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    • Related Articles An Open-Label, Intra-Individual Study to Evaluate a Regimen of Three Cosmetic Products Combined with Medical Treatment of Rosacea: Cutaneous Tolerability and Effect on Hydration. Dermatol Ther (Heidelb). 2019 Oct 17;: Authors: Santoro F, Lachmann N Abstract INTRODUCTION: Although rosacea management includes general skincare, previous studies have not evaluated comprehensive skincare regimens as adjuvants to other treatments. METHODS: The primary objective of this open-label, intra-individual study of subjects with rosacea was to evaluate the cutaneous tolerability of a regimen consisting of Cetaphil PRO Redness Control Day Moisturizing Cream (once daily in the morning), Cetaphil PRO Redness Control Night Repair Cream (once daily in the evening) and Cetaphil PRO Redness Control Facial Wash (foam once in the morning and once in the evening). Secondary objectives were to evaluate the effect on transepidermal water loss (TEWL) and cutaneous hydration and to determine the subjects' evaluation of efficacy, tolerability and future use. A dermatologist examined subjects and measured TEWL and cutaneous hydration on day (D) 0, D7 and D21, when subjects ranked symptoms. Subjects completed a questionnaire on D21. RESULTS: The per-protocol population consisted of 42 subjects receiving treatment for rosacea. Eleven subjects developed adverse events, none of which were considered to be related to the skincare products. Five subjects showed signs or symptoms that were potentially associated with the skincare products that might suggest poor cutaneous tolerability; these were generally mild. TEWL decreased significantly by a mean of 17% on D7 and a mean of 28% on D21 compared with baseline (both P < 0.001). Skin hydration increased significantly by a mean of 5% on D7 (P = 0.008) and a mean of 10% on D21 (P < 0.001) compared with baseline. Subjects reported that the regimen was pleasant (98%) and effective (95%) and that it offered various benefits; 90% of subjects reported that they would like to continue to use the regimen and would buy the products. CONCLUSION: The skincare regimen improved skin hydration and skin barrier function in subjects receiving medical treatment for rosacea and was well tolerated. FUNDING: Galderma S.A. PMID: 31625112 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Dermoscopy in the differential diagnosis between malar rash of systemic lupus erythematosus and erythematotelangiectatic rosacea: an observational study. Lupus. 2019 Oct 16;:961203319882493 Authors: Errichetti E, Lallas A, De Marchi G, Apalla Z, Zabotti A, De Vita S, Stinco G Abstract BACKGROUND: Malar rash is one of the three cutaneous diagnostic criteria of systemic lupus erythematosus (SLE). Although its clinical recognition is often straightforward, the differential diagnosis with erythematotelangiectatic rosacea may sometimes be challenging. OBJECTIVE: To describe dermoscopic features of SLE malar rash and investigate the accuracy of dermoscopy for the differential diagnosis with erythematotelangiectatic rosacea. METHODS: A representative dermoscopic image of target areas was evaluated for the presence of specific features. Fisher's test was used to compare their prevalence between the two cohorts, and accuracy parameters (specificity, sensitivity, and positive and negative predictive values) were evaluated. RESULTS: Twenty-eight patients were included in the analysis, of which 13 had SLE malar rash and 15 erythematotelangiectatic rosacea. The main dermoscopic features of malar rash were reddish/salmon-coloured follicular dots surrounded by white halos ('inverse strawberry' pattern), being present in 53.9% of the cases, while network-like vessels (vascular polygons) turned out to be the main feature of erythematotelangiectatic rosacea, with a prevalence of 93.3%. The comparative analysis showed that the 'inverse strawberry' pattern was significantly more common in SLE malar rash, with a specificity of 86.7%, while vascular polygons were significantly more frequent in rosacea, with a specificity of 92.3%. CONCLUSION: Dermoscopy may be a useful support to distinguish SLE malar rash and erythematotelangiectatic rosacea by showing peculiar features. PMID: 31619142 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Immunohistochemical Evaluation of Matrix Metalloproteinases-1, -9, Transient Receptor Potential Vanilloid Type 1, and CD117 in Granulomatous Rosacea Compared with Non-granulomatous Rosacea. Acta Derm Venereol. 2019 Oct 17;: Authors: Park JB, Suh KS, Jang JY, Seong SH, Yang MH, Kang JS, Jang MS PMID: 31620803 [PubMed - as supplied by publisher] {url} = URL to article
