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  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. Related Articles Skin changes in the obese patient. J Am Acad Dermatol. 2019 Nov;81(5):1037-1057 Authors: Hirt PA, Castillo DE, Yosipovitch G, Keri JE Abstract Obesity is a worldwide major public health problem with an alarmingly increasing prevalence over the past 2 decades. The consequences of obesity in the skin are underestimated. In this paper, we review the effect of obesity on the skin, including how increased body mass index affects skin physiology, skin barrier, collagen structure, and wound healing. Obesity also affects sebaceous and sweat glands and causes circulatory and lymphatic changes. Common skin manifestations related to obesity include acanthosis nigricans, acrochordons, keratosis pilaris, striae distensae, cellulite, and plantar hyperkeratosis. Obesity has metabolic effects, such as causing hyperandrogenism and gout, which in turn are associated with cutaneous manifestations. Furthermore, obesity is associated with an increased incidence of bacterial and Candida skin infections, as well as onychomycosis, inflammatory skin diseases, and chronic dermatoses like hidradenitis suppurativa, psoriasis, and rosacea. The association between atopic dermatitis and obesity and the increased risk of skin cancer among obese patients is debatable. Obesity is also related to rare skin conditions and to premature hair graying. As physicians, understanding these clinical signs and the underlying systemic disorders will facilitate earlier diagnoses for better treatment and avoidance of sequelae. PMID: 31610857 [PubMed - in process] {url} = URL to article
  8. The efficacy and safety of permethrin 2.5% with tea tree oil gel on rosacea treatment: A double-blind, controlled clinical trial. J Cosmet Dermatol. 2019 Oct 15;: Authors: Ebneyamin E, Mansouri P, Rajabi M, Qomi M, Asgharian R, Azizian Z Abstract BACKGROUND: Rosacea is a chronic skin condition that typically affects the face and it results in redness and inflammation. The main risk factors of this disease are Demodex folliculorum, living in the pilosebaceous units. AIMS: To evaluate the efficacy and safty of permethrin 2.5% in combination with tea tree oil (TTO) topical gel versus placebo on Demodex density (Dd) and clinical manifestation using standard skin surface biopsy (SSSB) in rosacea patients. PATIENT/METHODS: In this double-blind, randomized clinical trial, 47 papulopustular rosacea patients were enrolled, with 35 patients finishing the 12 weeks of treatment. Each patient used permethrin 2.5% with TTO on one side of the face and a placebo on the other, twice daily for 12 weeks. SSSB, photography and clinical rosacea scores according to National Rosacea Society, as well as adverse drug reaction (ADRs) were reported at the baseline, 2nd, 5th, 8th, and 12th weeks. RESULTS: A total of 47 patients were enrolled with papulopustular rosacea, and 35 patients finished the study. The effects of permethrin 2.5% with TTO gel on mite density were significant at week 5, 8, 12 (P value = .001). Clinical features and global assessments showed papules, pustules and nontransient erythema had improvement in drug group after 12 weeks (P values <.05). The improvement of burning and stinging and dry appearance was greater than the placebo gel (P value <.05). Itching in placebo group was significantly more than other group (P value = .002). CONCLUSION: Administration of permethrin 2.5% with TTO gel demonstrated good efficacy and safety in rosacea. This topical gel inhibited the inflammatory effects of rosacea and reduced Demodex mite. PMID: 31613050 [PubMed - as supplied by publisher] {url} = URL to article
  9. Related Articles Gnathophyma. Skinmed. 2018;16(1):45 Authors: Kumar P, Das A PMID: 29551113 [PubMed - indexed for MEDLINE] {url} = URL to article
