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  1. Elucidating the role of Demodex folliculorum in the pathogenesis of rosacea: exciting first steps…. Br J Dermatol. 2018 Jul 19;: Authors: Forton FMN PMID: 30024649 [PubMed - as supplied by publisher] {url} = URL to article
  2. Highlights of Skin Disease Education Foundations 42nd Annual Hawaii Dermatology Seminar. Semin Cutan Med Surg. 2018 Jun;37(4S):S75-S84 Authors: Baldwin HE, Stein Gold LF, Gordon KB, Green JB, Leonardi CL, Sengelmann RD Abstract Updates on managing some of the most common dermatologic conditions for which patients seek care illuminated presentations at the Skin Disease Education Foundation's 42nd Annual Hawaii Dermatology Seminar®. This educational supplement summarizes the highlights of clinical sessions presented during this CME/CE conference. Treatment of psoriasis has continued to advance, with three interleukin (IL)-17 antagonists approved by the US Food and Drug Administration (FDA) and a fourth in phase 3 trials. An authority on the use of biologics in psoriasis presents current data on the safety and efficacy of these therapies. Tumor necrosis factor (TNF) inhibitors also retain a place in the management of psoriasis, with records of long-term safety. A fourth TNF inhibitor awaits FDA approval for use in psoriasis, offering data on transmission during pregnancy and lactation. An expert on the use of this drug class presents the evidence. Topical therapies remain the cornerstone of care for many patients with psoriasis as well as those with rosacea. Our faculty update readers about new and investigational topical therapies for moderate or severe psoriasis, as well as for acne and rosacea. The current literature on monitoring patients receiving isotretinoin also is summarized. Aesthetic and cosmetic dermatology services form a sizable portion of some practices. Our faculty review data on safety of topical and procedural therapies for cellulite as well as safe injection of facial fillers. PMID: 30016379 [PubMed - in process] {url} = URL to article
  3. Related Articles Advanced oxidation protein products and serum total oxidant/antioxidant status levels in rosacea. Postepy Dermatol Alergol. 2018 Jun;35(3):304-308 Authors: Erdogan HK, Bulur I, Kocaturk E, Saracoglu ZN, Alatas O, Bilgin M Abstract Introduction: Rosacea is a chronic, inflammatory dermatosis which develops due to the effect of genetic and environmental factors. Aim: To evaluate the oxidative stress in rosacea patients by measuring serum total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) and advanced oxidation protein products (AOPP) levels in our study. Material and methods: Our study included rosacea patients and healthy volunteers aged between 18 and 65 years. Total antioxidant status, TOS and AOPP levels were measured and OSI was calculated. Results: The study included 70 rosacea patients and 30 healthy volunteers as a control group. When TAS, TOS, OSI and AOPP levels were compared between rosacea and control groups, there was no difference for OSI levels; while TAS, TOS and AOPP levels were significantly higher in the rosacea group (p = 0.151, p = 0.013, p = 0.034, p = 0.017, respectively). In the rosacea group, there was no correlation between TAS, TOS, OSI and AOPP levels and disease duration. Besides there was no difference between family history, rosacea type, symptom frequency and ocular involvement and TAS, TOS, OSI and AOPP levels in the rosacea group. Conclusions: We observed that serum TAS, TOS and AOPP levels were significantly higher in rosacea patients, but there was no significant difference among the disease activity parameters. These results can support the role of oxidative stress in the pathogenesis of rosacea. PMID: 30008650 [PubMed] {url} = URL to article
  4. Related Articles Drugs and Lactation Database (LactMed) Book. 2006 Authors: Abstract Limited information indicates that maternal use of brimonidine 0.2% ophthalmic drops do not adversely affect their nursing infants. To substantially diminish the amount of drug that reaches the breastmilk after using eye drops, place pressure over the tear duct by the corner of the eye for 1 minute or more, then remove the excess solution with an absorbent tissue. Topical brimonidine gel used to treat rosacea has not been studied during breastfeeding. It is unlikely that the topical gel would affect the breastfed infant, but the manufacturer states that it should not be used during nursing. Until more data are available, an alternative topical agent might be preferred PMID: 30000738 {url} = URL to article
