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  1. Related Articles An empirically generated responder definition for rosacea treatment. Clin Cosmet Investig Dermatol. 2017;10:347-352 Authors: Staedtler G, Shakery K, Endrikat J, Nkulikiyinka R, Gerlinger C Abstract OBJECTIVE: The aim of this study was to empirically generate a responder definition for the treatment of papulopustular rosacea. METHODS: A total of 8 multicenter clinical studies on patients with papulopustular facial rosacea were analyzed. All patients were treated with azelaic acid and/or comparator treatments. The severity of rosacea was described by the Investigator Global Assessment (IGA) and the number of lesions. Patients with the IGA score of "clear/minimal" were considered as responders, and those staying in the range of IGA "mild to severe" as nonresponders. The respective number of lesions was determined. RESULTS: A total of 2,748 patients providing 12,410 measurements were included. After treatment, responders showed 2.23±2.48 lesions (median 2 lesions [0-3]), and nonresponders showed 13.74±10.40 lesions (median 12 lesions [6-18]). The optimal cutoff point between both groups was 5.69 lesions. CONCLUSION: The calculated cutoff point of 5.69 lesions allows discrimination of responders (5 or less remaining lesions) and nonresponders (6 or more remaining lesions) of therapeutic interventions in rosacea. PMID: 28932125 [PubMed] {url} = URL to article
  2. The relationship between migraine and rosacea: Systematic review and meta-analysis. Cephalalgia. 2017 Jan 01;:333102417731777 Authors: Christensen CE, Andersen FS, Wienholtz N, Egeberg A, Thyssen JP, Ashina M Abstract Objective To systematically review the association between migraine and rosacea. Background Migraine is a complex disorder with episodes of headache, nausea, photo- and phonophobia. Rosacea is an inflammatory skin condition with flushing, erythema, telangiectasia, papules, and pustules. Both are chronic disorders with exacerbations of symptoms almost exclusively in areas innervated by the trigeminal nerve. Previous studies found an association between these disorders. We review these findings, provide a meta-analysis, and discuss possible pathophysiological commonalities. Methods A search through PubMed and EMBASE was undertaken for studies investigating the association between all forms of migraine and rosacea published until November 2016, and meta-analysis of eligible studies. Results Nine studies on eight populations were identified. Studies differed in methodology and diagnostic process, but all investigated co-occurrence of migraine and rosacea. Four studies were eligible for meta-analysis, resulting in a pooled odds ratio of 1.96 (95% confidence interval 1.41-2.72) for migraine in a rosacea population compared to a non-rosacea population. Conclusion Our meta-analysis confirmed an association in occurrence of migraine and rosacea. Future studies should specifically investigate possible shared pathophysiological mechanisms between the two disorders. PMID: 28920449 [PubMed - as supplied by publisher] {url} = URL to article
  3. Related Articles Painful subcutaneous nodules in a patch of livedo reticularis. Int J Dermatol. 2017 Mar;56(3):e44-e46 Authors: Barnes P, Chapman C, Fett N PMID: 27496315 [PubMed - indexed for MEDLINE] {url} = URL to article
  4. Treatment of Rosacea With Concomitant Use of Topical Ivermectin 1% Cream and Brimonidine 0.33% Gel: A Randomized, Vehicle-controlled Study. J Drugs Dermatol. 2017 Sep 01;16(9):909-916 Authors: Gold LS, Papp K, Lynde C, Lain E, Gooderham M, Johnson S, Kerrouche N Abstract BACKGROUND: There is currently a lack of data on the simultaneous treatment of different features of rosacea. Individually, ivermectin 1% (IVM) cream and brimonidine 0.33% (BR) gel have demonstrated efficacy on inflammatory lesions and persistent erythema, respectively. OBJECTIVE: To evaluate the efficacy, safety, patient satisfaction, and optimal timing of administration of IVM associated with BR (IVM+BR) versus their vehicles in rosacea (investigator global assessment [IGA] ≥3). METHODS: Multicenter, randomized, double-blind study including subjects with rosacea characterized by moderate to severe persistent erythema and inflammatory lesions. The active treatment group included the IVM+BR/12 weeks subgroup (once-daily BR and once-daily IVM for 12 weeks), and the IVM+BR/8 weeks subgroup (once-daily BR vehicle for 4 weeks followed by once-daily BR for the remaining 8 weeks and once-daily IVM for 12 weeks). The vehicle group received once-daily BR vehicle and once-daily IVM vehicle for 12 weeks. RESULTS: The association showed superior efficacy (IGA success [clear/almost clear]) for erythema and inflammatory lesions in the total active group (combined active subgroups) compared to vehicle (55.8% vs. 36.8%, P=0.007) at week 12. The success rate increased from 32.7% to 61.2% at hour 0 and hour 3, respectively, in the