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    • Related Articles Rosacea associated with increased risk of generalized anxiety disorder: a case-control study of prevalence and risk of anxiety in patients with rosacea. An Bras Dermatol. 2019 Oct 26;: Authors: Incel Uysal P, Akdogan N, Hayran Y, Oktem A, Yalcin B Abstract BACKGROUND: Rosacea may result in emotional distress and anxiety. However, data on the presence of generalized anxiety disorder in rosacea patients are scarce. OBJECTIVE: The aim of the study was to detect the frequency and level of anxiety and depression in patients with rosacea. METHODS: A total of 194 consecutive rosacea patients and 194 age- and sex-matched controls were enrolled. Severity of rosacea was assessed in patients according to the criteria of the National Rosacea Society Ethics Committee. Both patients and controls were evaluated by the Generalized Anxiety Disorder 7-item scale, and severity was measured by the Generalized Anxiety Disorder-Adult. RESULTS: Individuals who were diagnosed with an anxiety and/or depressive disorder were more common in patient group (24.7% vs. 7.2%, p<0,01). Female patients were particularly at risk for having generalized anxiety disorder (OR=2.8; 95% CI 1.15-7.37; p=0.02). STUDY LIMITATIONS: Single center study and limited sample size. CONCLUSIONS: Rosacea patients show greater risk of having anxiety disorders, including generalized anxiety disorder. Female patients, those with lower educational levels, those with phymatous subtype, untreated patients, and patients with prior psychiatric morbidity may be at particular risk for anxiety. It is essential to consider the psychological characteristics of patients to improve their well-being. PMID: 31789266 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles ACTH-dependent Hypercortisolemia in a Patient with a Pituitary Microadenoma and an Atypical Carcinoid Tumour of the Thymus. Medicina (Kaunas). 2019 Nov 27;55(12): Authors: Baranowska-Jurkun A, Szychlińska M, Matuszewski W, Modzelewski R, Bandurska-Stankiewicz E Abstract Cushing's syndrome (CS) is a set of clinical symptoms which occur as a result of hypercortisolemia. Endogenous ACTH-dependent CS related to an ectopic ACTH-secreting tumour constitutes 12%-17% of CS cases and is one of the most common causes of paraneoplastic syndromes. This study presents a case of a 31 year-old man with diabetes, hypertension, rosacea, purple stretch marks and hypokalemia. Findings of diagnostic procedures include high concentrations of cortisol and ACTH, pituitary microadenoma and a tumour in the anterior mediastinum. Dynamic hormone tests determined the source of excess hormone secretion and ectopic ACTH-dependent CS was diagnosed. Due to increasing symptoms of superior vena cava syndrome, an emergency resection of almost the whole tumour was performed, with only a small part of the upper pole left because of the proximity of large vessels and a risk of damaging them. On the basis of histopathological tests, an atypical carcinoid tumour of the thymus was identified. Immediately after the surgical procedure, there was a significant reduction of clinical and laboratory traits of hypercortisolemia, yet, during the 46 weeks of postoperative observation, despite chemotherapy, the progression of residual masses of the tumour occurred with metastases and increased hormone indices. The presented case shows and discusses the differentiation of ACTH-dependent hypercortisolemia and its causes, difficulties in surgical therapy and chemotherapy, as well as prognosis for atypical carcinoid of the thymus, which is a rare disease. PMID: 31783507 [PubMed - in process] {url} = URL to article
    • Ocular surface changes in the treatment of rosacea: comparison between low-dose oral isotretinoin and doxycycline. Arq Bras Oftalmol. 2019 Nov 25;: Authors: Andrade FMX, Picosse FR, Cunha LPD, Valente CM, Bezerra FM, Miot H, Bagatin E, Freitas D Abstract PURPOSE: To compare the impact of ocular changes between systemic treatment with doxycycline and low-dose oral isotretinoin in patients with moderate-to-severe papulopustular rosacea. METHODS: Patients were randomized to receive either isotretinoin 0.3-0.4 mg/kg (group A) or doxycycline 100 mg/day (group B) for 16 weeks. Ocular symptoms were searched and evaluated, including best-corrected visual acuity (BCVA), Schirmer test, breakup time, rose bengal staining score, and meibomian gland dysfunction grading. The patients were retested at the end of treatment. RESULTS: The present study included 39 patients (30 females and 9 