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    The RRDi Medical Advisory Consultants list (46 RRDi MAC Members) is in alphabetical order by last name. For more information.

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    • Skin Res Technol. 2024 Mar;30(3):e13616. doi: 10.1111/srt.13616. ABSTRACT OBJECTIVE: To investigate the life, sleep quality and anxiety of rosacea patients in Yunnan and the improvement of these aspects after treatment. METHODS: A total of 141 patients with rosacea and 123 healthy controls were included in our study. The quality of life, sleep quality and anxiety of patients with rosacea and healthy controls were investigated by the Rosacea Severity Scores (RSSs), the Medical Outcomes Study 36-item short-form health survey (SF-36), the Pittsburgh Sleep Quality Index (PSQI) and Self-rating Anxiety Scale (SAS). The quality of life, sleep quality and anxiety of patients with rosacea were assessed again after treatment. RESULTS: Compared with healthy controls, patients with rosacea had significantly lower physical component scores (PCS) and mental component scores (MCS) but higher PSQI and SAS scores. After treatment, rosacea patients showed significantly higher MCS but lower PSQI and SAS scores. Correlation analysis showed a significant correlation between PCS, MCS, PSQI, SAS and RSSs. CONCLUSIONS: Patients with rosacea have a lower quality of life and sleep quality and tend to be more anxious than healthy controls. In addition, the mental quality of life, sleep quality and anxiety of rosacea patients can be significantly improved after treatment. Therefore, it is important to pay attention to the psychological status of rosacea patients. Psychological counseling and intervention are necessary to better prevent and treat rosacea. PMID:38424730 | DOI:10.1111/srt.13616 {url} = URL to article
    • Int J Dermatol. 2024 Mar 1. doi: 10.1111/ijd.17114. Online ahead of print. NO ABSTRACT PMID:38429862 | DOI:10.1111/ijd.17114 {url} = URL to article
    • Australas J Dermatol. 2024 Feb 28. doi: 10.1111/ajd.14224. Online ahead of print. ABSTRACT BACKGROUND: Atrophic acne scarring is a common sequela of inflammatory acne, causing significant problems for affected patients. Although prolonged inflammation and subsequent aberrant tissue regeneration are considered the underlying pathogenesis, the role of epidermal stem cells, which are crucial to the regeneration of pilosebaceous units, remains unknown. OBJECTIVES: To examine the changes occurring in epidermal stem cells in atrophic acne scars. METHODS: Changes in collagen, elastic fibre and human leukocyte antigen (HLA)-DR expression were analysed in normal skin and inflammatory acne lesions at days 1, 3 and 7 after development. The expression of epidermal stem cell markers and proliferation markers was compared between normal skin and mature atrophic acne scar tissue. RESULTS: In acne lesions, inflammation had invaded into pilosebaceous units over time. Their normal structure had been destructed and replaced with a reduced amount of collagen and elastic fibre. Expression of stem cell markers including CD34, p63, leucine-rich repeat-containing G protein-coupled receptor (LGR)6 and LGR5, which are expressed in the interfollicular epidermis, isthmus and bulge of hair follicles, significantly decreased in atrophic acne scar tissue compared to normal skin. Epidermal proliferation was significantly reduced in scar tissue. CONCLUSIONS: These findings suggest that as inflammatory acne lesions progress, inflammation gradually infiltrates the pilosebaceous unit and affects the resident stem cells. This disruption impedes the normal regeneration of the interfollicular epidermis and adnexal structures, resulting in atrophic acne scars. PMID:38419202 | DOI:10.1111/ajd.14224 {url} = URL to article
    • J Dermatol. 2024 Feb 29. doi: 10.1111/1346-8138.17168. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory skin disease. Systemic inflammation plays a vital role in the pathogenesis of rosacea. Many studies have reported hematological parameters as biomarkers for diseases with inflammatory processes. However, the diagnostic value of hematological parameters in rosacea remains a puzzle. This study involved 462 patients with rosacea, including erythematotelangiectatic rosacea (ETR, n = 179), papulopustular rosacea (PPR, n = 250), and phymatous rosacea (PhR, n = 33), and 924 healthy control subjects. Demographic, clinical, and laboratory information was collected and compared between rosacea subtypes. The hematological parameters of the patients and the healthy controls were compared retrospectively. The platelet volume (MPV) and platelet crit (PCT) were significantly upregulated, and the lower red cell distribution width (RDW) was significantly downregulated in rosacea compared to healthy controls, and