IVM+BR/12 weeks subgroup, and from 28.3% to 50% in the IVM+BR/8 weeks subgroup. Reductions in erythema and inflammatory lesion counts confirmed the additive effect of BR to IVM treatment. Subjects reported greater improvement in the active subgroups than in the vehicle group, and similar rates for facial appearance satisfaction after the first 4 weeks of treatment in both active subgroups. All groups showed similar tolerability profiles. CONCLUSION: Concomitant administration of IVM cream with BR gel demonstrated good efficacy and safety, endorsing the comprehensive approach to this complex disease. Early introduction of BR, along with a complete daily skin care regimen may accelerate treatment success without impairing tolerability. <p><em>J Drugs Dermatol. 2017;16(9):909-916.</em></p>. PMID: 28915286 [PubMed - in process] {url} = URL to article
  5. Related Articles Painful subcutaneous nodules in a patch of livedo reticularis. Int J Dermatol. 2017 Mar;56(3):e44-e46 Authors: Barnes P, Chapman C, Fett N PMID: 27496315 [PubMed - indexed for MEDLINE] {url} = URL to article
  6. Treatment of Rosacea With Concomitant Use of Topical Ivermectin 1% Cream and Brimonidine 0.33% Gel: A Randomized, Vehicle-controlled Study. J Drugs Dermatol. 2017 Sep 01;16(9):909-916 Authors: Gold LS, Papp K, Lynde C, Lain E, Gooderham M, Johnson S, Kerrouche N Abstract BACKGROUND: There is currently a lack of data on the simultaneous treatment of different features of rosacea. Individually, ivermectin 1% (IVM) cream and brimonidine 0.33% (BR) gel have demonstrated efficacy on inflammatory lesions and persistent erythema, respectively. OBJECTIVE: To evaluate the efficacy, safety, patient satisfaction, and optimal timing of administration of IVM associated with BR (IVM+BR) versus their vehicles in rosacea (investigator global assessment [IGA] ≥3). METHODS: Multicenter, randomized, double-blind study including subjects with rosacea characterized by moderate to severe persistent erythema and inflammatory lesions. The active treatment group included the IVM+BR/12 weeks subgroup (once-daily BR and once-daily IVM for 12 weeks), and the IVM+BR/8 weeks subgroup (once-daily BR vehicle for 4 weeks followed by once-daily BR for the remaining 8 weeks and once-daily IVM for 12 weeks). The vehicle group received once-daily BR vehicle and once-daily IVM vehicle for 12 weeks. RESULTS: The association showed superior efficacy (IGA success [clear/almost clear]) for erythema and inflammatory lesions in the total active group (combined active subgroups) compared to vehicle (55.8% vs. 36.8%, P=0.007) at week 12. The success rate increased from 32.7% to 61.2% at hour 0 and hour 3, respectively, in the IVM+BR/12 weeks subgroup, and from 28.3% to 50% in the IVM+BR/8 weeks subgroup. Reductions in erythema and inflammatory lesion counts confirmed the additive effect of BR to IVM treatment. Subjects reported greater improvement in the active subgroups than in the vehicle group, and similar rates for facial appearance satisfaction after the first 4 weeks of treatment in both active subgroups. All groups showed similar tolerability profiles. CONCLUSION: Concomitant administration of IVM cream with BR gel demonstrated good efficacy and safety, endorsing the comprehensive approach to this complex disease. Early introduction of BR, along with a complete daily skin care regimen may accelerate treatment success without impairing tolerability. <p><em>J Drugs Dermatol. 2017;16(9):909-916.</em></p>. PMID: 28915286 [PubMed - in process] {url} = URL to article
  7. Chemical Peels: Indications and Special Considerations for the Male Patient. Dermatol Surg. 2017 Sep 04;: Authors: Reserva J, Champlain A, Soon SL, Tung R Abstract BACKGROUND: Chemical peels are a mainstay of aesthetic medicine and an increasingly popular cosmetic procedure performed in men. OBJECTIVE: To review the indications for chemical peels with an emphasis on performing this procedure in male patients. MATERIALS AND METHODS: Review of the English PubMed/MEDLINE literature and specialty texts in cosmetic dermatology, oculoplastic, and facial aesthetic surgery regarding sex-specific use of chemical peels in men. RESULTS: Conditions treated successfully with chemical peels in men include acne vulgaris, acne scarring, rosacea, keratosis pilaris, melasma, actinic keratosis, photodamage, resurfacing of surgical reconstruction scars, and periorbital rejuvenation. Chemical peels are commonly combined with other nonsurgical cosmetic procedures to optimize results. Male patients may require a greater number of treatments or higher concentration of peeling agent due to increased sebaceous quality of skin and hair follicle density. CONCLUSION: Chemical peels are a cost-effective and reliable treatment for a variety of aesthetic and medical skin conditions. Given the increasing demand for noninvasive cosmetic procedures among men, dermatologists should have an understanding of chemical peel applications and techniques to address the concerns of male patients. PMID: 28902026 [PubMed - as supplied by publisher] {url} = URL to article