  5. Related Articles Relationship between Helicobacter pylori and Rosacea: review and discussion. BMC Infect Dis. 2018 Jul 11;18(1):318 Authors: Yang X Abstract BACKGROUND: Rosacea is an inflammatory disease affecting the central part of face characterized by persistent or recurrent episodes of erythema, papules, pustules and telangiectasias of unknown etiology. Helicobacter pylori (H. pylori) is a gram-negative bacillus, which is one of the main causes of chronic gastritis, gastric cancer and gastrointestinal ulcers. Recent evidences have suggested that H. pylori infection is closely related to the occurrence of diseases. In recent years, studies have found that Helicobacter pylori infection is associated with the occurrence of acne rosacea. So the treatment of Helicobacter pylori infection may be a therapeutic method of acne rosacea. But it continues to be controversial. In other studies, the treatment of Helicobacter pylori did not significantly reduce the severity of acne rosacea. To further explore the association between acne rosacea and Helicobacter pylori infection, a summarize method was used to study the relationship between acne rosacea and Helicobacter pylori, providing reference for clinical acne rosacea therapy. METHODS: Systematic searches were conducted on Wanfang Data, CQVIP, Springer, Public Health Management Corporation (PHMC), CNKI, and Pubmed, from January 1,2008 to Mar. 1, 2018, using Helicobacter pylori and rosacea to retrieve the literature. Depending on the inclusion and exclusion criteria, 27 articles considered or confirmed the correlation between H. pylori and rosacea. RESULTS: Epidemiological investigations and experiments have confirmed that H. pylori infection is associated with the development of rosacea. The effect of anti-H. pylori therapy is better than the routine therapy for rosacea. H. pylori can stimulate the immune system to produce a large number of inflammatory mediators, leading to the occurrence and aggravation of rosacea inflammation. CONCLUSIONS: It is confirmed that H. pylori infection is involved in the development of rosacea. It is suggested that rosacea patients should be tested for H. pylori infection, the H. pylori-positive rosacea patients should be treated with eradication of H. pylori, so as to enhance the therapeutic effect of rosacea. This study adds that H. pylori infection is involved in the development of rosacea. Epidemiological investigations and experiments have confirmed the rationality. The effect of anti-H. pylori therapy is better than the routine therapy for rosacea. H. pylori-positive rosacea patients should be treated with the therapeutic method of eradication of H. pylori. PMID: 29996790 [PubMed - in process] {url} = URL to article
  6. Related Articles Energy-Based Devices in Male Skin Rejuvenation. Dermatol Clin. 2018 Jan;36(1):21-28 Authors: Juhász M, Marmur E Abstract Men seek cosmetic procedures for vastly different reasons than women. Men often seek discrete cosmetic services with little downtime. Male skin structure generally differs from female skin structure. Dermatologists should consider subtle differences in the psyche of the male cosmetic patient. PMID: 29108542 [PubMed - indexed for MEDLINE] {url} = URL to article
  7. Related Articles Prescription to Over-the-Counter Switch of Metronidazole and Azelaic Acid for Treatment of Rosacea. JAMA Dermatol. 2018 Jul 03;: Authors: McGee JS, Wilkin JK PMID: 29971432 [PubMed - as supplied by publisher] {url} = URL to article
  8. Effects of Initiation Time of Glycemic Control on Skin Collagen Recovery in Streptozotocin-Induced Diabetic Rats. Dermatology. 2018 Jul 04;:1-9 Authors: Suh Y, Moon J, Yoon JY, Kim SW, Choi YS Abstract BACKGROUND: Diabetes damages the collagen in the skin. No study has investigated the relationship between the treatment initiation time and the degree of collagen recovery. This study aimed to evaluate the effects of the initiation time of glycemic control on collagen recovery and to determine the basic molecules mediating the process. METHODS: Streptozotocin-induced diabetic rats were divided into five groups: normal controls (C), those with untreated diabetes (DM), and those with diabetes treated with daily insulin injections from 7 weeks (7W), 10 weeks (10W), and 13 weeks (13W) after diabetes induction. The levels of collagen and several molecules were compared among skin tissues collected at 14 weeks. RESULTS: The amounts of total collagen, collagen 1, and collagen 3 were significantly lower in DM than in C. Among the treated groups, recovery reaching normal levels was only observed in 7W and 10W. The earlier the treatment began, the greater was the collagen recovery. Similar to that of collagen, the expression of transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF), and insulin-like growth factor 1 receptor (IGF-1R) significantly decreased in DM compared with that in C. Higher recovery of TGF-β1 and VEGF was detected in groups with earlier treatment, whereas the IGF-1R level was identically elevated in all treated groups. The results suggest that these molecules affect collagen recovery at different time points during glycemic control. CONCLUSION: The initiation time of glycemic control is expected to have a considerable effect on collagen recovery in the diabetic skin through modulation of TGF-β1, VEGF, and IGF-1R. PMID: 29972827 [PubMed - as supplied by publisher] {url} = URL to article