males). Best-corrected visual acuity was > 20/30 in >90% of patients in both groups and did not change after treatment. After treatment, improvement in ocular symptoms and meibomian gland dysfunction was more pronounced in group B (p<0.05); the other parameters did not reach statistical significance. CONCLUSION: Doxycycline improved meibomian gland dysfunction, ocular symptoms, and ocular surface in patients with rosacea. Even though some patients experienced worsening meibomian gland dysfunction and symptoms, no subject experienced any serious complications after administration of low-dose isotretinoin. PMID: 31778446 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Rhinophyma is associated with alcohol intake. J Am Acad Dermatol. 2019 07;81(1):249-250 Authors: Second J, Severac F, Paix A, Cribier B PMID: 30630023 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Rosacea treatment: a patient-centric approach. Br J Dermatol. 2019 Nov 26;: Authors: Elewski B PMID: 31773725 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Unilateral Periocular Intralymphatic Histiocytosis, Associated With Rosacea (Morbihan Disease). Am J Dermatopathol. 2019 Nov 19;: Authors: Belousova IE, Kastnerova L, Khairutdinov VR, Kazakov DV Abstract Intralymphatic histiocytosis is a rare reactive skin condition characterized by a nonspecific clinical presentation and, microscopically, by the collections of mononuclear histiocytes within the lumina of dilated lymphatic vessels. We report a rare case of intralymphatic histiocytosis associated with rosacea and prominent periocular edema (Morbihan disease). The patient is a 56-year-old woman with a 12-year history of rosacea who suddenly developed edema of the right upper eyelid that persisted 6 months before she sought medical advice. Because of an unclear clinical diagnosis, surgical excision of the edematous upper eyelid was performed. The histologic slides showed interstitial edema of the dermis with dilated vascular channels and small epithelioid cell granulomas around hair follicles. In addition, there were aggregates of cells inside numerous lymphatic vessels that were immunohistochemically positive for CD45, CD4, CD68, CD163, CD64, CD14, CD11c, and lysozyme and negative for CD3, CD20, CD30, CD56, S100, CD1a, and langerin. PMID: 31764086 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Microvascular Effects of Pulsed Dye Laser in Combination With Oxymetazoline. Lasers Surg Med. 2019 Nov 22;: Authors: Kelly A, Pai A, Lertsakdadet B, Choi B, Kelly KM Abstract BACKGROUND AND OBJECTIVE: Oxymetazoline, an α-1A agonist, is approved by the United States Food and Drug Administration (FDA) for treatment of persistent facial erythema associated with rosacea and induces vasoconstriction by interacting with α receptors. The objective of our study was to study the microvascular effects of oxymetazoline and pulsed dye laser (PDL). MATERIALS AND METHODS: A dorsal window chamber was surgically installed on 20 mice. Each animal was assigned to one of four experimental groups: saline alone, oxymetazoline alone (10 μl applied once daily × 7 days), saline + PDL (saline applied 5 minutes before PDL irradiation [10 mm spot, 1.5 ms pulse duration, 7 J/cm2 delivered to epidermis]), or oxymetazoline + PDL (10 μl oxymetazoline applied 5 minutes before PDL and then once daily × 7 days). Brightfield and laser speckle imaging were performed for 7 days to monitor vascular architectural and functional changes. RESULTS: We observed persistent blood flow in all of the saline-only and oxymetazoline-only experiments. A higher rate of vascular shutdown was observed with oxymetazoline + PDL (66.7%) compared with saline + PDL alone (16.7%). Oxymetazoline application increased venule diameter at 5 minutes post-application and decreased both arteriole and venule diameters at 60 minutes post-application. CONCLUSION: The combination protocol of oxymetazoline + PDL induces persistent vascular shutdown observed 7 days after irradiation. This result may be associated with the acute vascular effects of oxymetazoline. Oxymetazoline + PDL should be evaluated as a treatment for cutaneous vascular disease, including rosacea and port wine birthmarks. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc. PMID: 31758568 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Global Perspectives of the Patient of Color J Drugs Dermatol. 