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  1. Impact of nanostructured lipid carriers on dapsone delivery to the skin; in vitro and in vivo studies. Int J Pharm. 2019 Nov 09;:118781 Authors: Elmowafy M, Shalaby K, Ali HM, Alruwaili NK, Salama A, Ibrahim MF, Akl MA, Ahmed TA Abstract The main objective of this study was to develop, characterize and evaluate the potential use of dapsone-loaded nanostructured lipid carriers (NLCs) as a topical treatment for acne. Differently charged NLC formulations were successfully prepared using an emulsification/sonication method. The particle sizes ranged from 106.2±5.6 nm to 151.3±7.4 nm, and the NLCs possessed the predicted surface charges, depending on the emulsifier used (Tween 80, Transcutol P, or cetyltrimethylammonium bromide). The entrapment efficiencies ranged from 76.5±3.8 % to 91.1±3.9 %. Selected formulations were assessed for possible interactions, in vitro release, ex vivo skin permeation, pharmacological efficacy and safety compared with a hydroalcoholic solution. Dapsone was embedded in the lipid matrix of NLCs and behaved as controlled release system with a good occlusive effect. Dapsone-loaded cationic NLC formulation enhanced the skin permeation of dapsone, increase the amount of dapsone retained in the skin in controlled manner, and improved the anti-rosacea activity. Based on these encouraging results, cationic NLC represents a promising carrier for the safe topical delivery of dapsone. PMID: 31715347 [PubMed - as supplied by publisher] {url} = URL to article
  2. Related Articles Treatment of Erythematotelangiectatic Rosacea With Pulsed-Dye Laser and Oxymetazoline 1.0% Cream: A Retrospective Study. Lasers Surg Med. 2019 Nov 10;: Authors: Suggs AK, Macri A, Richmond H, Munavalli G, Friedman PM Abstract BACKGROUND AND OBJECTIVES: Pulsed-dye laser (PDL) and oxymetazoline 1.0% cream are each used for the treatment of erythematotelangiectatic (ET) rosacea. PDL targets oxyhemoglobin and can reduce facial erythema and telangiectasias. Oxymetazoline 1.0% cream is an α adrenergic agonist, which has shown to reduce facial erythema. The aim of this study was to determine the degree of erythema improvement and telangiectasia clearance after combination treatment with PDL plus oxymetazoline 1.0% cream. STUDY DESIGN/MATERIALS AND METHODS: This retrospective study was conducted at two sites. Pre- and post-treatment cross-polarized images from subjects on combination treatment with PDL and oxymetazoline 1.0% cream were graded by a board-certified dermatologist at each practice. Blinded images were analyzed using the Clinical Erythema Assessment (CEA) Scale (0 = clear and 4 = severe). Unblinded images were analyzed using the five-point Telangiectasia Scale to determine the degree of improvement post-treatment compared with baseline (1 = <5% clearance and 5 = 75-100% clearance). RESULTS: Thirty-one subjects (20 females, 11 males) of age 51 ± 13 years (mean ± standard deviation) were included in the study after an average of 4 months (range: 1-13) of daily oxymetazoline 1.0% cream and two (range: 1-4) PDL treatments. At baseline, 87% of subjects had CEA Grade 2 (mild erythema) or higher. For erythema, 55% of subjects improved by at least one CEA grade and 13% achieved two grades of improvement post-treatment. For telangiectasias, 90% of subjects achieved at least a two-point clearance (5-25%), 62% at least a three-point clearance (25-50%), and 41% at least a four-point clearance (50-75%) post-treatment. Compared with subjects with baseline CEA Grade 1-2 (almost clear to mild erythema), significantly more subjects with baseline CEA Grade 3-4 (moderate to severe erythema) achieved at least one CEA grade of improvement (P = 0.021) and two grades of CEA improvement (P = 0.041). A higher percentage of baseline CEA Grade 3-4 subjects achieved at least a two-point clearance in telangiectasias (P = 0.055). CONCLUSIONS: Combination treatment with PDL and daily oxymetazoline 1.0% cream can safely and effectively reduce erythema and telangiectasias. Limitations include the retrospective design of the study, small sample size, and lack of a control group. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc. PMID: 31709571 [PubMed - as supplied by publisher] {url} = URL to article