  9. Related Articles Rosacea-like demodicosis and papulopustular rosacea may be two phenotypes of the same disease, and pityriasis folliculorum may be their precursor. Response to the comment of Tatu. J Eur Acad Dermatol Venereol. 2018 Jul 01;: Authors: Forton F, De Maertelaer V Abstract We thank Tatu et al for their comment1 on our recent article2 in which they agree with the idea that rosacea-like demodicosis (RLD) and papulopustular rosacea (PPR) may be two phenotypes of the same disease. Tatu et al raise the question of the potential role of some of the numerous species of bacteria3 inadvertently ingested by Demodex that could potentially influence its behaviour.1 We did not explore this interesting hypothesis in our study but agree that this and other types of interactions, such as those of Staphylococcus epidermidis,4 are important areas for future study. This article is protected by copyright. All rights reserved. PMID: 29961950 [PubMed - as supplied by publisher] {url} = URL to article
  10. Long-term effects of intense pulsed light treatment on the ocular surface in patients with rosacea-associated meibomian gland dysfunction. Cont Lens Anterior Eye. 2018 Jun 26;: Authors: Seo KY, Kang SM, Ha DY, Chin HS, Jung JW Abstract PURPOSE: We aimed to determine the long-term effects of intense pulsed light (IPL) treatment in rosacea-associated meibomian gland dysfunction (MGD). METHODS: We enrolled 17 rosacea subjects with moderate and severe MGD who underwent four IPL sessions at 3-week intervals and were followed up for 12 months. The subjects underwent clinical examinations at baseline (first IPL) and at 3 (second), 6 (third), 9 (fourth), and 12 weeks, as well as 6 and 12 months, after baseline. Ocular surface parameters, including the Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), staining score, and noninvasive Keratograph tear break-up time (NIKBUT), as well as meibomian gland parameters, including the lid margin vascularity and meibum expressibility and quality, were evaluated. RESULTS: All ocular surface and meibomian gland parameters for all subjects exhibited significant changes from baseline to the final examination (Friedman, P < 0.050 for all). In particular, improvements in the lower lid margin vascularity, meibum expressibility and quality, and ocular symptoms persisted up to the final examination (Wilcoxon, P < 0.050 for all). However, the improvements of TBUT, staining score, and NIKBUT after IPL were not maintained at 6 and 12 months after baseline. CONCLUSIONS: In rosacea-associated MGD, four IPL treatments at 3-week intervals can improve long-term lid parameters and ocular symptoms without adverse effects. PMID: 29958778 [PubMed - as supplied by publisher] {url} = URL to article
  11. Rosacea-like demodicosis (but not primary demodicosis) and papulo pustular rosacea may be two phenotypes of the same disease-a microbioma,therapeutic and diagnostic tools perspective. J Eur Acad Dermatol Venereol. 2018 Jun 29;: Authors: Tatu AL, Clatici VG, Nwabudike LC Abstract The scope of their research appears to be limited to the effects of Demodex spp in rosacea and thus does not consider possible confounding factors such as the effects of Bacillus oleronius, which has been isolated from Demodex folliculorum and been identified as a trigger of inflammation in rosacea(2). Other endosymbionts described as related to Demodex are:I.Bacillus simplex, which was isolated from Demodex folliculorum in a patient with primary demodicosis(3) II. Bacillus pumilus positive culture and mass spectrometry were found in a patient with rosacea and D. Folliculorum(4)III.Bacillus cereus, instead of B. oleronius was identified in a patient with secondary demodicosis associated with steroid-induced rosacea-like facial dermatitis in one positive culture.(5) Would they care to comment on this? This article is protected by copyright. All rights reserved. PMID: 29959784 [PubMed - as supplied by publisher] {url} = URL to article
  12. Related Articles Successful Treatment of Actinic Keratosis with Kanuka Honey. Case Rep Dermatol Med. 2018;2018:4628971 Authors: Mane S, Singer J, Corin A, Semprini A Abstract Actinic keratoses form as rough, scaly plaques on sun-exposed areas; they can be an important step in premalignant progression to squamous cell cancer of the skin. Currently, pharmacological treatments consist of topical immunomodulatory agents with poor side effect profiles. Use of honey has been common in both ancient and modern medicine, where it is now a key therapy in the management of wound healing. In vitro studies show the New Zealand native Kanuka honey to have immunomodulatory and antimitotic effects, with recent evidence suggesting efficacy of topical application in a variety of dermatological contexts, including rosacea and psoriasis. Here, we present a case report of a 66-year-old gentleman with an actinic keratosis on his hand, which had been present for years. Regular application of Kanuka honey over three months resulted in remission immediately following the treatment period with no signs of recurrence at nine months. PMID: 29955399 [PubMed] {url} = URL to article