2019 Jul 01;18(7):615 Authors: Burgess CM Abstract Many cultures associate beauty with an even complexion. It has been shown in many reported references, the major cosmetic concern in patients of color is discoloration. This issue addresses discoloration of individuals of color and the use of a multitude of preparations that can blend the complexion. Authors in Asia, Sweden, France, and Brazil discuss the use of injectable deoxycholic acid in nonsubmental regions and hyaluronic acid for skin boosting, an off-label usage or procedures in the United States. Skin boosting improves hydration and the smoothness of the skin. Additionally, international methods of treating cosmetic patients with multiple modalities are discussed. PMID: 31329381 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Effects of Zinc Supplementation on Inflammatory Skin Diseases: A Systematic Review of the Clinical Evidence. Am J Clin Dermatol. 2019 Nov 19;: Authors: Dhaliwal S, Nguyen M, Vaughn AR, Notay M, Chambers CJ, Sivamani RK Abstract BACKGROUND: Zinc has been used in patients with acne vulgaris for its anti-inflammatory effects; however, it is unclear if zinc supplementation is also beneficial in other inflammatory skin conditions. OBJECTIVE: The objective of this article was to determine the effect of zinc supplementation on inflammatory dermatologic conditions. DATA SOURCES: We searched the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and Ovid with no time limit up to 29 May, 2019. Trials examining supplementation with zinc in the treatment of inflammatory dermatological conditions (acne vulgaris, atopic dermatitis, diaper dermatitis, hidradenitis suppurativa, psoriasis, and rosacea) in children and adults were selected. RESULTS: Of 229 articles, 22 met inclusion criteria. Supplementation with zinc was found to be beneficial in ten of 14 studies evaluating its effects on acne vulgaris, one of two studies on atopic dermatitis, one of one study on diaper dermatitis, and three of three studies evaluating its effects on hidradenitis suppurativa. However, the one article found on psoriasis and the one article found on rosacea showed no significant benefit of zinc treatment on disease outcome. CONCLUSIONS AND IMPLICATIONS: Some preliminary evidence supports the use of zinc in the treatment of acne vulgaris and hidradenitis suppurativa; however, more research is needed with similar methodologies and larger sample sizes in these diseases. Further, zinc may be of some benefit in the treatment plan for atopic dermatitis and diaper dermatitis; however, additional studies should be conducted to further evaluate these potentially positive associations. To date, no evidence is available to suggest that zinc may be of benefit in rosacea and psoriasis; however, limited data are available evaluating the use of zinc in these conditions. PMID: 31745908 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Cutaneous pseudolymphoma with rhinophyma-like lesion. J Dermatol. 2019 09;46(9):e335-e337 Authors: Oginezawa M, Kawai K PMID: 30951205 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Topical treatments for rosacea. Can Fam Physician. 2019 Nov;65(11):803 Authors: Fritsch P, Kolber MR, Korownyk C PMID: 31722913 [PubMed - in process] {url} = URL to article
    • Related Articles [Rhinophyma, management methods and oncological risk]. Rev Med Liege. 2019 Nov;74(11):606-610 Authors: Bachelet JT, Delafond C, Buchholzer S, Modaressi SA, Nizet C, Termont A Abstract Rhinophyma is the most advanced stage of rosacea (stage IV). It is a benign lesion but aesthetically disabling. We present through a major case of rhinophyma and a review of the literature the diagnostic modalities, the therapeutic alternatives and the risks to be known. Particularly, we detail the risks of oncologic transformation of these poorly known lesions.The management of these rare lesions is based on a collaboration between the surgeon and the dermatologist. PMID: 31729850 [PubMed - in process] {url} = URL to article
    • Related Articles Cutaneous pseudolymphoma with rhinophyma-like lesion. J Dermatol. 2019 09;46(9):e335-e337 Authors: Oginezawa M, Kawai K PMID: 30951205 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles Topical treatments for rosacea. Can Fam Physician. 2019 Nov;65(11):803 Authors: Fritsch P, Kolber MR, Korownyk C PMID: 31722913 [PubMed - in process] {url} = URL to article
    • Related Articles [Rhinophyma, management methods and oncological risk]. Rev Med Liege. 2019 Nov;74(11):606-610 Authors: Bachelet JT, Delafond C, Buchholzer S, Modaressi SA, Nizet C, Termont A Abstract Rhinophyma is the most advanced stage of rosacea (stage IV). It is a benign lesion but aesthetically disabling. We present through a major case of rhinophyma and a review of the literature the diagnostic modalities, the therapeutic alternatives and the risks to be known. Particularly, we detail the risks of oncologic transformation of these poorly known lesions.The management of these rare lesions is based on a collaboration between the surgeon and the dermatologist. PMID: 31729850 [PubMed - in process] {url} = URL to article
