directed by your doctor.
      Instead relying on oral and topical steroids my doctor prescribed me with bacterial and fungal medications because taking steroids for SD and blepharitis can exacerbate the condition of rosacea and relying on antibiotics and anti-fungal treatments can lessen the condition of SD and blepharitis and keep the rosacea at bay. References :
      https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/blepharitis.(1)
      http://eyewiki.aao.org/Blepharitis.(2)
      http://www.londoneyeunit.co.uk/services/blepharitis/.(3)
      https://www.everydayhealth.com/drugs/doxycycline.(4)
      https://www.webmd.com/drugs/2/drug-8648-7073/doxycycline-hyclate-oral/doxycycline-oral/details.(5)
      https://www.webmd.com/drugs/2/drug-6426/metro
        end article_________________  
    • article.docx   Administrator Note: Read the next post that explains the above. 
    • Association between rosacea severity and relative muscle mass: A cross-sectional study. J Dermatol. 2018 Oct 31;: Authors: Nam JH, Yang J, Park J, Seo JH, Chang Y, Ryu S, Kim WS Abstract
      Rosacea is thought to be associated with factors involved in metabolic syndrome (MetS). Muscle mass has a beneficial role in preventing MetS, but its link to rosacea remains unknown. We sought to investigate the association between rosacea severity and relative skeletal muscle mass. A cross-sectional study was conducted on subjects who attended a skin check-up program at the Kangbuk Samsung Hospital Health Screening Center between 2014 and 2016. Polarized light photographs of the face were taken and evaluated by two dermatologists. Skeletal muscle mass index (SMI, [%] = total skeletal muscle mass [kg] / bodyweight [kg] × 100) was estimated using a bioelectrical impedance analyzer. A logistic regression model was used to evaluate an association between SMI and rosacea. Of 110 rosacea subjects who were finally enrolled, 17 (15.5%) and 93 (84.5%) were classified as having papulopustular and erythematotelangiectatic rosacea, respectively. Categories of SMI comprised the following tertiles: 22.86-38.40%, 38.41-43.44% and 43.45-80.65%. In severity, compared with mild rosacea (75.5%), moderate rosacea (24.5%) incrementally increased as SMI decreased (Ptrend < 0.01). Severe rosacea was not observed. After adjustment for age and sex, odds ratios (95% confidence intervals) for moderate rosacea comparing SMI tertiles 1 and 2 to the highest tertile (reference) were 5.66 (1.22-26.20) and 4.43 (1.12-17.55), respectively (Ptrend = 0.03). This association was present in women with marginal significance (Ptrend = 0.06), but not in men. Relative muscle mass is negatively associated with an increased risk of more severe rosacea, suggesting that skeletal muscle can have a protective effect on rosacea exacerbation.
      PMID: 30379346 [PubMed - as supplied by publisher] {url} = URL to article
    • Thanks so much for your post, very detailed and informative and without a doubt will help many. 
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