  3. Related Articles Sebaceous Glands participate in the inflammation of Rosacea. J Eur Acad Dermatol Venereol. 2019 Nov 11;: Authors: Lee SH, Lee SB, Heo JH, Yoon HS, Byun JW, Choi GS, Shin J Abstract Rosacea is a chronic inflammatory dermatosis that can present with a variety of cutaneous manifestations.1 Recently, mast cells are known to be importantly related to the pathogenesis of rosacea.2 The disease characteristically presents a centrofacial distribution1,3 , an area rich in sebaceous glands. PMID: 31709649 [PubMed - as supplied by publisher] {url} = URL to article
  4. Related Articles Alterations of Immune and Keratinization Gene Expression in Papulopustular Rosacea by Whole Transcriptome Analysis. J Invest Dermatol. 2019 Nov 06;: Authors: Shih YH, Xu J, Kumar A, Li R, Chang ALS PMID: 31705873 [PubMed - as supplied by publisher] {url} = URL to article
  5. Related Articles [Mushroom keratoplasty in rosacea keratitis complicated by corneal perforation (a clinical case)]. Vestn Oftalmol. 2019;135(5. Vyp. 2):215-219 Authors: Trufanov SV, Krakhmaleva DA, Zaitsev AV, Salovarova EP, Tekeeva LY, Budnikova EA Abstract Rosacea is a polyethiologic chronic inflammatory disease with varying clinical manifestations. It is primarily a dermatologic disease, which often manifests in the eyes affecting eyelids, cornea and conjunctiva. The leading role in the pathological process belongs to disruption of regulatory mechanisms in the vascular, immune and nervous systems. It is accompanied by increased levels of metalloproteinases and vascular endothelial growth factor (VEGF). Treatment depends on the severity of the disease and may vary from hygiene of the eyelid margins and use of artificial tears for dry eye disease management, to antibiotics and anti-inflammatory agents in moderate cases, and surgical treatment in severe or neglected state. A clinical case of severe rosacea shows that keratoplasty with mushroom-shaped profile of the surgical incision helps achieve good functional results and reduce the post-operative rehabilitation time, while significantly reducing the risk of postsurgical complications. Anti-VEGF therapy significantly reduces the risk of histoincompatibility reaction typical for rosacea keratitis. PMID: 31691663 [PubMed - in process] {url} = URL to article
  6. Related Articles [Chronic mucocutaneous candidiasis with STAT1 gain-of-function mutation associated with herpes virus and mycobacterial infections]. Ann Dermatol Venereol. 2019 Oct 30;: Authors: Baghad B, Benhsaien I, El Fatoiki FZ, Migaud M, Puel A, Chiheb S, Bousfiha AA, Ailal F Abstract INTRODUCTION: Chronic mucocutaneous candidiasis (CMC) is characterized by susceptibility to chronic or recurrent infections with yeasts of the genus Candida affecting the skin, nails and mucous membranes. We describe a Moroccan patient presenting CMC with heterozygous STAT1 gain-of-function (GOF) mutation. PATIENTS AND METHODS: A 5-year-old boy with no consanguinity presented recurrent episodes of oral thrush, chronic nail candidiasis and herpetic gingivostomatitis from the age of 8 months. He also had mycobacterial adenitis secondary to BCG vaccination and atypical rosacea. Genetic analysis revealed GOF mutation of the STAT1 gene. DISCUSSION: CMC was diagnosed in our patient despite poor clinical features. Sequencing of the genome revealed STAT1GOF mutation. This mutation affects production of IL-17, an important cytokine in mucocutaneous defense against Candida. The association with mycobacterial adenitis is rare and continues to be poorly understood. The presence of atypical rosacea in this setting is suggestive of this entity. Antifungal therapy and prevention of complications are necessary to reduce the morbidity and mortality associated with this condition. CONCLUSION: CMC due to STAT1GOF mutation is characterized by a broad clinical spectrum and should be considered in all cases of chronic or recurrent fungal infection, whether or not associated with other infections. PMID: 31677808 [PubMed - as supplied by publisher] {url} = URL to article
  7. Related Articles Association of dental foci of infection and rosacea: a case report. Gen Dent. 2019 Nov-Dec;67(6):52-54 Authors: Sopi M, Meqa K Abstract Rosacea, a chronic inflammatory disease of the skin, is characterized by rash, pustules, papules, and dilated blood vessels. The etiology is unknown, and the disease is more common among women than among men. Among the proposed causes of this disorder are dental foci of infection, with periapical lesions the most common pathologic lesion in the alveolar bone. The aim of this report is to examine the possible relationship between periapical lesions as dental foci and rosacea. A 50-year-old woman reported redness in her face, for which she had been treated by a gastroenterologist for Helicobacter pylori and a dermatologist for rosacea. After clinical, radiographic, and laboratory examinations, suspicions of dental foci were raised. The residual roots of teeth 4, 5, 12, 15, and 18 were extracted, and teeth 16, 29, and 31 underwent endodontic treatment. One year after dental treatment, all signs of redness in the patient's face had healed, she stopped all treatments, and her laboratory values were normal. PMID: 31658025 [PubMed - in process] {url} = URL to article