they were identified as the diagnostic biomarkers for rosacea with area under the curve values of 0.828, 0.742, and 0.787, respectively. Comparing the hematological parameters among the three rosacea subtypes, we found that platelet-to-lymphocyte ratio and platelet-to-neutrophil ratio values in the ETR group were significantly higher than those in the PPR and PhR groups. The correlation between hematological parameters and clinical scores showed that RDW was negatively correlated with the Clinician Erythema Assessment score. However, there was no significant correlation between the Investigator Global Assessment score and hematological parameters. In conclusion, PCT, MPV, and RDW have diagnostic value for rosacea, and RDW is correlated with the severity of rosacea erythema, implying the potential applications of PCT, MPV, and RDW in the diagnosis and monitoring of rosacea. PMID:38421898 | DOI:10.1111/1346-8138.17168 {url} = URL to article
    • Med Mycol J. 2024;65(1):23-26. doi: 10.3314/mmj.23-00014. ABSTRACT A Filipino woman in her forties had facial erythema that was being self-treated with over-the-counter (OTC) drugs purchased outside of Japan. The drugs included clobetasol propionate, antibiotic, and antifungal components. Her facial erythema symptoms were worse during summertime. KOH direct examination of annular erythema was positive for fungal hyphae and negative for Demodex folliculorum. Fungal culture revealed Trichophyton indotineae based on internal transcribed spacer sequence analysis. Minimal inhibitory concentration for terbinafine was 0.06 µg/mL. We made a diagnosis of tinea faciei with steroid rosacea. We treated the patient with oral itraconazole. Physicians should be aware of increasing T. indotineae infections and increasing self-medication using topical OTC steroids combined with antifungals and antibiotics not only in India but also among foreign people living in other countries such as Japan. PMID:38417884 | DOI:10.3314/mmj.23-00014 {url} = URL to article
    • Drugs. 2024 Feb 29. doi: 10.1007/s40265-024-02003-w. Online ahead of print. ABSTRACT Rosacea, a chronic skin condition affecting millions of people in the USA, leads to significant social and professional stigmatization. Effective management strategies are crucial to alleviate symptoms and improve patients' quality of life. Encapsulated benzoyl peroxide 5% (E-BPO 5%) is a newly FDA-approved topical treatment for rosacea that shows promise in enhancing therapeutic response and minimizing skin irritation. This review aims to assess the role of recently FDA approved E-BPO 5% in the current treatment landscape for rosacea management, as it is not yet included in clinical guidelines that predominantly rely on older approved therapies. The review focuses on randomized controlled trials conducted in English-speaking adults. It evaluates the efficacy, safety, and tolerability of various US Food and Drug Administration (FDA)-approved agents used for rosacea treatment, including E-BPO cream, metronidazole gel, azelaic acid gel and foam, ivermectin cream, minocycline foam, oral doxycycline, brimonidine gel, and oxymetazoline HCl cream. Existing therapies have been effective in reducing papulopustular lesions and erythema associated with rosacea for many years. E-BPO 5% offers a promising addition to the treatment options due to its microencapsulation technology, which prolongs drug delivery time and aims to improve therapeutic response while minimizing skin irritation. Further research is necessary to determine the exact role of E-BPO 5% in the therapeutic landscape for rosacea. However, based on available evidence, E-BPO 5% shows potential as a valuable treatment option for managing inflammatory lesions of rosacea, and it may offer benefits to patients including: rapid onset of action, demonstrated efficacy by Week 2, excellent tolerability, and sustained long-term results for up to 52 weeks of treatment. PMID:38418773 | DOI:10.1007/s40265-024-02003-w {url} = URL to article
    • This is an example of clinicians who still rely on the Subtype classification of rosacea which was abandoned several years ago. ETR is subtype 1. The new classification of rosacea into phenotypes separates this subtype into two phenotypes:  (2) Persistent Erythema (3) Telangiectasia Dapsone has been used to treat Granulomatous Rosacea [also known as Lupoid rosacea] [1] as well as PPR [2] [1] Hautarzt. 2013 Apr;64(4):226-8. doi: 10.1007/s00105-013-2556-7. Successful treatment of granulomatous rosacea with dapsone. Ehmann LM, Meller S, Homey B. Hautklinik des Universitätsklinikums Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland. PubMed RSS Feed - - Dapsone  for Unresponsive Granulomatous Rosacea. [2] Dapsone Gel in the Treatment of Papulopustular Rosacea: A Double-Blind Randomized Clinical Trial.        