  13. Related Articles Successful treatment of erythematotelangiectatic rosacea with intense pulsed light: Report of 13 cases. J Dermatol. 2018 Jun 28;: Authors: Tsunoda K, Akasaka K, Akasaka T, Amano H Abstract Here, we describe the use of intense pulsed light (IPL) treatment for 13 cases of erythematotelangiectatic rosacea delivered in three sessions. For two-step irradiation, after the whole face had been irradiated using conventional IPL equipment covering a wide area, localized IPL spot irradiation was performed for visibly dilated capillaries. The therapeutic effect was evaluated by image analysis using Image J and scored by 10 dermatologists using two IPL instruments in combination. This therapeutic approach was found to be much more effective than irradiation using a single instrument. Our findings demonstrate that IPL irradiation using the present method can deliver a sufficient therapeutic effect even with a small number of treatment sessions. Although rosacea is difficult to treat, we believe that IPL can be therapeutically useful in such cases. PMID: 29952023 [PubMed - as supplied by publisher] {url} = URL to article
  14. [Ophthalmic Rosacea: etiopathogenesis and modern treatment methods]. Vestn Oftalmol. 2018;134(3):121-128 Authors: Trufanov SV, Shakhbazyan NP Abstract Rosacea is a multifactorial chronic inflammatory disease with various clinical manifestations. Primarily it is seen as a dermatological condition, but it's not uncommon for it to develop ophthalmological implications affecting eyelids, cornea and conjunctiva. The article describes main aspects of its etiopathogenesis, variations in its clinical course and treatment approaches. There is currently no universal treatment strategy for the disease due to its varying clinical manifestation, particularly of its ophthalmological form, differing severity of the pathological process, lack of knowledge about its etiology and pathogenesis. Leading role in its pathological process belongs to disturbance of regulatory mechanisms of the vascular, immune and nervous systems. Additionally, higher levels of metalloproteinases and vascular endothelial growth factor (VEGF) can be observed. Possible influence of a range of micro-organisms also hasn't been excluded. Basic therapy involves both systemic and topical drugs. The first include tetracycline antibiotics. A new direction in Rosacea treatment that aims at structural and functional restoration of vascular endothelium, improvement of microcirculation and recovery of rheological properties of blood is angioprotector therapy, in particular with Calcium Dobesilate (Doxi-Hem). Aside from systemic drugs, the ophthalmological forms of Rosacea are treated topically with anti-inflammatory preparations, immunosuppressants and artificial tears that are chosen depending on the symptoms' severity. In cases with heavy corneal damage, various types of keratoplasty can be performed. Collaboration between ophthalmology and dermatology specialists is necessary in order to choose adequate strategy for Rosacea treatment. PMID: 29953092 [PubMed - in process] {url} = URL to article
  15. Related Articles Diffuse Large B-cell Lymphoma Occurring with Rhinophyma: A Case Report. Cureus. 2018 Apr 25;10(4):e2536 Authors: Shatkin S, Shatkin M, Smith K, Beland LE, Oppenheimer AJ Abstract Rhinophyma is the final stage in the evolution of acne rosacea, a common vasoactive dermatosis. Individuals with rhinophyma present with a typical, disfiguring nasal appearance consisting of bulbous enlargement, erythema, and telangiectasia with a sebaceous, oily skin surface. This classic appearance permits a facile diagnosis but may also lead the physician to overlook a coexistent malignancy. We report the occurrence of a diffuse large B-cell lymphoma (DLBCL) arising synchronously with a marked rhinophyma. A wide local excision of the malignancy was performed, and the defect was reconstructed with forehead flaps. The rhinophyma was treated with a skin graft and cheek flaps. Following surgery, chemotherapy was used to manage the systemic disease. This case demonstrates the necessity for clinical scrutiny in the diagnosis and treatment of rhinophyma. It is imperative to entertain a high degree of suspicion when non-typical changes are observed within a rhinophymatous lesion or in adjacent areas of the nose. PMID: 29946504 [PubMed] {url} = URL to article