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  1. Related Articles Erythromelalgia involving the face. Dermatol Online J. 2017 Apr 15;23(4): Authors: Gilmore RR, Applebaum DS, Parsons JL, Hsu S Abstract Erythromelalgia is a rare disorder characterized by burning pain, erythema, and increased temperature typically involving the distal extremities. Although it can progress to involve the face, erythromelalgia presenting only on the face is particularly rare. This disorder is often misdiagnosed when it presents on the extremities and is even more likely to be misdiagnosed when presenting only on the face, delaying appropriate treatment and causing considerable frustration for the patient. We report a case of a 26-year-old woman with erythromelalgia that involved only the face for a number of years and was treated unsuccessfully as rosacea, seborrheic dermatitis, and contact dermatitis. She subsequently developed involvement of the ears and hands in the more typical distribution of erythromelalgia. We discuss the differential diagnosis of erythromelalgia involving the face and extremities, the proposed pathogenesis and management of the disorder, and the psychological distress this condition can cause. Even when the correct diagnosis of erythromelalgiais made, treatment is difficult, with no single therapy consistently effective. PMID: 28541877 [PubMed - in process] {url} = URL to article
  2. Related Articles Updating the diagnosis,classification and assessment of rosacea by effacement of subtypes: reply from author. Br J Dermatol. 2017 May 19;: Authors: Tan J Abstract The National Rosacea Society Expert Committee (NRSCOR) 2002 publication indicated that the definition and classification system then proposed was based on scientific knowledge, that it was provisional, and that it would be refined with increasing knowledge.(1) A move from subtyping towards a phenotype approach was proposed by the American Acne and Rosacea Society (AARS)(2) and ROSCO presents the first international effort to advance the diagnosis and classification of rosacea. This article is protected by copyright. All rights reserved. PMID: 28542720 [PubMed - as supplied by publisher] {url} = URL to article
  3. Related Articles Rosacea is associated with Helicobacter pylori: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2017 May 23;: Authors: Jørgensen AR, Egeberg A, Gideonsson R, Weinstock LB, Thyssen EP, Thyssen JP Abstract BACKGROUND: Rosacea is a common skin disease characterized by facial erythema, telangiectasia, papules, and pustules. Helicobacter pylori infection has been suggested to play a role in the etiopathogenesis of rosacea. OBJECTIVE: Systematically review and meta-analyse the relationship between rosacea and infection with Helicobacter pylori . METHODS: A literature search was performed using PubMed, EMBASE, and Web of Science. Data extraction and analyses were performed on descriptive data. Study quality was assessed using the Newcastle-Ottawa Scale. Random effects models with DerSimonian-Laird methods were utilized to estimate pooled odds ratios (ORs), with 95% confidence intervals (95% CIs). Heterogeneity of results was assessed using I² statistics. RESULTS: A total of 454 articles were identified and 42 full text articles were chosen for further review. 14 studies were included in the quantitative meta-analysis, comprising a total of 928 rosacea patients and 1,527 controls. The overall association between Helicobacter pylori infection and rosacea was non-significant (OR 1.68, 95% CI 1.00-2.84, p=0.052), but analysis restricted to C-urea-breath test showed a significant association (OR 3.12, 95% CI 1.92-5.07, p<0.0001). Effect of eradication treatment on rosacea symptoms was assessed in seven studies, but without significant effect (RR 1.28, 95% CI 0.98-1.67, p=0.069). CONCLUSION: This meta-analysis found weak associations between rosacea and Helicobacter pylori infection as well as an effect of Helicobacter pylori therapy on rosacea symptoms, albeit that these did not reach statistical significance. Whether a pathogenic link between the two conditions exists, or whether Helicobacter pylori infection represents a proxy for other factors remains unknown. This article is protected by copyright. All rights reserved. PMID: 28543746 [PubMed - as supplied by publisher] {url} = URL to article
  4. Cutaneous adverse effects during ipilimumab treatment for metastatic melanoma: a prospective study. Eur J Dermatol. 