    • Coffee and Skin - Considerations Beyond the Caffeine Perspective. J Am Acad Dermatol. 2019 Oct 14;: Authors: Bray ER, Kirsner RS, Issa NT PMID: 31622642 [PubMed - as supplied by publisher] {url} = URL to article
    • Clinical diagnosis through paintworks observation Rev Med Inst Mex Seguro Soc. 2019 Jul 31;57(2):113-117 Authors: Zamudio-Martínez G, Zamudio-Martínez A Abstract Despite of the important technological advances which today allow a precise diagnosis through genetic or imaging studies, one of the fundamental pillars of medical diagnosis is, and always will be, patient examination. The visual identification of the signs that distinguish a disease is still important to make a clinical diagnosis. These very same examination skills and the knowledge on the disorders’ appearance, as well as the technical abilities of the artists that once painted pictures, allow us to diagnose a rosacea among Rembrandt’s self-portraits, or Marfan’s syndrome amidst Egon Schiele’s elongated figures. It is possible to find diseases represented in paintworks from long before someone ever described them in a book, longer even before someone considered them illnesses. PMID: 31618566 [PubMed - as supplied by publisher] {url} = URL to article
    • Aclaris has now sold Rhofade to EPI Health, LLC.  
    • "Aclaris Therapeutics, Inc. (Nasdaq: ACRS), a physician-led biopharmaceutical company focused on immuno-inflammatory diseases, today announced it has divested RHOFADE® (oxymetazoline hydrochloride) cream, 1% (RHOFADE) and related intellectual property assets to EPI Health, LLC (EPI Health). The divestiture of RHOFADE is a key component of Aclaris’ recently announced strategic plan to refocus resources on the development of its immuno-inflammatory development programs." GlobalNewswire, Inc, October 10, 2019 "Allergan developed and brought RHOFADE to market in 2017 after acquiring the drug as part of its 2011 acquisition of Vicept Therapeutics, Inc., a company established by certain members of the current senior management team of Aclaris." Business Insider, October 15. 2018 Aclaris owned Rhofade and sold it to Allergan and bought it back on October 2018.  The new owner, EPI Health, states on its website, "EPI Health is continually expanding our prescription product line to offer healthcare professionals and patients new and better options to treat skin conditions." EPI Health's president, John A. Donofrio, joined EPI Health in March of 2019. image courtesy of EPI Health, LLC  
    • Related Articles Skin changes in the obese patient. J Am Acad Dermatol. 2019 Nov;81(5):1037-1057 Authors: Hirt PA, Castillo DE, Yosipovitch G, Keri JE Abstract Obesity is a worldwide major public health problem with an alarmingly increasing prevalence over the past 2 decades. The consequences of obesity in the skin are underestimated. In this paper, we review the effect of obesity on the skin, including how increased body mass index affects skin physiology, skin barrier, collagen structure, and wound healing. Obesity also affects sebaceous and sweat glands and causes circulatory and lymphatic changes. Common skin manifestations related to obesity include acanthosis nigricans, acrochordons, keratosis pilaris, striae distensae, cellulite, and plantar hyperkeratosis. Obesity has metabolic effects, such as causing hyperandrogenism and gout, which in turn are associated with cutaneous manifestations. Furthermore, obesity is associated with an increased incidence of bacterial and Candida skin infections, as well as onychomycosis, inflammatory skin diseases, and chronic dermatoses like hidradenitis suppurativa, psoriasis, and rosacea. The association between atopic dermatitis and obesity and the increased risk of skin cancer among obese patients is debatable. Obesity is also related to rare skin conditions and to premature hair graying. As physicians, understanding these clinical signs and the underlying systemic disorders will facilitate earlier diagnoses for better treatment and avoidance of sequelae. PMID: 31610857 [PubMed - in process] {url} = URL to article