  8. The Association Between Low Grade Systemic Inflammation and Skin Diseases: A Cross-sectional Survey in the Northern Finland Birth Cohort 1966. Acta Derm Venereol. 2017 Sep 13;: Authors: Sinikumpu SP, Huilaja L, Auvinen J, Jokelainen J, Puukka K, Ruokonen A, Timonen M, Tasanen K Abstract Low grade inflammation is associated with many noncommunicable diseases. The association between skin diseases in general and systemic inflammation has not previously been studied at the population level. A whole-body investigation on 1,930 adults belonging to Northern Finland Birth Cohort 1966 was performed and high sensitive C-reactive protein (CRP) level was measured as a marker of low grade inflammation in order to determine the association between low grade inflammation and skin diseases in an unselected adult population. After adjustment for confounding factors the following skin disorders were associated with low grade inflammation in multinomial logistic regression analysis: atopic eczema (OR 2.2, 95% CI 1.2-3.9), onychomycosis (OR 2.0, 1.2-3.2) and rosacea (OR 1.7, 1.1-2.5). After additionally adjusting for body mass index and systemic diseases, the risks for atopic eczema (OR 2.4, 1.3-4.6) and onychomycosis (OR 1.9, 1.1-3.1) remained statistically significant. In conclusion, low grade inflammation is present in several skin diseases. PMID: 28902946 [PubMed - as supplied by publisher] {url} = URL to article
  9. Quality of Life Measurement in Acne. Position Paper of the European Academy of Dermatology and Venereology (EADV) Task Forces on Quality of Life and Patient Oriented Outcomes (QoL and PO) and Acne, Rosacea and Hidradenitis Suppurativa (ARHS). J Eur Acad Dermatol Venereol. 2017 Sep 12;: Authors: Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Manolache L, Tzellos T, Sampogna F, Evers AWM, Dessinioti C, Marron SE, Bettoli V, van Cranenburgh OD, Svensson A, Liakou AI, Poot F, Szepietowski JC, Salek, Finlay AY Abstract Acne causes profound negative psychological and social effects on the quality of life (QoL) of patients. The European Dermatology Forum S3-Guideline for the Treatment of Acne recommended adopting a QoL measure as an integral part of acne management. Because of constantly growing interest in health-related QoL assessment in acne and because of the high impact of acne on patients' lives, the European Academy of Dermatology and Venereology Task Force on QoL and Patient Oriented Outcomes and the Task Force on Acne, Rosacea and Hidradenitis Suppurativa have documented the QoL instruments that have been used in acne patients, with information on validation, purposes of their usage, description of common limitations and mistakes in their usage and overall recommendations. This article is protected by copyright. All rights reserved. PMID: 28898474 [PubMed - as supplied by publisher] {url} = URL to article
  10. Treatment of erythemato-telangiectatic rosacea with brimonidine alone or combined with vascular laser based on preliminary instrumental evaluation of the vascular component. Lasers Med Sci. 2017 Sep 09;: Authors: Micali G, Dall'Oglio F, Verzì AE, Luppino I, Bhatt K, Lacarrubba F Abstract The purpose of this study is to evaluate the outcome of a series of patients with erythematotelangiectatic rosacea (ETR) affected by persistent erythema and varying degree of telangiectasias being treated with brimonidine alone or combined with a vascular laser based on the type of vascular components preliminarily evaluated by clinical and instrumental observation. Ten patients affected by ETR were enrolled in a pilot, open study. Instrumental evaluation included erythema-directed digital photography by VISIA-CR™ system and X10 dermoscopy. Those patients showing marked background erythema and minimal telangiectasias (group A) were treated with a single application of brimonidine 0.33% gel, while patients showing both marked background erythema and marked telangiectasias (group B) were treated with a session of Nd:YAG laser and reevaluated 1 month later after a single application of brimonidine. An Investigator Global Assessment (IGA) of treatment outcome was performed at the end of treatment in both groups. In group A, 6 h after brimonidine application, a marked reduction of the background erythema was observed in all patients, and IGA was rated as excellent. In group B, 6 h following the application of brimonidine, a marked reduction of the background erythema was observed in all cases, while telangiectasias remained unchanged. A further treatment with brimonidine 1 month after the Nd:YAG laser session determined complete clearing of facial erythema, and IGA was rated as excellent. In conclusion, a preliminary evaluation of the vascular component by erythema-directed digital photography and dermoscopy in ETR may be helpful to select the most appropriate therapeutic strategy. PMID: 28889348 [PubMed - as supplied by publisher] {url} = URL to article