    • Related Articles The Skin and Gut Microbiome and Its Role in Common Dermatologic Conditions. Microorganisms. 2019 Nov 11;7(11): Authors: Ellis SR, Nguyen M, Vaughn AR, Notay M, Burney WA, Sandhu S, Sivamani RK Abstract Microorganisms inhabit various areas of the body, including the gut and skin, and are important in maintaining homeostasis. Changes to the normal microflora due to genetic or environmental factors can contribute to the development of various disease states. In this review, we will discuss the relationship between the gut and skin microbiome and various dermatological diseases including acne, psoriasis, rosacea, and atopic dermatitis. In addition, we will discuss the impact of treatment on the microbiome and the role of probiotics. PMID: 31717915 [PubMed] {url} = URL to article
    • Impact of nanostructured lipid carriers on dapsone delivery to the skin; in vitro and in vivo studies. Int J Pharm. 2019 Nov 09;:118781 Authors: Elmowafy M, Shalaby K, Ali HM, Alruwaili NK, Salama A, Ibrahim MF, Akl MA, Ahmed TA Abstract The main objective of this study was to develop, characterize and evaluate the potential use of dapsone-loaded nanostructured lipid carriers (NLCs) as a topical treatment for acne. Differently charged NLC formulations were successfully prepared using an emulsification/sonication method. The particle sizes ranged from 106.2±5.6 nm to 151.3±7.4 nm, and the NLCs possessed the predicted surface charges, depending on the emulsifier used (Tween 80, Transcutol P, or cetyltrimethylammonium bromide). The entrapment efficiencies ranged from 76.5±3.8 % to 91.1±3.9 %. Selected formulations were assessed for possible interactions, in vitro release, ex vivo skin permeation, pharmacological efficacy and safety compared with a hydroalcoholic solution. Dapsone was embedded in the lipid matrix of NLCs and behaved as controlled release system with a good occlusive effect. Dapsone-loaded cationic NLC formulation enhanced the skin permeation of dapsone, increase the amount of dapsone retained in the skin in controlled manner, and improved the anti-rosacea activity. Based on these encouraging results, cationic NLC represents a promising carrier for the safe topical delivery of dapsone. PMID: 31715347 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Treatment of Erythematotelangiectatic Rosacea With Pulsed-Dye Laser and Oxymetazoline 1.0% Cream: A Retrospective Study. Lasers Surg Med. 2019 Nov 10;: Authors: Suggs AK, Macri A, Richmond H, Munavalli G, Friedman PM Abstract BACKGROUND AND OBJECTIVES: Pulsed-dye laser (PDL) and oxymetazoline 1.0% cream are each used for the treatment of erythematotelangiectatic (ET) rosacea. PDL targets oxyhemoglobin and can reduce facial erythema and telangiectasias. Oxymetazoline 1.0% cream is an α adrenergic agonist, which has shown to reduce facial erythema. The aim of this study was to determine the degree of erythema improvement and telangiectasia clearance after combination treatment with PDL plus oxymetazoline 1.0% cream. STUDY DESIGN/MATERIALS AND METHODS: This retrospective study was conducted at two sites. Pre- and post-treatment cross-polarized images from subjects on combination treatment with PDL and oxymetazoline 1.0% cream were graded by a board-certified dermatologist at each practice. Blinded images were analyzed using the Clinical Erythema Assessment (CEA) Scale (0 = clear and 4 = severe). Unblinded images were analyzed using the five-point Telangiectasia Scale to determine the degree of improvement post-treatment compared with baseline (1 = <5% clearance and 5 = 75-100% clearance). RESULTS: Thirty-one subjects (20 females, 11 males) of age 51 ± 13 years (mean ± standard deviation) were included in the study after an average of 4 months (range: 1-13) of daily oxymetazoline 1.0% cream and two (range: 1-4) PDL treatments. At baseline, 87% of subjects had CEA Grade 2 (mild erythema) or higher. For erythema, 55% of subjects improved by at least one CEA grade and 13% achieved two grades of improvement post-treatment. For telangiectasias, 90% of subjects achieved at least a two-point clearance (5-25%), 62% at least a three-point clearance (25-50%), and 41% at least a four-point clearance (50-75%) post-treatment. Compared with subjects with baseline CEA Grade 1-2 (almost clear to mild erythema), significantly more subjects with baseline CEA Grade 3-4 (moderate to severe erythema) achieved at least one CEA grade of improvement (P = 0.021) and two grades of CEA improvement (P = 0.041). A higher percentage of baseline CEA Grade 3-4 subjects achieved at least a two-point clearance in telangiectasias (P = 0.055). CONCLUSIONS: Combination treatment with PDL and daily oxymetazoline 1.0% cream can safely and effectively reduce erythema and telangiectasias. Limitations include the retrospective design of the study, small sample size, and lack of a control group. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc. PMID: 31709571 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Sebaceous Glands participate in the inflammation of Rosacea. J Eur Acad Dermatol Venereol. 2019 Nov 11;: Authors: Lee SH, Lee SB, Heo JH, Yoon HS, Byun JW, Choi GS, Shin J Abstract Rosacea is a chronic inflammatory dermatosis that can present with a variety of cutaneous manifestations.1 Recently, mast cells are known to be importantly related to the pathogenesis of rosacea.2 The disease characteristically presents a centrofacial distribution1,3 , an area rich in sebaceous glands. PMID: 31709649 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Alterations of Immune and Keratinization Gene Expression in Papulopustular Rosacea by Whole Transcriptome Analysis. J Invest Dermatol. 2019 Nov 06;: Authors: Shih YH, Xu J, Kumar A, Li R, Chang ALS PMID: 31705873 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles [Mushroom keratoplasty in rosacea keratitis complicated by corneal perforation (a clinical case)]. Vestn Oftalmol. 2019;135(5. Vyp. 2):215-219 Authors: Trufanov SV, Krakhmaleva DA, Zaitsev AV, Salovarova EP, Tekeeva LY, Budnikova EA Abstract Rosacea is a polyethiologic chronic inflammatory disease with varying clinical manifestations. It is primarily a dermatologic disease, which often manifests in the eyes affecting eyelids, cornea and conjunctiva. The leading role in the pathological process belongs to disruption of regulatory mechanisms in the vascular, immune and nervous systems. It is accompanied by increased levels of metalloproteinases and vascular endothelial growth factor (VEGF). Treatment depends on the severity of the disease and may vary from hygiene of the eyelid margins and use of artificial tears for dry eye disease management, to antibiotics and anti-inflammatory agents in moderate cases, and surgical treatment in severe or neglected state. A clinical case of severe rosacea shows that keratoplasty with mushroom-shaped profile of the surgical incision helps achieve good functional results and reduce the post-operative rehabilitation time, while significantly reducing the risk of postsurgical complications. Anti-VEGF therapy significantly reduces the risk of histoincompatibility reaction typical for rosacea keratitis. PMID: 31691663 [PubMed - in process] {url} = URL to article
    • Related Articles [Chronic mucocutaneous candidiasis with STAT1 gain-of-function mutation associated with herpes virus and mycobacterial infections]. Ann Dermatol Venereol. 2019 Oct 30;: Authors: Baghad B, Benhsaien I, El Fatoiki FZ, Migaud M, Puel A, Chiheb S, Bousfiha AA, Ailal F Abstract INTRODUCTION: Chronic mucocutaneous candidiasis (CMC) is characterized by susceptibility to chronic or recurrent infections with yeasts of the genus Candida affecting the skin, nails and mucous membranes. We describe a Moroccan patient presenting CMC with heterozygous STAT1 gain-of-function (GOF) mutation. PATIENTS AND METHODS: A 5-year-old boy with no consanguinity presented recurrent episodes of oral thrush, chronic nail candidiasis and herpetic gingivostomatitis from the age of 8 months. He also had mycobacterial adenitis secondary to BCG vaccination and atypical rosacea. Genetic analysis revealed GOF mutation of the STAT1 gene. DISCUSSION: CMC was diagnosed in our patient despite poor clinical features. Sequencing of the genome revealed STAT1GOF mutation. This mutation affects production of IL-17, an important cytokine in mucocutaneous defense against Candida. The association with mycobacterial adenitis is rare and continues to be poorly understood. The presence of atypical rosacea in this setting is suggestive of this entity. Antifungal therapy and prevention of complications are necessary to reduce the morbidity and mortality associated with this condition. CONCLUSION: CMC due to STAT1GOF mutation is characterized by a broad clinical spectrum and should be considered in all cases of