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  1. Comparative effectiveness of purpuragenic 595 nm pulsed dye laser versus sequential emission of 595 nm pulsed dye laser and 1,064 nm Nd:YAG laser: a double-blind randomized controlled study. Acta Dermatovenerol Alp Pannonica Adriat. 2019 Mar;28(1):1-5 Authors: Campos MA, Sousa AC, Varela P, Baptista A, Menezes N Abstract INTRODUCTION: Erythematotelangiectatic rosacea is a common condition in Caucasians. The most frequently used lasers to treat this condition are pulsed dye laser (PDL) and neodymium:yttrium-aluminum-garnet laser (Nd:YAG). This study compares the treatment efficacy of purpuragenic PDL with that of sequential emission of 595 nm PDL and 1,064 nm Nd:YAG (multiplexed PDL/Nd:YAG). METHODS: We performed a prospective, randomized, and controlled split-face study. Both cheeks were treated, with side randomization to receive treatment with PDL or multiplexed PDL/Nd:YAG. Efficacy was evaluated by spectrophotometric measurement, visual photograph evaluation, the Dermatology Quality of Life Index questionnaire, and a post-treatment questionnaire. RESULTS: Twenty-seven patients completed the study. Treatment was associated with a statistically significant improvement in quality of life (p < 0.001). PDL and multiplexed PDL/Nd:YAG modalities significantly reduced the erythema index (EI; p < 0.05). When comparing the degree of EI reduction, no differences were observed between the two treatment modalities. PDL was associated with a higher degree of pain and a higher percentage of purpura. Multiplexed PDL/Nd:YAG modality was associated with fewer side effects and greater global satisfaction, and 96.3% of the patients would recommend this treatment to a friend. CONCLUSIONS: Both laser modalities are efficacious in the treatment of erythematotelangiectatic rosacea. The multiplexed PDL/Nd:YAG modality was preferred by the patients. PMID: 30901061 [PubMed - in process] {url} = URL to article
  2. Related Articles Skin diseases are more common than we think: screening results of an unreferred population at the Munich Oktoberfest. J Eur Acad Dermatol Venereol. 2019 Mar 19;: Authors: Tizek L, Schielein MC, Seifert F, Biedermann T, Böhner A, Zink A Abstract BACKGROUND: Skin diseases are ranked as the fourth most common cause of human illness, resulting in an enormous non-fatal burden. Despite this, many affected people do not consult a physician. Accordingly, the actual skin disease burden might be even higher since reported prevalence rates are typically based on secondary data that exclude individuals who do not seek medical care. OBJECTIVE: The aim of the study was to investigate the prevalence of skin diseases in an unreferred population in a real-life setting. METHODS: A cross-sectional study of 9 days duration was performed in 2016 at the 'Bavarian Central Agricultural Festival', which is part of the Munich Oktoberfest. As part of a public health check-up, screening examinations were performed randomly on participating visitors. All participants were 18 years or older and provided written informed consent. RESULTS: A total of 2701 individuals (53.5% women, 46.2% men; mean age 51.9 ± 15.3 years) participated in the study. At least one skin abnormality was observed in 1662 of the participants (64.5%). The most common diagnoses were actinic keratosis (26.6%), rosacea (25.5%) and eczema (11.7%). Skin diseases increased with age and were more frequent in men (72.3%) than in women (58.0%). Clinical examinations showed that nearly two-thirds of the affected participants were unaware of their abnormal skin findings. CONCLUSION: Skin diseases might be more common than previously estimated based on the secondary data of some sub-populations. Further information and awareness campaigns are needed to improve people's knowledge and reduce the global burden associated with skin diseases. PMID: 30891839 [PubMed - as supplied by publisher] {url} = URL to article