    • The efficacy and safety of permethrin 2.5% with tea tree oil gel on rosacea treatment: A double-blind, controlled clinical trial. J Cosmet Dermatol. 2019 Oct 15;: Authors: Ebneyamin E, Mansouri P, Rajabi M, Qomi M, Asgharian R, Azizian Z Abstract BACKGROUND: Rosacea is a chronic skin condition that typically affects the face and it results in redness and inflammation. The main risk factors of this disease are Demodex folliculorum, living in the pilosebaceous units. AIMS: To evaluate the efficacy and safty of permethrin 2.5% in combination with tea tree oil (TTO) topical gel versus placebo on Demodex density (Dd) and clinical manifestation using standard skin surface biopsy (SSSB) in rosacea patients. PATIENT/METHODS: In this double-blind, randomized clinical trial, 47 papulopustular rosacea patients were enrolled, with 35 patients finishing the 12 weeks of treatment. Each patient used permethrin 2.5% with TTO on one side of the face and a placebo on the other, twice daily for 12 weeks. SSSB, photography and clinical rosacea scores according to National Rosacea Society, as well as adverse drug reaction (ADRs) were reported at the baseline, 2nd, 5th, 8th, and 12th weeks. RESULTS: A total of 47 patients were enrolled with papulopustular rosacea, and 35 patients finished the study. The effects of permethrin 2.5% with TTO gel on mite density were significant at week 5, 8, 12 (P value = .001). Clinical features and global assessments showed papules, pustules and nontransient erythema had improvement in drug group after 12 weeks (P values <.05). The improvement of burning and stinging and dry appearance was greater than the placebo gel (P value <.05). Itching in placebo group was significantly more than other group (P value = .002). CONCLUSION: Administration of permethrin 2.5% with TTO gel demonstrated good efficacy and safety in rosacea. This topical gel inhibited the inflammatory effects of rosacea and reduced Demodex mite. PMID: 31613050 [PubMed - as supplied by publisher] {url} = URL to article
    • I have with my care controlled or you can say remitted the condition of rosacea. It is less exacerbating and only bothers in fall and winter and I have control over it at many times but how stress and less sleep can relapse the condition of rosacea when it is already in control, I have experienced. The dilation of blood capillaries start showing and the erythematic condition characterized by flushing is more prevalent when there were less signs. So the things you can do are take more antioxidants since stress means if you go beyond it is cellular stress which changes the skin resident proteins and immune cells and do the things which help alleviate stress so that you can have good sound sleep because again less sleep means increasing the oxidative stress. Antioxidants and good sleep are the main things you can count on.
    • Related Articles Gnathophyma. Skinmed. 2018;16(1):45 Authors: Kumar P, Das A PMID: 29551113 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Well-Circumscribed Localized-Rhinophyma as a Very Rare Presentation of Rhinophyma. Iran J Otorhinolaryngol. 2019 Sep;31(106):323-326 Authors: Kavoussi H, Ramezani M, Ahmadaghaei F, Ghorbani I, Eftekhari Pirouz H, Kavoussi R Abstract Introduction: Rhinophyma is an uncommon subtype of rosacea, the clinical diagnosis of which is straightforward. However, localized, especially well-circumscribed, rhinophyma is a very rare condition, which requires a paraclinical assessment to be accurately diagnosed. Case Report: We report a 48-year-old male patient who presented with a well-circumscribed and dark red tumoral mass of 28 mm in diameter and smooth consistency in the right nasal ala. The patient had no former and concomitant characteristic skin lesions on the other part of his face. Histopathology and immunohistochemistry assessments documented the diagnosis of rhinophyma. Conclusion: To the best of our knowledge, this is the first case report of well-circumscribed localized rhinophyma. This lesion can be treated by CO2 laser in a fast and efficient manner with esthetically satisfactory outcome and no significant complications. PMID: 31598502 [PubMed] {url} = URL to article
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