chronic or recurrent fungal infection, whether or not associated with other infections. PMID: 31677808 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Association of dental foci of infection and rosacea: a case report. Gen Dent. 2019 Nov-Dec;67(6):52-54 Authors: Sopi M, Meqa K Abstract Rosacea, a chronic inflammatory disease of the skin, is characterized by rash, pustules, papules, and dilated blood vessels. The etiology is unknown, and the disease is more common among women than among men. Among the proposed causes of this disorder are dental foci of infection, with periapical lesions the most common pathologic lesion in the alveolar bone. The aim of this report is to examine the possible relationship between periapical lesions as dental foci and rosacea. A 50-year-old woman reported redness in her face, for which she had been treated by a gastroenterologist for Helicobacter pylori and a dermatologist for rosacea. After clinical, radiographic, and laboratory examinations, suspicions of dental foci were raised. The residual roots of teeth 4, 5, 12, 15, and 18 were extracted, and teeth 16, 29, and 31 underwent endodontic treatment. One year after dental treatment, all signs of redness in the patient's face had healed, she stopped all treatments, and her laboratory values were normal. PMID: 31658025 [PubMed - in process] {url} = URL to article
    • Related Articles Safety of Combination Laser or Intense Pulsed Light Therapies and Doxycycline for the Treatment of Rosacea. Dermatol Surg. 2019 Nov;45(11):1401-1405 Authors: Schilling LM, Halvorson CR, Weiss RA, Weiss MA, Beasley KL Abstract BACKGROUND: Current treatment options for rosacea include topical agents, oral therapies, phototherapy using lasers, or intense pulsed light (IPL). Combination therapy for rosacea often yields better results than monotherapy. The safety of laser/light treatments in combination with systemic doxycycline has been questioned because of the theoretical risk of photosensitivity. OBJECTIVE: The purpose of this study was to assess the incidence of phototoxicity or photosensitivity in rosacea patients receiving concomitant laser or light treatments and systemic doxycycline. METHODS: Treatment records of 36 patients receiving laser/light treatments while also being treated with standard dose or anti-inflammatory dose of doxycycline were retrospectively reviewed. RESULTS: No adverse reactions related to doxycycline combined with laser/light therapy were reported. Specifically, no photosensitivity or sensitivity to wavelengths in the pulsed dye laser (PDL), or IPL range was observed in this cohort. All patients achieved some degree of clearance. CONCLUSION: The results of this retrospective study demonstrate that doxycycline used in conjunction with laser or nonlaser light therapy is a valid combination therapy for improving signs and symptoms of rosacea. No photosensitivity reactions were observed to commonly used IPL or PDL devices. PMID: 31658188 [PubMed - in process] {url} = URL to article
    • Related Articles Use of laser therapy in the treatment of severe rhinophyma: a report of two cases. J Cosmet Laser Ther. 2019 Oct 24;:1-5 Authors: Borzęcki A, Turska M, Strus-Rosińska B, Sajdak-Wojtaluk A Abstract Rhinophyma is a rare manifestation of rosacea. It is clinically characterized by sebaceous hypertrophy, fibrosis, and telangiectasia. Usually, it is considered as a cosmetic defect; however, in some cases, it might cause problems with nasal breathing and food consumption which forces the need for treatment. The following article presents the effectiveness of laser treatment with the neodymium-yttrium-aluminum garnet (Nd:YAG), carbon dioxide laser (CO2), and fractional CO2 laser. PMID: 31648601 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Apoptosis Induction of Armeniacae Semen Extractin Human Acute Leukemia (NALM-6 and KG-1) Cells. Int J Hematol Oncol Stem Cell Res. 2019 Jul 01;13(3):116-121 Authors: Mosadegh Manshadi S, Safavi M, Rostami S, Nadali F, Shams Ardekani MR Abstract Background: Prunusarmeniaca is a member of the Rosacea family. The most important ingredient of this family is amygdalin that is believed to have anti-tumor and analgesic properties. The aim of this study was to evaluate the anti-proliferative effects of Armeniacae semen extract on the acute leukemia, NALM-6, and KG-1 cell lines, and investigate the effect of the extract on apoptosis of these cell lines and caspase-3 gene expression. Materials and Methods: We prepared aqueous, ethyl acetate, and hydro alcoholic extracts of the Armeniacae semen. The NALM-6 and