  8. Related Articles Safety of Combination Laser or Intense Pulsed Light Therapies and Doxycycline for the Treatment of Rosacea. Dermatol Surg. 2019 Nov;45(11):1401-1405 Authors: Schilling LM, Halvorson CR, Weiss RA, Weiss MA, Beasley KL Abstract BACKGROUND: Current treatment options for rosacea include topical agents, oral therapies, phototherapy using lasers, or intense pulsed light (IPL). Combination therapy for rosacea often yields better results than monotherapy. The safety of laser/light treatments in combination with systemic doxycycline has been questioned because of the theoretical risk of photosensitivity. OBJECTIVE: The purpose of this study was to assess the incidence of phototoxicity or photosensitivity in rosacea patients receiving concomitant laser or light treatments and systemic doxycycline. METHODS: Treatment records of 36 patients receiving laser/light treatments while also being treated with standard dose or anti-inflammatory dose of doxycycline were retrospectively reviewed. RESULTS: No adverse reactions related to doxycycline combined with laser/light therapy were reported. Specifically, no photosensitivity or sensitivity to wavelengths in the pulsed dye laser (PDL), or IPL range was observed in this cohort. All patients achieved some degree of clearance. CONCLUSION: The results of this retrospective study demonstrate that doxycycline used in conjunction with laser or nonlaser light therapy is a valid combination therapy for improving signs and symptoms of rosacea. No photosensitivity reactions were observed to commonly used IPL or PDL devices. PMID: 31658188 [PubMed - in process] {url} = URL to article
  9. Related Articles Use of laser therapy in the treatment of severe rhinophyma: a report of two cases. J Cosmet Laser Ther. 2019 Oct 24;:1-5 Authors: Borzęcki A, Turska M, Strus-Rosińska B, Sajdak-Wojtaluk A Abstract Rhinophyma is a rare manifestation of rosacea. It is clinically characterized by sebaceous hypertrophy, fibrosis, and telangiectasia. Usually, it is considered as a cosmetic defect; however, in some cases, it might cause problems with nasal breathing and food consumption which forces the need for treatment. The following article presents the effectiveness of laser treatment with the neodymium-yttrium-aluminum garnet (Nd:YAG), carbon dioxide laser (CO2), and fractional CO2 laser. PMID: 31648601 [PubMed - as supplied by publisher] {url} = URL to article
  10. Related Articles Apoptosis Induction of Armeniacae Semen Extractin Human Acute Leukemia (NALM-6 and KG-1) Cells. Int J Hematol Oncol Stem Cell Res. 2019 Jul 01;13(3):116-121 Authors: Mosadegh Manshadi S, Safavi M, Rostami S, Nadali F, Shams Ardekani MR Abstract Background: Prunusarmeniaca is a member of the Rosacea family. The most important ingredient of this family is amygdalin that is believed to have anti-tumor and analgesic properties. The aim of this study was to evaluate the anti-proliferative effects of Armeniacae semen extract on the acute leukemia, NALM-6, and KG-1 cell lines, and investigate the effect of the extract on apoptosis of these cell lines and caspase-3 gene expression. Materials and Methods: We prepared aqueous, ethyl acetate, and hydro alcoholic extracts of the Armeniacae semen. The NALM-6 and KG-1 cell lines and mononuclear cells (PBMCs) of healthy controls were treated with different doses of the extracts for 48 hours, and then cell viability was investigated with the MTT test. High-Performance Liquid Chromatography was done for amygdalin identification. The percentage of apoptotic cells was determined using the Annexin V-FITC/PI flow cytometric kit, and caspase-3 gene expression was evaluated. Results: MTT test revealed that the strongest Inhibition Concentration (IC50) in KG-1 and NALM-6 cell lines was related to the ethyl acetate extract. This extract did not have toxic effects on PBMCs. Flow cytometric analysis showed that the ethyl acetate extract at its IC50 concentration led to almost 50% apoptosis in both cell lines after 48 hours. In the molecular examination, after treatment, a significant increase was seen in caspase-3 gene expression in NALM6 and KG1 cells compared to the control (P<0.001 and P <0.05, respectively). Conclusion: Our data confirmed that the ethyl acetate extract of Prunusarmeniaca could reduce the proliferation of KG-1 and NALM-6 cell lines probably by activating the apoptotic pathway. PMID: 31649801 [PubMed] {url} = URL to article