  3. Fractionated Carbon Dioxide Laser Resurfacing as an Ideal Treatment Option for Severe Rhinophyma: A Case Report and Discussion. J Clin Aesthet Dermatol. 2019 Jan;12(1):24-27 Authors: Comeau V, Goodman M, Kober MM, Buckley C Abstract Rhinophyma is a progressive, disfiguring condition that affects the nose and is caused by the hypertrophy of sebaceous glands and connective tissue. Although its exact pathogenesis remains unclear, it is generally thought to be a subtype of the chronic, inflammatory condition rosacea. To date, oral and topical treatments have been largely ineffective at treating rhinophyma. Laser resurfacing is an emerging treatment modality that offers hope for patients with severe rhinophyma. We present a case of rhinophyma treated via fractionated carbon dioxide laser resurfacing with impressive results, excellent tolerability, and minimal downtime. PMID: 30881573 [PubMed] {url} = URL to article
  4. Effective Treatment of Morbihan's Disease with Long-term Isotretinoin: A Report of Three Cases. J Clin Aesthet Dermatol. 2019 Jan;12(1):32-34 Authors: Olvera-Cortés V, Pulido-Díaz N Abstract Morbihan's disease is characterized by the presence of chronic and persistent edema of the periorbital tissue, forehead, glabella, nose, and cheeks. In some cases, it is related to acne and rosacea, but its exact etiology remains unknown. A defined therapeutic approach has yet to be established for the treatment of Morbihan's disease. To date, the systemic and surgical options attempted have not been very successful and/or do not yield sustained results. Isotretinoin is a key systemic treatment used for the treatment of various skin conditions. However, there are few reports of isotretinoin being used to treat Morbihan's disease. Here, we present the details of three patients with Morbihan's disease who were successfully treated long-term with isotretinoin. PMID: 30881575 [PubMed] {url} = URL to article
  5. [Acne, rosacea, seborrheic dermatitis]. Rev Prat. 2018 Oct;68(8):e303-e309 Authors: Badaoui A, Mahé E Abstract PMID: 30869466 [PubMed - in process] {url} = URL to article
  6. [Ocular and cutaneous rosacea in a child]. Arch Argent Pediatr. 2019 Apr 01;117(2):e170-e172 Authors: Di Matteo MC, Stefano PC, Cirio A, López B, Centeno M, Bocian M, Cervini AB Abstract Rosacea is a chronic skin disease characterized by erythema, telangiectasia, papules and pustules in the central facial region. It most often affects adults and is rare in children. Rosacea can also present ocular involvement. Symptoms can precede cutaneous findings, appear simultaneously or after them, with a higher risk of ocular complications in children. Because of low prevalence of rosacea in childhood, the diagnosis is frequently delayed. We report a 1-year-old boy with ocular and cutaneous rosacea who developed corneal opacities and visual impairment. Early diagnosis and treatment is considerable to avoid sequels. PMID: 30869500 [PubMed - in process] {url} = URL to article
  7. Related Articles New indications for topical ivermectin 1% cream: a case series study. Postepy Dermatol Alergol. 2019 Feb;36(1):58-62 Authors: Barańska-Rybak W, Kowalska-Olędzka E Abstract Introduction: Topical ivermectin is an effective treatment for inflammatory papulopustular rosacea in adults. Positive therapeutic effects of ivermectin due to its potential anti-inflammatory properties could be achieved in the other facial dermatoses. Aim: To assess the efficacy of topical ivermectin 1% cream therapy in mild and moderate perioral dermatitis (PD), seborrheic dermatitis (SD) and acne vulgaris (AV). Material and methods: The study comprising 20 patients diagnosed with PD (8), SD (8) and AV (4) was conducted between November 2016 and July 2017. Two scales were applied to establish efficacy of the treatment: Investigator Global Assessment score (IGA) and Patient Global Assessment of Treatment (PGA). Results: All patients responded to the treatment with topical ivermectin very well with a gradual reduction in inflammatory skin lesions. Complete or almost complete clearance (IGA score 0-1) was achieved in 20 cases. Four patients with PD achieved IGA 0-1 after 4 weeks of treatment, 1 patient after 5 weeks, 2 patients after 6 weeks and 1 patient after 12 weeks. In the total group of 8 patients with SD, 4 presented IGA 0 after 4 weeks of therapy, while 4 patients demonstrated IGA 1 after 6 weeks. Patients with AV required 8 and 10 weeks to obtain IGA 1. Nineteen patients of the studied group reported "very good" or "excellent" response to the therapy, only one patient with AV assessed therapy with topical ivermectin as "good". The adverse events were transient and manifested as mild-moderate desquamation, stinging and burning in 2 patients with PD. Conclusions: Topical ivermectin was well tolerated and beneficial for treatment of mild and moderate PD, SD and AV. PMID: 30858780 [PubMed] {url} = URL to article