KG-1 cell lines and mononuclear cells (PBMCs) of healthy controls were treated with different doses of the extracts for 48 hours, and then cell viability was investigated with the MTT test. High-Performance Liquid Chromatography was done for amygdalin identification. The percentage of apoptotic cells was determined using the Annexin V-FITC/PI flow cytometric kit, and caspase-3 gene expression was evaluated. Results: MTT test revealed that the strongest Inhibition Concentration (IC50) in KG-1 and NALM-6 cell lines was related to the ethyl acetate extract. This extract did not have toxic effects on PBMCs. Flow cytometric analysis showed that the ethyl acetate extract at its IC50 concentration led to almost 50% apoptosis in both cell lines after 48 hours. In the molecular examination, after treatment, a significant increase was seen in caspase-3 gene expression in NALM6 and KG1 cells compared to the control (P<0.001 and P <0.05, respectively). Conclusion: Our data confirmed that the ethyl acetate extract of Prunusarmeniaca could reduce the proliferation of KG-1 and NALM-6 cell lines probably by activating the apoptotic pathway. PMID: 31649801 [PubMed] {url} = URL to article
    • Related Articles Rosacea causing unilateral Morbihan syndrome. BMJ Case Rep. 2019 Oct 25;12(10): Authors: Weeraman S, Birnie A Abstract Morbihan syndrome is a rare entity causing woody induration of the face. There are numerous case reports of bilateral Morbihan syndrome. We present a case of a 46-year-old man with right infra-orbital cheek swelling and symptoms of rosacea who had histology consistent with granulomatous rosacea following debulking surgery. His clinical presentation and investigation findings support a diagnosis of rosacea causing unilateral Morbihan syndrome. PMID: 31653629 [PubMed - in process] {url} = URL to article
    • Pediatric Ocular Acne Rosacea: Clinical Features and Long Term Follow-Up of Sixteen Cases. Ocul Immunol Inflamm. 2019 Oct 24;:1-9 Authors: Donmez O, Akova YA Abstract Purpose: To report the clinical characteristics, treatment modalities and long term follow-up of 16 pediatric ocular acne rosacea patients. Methods: The medical records of pediatric ocular acne rosacea patients were reviewed. Results: There were 16 patients with a mean age of 7.7 ± 5 (1-16) years. The mean follow-up period was 52.8 ± 52 (3-150) months. Eight patients had skin involvement. The mean duration of delay for diagnosis was 16.2 ± 5.1 (4-48) months. Nine patients had a delayed diagnosis. Meibomitis, blepharitis, lid telangiectasia, and conjunctival hyperemia were present in all cases. Systemic antibiotics were prescribed in 12 patients. The mean delay in diagnosis was longer in patients with conjunctival/corneal involvement (p = .001) and these patients required longer systemic treatment (p = .001). Complete remission was achieved in 87.5% of cases. Conclusion: Children presenting with a long history of ocular irritation, meibomian gland disease, recurrent chalazia and peripheral corneal infiltrates should alert ophthalmologists to consider the diagnosis of ocular acne rosacea even in the absence of skin changes. PMID: 31647686 [PubMed - as supplied by publisher] {url} = URL to article
    • Scanning electron micrograph of a human T lymphocyte (also called a T cell) from the immune system of a healthy donor. Image courtesy of Wikimedia Commons Chronic Mucocutaneous Candidiasis (CMC) "is an immune disorder of T cells, it is characterized by chronic infections with Candida that are limited to mucosal surfaces, skin, and nails." [1] One report states, "Heterozygous STAT1 gain-of-function (GOF) mutations result in a combined form of immunodeficiency which is the most common genetic cause of chronic mucocutaneous candidiasis (CMC)." [2] This same report connects "chronic demodicosis in the form of a facial papulopustular eruption, blepharitis, and chalazion" with CMC. This could also be described as demodectic rosacea.  Candida has been connected to rosacea in at least one paper. [3] End Notes [1] Wikipedia [2] Pediatr Dermatol. 2019 Oct 21; STAT1 gain-of-function and chronic demodicosis. Molho-Pessach V, Meltser A, Kamshov A, Ramot Y, Zlotogorski A [3] Candida Albicans