    • Pediatr Dermatol. 2024 Feb 27. doi: 10.1111/pde.15571. Online ahead of print. ABSTRACT BACKGROUND: Idiopathic aseptic facial granuloma (IAFG) is an underrecognized pediatric skin disease, currently considered within the spectrum of rosacea. It usually manifests as a solitary, reddish, asymptomatic nodule on the cheek that resolves spontaneously. METHODS: Retrospective and descriptive observational study of 43 pediatric patients with a clinical diagnosis of IAFG, followed between 2004 and 2022, at two general hospitals in Argentina. RESULTS: IAFG predominated in girls (65%) and the average age of onset was about 6 years. A single asymptomatic nodule was seen in 79% of patients. The most common localization was the cheek (58%) followed by lower eyelids (41%). Family history of rosacea was present in 16% of patients. A concomitant diagnosis of rosacea and periorificial dermatitis was made in 14% and 9% of our population, respectively. Past or present history of chalazia was detected in 42% of the children. IAFG diagnosis was mainly clinical (88% of cases). Oral antibiotics were the most common indicated treatment (84%). Complete healing was achieved by the majority, but 18% of those with eyelid compromise healed with scars. CONCLUSIONS: IAFG is a benign pediatric condition that physicians should recognize in order to manage correctly. We herein refer to a particular morphologic aspect of IAFG lesions affecting the lower eyelids, where nodules adopt a linear distribution and have a higher probability of involute leaving a scar. Also, we consider that the concomitant findings of rosacea, periorificial dermatitis and chalazia in our patients, reinforce the consideration of IAFG within the spectrum of rosacea. PMID:38413004 | DOI:10.1111/pde.15571 {url} = URL to article
    • Cesk Slov Oftalmol. 2024;80(Ahead of print):1001-1008. doi: 10.31348/2024/3. ABSTRACT OBJECTIVE: This study aims to address the issues surrounding the diagnosis of ocular rosacea and to evaluate the development of the patients' condition after treatment, as well as to distinguish between healthy and diseased patients using a glycomic analysis of tears. METHODOLOGY: A prospective study was conducted to assess a total of 68 eyes in 34 patients over a six-week period. These patients were diagnosed with ocular rosacea based on subjective symptoms and clinical examination. The study monitored the development of objective and subjective values. The difference between patients with the pathology and healthy controls was established by means of analysis of glycans in tears. RESULTS: Skin lesions were diagnosed in 94% of patients with ocular rosacea, with the most commonly observed phenotype being erythematotelangiectatic (68.8%). The mean duration of symptoms was 29.3 months (range 0.5-126 months) with a median of 12 months. Throughout the study, an improvement in all monitored parameters was observed, including Meibomian gland dysfunction, bulbar conjunctival hyperemia, telangiectasia of the eyelid margin, anterior blepharitis, uneven and reddened eyelid margins, and corneal neovascularization. The study also observed improvements in subjective manifestations of the disease, such as foreign body sensation, burning, dryness, lachrymation, itching eyes, photophobia, and morning discomfort. The analysis of glycans in tears partially separated tear samples based on their origin, which allowed for the differentiation of patients with rosacea from healthy controls. In the first sample, the pathology was determined in a total of 63 eyes (98.4%) of 32 patients, with further samples showing a change in the glycomic profile of patients' tears during treatment. CONCLUSION: The study demonstrated objective and subjective improvements in all the patients. Tear sampling and analysis could provide a means of timely diagnosis of ocular rosacea. PMID:38413227 | DOI:10.31348/2024/3 {url} = URL to article
    • This test seems to have cornered the diagnosis of different skin diseases. Gate Recurrent Unit "introduced in 2014 by Kyunghyun Cho et al." Wikipedia Maybe we will hear more about this in diagnosing rosacea?
    • This is a new variant of demodicidosis (demodectic rosacea). The variants keep growing. 
    • The RRDi has an extensive list of non prescription treatments for rosacea including natural treatments. Click Here
    • What is a bi-directional two-sample Mendelian randomization (2SMR) analysis? Answer:  Mendelian randomisation is a statistical approach that uses genetics to provide information about the relationship between an exposure and outcome (a type of instrumental variable analysis) [1]   Additionally, bi-directional Mendelian randomisation can be used to assess in which direction causality is most likely to flow (1). In bi-directional Mendelian randomisation, Mendelian randomisation analyses are performed in both directions (exposure to outcome, and outcome to exposure). [1] The summary concludes that there is 'evidence for the causality between GM [gut microbiota] and inflammatory skin diseases.' [1] End Notes [1] Making sense of Mendelian randomisation and its use in health research A short overview Sean Harrison, Laura Howe and Alisha R. Davies      
    • This article says acne can appear on the truncal area of the body. Whether rosacea could also involve the truncal area hasn't been investigated or confirmed, however the NHS article above says rosacea can appear on the chest, so that at least confirms the chest area. Is it a big stretch to say rosacea also appears on the truncal area?  Any comments? 