  10. Related Articles Well-Circumscribed Localized-Rhinophyma as a Very Rare Presentation of Rhinophyma. Iran J Otorhinolaryngol. 2019 Sep;31(106):323-326 Authors: Kavoussi H, Ramezani M, Ahmadaghaei F, Ghorbani I, Eftekhari Pirouz H, Kavoussi R Abstract Introduction: Rhinophyma is an uncommon subtype of rosacea, the clinical diagnosis of which is straightforward. However, localized, especially well-circumscribed, rhinophyma is a very rare condition, which requires a paraclinical assessment to be accurately diagnosed. Case Report: We report a 48-year-old male patient who presented with a well-circumscribed and dark red tumoral mass of 28 mm in diameter and smooth consistency in the right nasal ala. The patient had no former and concomitant characteristic skin lesions on the other part of his face. Histopathology and immunohistochemistry assessments documented the diagnosis of rhinophyma. Conclusion: To the best of our knowledge, this is the first case report of well-circumscribed localized rhinophyma. This lesion can be treated by CO2 laser in a fast and efficient manner with esthetically satisfactory outcome and no significant complications. PMID: 31598502 [PubMed] {url} = URL to article
  11. Related Articles Association of rosacea with inflammatory bowel disease: A MOOSE-compliant meta-analysis. Medicine (Baltimore). 2019 Oct;98(41):e16448 Authors: Wang FY, Chi CC Abstract Rosacea has been reported with several systemic comorbidities, but its relationship with inflammatory bowel disease (IBD) is unclear. Thus, our objective is to conduct a meta-analysis on the association of rosacea with IBD.We conduct a meta-analysis and searched MEDLINE, CENTRAL, and Embase databases for case-controlled and cohort studies that assessed the association of rosacea with IBD from inception to July 2nd, 2018. Two authors independently selected studies, extracted data, and assessed the risk of bias of included studies. Disagreement was resolved by discussion. We performed random-effects model meta-analysis to obtain the pooled risk estimates for Crohn disease (CD) and ulcerative colitis (UC) in patients with rosacea.We included three case-control and three cohort studies. The risk of bias of included studies was generally low. The meta-analysis on case-control studies showed marginally increased odds of CD (pooled odds ratio (OR) 1.30, 95% confidence interval (CI) 0.99-1.69) and a significantly increased odds of UC (pooled OR 1.64, 95% CI 1.43-1.89) in patients with rosacea. The meta-analysis on cohort studies demonstrated significant increased risk of CD (pooled hazard ratio (HR) 1.58, 95% CI 1.14-2.20) and UC (pooled HR 1.18, 95% CI 1.01-1.37) in patients with rosacea.The evidence indicates an association of rosacea with IBD. If patients with rosacea suffer from prolonged abdominal pain, diarrhea, and bloody stool, referral to gastroenterologists may be considered. PMID: 31593075 [PubMed - in process] {url} = URL to article
  12. Related Articles Treatment of Demodex-Associated Inflammatory Skin Conditions: A Systematic Review. Dermatol Ther. 2019 Oct 03;:e13103 Authors: Jacob S, VanDaele MA, Brown JN Abstract Bacterial folliculitis, rosacea, and other common skin conditions have been linked to infestation by Demodex mites (human demodicosis). Currently, there is little guidance for treatment of inflammatory conditions associated with demodicosis. Thus, the objective of this review is to evaluate the efficacy and safety of treatments utilized for Demodex infestation. Pubmed (1946 to January 2019) and Embase (1947 to January 2019) were searched with the following term combinations: Demodex mites, Demodex folliculitis, demodicosis, Demodex folliculorum, or Demodex brevis and articles evaluating treatment of body surface colonization with Demodex mites were included. Common interventions used for Demodex infestation include metronidazole-based therapies, permethrin, benzoyl benzoate, crotamiton, lindane, and sulfur. Short courses of metronidazole taken orally has shown efficacy in reducing Demodex density. Additionally, topical administration of permethrin daily or twice daily was shown to be efficacious across multiple studies. Crotamiton and benzyl benzoate were also efficacious treatments. Several therapies were associated with mild-to-moderate skin irritation. Due to limited data, no standard of care can be identified at this time. Efficacious treatment options may include permethrin, crotamiton, benzyl benzoate, and oral metronidazole; however, long-term efficacy has not been established. This article is protected by copyright. All rights reserved. PMID: 31583801 [PubMed - as supplied by publisher] {url} = URL to article