  11. Related Articles Rosacea causing unilateral Morbihan syndrome. BMJ Case Rep. 2019 Oct 25;12(10): Authors: Weeraman S, Birnie A Abstract Morbihan syndrome is a rare entity causing woody induration of the face. There are numerous case reports of bilateral Morbihan syndrome. We present a case of a 46-year-old man with right infra-orbital cheek swelling and symptoms of rosacea who had histology consistent with granulomatous rosacea following debulking surgery. His clinical presentation and investigation findings support a diagnosis of rosacea causing unilateral Morbihan syndrome. PMID: 31653629 [PubMed - in process] {url} = URL to article
  12. Pediatric Ocular Acne Rosacea: Clinical Features and Long Term Follow-Up of Sixteen Cases. Ocul Immunol Inflamm. 2019 Oct 24;:1-9 Authors: Donmez O, Akova YA Abstract Purpose: To report the clinical characteristics, treatment modalities and long term follow-up of 16 pediatric ocular acne rosacea patients. Methods: The medical records of pediatric ocular acne rosacea patients were reviewed. Results: There were 16 patients with a mean age of 7.7 ± 5 (1-16) years. The mean follow-up period was 52.8 ± 52 (3-150) months. Eight patients had skin involvement. The mean duration of delay for diagnosis was 16.2 ± 5.1 (4-48) months. Nine patients had a delayed diagnosis. Meibomitis, blepharitis, lid telangiectasia, and conjunctival hyperemia were present in all cases. Systemic antibiotics were prescribed in 12 patients. The mean delay in diagnosis was longer in patients with conjunctival/corneal involvement (p = .001) and these patients required longer systemic treatment (p = .001). Complete remission was achieved in 87.5% of cases. Conclusion: Children presenting with a long history of ocular irritation, meibomian gland disease, recurrent chalazia and peripheral corneal infiltrates should alert ophthalmologists to consider the diagnosis of ocular acne rosacea even in the absence of skin changes. PMID: 31647686 [PubMed - as supplied by publisher] {url} = URL to article
  13. Related Articles Analysis of acne-related judicial precedents from 1997 to 2018 in South Korea. J Dermatol. 2019 Oct 23;: Authors: Cho SI, Shin SH, Yang JH, Lee W, Kim SY, Suh DH Abstract Medicolegal disputes are increasing in practical medicine. Medications or procedures related to acne could lead to medical malpractice. This study analyzed medical litigation associated with acne in South Korea. Acne-related judgments were searched using the Supreme Court of Korea's Written Judgment Management System based on the keyword "acne". Eleven cases were selected; eight cases were related to acne scar and three cases were related to acne. Treatment modalities such as peeling, laser treatment, photodynamic therapy and antibiotics resulted in lawsuits. Claimed sequelae of the treatments were hyperpigmentation, scar worsening, erythema, skin bumps and liver transplant. Eight cases were awarded to the plaintiff, and the others were dismissed. This study shows that various treatments for acne can cause medical disputes. PMID: 31642108 [PubMed - as supplied by publisher] {url} = URL to article
  14. Related Articles STAT1 gain-of-function and chronic demodicosis. Pediatr Dermatol. 2019 Oct 21;: Authors: Molho-Pessach V, Meltser A, Kamshov A, Ramot Y, Zlotogorski A Abstract Heterozygous STAT1 gain-of-function (GOF) mutations result in a combined form of immunodeficiency which is the most common genetic cause of chronic mucocutaneous candidiasis (CMC). We present a pedigree with a GOF mutation in STAT1, manifesting with chronic demodicosis in the form of a facial papulopustular eruption, blepharitis, and chalazion. So far, demodicosis has been described in only one family with STAT1-GOF mutation. We suggest that chronic demodicosis is an under-recognized feature of the immune dysregulation disorder caused by STAT1 gain-of-function mutations. PMID: 31637766 [PubMed - as supplied by publisher] {url} = URL to article
  15. 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
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