    • We are careful who we put on our links page since we do not want to appear to be a commercial site or influenced in any way with the skin industry (unless the skin industry donates or sponsors our own independent rosacea research). This Korean Acne and Rosacea Society is sponsored by Galderma and the research appears to be with no conflict of interest so we are listing this society on our links page.  
    • This article is some good research since rosacea is an ISD (Inflammatory Skin Diseases). I have always known that the human microbiome is important to understanding rosacea. Since the skin comprises the largest organ it makes sense that the different microbes existing in this organ would interact and be important to understanding why an inflammatory response is indicated in rosacea. Could rosacea actually be the result of various microbes interplaying or could it actually be just one microbe that is triggering it? In normal skin without rosacea, these various microbes seem to live together without an inflammatory response or initiating an immune system response. There may be other factors that would contribute to upsetting the skin microbiome, i.e., age, diet and exercise, lifestyle, stress, cormobidities, co-existing conditions, medications, etc., which complicates the issue, but nevertheless, rosacea is a skin disease and microbes may play a part in triggering it. The classic example proving this point is that antibiotics have been used to treat rosacea for decades and more recently treatment for the eradication of demodex mites are just two microbes worth considering, bacteria and demodex, which the vast majority of rosacea research has focused on. There is little, if any, research done on rosacea involving other microbes, i.e., virus, archaea, fungi, protozoa, helminths, parasites, etc., and the list of microbes on the skin microbiome could include other microbes not yet considered since the bias in rosacea research has mainly focused on bacteria as the culprit. since antibiotic treatment does indeed clears rosacea, but overtime complicates the issue with side effects worse than the actual disease.  If you note, the research in this article is Chinese and apparently no conflict of interest is involved, for example, the skin industry in western medicine probably didn't give these researchers a dime. Bravo for such research. If only the RRDi could engage in such novel research. The following reveals who funded this research:  "This work was supported by the Chengdu University of Traditional Chinese Medicine “Xinglin Scholars” Discipline Talent Research Improvement Program, Project Number: QJJJ2021001; Chengdu University of Traditional Chinese Medicine “Foundation Thickening” Action Plan (2023-42); Chengdu University of Traditional Chinese Medicine Hospital’s “Hundred Person Plan” (21-L03 and 22-B09). “Young Qihuang” Scholars of the State Administration of Traditional Chinese Medicine (2022-256)" Read the full article. Furthermore, we also know that Gut Rosacea is related to this subject. For example, this research paper states, "Accumulating evidence shows that dysregulation of intestinal flora is associated with inflammatory skin diseases, specifically atopic dermatitis (AD), psoriasis (PSO), and rosacea (ROS). However, the causality is still unclear." [1] This same article notes that "A total of 24 specific gut microbiota species related to AD, PSO, and ROS were identified by 2SMR analysis." [1]  Can you see we need more research and that rosaceans could be involved with such novel research rather than letting the skin industry in western medicine sponsor the vast amount of rosacea research? Could rosaceans actually be united into sponsoring their own rosacea research? End Notes [1] PubMed RSS Feed - -The associations between gut microbiota and inflammatory skin diseases: a bi-directional two-sample Mendelian randomization study  