  11. Vitamin B Derivative (Nicotinamide)Appears to Reduce Skin Cancer Risk. Skin Therapy Lett. 2017 Sep;22(5):1-4 Authors: Nazarali S, Kuzel P Abstract Nicotinamide, an amide form of vitamin B3, has shown the potential to treat a variety of dermatological conditions, including acne, rosacea, and atopic dermatitis. Recent studies have demonstrated the role of nicotinamide, in both topical and oral forms, as a chemopreventive agent against skin cancer. Its anti-carcinogenic role may be due to its ability to enhance DNA repair and prevent ultraviolet (UV)-induced immunosuppression, which is known to contribute to the progression of pre-malignant lesions. Furthermore, nicotinamide is a precursor of essential coenzymes for many important reactions in the body, including the production of nicotinamide adenine dinucleotide (NAD). NAD is a key coenzyme in the synthesis of adenosine triphosphate (ATP), which transports chemical energy within cells. Therefore, nicotinamide plays a significant role in supporting energy-dependent cellular processes, including DNA repair. PMID: 28888216 [PubMed - in process] {url} = URL to article
  12. A photoconverter gel-assisted blue light therapy for the treatment of rosacea. Int J Dermatol. 2017 Sep 07;: Authors: Braun SA, Gerber PA PMID: 28884800 [PubMed - as supplied by publisher] {url} = URL to article
  13. Can Hematologic Parameters be an Indicator of Metabolic Disorders Accompanying Rosacea? Acta Dermatovenerol Croat. 2017 Jul;25(2):145-150 Authors: Akin Belli A, Kara A, Ozbas Gok S Abstract Recently, diverse hematologic parameters have been used as an indicator of the presence or severity of inflammatory and cardiovascular diseases. Our aim was to investigate the ratios of neutrophils to lymphocytes (NL), monocytes to high-density lipoprotein (HDL) cholesterol (MHC), and platelets to lymphocytes (PL) in patients with rosacea in comparison with the control group and determine whether there was a correlation between these ratios and metabolic disorders in patients with rosacea. We conducted a case-control study on 61 patients with rosacea and 60 healthy controls between January 2015 and January 2016 at the Dermatology Outpatient Clinic, Mugla, Turkey. Demographic data, biochemical parameters, hematologic parameters and ratios, the presence of metabolic syndrome (MS), and the presence of insulin resistance (IR) in the participants were recorded. Sixty one patients with rosacea (16 men, 45 women) and 60 controls (13 men, 47 women) were included in the study. The NL ratio, mean levels of low-density lipoprotein (LDL) and total cholesterol, triglyceride, C-reactive protein (CRP), systolic and diastolic blood pressures, and the presence of IR were significantly higher in patients with rosacea than in controls. In the rosacea group, the MHC ratio was significantly higher in patients with rosacea with IR and MS. Moreover, only the MHC ratio was an independent predictor of MS according to univariate logistic regression analysis. The cutoff value of MHC on admission for predicting MS in patients with rosacea was 0.013.The higher levels of NL ratio and IR in the rosacea group corroborate the previous studies demonstrating a high level of cardiovascular risk factors in patients with rosacea. The MHC ratio may be used as a simple and inexpensive method to predict metabolic disorders in patients with rosacea. PMID: 28871930 [PubMed - in process] {url} = URL to article
  14. Rosacea treatment schema: an update. Cutis. 2017 Jul;100(1):11-13 Authors: Rosamilia LL PMID: 28873101 [PubMed - in process] {url} = URL to article
  15. Lack of significant anti-inflammatory activity with clindamycin in the treatment of rosacea: results of 2 randomized, vehicle-controlled trials. Cutis. 2017 Jul;100(1):53-58 Authors: Martel P, Jarratt M, Weiss J, Carlavan I Abstract Rosacea is a chronic inflammatory skin disease of the face. The objective of the studies described here was to evaluate the efficacy of clindamycin in the treatment of rosacea. Two multicenter, randomized, vehicle-controlled, phase 2 studies were conducted in participants with moderate to severe rosacea. Study A was a 12-week dose-comparison, 5-arm, parallel group comparison of clindamycin cream 1% or vehicle once or twice daily and clindamycin cream 0.3% once daily. Study B was a 2-arm comparison of twice daily clindamycin gel 1% versus vehicle gel. A total of 629 participants (study A, N=416; study B, N=213) were randomized. The results of these studies indicated that clindamycin cream 0.3% and 1% and clindamycin gel 1% were no more effective than the vehicle in the treatment of moderate to severe rosacea, suggesting clindamycin has no intrinsic anti-inflammatory activity in rosacea. PMID: 28873109 [PubMed - in process] {url} = URL to article
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