  8. Related Articles Treatment of granulomatous rosacea with chromophore gel-assisted phototherapy. Photodermatol Photoimmunol Photomed. 2019 Mar 10;: Authors: Liu RC, Makhija M, Wong XL, Sebaratnam DF Abstract Granulomatous rosacea is a variant of rosacea characterized by discrete erythematous papules most commonly affecting the central face. It is a rare condition reported primarily in middle-aged women, and tends to have a chronic course often recalcitrant to therapy. We report a case of granulomatous rosacea treated with chromophore gel-assisted phototherapy (CGAP). This article is protected by copyright. All rights reserved. PMID: 30854732 [PubMed - as supplied by publisher] {url} = URL to article
  9. Increased Risk of Cardiovascular Diseases in Female Rosacea Patients: A Nested Case-control Study. Acta Derm Venereol. 2019 Mar 08;: Authors: Sinikumpu SP, Jokelainen J, Auvinen J, Puukka K, Kaikkonen K, Tasanen K, Huilaja L PMID: 30848290 [PubMed - as supplied by publisher] {url} = URL to article
  10. Characterization of the Blood Microbiota in Korean Females with Rosacea. Dermatology. 2019 Mar 07;:1-5 Authors: Yun Y, Kim HN, Chang Y, Lee Y, Ryu S, Shin H, Kim WS, Kim HL, Nam JH PMID: 30844814 [PubMed - as supplied by publisher] {url} = URL to article
  11. Related Articles Spanish Consensus Document on the Treatment Algorithm for Rosacea. Actas Dermosifiliogr. 2019 Mar 02;: Authors: Salleras M, Alegre M, Alonso-Usero V, Boixeda P, Domínguez-Silva J, Fernández-Herrera J, García-Navarro X, Jiménez N, Llamas M, Nadal C, Del Pozo-Losada J, Querol I, Salgüero I, Schaller M, Soto de Delás J Abstract Recent scientific evidence and the incorporation of new drugs into the therapeutic arsenal against rosacea have made it necessary to review and update treatment criteria and strategies. To this end, a panel of 15 dermatologists, all experts in rosacea, was formed to share experiences and discuss treatment options, response criteria, and changes to treatment. Based on a critical review of the literature and a discussion of the routine practices of Spanish dermatologists, the panel proposed and debated different options, with consideration of the experience of professionals and the preferences of patients or equality criteria. Following validation of the proposals, the final recommendations were formulated and, together with the evidence from the main international guidelines and studies, used to produce this consensus document. The goal of this consensus document is to provide dermatologists with practical recommendations for the management of rosacea. PMID: 30837074 [PubMed - as supplied by publisher] {url} = URL to article
  12. Related Articles Rare diseases that mimic Systemic Lupus Erythematosus (Lupus mimickers). Joint Bone Spine. 2019 Mar;86(2):165-171 Authors: Chasset F, Richez C, Martin T, Belot A, Korganow AS, Arnaud L Abstract Several conditions have clinical and laboratory features that can mimic those present in Systemic Lupus Erythematosus (SLE). Some of these "SLE mimickers" are very common, such as rosacea which can be mistaken for the butterfly rash, while others such as Kikuchi disease, type-1 interferonopathies, Castleman's disease, prolidase deficiency, angioimmunoblastic T-cell lymphoma, Evans' syndrome in the context of primary immune deficiencies and the autoimmune lymphoproliferative syndrome are exceptionally uncommon. A proper diagnosis of SLE must therefore be based upon a complete medical history as well as on the adequate constellation of clinical or laboratory findings. While there is no single test that determines whether a patient has lupus or not, the search for auto-antibodies towards nuclear antigens is a key step in the diagnosis strategy, keeping in mind that ANAs are not specific for SLE. In case of persistent doubt, patients should be referred to reference centers with experience in the management of the disease. PMID: 30837156 [PubMed - in process] {url} = URL to article