    • J Clin Med. 2024 Feb 16;13(4):1126. doi: 10.3390/jcm13041126. ABSTRACT Childhood rosacea is a lesser known, yet significant, skin condition presenting diagnostic and treatment challenges. Although often underdiagnosed due to unclear diagnostic criteria, it manifests similarly to adult rosacea, with features such as papulopustular, telangiectasia, granulomatous, idiopathic facial aseptic granuloma, and ocular rosacea. The complex pathophysiology involves genetic, immunological, and environmental factors. Distinguishing childhood rosacea from conditions like acne, steroid rosacea, sarcoidosis, and lupus vulgaris is crucial but complicated by the lack of established criteria. Treatment strategies, mainly extrapolated from adult management protocols, include topical therapies, systemic medications, and laser treatments, adapted for pediatric patients. Special attention is given to ocular rosacea, often preceding skin manifestations, necessitating multidisciplinary care. The review underscores the urgent need for clear diagnostic guidelines, increased awareness, and tailored pediatric treatment protocols to improve patient outcomes and mitigate the condition's evolution into adulthood. PMID:38398439 | DOI:10.3390/jcm13041126 {url} = URL to article
    • Pharmaceutics. 2024 Jan 26;16(2):176. doi: 10.3390/pharmaceutics16020176. ABSTRACT Dexamethasone has a high anti-inflammatory efficacy in treating skin inflammation. However, its use is related to the rebound effect, rosacea, purple, and increased blood glucose levels. Nanotechnology approaches have emerged as strategies for drug delivery due to their advantages in improving therapeutic effects. To reduce dexamethasone-related adverse effects and improve the anti-inflammatory efficacy of treatments, we developed nanocarriers containing this corticosteroid and oleic acid. Nanocapsules and nanoemulsion presented dexamethasone content close to the theoretical value and controlled dexamethasone release in an in vitro assay. Gellan gum-based hydrogels were successfully prepared to employ the nanostructured systems. A permeation study employing porcine skin showed that hydrogels containing non-nanoencapsulated dexamethasone (0.025%) plus oleic acid (3%) or oleic acid (3%) plus dexamethasone (0.025%)-loaded nanocapsules provided a higher amount of dexamethasone in the epidermis compared to non-nanoencapsulated dexamethasone (0.5%). Hydrogels containing oleic acid plus dexamethasone-loaded nanocapsules effectively inhibited mice ear edema (with inhibitions of 89.26 ± 3.77% and 85.11 ± 2.88%, respectively) and inflammatory cell infiltration (with inhibitions of 49.58 ± 4.29% and 27.60 ± 11.70%, respectively). Importantly, the dexamethasone dose employed in hydrogels containing the nanocapsules that effectively inhibited ear edema and cell infiltration was 20-fold lower (0.025%) than that of non-nanoencapsulated dexamethasone (0.5%). Additionally, no adverse effects were observed in preliminary toxicity tests. Our study suggests that nanostructured hydrogel containing a reduced effective dose of dexamethasone could be a promising therapeutic alternative to treat inflammatory disorders with reduced or absent adverse effects. Additionally, testing our formulation in a clinical study on patients with skin inflammatory diseases would be very important to validate our study. PMID:38399236 | DOI:10.3390/pharmaceutics16020176 {url} = URL to article
    • Pharmaceuticals (Basel). 2024 Feb 6;17(2):212. doi: 10.3390/ph17020212. ABSTRACT Rosacea is a chronic skin disorder that affects more than 5% of the world's population, with the number increasing every year. Moreover, studies show that one-third of those suffering from rosacea report a degree of depression and are less compliant with treatment. Despite being the subject of prolonged studies, the pathogenesis of rosacea remains controversial and elusive. Since most medications used for the management of this pathology have side effects or simply do not yield the necessary results, many patients lose trust in the treatment and drop it altogether. Thus, dermato-cosmetic products with natural ingredients are gaining more and more notoriety in front of synthetic ones, due to the multiple benefits and the reduced number and intensity of side effects. This review is a comprehensive up-to-date report of studies that managed to prove the beneficial effects of different botanicals that may be useful in the short and long-term management of rosacea-affected skin. Based on recent preclinical and clinical studies, this review describes the mechanisms of action of a large array of phytochemicals responsible for alleviating the clinical symptomatology of the disease. This is useful in further aiding and better comprehending the way plant-based products may help in managing this complex condition, paving the way for research in this area of study. PMID:38399428 | DOI:10.3390/ph17020212 {url} = URL to article