2017 May 19;: Authors: Dika E, Ravaioli GM, Fanti PA, Piraccini BM, Lambertini M, Chessa MA, Baraldi C, Ribero S, Andrea A, Melotti B, Patrizi A Abstract Ipilimumab is an immunomodulatory antibody directed against cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), which is administered to patients with advanced melanoma, with a proven positive effect on overall survival. The cutaneous adverse effects (AEs) of ipilimumab are relatively frequent, although described as usually mild and rarely life threatening. To describe a three-year experience of a single institute in detecting and managing cutaneous AEs. A cohort of patients (n = 41) treated with ipilimumab (3 mg/kg/three weeks) for metastatic melanoma, from 2013 to 2016, was investigated for adverse cutaneous events. On dermatological evaluation, 34.1% of the patients in our series developed cutaneous AEs: rash (7.3%; n = 3), folliculitis (7.3%; n = 3), mucositis (2.4%; n = 1), rosacea (2.4%; n = 1), eczema (2.4%; n = 1), acneiform eruption (2.4%; n = 1), syringometaplasia mucinosa (2.4%; n = 1), Stevens-Johnson syndrome (2.4%; n = 1), and vitiligo (4.9%; n = 2). These were all Grade 1 and 2 AEs, except for the case of Stevens-Johnson syndrome (Grade 4). On a patient-reported scale, 4.9% (n = 2) and 9.8% (n = 4) of the patients complained of severe xerosis and pruritus, respectively. Ipilimumab was relatively well tolerated in our series, mainly causing mild cutaneous AEs, which, in our experience, responded satisfactorily to conventional therapies. Only in one case the treatment was discontinued, due to Grade 4 side effects. PMID: 28524050 [PubMed - as supplied by publisher] {url} = URL to article
  5. Surgical treatment of rhinophyma: experience from a German cohort of 70 patients. Eur J Dermatol. 2017 May 19;: Authors: Schweinzer K, Kofler L, Spott C, Krug M, Schulz C, Schnabl SM, Breuninger H, Häfner HM, Eberle FC Abstract Rhinophyma is a deforming soft tissue hyperplasia of the nose and surgical removal represents the treatment of choice. Comprehensive data on surgical therapy and the impact of rhinophyma on patient quality of life are lacking. Patients who received surgery for rhinophyma between 2006 and 2015 were retrospectively evaluated for postoperative complications, clinical outcome, recurrence of rhinophyma, and the impact of rhinophyma on daily life. A total of 143 patients were treated with superficial tumour decortication by scalpel under tumescent anaesthesia. Outcomes were determined by clinical review, clinical files, and a patient questionnaire. Of 143 patients, 70 answered the questionnaire and were included in this study with a mean follow-up time of 54 months. Cosmetic results were evaluated as very good or good in 77% of patients. The majority of patients (87%) were very satisfied or satisfied with the postoperative result. Surgical treatment of rhinophyma improved patients' quality of life in 67% of patients. Recurrence of rhinophyma was detected in 38% of patients. Surgery is an effective therapy for rhinophyma with excellent outcome. PMID: 28524054 [PubMed - as supplied by publisher] {url} = URL to article
  6. Related Articles Oxymetazoline cream (Rhofade) for rosacea. Med Lett Drugs Ther. 2017 May 22;59(1521):84-86 Authors: PMID: 28520699 [PubMed - in process] {url} = URL to article
  7. Related Articles Comparison table: some topical drugs for rosacea. Med Lett Drugs Ther. 2017 May 22;59(1521):e92 Authors: PMID: 28520703 [PubMed - in process] {url} = URL to article
  8. Related Articles Inhibition of mast cell infiltration in an LL-37-induced rosacea mouse model using topical brimonidine tartrate 0.33% gel. Exp Dermatol. 2017 May 13;: Authors: Kim M, Kim J, Jeong SW, Jo H, Woo YR, Park HJ PMID: 28500634 [PubMed - as supplied by publisher] {url} = URL to article
  9. Related Articles The Role of Skin Care in Optimizing Treatment of Acne and Rosacea. Skin Therapy Lett. 2017 May;22(3):5-7 Authors: Zip C Abstract A triad approach to the treatment of acne and rosacea has been recommended. This integrated management approach includes patient education, selection of therapeutic agents, and initiation of an appropriate skin care regime. Proper skin care in patients undergoing treatment of both acne and rosacea includes use of products formulated for sensitive skin that cleanse, moisturize and photoprotect the skin. Both acne and rosacea are associated with epidermal barrier dysfunction, which can be mitigated by suitable skin care practices. Appropriate skin care recommendations for patients with acne and rosacea will be discussed. PMID: 28492949 [PubMed - in process] {url} = URL to article
  10. Related Articles Updating the diagnosis, classification and assessment of rosacea by effacement of subtypes. Br J Dermatol. 2017 May 06;: Authors: Wilkin J Abstract Tan, et al.,(ROSCO) propose to "transition beyond a subtype classification", which they ascribe to the National Rosacea Society's Classification of Rosacea (NRSCOR), asserting "Subtype classification may not fully cover the range of clinical presentations and is likely to confound severity assessment, whereas a phenotype-based approach could improve patient outcomes by addressing an individual patient's clinical presentation and concerns"(1). NRSCOR did not invent the phenotypic subtypes, described by expert dermatologists over preceding decades, but sought a common terminology for use in communicating ideas about rosacea (compare use in Fig. 1 by ROSCO). NRSCOR emphasized the potential evolution from one phenotypic subtype to another, and that phenotypic subtypes can occur together. ROSCO's claimed 'phenotypic approach' seems to be simply the elimination of these phenotypic subtypes. This article is protected by copyright. All rights reserved. PMID: 28477357 [PubMed - as supplied by publisher] {url} = URL to article