  13. Related Articles Idiopathic Facial Aseptic Granuloma: Updated Review of Diagnostic and Therapeutic Difficulties. Actas Dermosifiliogr. 2019 Feb 25;: Authors: Hasbún Z C, Ogueta C I, Dossi C T, Wortsman X Abstract Idiopathic facial aseptic granuloma is a pediatric skin condition involving asymptomatic reddish nodules. The etiology and pathogenesis is still under discussion, although the literature tends to place this condition within the spectrum of childhood rosaceas. The clinical course is chronic but benign, and cases have been reported to resolve spontaneously in less than a year. Even though no well-defined treatment has emerged, a conservative approach that avoids aggressive therapies is preferred. PMID: 30819406 [PubMed - as supplied by publisher] {url} = URL to article
  14. Atrophic acne scar: A process from altered metabolism of elastic fibers and collagen fibers based on TGF-β1 signaling. Br J Dermatol. 2019 Mar 01;: Authors: Moon J, Yoon JY, Yang JH, Kwon HH, Min S, Suh DH Abstract BACKGROUND: Atrophic acne scar, a persistent sequela from acne, is undesirably troubling many patients in cosmetic and psychosocial aspects. Although there have been some reports to emphasize the role of early inflammatory responses in atrophic acne scarring, evolving perspectives on the detailed pathogenic process are promptly needed. OBJECTIVES: Examining the histological, immunological and molecular changes in early acne lesions susceptible to atrophic scarring can provide new insights to understand the pathophysiology of atrophic acne scar. METHODS: We experimentally validated several early fundamental hallmarks accounting for the transition of early acne lesions to atrophic scars by comparing molecular profiles of skin and acne lesions between patients who were prone to scar (APS) and not (ANS). RESULTS: In APS, compared to ANS, devastating degradation of elastic fibers and collagen fibers occurred in the dermis, followed by their incomplete recovery. Abnormally excessive inflammation mediated by innate immunity with Th17/Th1 cells was observed. Epidermal proliferation was significantly diminished. TGF-β1 was drastically elevated in APS, suggesting that the aberrant TGF-β1 signaling is an underlying modulator of all these pathological processes. CONCLUSIONS: These results may provide a basis for understanding the pathogenesis of atrophic acne scarring. Reduction of excessive inflammation and TGF-β1 signaling in early acne lesions is expected to facilitate the protection of normal extracellular matrix metabolism and the prevention of atrophic scar formation ultimately. This article is protected by copyright. All rights reserved. PMID: 30822364 [PubMed - as supplied by publisher] {url} = URL to article
  15. Related Articles Global rosacea treatment guidelines and expert consensus points: The differences. J Cosmet Dermatol. 2019 Feb 26;: Authors: Juliandri J, Wang X, Liu Z, Zhang J, Xu Y, Yuan C Abstract BACKGROUND: Rosacea is a highly prevalent, chronic inflammatory disease. The treatment of rosacea remains a challenge to dermatologists. Therapies include skin care, medications, lasers, and various combinations of these modalities. The appropriate treatment depends on clinical types and patient's various clinical symptoms. PURPOSE: The purpose of this study was to review and compare current therapies for rosacea of all severities from four different guidelines. METHODOLOGY: We searched PubMed using the keywords "rosacea," "treatment" AND ["erythema rosacea" OR "papulopustular rosacea" OR "ocular rosacea" OR "phymatous rosacea"]. We selected randomized controlled trials, observational studies, controlled clinical trials, and clinical trials. We indentified further studies (including the guidelines) by hand-searching relevant publications and included those that met the inclusion criteria. RESULTS: The total number of records identified was 421. We limited our search to the specific abovementioned study types. Twenty-five of these studies met with our inclusion criteria. An additional five manuscripts were selected using the abovementioned method, and four guidelines were included in this review. CONCLUSION: Diagnosing and choosing the appropriate treatment options of rosacea according to guidelines is the basis of scientific criteria. More large-scale randomized controlled clinical trials on new treatment methods, new drugs, or new dosage forms provide a new guideline for future rosacea treatment. Although there are some differences in the treatment of rosacea, it is generally based on anti-demodex, anti-inflammatory, and anti-angiogenesis. PMID: 30809947 [PubMed - as supplied by publisher] {url} = URL to article
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