    • Exp Dermatol. 2024 Feb;33(2):e15037. doi: 10.1111/exd.15037. ABSTRACT The skin is increasingly recognized as a biological active organ interacting with the immune system. Given that the epidermal skin layer actively releases various cytokines, non-invasive skin sampling methods could detect these cytokines, offering insights into clinical conditions. This study aims non-invasively measuring cytokine levels directly from the skin surface to characterize different inflammatory chronic disorders in the adult and elderly population: psoriasis, diabetes type 2, rosacea, chronic kidney disease (CKD) and aging. Cytokines IL-1β, IL-8 and IL-10 were sampled from healthy subjects and patients aged 18-80 using skin surface wash technique. A well with sterile phosphate-buffered saline solution was placed on the skin for 30 min, and the extracted solution was collected from the well for further cytokine levels analysis using ELISA assay. Results show distinct cytokine profiles in different pathological processes, healthy controls, affected and unaffected areas. Aging was associated with increased IL-1β, IL-8, and IL-10 levels in skin. In diabetes, IL-1β and IL-8 levels were elevated in lesional areas, while IL-10 levels were decreased in non-lesional skin. Psoriatic lesions showed elevated levels of IL-1β and IL-8. Rosacea patients had lower IL-10 levels in both lesional and non-lesional areas. CKD patients exhibited significantly lower IL-10 levels compared to healthy individuals. In conclusion, skin surface wash-derived cytokine profiles could serve as "alert biomarkers" for disease prediction, enabling early detection. Additionally, this method's cost-effectiveness allows pre-screening of molecules in clinical studies and holds potential as a tool for biomarkers and omics analysis, enhancing disorder characterization and disease management. PMID:38389180 | DOI:10.1111/exd.15037 {url} = URL to article
    • Actas Dermosifiliogr. 2024 Feb 19:S0001-7310(24)00155-8. doi: 10.1016/j.ad.2024.02.014. Online ahead of print. ABSTRACT INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea. PMID:38382749 | DOI:10.1016/j.ad.2024.02.014 {url} = URL to article
    • J Inflamm Res. 2024 Feb 15;17:1057-1082. doi: 10.2147/JIR.S441100. eCollection 2024. ABSTRACT As the body's largest organ, the skin harbors a highly diverse microbiota, playing a crucial role in resisting foreign pathogens, nurturing the immune system, and metabolizing natural products. The dysregulation of human skin microbiota is implicated in immune dysregulation and inflammatory responses. This review delineates the microbial alterations and immune dysregulation features in common Inflammatory Skin Diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis(AD), seborrheic dermatitis(SD), diaper dermatitis(DD), and Malassezia folliculitis(MF).The skin microbiota, a complex and evolving community, undergoes changes in composition and function that can compromise the skin microbial barrier. These alterations induce water loss and abnormal lipid metabolism, contributing to the onset of ISDs. Additionally, microorganisms release toxins, like Staphylococcus aureus secreted α toxins and proteases, which may dissolve the stratum corneum, impairing skin barrier function and allowing entry into the bloodstream. Microbes entering the bloodstream activate molecular signals, leading to immune disorders and subsequent skin inflammatory responses. For instance, Malassezia stimulates dendritic cells(DCs) to release IL-12 and IL-23, differentiating into a Th17 cell population and producing proinflammatory mediators such as IL-17, IL-22, TNF-α, and IFN-α.This review offers new insights into the role of the human skin microbiota in ISDs, paving the way for future skin microbiome-specific targeted therapies. PMID:38375021 | PMC:PMC10876011 | DOI:10.2147/JIR.S441100 {url} = URL to article
    • Curr Med Mycol. 2023 Jun;9(2):52-63. doi: 10.22034/cmm.2023.345069.1425. ABSTRACT BACKGROUND AND PURPOSE: Tinea incognita (TI), or the other equivalent tinea atypica, is a term used to declare the atypical presentation of dermatophyte infections caused by the administration of steroids or other immunosuppressive medications which modulate the local and systemic immune response. It can mimic other dermatoses; hence making diagnostic challenges for dermatologists. Tina incognita may be misdiagnosed as many dermatoses. Based on previous studies, corticosteroids may cause different clinical manifestations of dermatophytes that might be very different from those that are commonly described. MATERIALS AND METHODS: This narrative review was conducted using PubMed and Scopus databases. Search terms included "Tinea incognita" and "Atypical dermatophytosis". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews, and case reports. The search was restricted to articles written in the English language from 2006 to Feb 01, 2023. Moreover, duplicate articles and non-available full-text articles were excluded. The extracted data of the search results were retrieved in this study. The morphological patterns, prevalence, sight of infection, and causative agents were also described. RESULTS: Prevalence of different patterns of TI were recorded as 50% (431 out of 862 cases) for eczema-like lesions followed by psoriasis-like and 6.61% (57 out of 862) for parapsoriasis-like pattern. Moreover, each of the rosacea-like and pyoderma-like lesions equally accounted for 4.98 % of cases (43 out of 862). In addition, the prevalence of causative agents was reported as follows: Trichophyton rubrum accounted for 247 isolates (40%) as the most prevalent, followed by Trichophyton mentagrophytes (n=152, 24%) and Microsporum canis (n=119, 19%). CONCLUSION: Tinea incognita is a great mimicker; hence, dermatologists should obtain a full medical history of the patients to make correct diagnoses. It is vital to encourage an exact identification of the etiological agent according to the internal transcribed spacer sequencing in some uncertain cases. This review highlights the importance of mycological tests and fast diagnosis of TI, especially in cases of atypical skin lesions, to choose appropriate treatment and avoid the spread of drug-resistant species. PMID:38375520 | PMC:PMC10874480 | DOI:10.22034/cmm.2023.345069.1425 {url} = URL to article
    • Front Immunol. 2024 Feb 2;15:1297240. doi: 10.3389/fimmu.2024.1297240. eCollection 2024. ABSTRACT BACKGROUND: Accumulating evidence shows that dysregulation of intestinal flora is associated with inflammatory skin diseases, specifically atopic dermatitis (AD), psoriasis (PSO), and rosacea (ROS). However, the causality is still unclear. OBJECTIVES: To study the underlying causality between gut microbiota (GM) and AD, PSO, and ROS, a bi-directional two-sample Mendelian randomization (2SMR) analysis was conducted. METHODS: Summary statistics of gut microbiota, AD, PSO, and ROS were extracted from large-scale genome-wide association studies (GWASs). In 2SMR analysis, in addition to the inverse variance weighted as the principal method for evaluating causal association, four different methods were also used. Sensitivity analysis and reverse 2SMR study were implemented to evaluate the robustness of 2SMR results or reverse causal relationship, respectively. RESULTS: A total of 24 specific gut microbiota species related to AD, PSO, and ROS were identified by 2SMR analysis. After using the Bonferroni method for multiple testing correction, family FamilyXIII (ID: 1957) [OR = 1.28 (1.13, 1.45), p = 9.26e-05] and genus Eubacteriumfissicatenagroup (ID: 14373) [OR = 1.20 (1.09, 1.33), p = 1.65e-04] were associated with an increased risk for AD and PSO, respectively. The genus Dialister showed a negative association, suggesting a protective role against both atopic dermatitis and rosacea. Our reverse 2SMR analysis indicated no reverse causality between these inflammatory skin diseases and the identified gut microbiota. CONCLUSIONS: In summary, this study provided evidence for the causality between GM and inflammatory skin diseases. These findings suggested that supplementing specific bacterial taxa may be an effective therapy for AD, PSO, and ROS. PMID:38370414 | PMC:PMC10869565 | DOI:10.3389/fimmu.2024.1297240 {url} = URL to article
    • Indian J Dermatol. 2023 Nov-Dec;68(6):727. doi: 10.4103/ijd.ijd_367_23. Epub 2024 Jan 9. NO ABSTRACT PMID:38371544 | PMC:PMC10869002 | DOI:10.4103/ijd.ijd_367_23 {url} = URL to article
    • Rosacea of the scalp: Results from a retrospective and prospective randomized controlled study
    • J Dtsch Dermatol Ges. 2024 Feb;22(2):167-176. doi: 10.1111/ddg.15290_g. ABSTRACT Die Rosazea ist eine häufige chronische Hauterkrankung, die sich hauptsächlich im mittleren Bereich des Gesichtes manifestiert. Die okulären Manifestationen der Rosazea wurden bisher nur unzureichend untersucht und bereits die Schätzungen der Prävalenz schwanken erheblich zwischen 6% und 72% der Gesamtpopulation aller Rosazea-Patienten. Zu den Behandlungsmöglichkeiten der okuläre Rosazea gehören die Lidhygiene, topisch anwendbare antimikrobielle Substanzen, topisch oder oral verabreichte Antibiotika und Vitamin-A-Derivate, Cisclosporin-haltige Emulsionen speziell für das Auge und IPL-Behandlungen (intense pulsed light). Direkte Vergleiche zwischen den verschiedenen Therapieoptionen fehlen jedoch. Ziel dieser Literatur-Übersicht ist es, die Wirksamkeit und Nebenwirkungen der verschiedenen Behandlungsmöglichkeiten der okulären Rosazea zu vergleichen. Dazu wurden systematische Datenbankrecherchen in Cochrane, MEDLINE und Embase durchgeführt. Titel, Abstrakt, Volltext und Daten wurden jeweils doppelt durchgesehen. Insgesamt erfüllten 66 Artikel mit einer kumulierten Patientenzahl von 1275 Patienten die Einschlusskriterien. Zu den wirksamsten Behandlungsoptionen zählten topisch anwendbare antimikrobielle Substanzen und die orale Gabe von Antibiotika. Damit konnte bei 91% (n = 82/90) bzw. 89% (n = 525/580) der Patienten ein vollständiges oder partielles Ansprechen erzielt werden. Es folgten die IPL-Behandlung (89%, n = 97/109 partielles Ansprechen), die Ciclosporin-Augen-Emulsion (87% n = 40/46) und die Lidhygiene (65%, n = 67/105). Kombinationsbehandlungen führten in 90% der Fälle (n = 69/77) zu einem vollständigen bzw. partiellen Ansprechen. Diese Ergebnisse deuten darauf hin, dass eine topische Therapie mit antimikrobiellen Substanzen, Antibiotika per os, IPL und Ciclosporin-haltige Emulsionen die effektivsten Einzelmaßnahmen zur Behandlung der okulären Rosazea darstellen. PMID:38361192 | DOI:10.1111/ddg.15290_g {url} = URL to article
    • Dermatol Pract Concept. 2024 Jan 1;14(1):e2024034. doi: 10.5826/dpc.1401a34. ABSTRACT INTRODUCTION: Many topical drugs are used in the treatment of erythematotelangiectatic rosacea (ETR). However, dapsone 5% gel has never been used in ETR to date. OBJECTIVES: To evaluate the efficacy of dapsone 5% gel as a new treatment option for ETR. METHODS: Thirty-five patients with ETR were included in the study. Diagnosis was made with National Rosacea Society criteria. Dapsone 5% gel was used topically twice a day for 12 weeks. Investigator Global Assessment (IGA) 4-point scale ( 0 → Clean, 1 → mild, 2 → moderate, 3 → severe, 4 → very severe), Visual Analogue Scale (VAS) and Dermatology Life Quality Index (DLQI) were used for evaluation (at baseline, 2nd, 6th, and 12th weeks). RESULTS: IGA scores among baseline (2 → 62.9%, 3 → 34.3%, 4 → 2.9%) and 2nd (1 → 14.3%, 2 → 77, 1%, 3 → 8.6%), 6th (1 → 45, 7%, 2 → 54.3%) and 12th weeks (1 → 62.9%, 2 → 37.1%) were found to be statistically significant (P < 0.001). Median VAS scores among baseline (median = 7 [5-9]) and 2nd (median=5 [3-8]), 6th (median=5 [3-6]) and 12th weeks (median = 4 [2-6]) were statistically significant (P < 0.001). Median DLQI scores among baseline (median = 8 [6-14]) and 2nd (median = 5 [3-11]), 6th (median = 5 [3-11]) and 12th weeks (median = 4 [2-9]) were statistically significant (p<0.001). Concurrent systemic disease was a risk factor for poor treatment response (P = 0.034). Mild irritation was observed in 3 patients (8.5%) during treatment. CONCLUSIONS: Dapsone 5% gel was effective and well tolerated in ETR treatment. PMID:38364435 | PMC:PMC10868780 | DOI:10.5826/dpc.1401a34 {url} = URL to article
    • Int Immunopharmacol. 2024 Mar 10;129:111636. doi: 10.1016/j.intimp.2024.111636. Epub 2024 Feb 15. ABSTRACT Rosacea is a long-term inflammatory skin disease associated with the dysfunction of vascular and immunological systems. Treatment options for rosacea are difficult to implement. Oroxylin A(OA), a traditional Chinese medicine, has anti-inflammation effects in a variety of inflammatory diseases. However, it is not known that whether OA exerts protective effects against LL-37-induced rosacea. In this study, bioinformatics analyses showed that the mechanisms of rosacea and the pharmacological targets of OA were highly overlapped. Subsequently, it was shown that the administration of OA resulted in a notable amelioration of rosacea-like skin lesions, as evidenced by a reduction in immune cell infiltration, modulation of cytokine production, and inhibition of angiogenesis. Plus, it was shown that OA effectively suppressed the generation of ROS generated by LL-37, as well as the subsequent activation of NF-κB signaling pathway. To explore further, we found that OA inhibited LL-37-induced ROS production via SIRT3-SOD2 signaling pathway in keratinocytes. Based on the aforementioned evidence, it can be inferred that OA exhibits a mitigating effect on the inflammatory response in rosacea by modulating the SIRT3-SOD2-NF-κB signaling pathway. PMID:38364746 | DOI:10.1016/j.intimp.2024.111636 {url} = URL to article
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