  11. Related Articles The Role of Skin Care in Optimizing Treatment of Acne and Rosacea. Skin Therapy Lett. 2017 May;22(3):5-7 Authors: Zup C Abstract A triad approach to the treatment of acne and rosacea has been recommended. This integrated management approach includes patient education, selection of therapeutic agents, and initiation of an appropriate skin care regime. Proper skin care in patients undergoing treatment of both acne and rosacea includes use of products formulated for sensitive skin that cleanse, moisturize and photoprotect the skin. Both acne and rosacea are associated with epidermal barrier dysfunction, which can be mitigated by suitable skin care practices. Appropriate skin care recommendations for patients with acne and rosacea will be discussed. PMID: 28486718 [PubMed - in process] {url} = URL to article
  12. Related Articles More than meets the (painful red) eye. Aust Fam Physician. 2016 Jun;45(6):383-4 Authors: Navaratna AF, Walsh A, Magin P PMID: 27622227 [PubMed - indexed for MEDLINE] {url} = URL to article
  13. Mucocutaneous Hyperpigmentation in a Patient With a History of Both Minocycline and Silver Ingestion. Am J Dermatopathol. 2017 Apr 27;: Authors: Fernandez-Flores A, Nguyen T, Cassarino DS Abstract Minocycline is a derivative of tetracycline. It has been widely used in dermatology for the treatment of acne and rosacea. One of its adverse effects is pigmentation of various body tissues. Clinically, 3 main distinct types of hyperpigmentation by minocycline have been distinguished: type I, with blue-gray to black pigment on the face in areas of scarring or inflammation; type II, with blue-gray pigment on normal skin of the legs, forearms and on the shins; and type III, with a diffuse muddy-brown discoloration in areas of sun exposure. In the current report, we present the case of a 50-year old man with a history of severe acne treated with minocycline in the past, who currently complained about discoloration of his face. He had also taken colloidal silver supplements for "good health" about 16 years ago. Physical examination revealed gray-blue discoloration on the face, sclera, hard palate and back. Histologic examination showed intracellular pigment deposits in macrophages of the superficial dermis in a perivascular and an interstitial distribution. The pigment stained with Fontana-Masson and von Kossa, whereas it was Perls' iron negative. This case does not fit well into any of the previously described patterns of minocycline-related hyperpigmentation. PMID: 28475520 [PubMed - as supplied by publisher] {url} = URL to article
  14. Related Articles Cigarette smoking and risk of incident rosacea in women. Am J Epidemiol. 2017 May 03;: Authors: Li S, Cho E, Drucker AM, Qureshi AA, Li WQ Abstract The relationship between smoking and rosacea is poorly understood; we aimed to conduct the first cohort study to determine the association between smoking and risk of incident rosacea. We included 95,809 women from Nurses' Health Study II (1991-2005). Information on smoking was collected biennially during follow-up. Information on history of clinician-diagnosed rosacea and year of diagnosis was collected in 2005. We used Cox proportional hazard models to estimate age and multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for the association between different measures of smoking and risk of rosacea. During the follow-up, we identified 5,462 incident cases of rosacea. Compared with never smokers, we observed an increased risk of rosacea associated with past smoking (multivariable-adjusted HR = 1.09, 95% CI: 1.03, 1.16) but a decreased risk of rosacea associated with current smoking (HR = 0.65, 95% CI: 0.58, 0.72). We further found that increasing pack-years of smoking was associated with an elevated risk of rosacea among past smokers (P for trend = 0.003), and was associated with a decreased risk of rosacea among current smokers (P for trend < 0.0001). The risk of rosacea was significantly increased within 3-9 years since smoking cessation, and the significant association persisted among past smokers who had quit for over 30 years. PMID: 28472217 [PubMed - as supplied by publisher] {url} = URL to article
  15. Related Articles Rosacea. Aust Fam Physician. 2017;46(5):277-281 Authors: Maor D, Chong AH Abstract BACKGROUND: Rosacea is a chronic and common cutaneous condition characterised by symptoms of facial flushing and a broad spectrum of clinical signs. The clinical presentation for rosacea is varied, and there are four primary subtypes, which may overlap - erythrotelangiectatic, inflammatory, phymatous and ocular. It is important to recognise the different subtypes because of the differences in therapy. OBJECTIVE: The objective of this article is to provide evidence-based clinical updates to clinicians, specifically general practitioners (GPs), to assist with their everyday practice, and effective assessment and treatment of rosacea. DISCUSSION: Therapeutic modalities are chosen on the basis of the subtypes and clinical features identified; often a combination of these therapies is required. PMID: 28472572 [PubMed - in process] {url} = URL to article