  13. Real life experience on effectiveness and tolerability of topical ivermectin in papulopustular rosacea and anti-parasitic effect on Demodex mites. Dermatol Ther. 2019 Oct 03;:e13093 Authors: Trave I, Merlo G, Cozzani E, Parodi A Abstract BACKGROUND: Ivermectin is a drug approved for the treatment of papulopustular rosacea. Although clinical guidelines recommend the use of ivermectin as the first-line treatment in patients with almost clear and mild rosacea, studies concerning its use on them are lacking. OBJECTIVE: This study investigated the effectiveness and the tolerability of ivermectin in almost clear to severe rosacea and assessed the anti-parasitic effect on Demodex mites. METHODS: This is a retrospective study based on 50 patients affected by papulopustular rosacea and treated with topical ivermectin 1% once daily over 16 weeks. The disease severity, the patient-examined improvement and the safety assessment of patients were evaluated. Demodex mites were studied with the standardized skin surface biopsy. RESULTS: Papulopustular rosacea to all severity achieved a therapeutic success. The number of inflammatory lesions was significantly decreased in almost clear (P<0.0001), mild, moderate and severe (P<0.001) forms. A complete remission of inflammatory lesions was achieved by almost clear (p<0,001) and mild (p=0,005) with 82% with none-to-mild cutaneous adverse events. Thirty-two percent were positive for Demodex mites and all of them turned negative after 16 weeks. CONCLUSION: Ivermectin is an effective treatment not only in moderate-severe papulopustular rosacea but also in almost clear/mild rosacea. This article is protected by copyright. All rights reserved. PMID: 31579993 [PubMed - as supplied by publisher] {url} = URL to article
  14. Related Articles Are demodex mites the best target for rosacea treatments? Br J Dermatol. 2019 Oct;181(4):652-653 Authors: Thyssen JP PMID: 31576573 [PubMed - in process] {url} = URL to article
  15. Clinicopathological and Immunohistochemical Study of 14 Cases of Morbihan Disease: An Insight Into Its Pathogenesis. Am J Dermatopathol. 2019 Oct;41(10):701-710 Authors: Ramirez-Bellver JL, Pérez-González YC, Chen KR, Díaz-Recuero JL, Requena L, Carlson JA, Llamas-Velasco M Abstract INTRODUCTION: Morbihan disease (MORD) is rare with only 45 clear-cut cases previously reported. Histopathologic findings are supposed to be nonspecific. We report 14 patients and review the previous cases. OBJECTIVES: To characterize the clinicopathologic findings, outcomes, and immunophenotype of MORD. MATERIAL AND METHODS: Inclusion criteria were a clinical picture of persistent, nonpitting edema affecting the mid and or upper third of the face and histopathological findings fitting previous reports and exclusion of other entities. RESULTS: The majority of our patients were males (71.5%) with a male/female ratio of 10/4. The mean age when diagnosed was 58.8 years. Eyelids and forehead were the most frequently involved areas. Two of the patients presented previous rosacea. Most constant histopathological findings were lymphatic vessel dilatations in the upper dermis and the presence of mast cells (7.5 in 10 high-power field as a mean). Mild edema was also present in most of the cases. Granulomas were found in 7 of the cases, and immunostaining with CD68 and CD14 only revealed an additional case. CONCLUSIONS: MORD occurs more in middle-aged males, not associated with rosacea and mostly affects eyelids and forehead. Granulomas are not mandatory for the diagnosis. Histopathology of MORD fits within the spectrum of localized lymphedema. PMID: 31567295 [PubMed - in process] {url} = URL to article
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