    • Related Articles Analysis of acne-related judicial precedents from 1997 to 2018 in South Korea. J Dermatol. 2019 Oct 23;: Authors: Cho SI, Shin SH, Yang JH, Lee W, Kim SY, Suh DH Abstract Medicolegal disputes are increasing in practical medicine. Medications or procedures related to acne could lead to medical malpractice. This study analyzed medical litigation associated with acne in South Korea. Acne-related judgments were searched using the Supreme Court of Korea's Written Judgment Management System based on the keyword "acne". Eleven cases were selected; eight cases were related to acne scar and three cases were related to acne. Treatment modalities such as peeling, laser treatment, photodynamic therapy and antibiotics resulted in lawsuits. Claimed sequelae of the treatments were hyperpigmentation, scar worsening, erythema, skin bumps and liver transplant. Eight cases were awarded to the plaintiff, and the others were dismissed. This study shows that various treatments for acne can cause medical disputes. PMID: 31642108 [PubMed - as supplied by publisher] {url} = URL to article
    • The skeleton structure of the SNRI venlafaxine, a typical example of an antidepressant. image courtesy of Wikimedia Commons "I’d never heard of antidepressants causing any issues with skin, which made me wonder if anyone else was having the same issue and just putting up with it in silence – or if the whole thing was in my head. I chatted with Dr Zubair Ahmed, the CEO of MedicSpot digital clinics, who confirmed that yes, antidepressants can absolutely cause or worsen skin conditions. ‘These skin issues range from innocent facial flushing to life threatening systemic rashes such as Stevens-Johnson syndrome,’ Dr Ahmed told metro.co.uk. ‘You may also notice purple dots on your skin (Purpura) or a condition called urticaria which is often due to an allergic reaction. ‘Eczema is also associated with antidepressant medication.’ " How your antidepressants might be messing with your skin, Ellen Scott, Metro Chai reports a serious rosacea flareup after withdrawing from mirtazapine.
    • Related Articles STAT1 gain-of-function and chronic demodicosis. Pediatr Dermatol. 2019 Oct 21;: Authors: Molho-Pessach V, Meltser A, Kamshov A, Ramot Y, Zlotogorski A Abstract Heterozygous STAT1 gain-of-function (GOF) mutations result in a combined form of immunodeficiency which is the most common genetic cause of chronic mucocutaneous candidiasis (CMC). We present a pedigree with a GOF mutation in STAT1, manifesting with chronic demodicosis in the form of a facial papulopustular eruption, blepharitis, and chalazion. So far, demodicosis has been described in only one family with STAT1-GOF mutation. We suggest that chronic demodicosis is an under-recognized feature of the immune dysregulation disorder caused by STAT1 gain-of-function mutations. PMID: 31637766 [PubMed - as supplied by publisher] {url} = URL to article
    • image courtesy of Wikimedia Commons There are a number of anti-flushing prescriptions reported by rosaceans and we have an exhaustive list here (also includes a list of non prescription treatments as well). 
    • Related Articles ADAMDEC1 promotes skin inflammation in rosacea via modulating the polarization of M1 macrophages. Biochem Biophys Res Commun. 2019 Oct 15;: Authors: Liu T, Deng Z, Xie H, Chen M, Xu S, Peng Q, Sha K, Xiao W, Zhao Z, Li J Abstract Rosacea is a chronic inflammatory cutaneous disease which mainly affects central face, leading to cosmetic disfigurement and compromised social psychology in billions of rosacea patients. Though the exact etiology of rosacea remains elusive, accumulating evidence has highlighted the dysfunction of innate immunity and inflammation in rosacea pathogenesis. Disintegrin Metalloprotease ADAM-like Decysin-1 (ADAMDEC1) is an orphan ADAM-like metalloprotease which is believed to be closely related to inflammation. Here for the first time, we reported that Adamdec1 expression was significantly increased in the skin lesions of rosacea patients and LL37-induced rosacea-like mouse models. Immunofluorescence analysis revealed co-localization of ADAMDEC1 and macrophages in patient and mouse biopsies. In cellular experiment, the expression of ADAMDEC1 was prominently elevated in M1 but not M2 macrophages. Knocking down of ADAMDEC1 significantly blunted M1 polarization in macrophages induced from human monocytes and THP-1 cell lines. Furthermore, silencing of Adamdec1 in LL-37-induced mouse model also suppressed the expression of M1 signature genes such as IL-6, iNOS and TNF-α, resulting in attenuated rosacea-like phenotype and inflammation. Taken together, our results demonstrate that ADAMDEC1 plays a pro-inflammatory role in rosacea via modulating the M1 polarization of macrophages. PMID: 31627897 [PubMed - as supplied by publisher] {url} = URL to article
    • 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.  
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