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  1. Related ArticlesRed scrotum syndrome: An update on clinicopathological features, pathogenesis, diagnosis and management. J Am Acad Dermatol. 2020 Jun 01;: Authors: Khalil S, Kurban M, Abbas O Abstract The genital skin may be affected by a variety of dermatoses, be it inflammatory, infectious, malignant, idiopathic or others. The Red Scrotum Syndrome is characterized by persistent erythema of the scrotum associated with a burning sensation, hyperalgesia, and itching. Its cause is unknown but proposed mechanisms include rebound vasodilation following prolonged topical corticosteroid use and localized erythromelalgia. It is a chronic condition and treatment is often difficult. In this paper, we review the etiology, the physical and histopathological findings, and the management of this condition. We also describe related conditions such as Red Scalp Syndrome, Red Ear Syndrome, and Red Vulva Syndrome. Finally, we summarize the different cases reported in the literature and discuss the features that help in the differentiation of red scrotum syndrome from its mimickers. PMID: 32497688 [PubMed - as supplied by publisher] {url} = URL to article
  2. Related ArticlesStatPearls Book. 2020 01 Authors: Abstract Rosacea is a common chronic inflammatory disease that presents with recurrent flushing, erythema, telangiectasia, papules, or pustules on nose, chin, cheeks, and forehead. There are four clinical subtypes of rosacea based on the predominant signs and symptoms: erythematotelangiectatic, papulopustular, phymatous, and ocular. The subtypes are not mutually exclusive. Patients can present with features of multiple subtypes, and the predominant features and areas of involvement can change over time. Fifty to seventy-five percent of patients with rosacea have eye involvement with symptoms including dryness, redness, tearing, tingling/burning sensation, foreign-body sensation, light sensitivity, and blurred vision. In addition to the skin and eye symptoms, rosacea can cause anxiety, embarrassment, and depression and can have a significant impact on the quality of life. Although usually limited to the skin, an association of rosacea with systemic comorbidities such as neurologic diseases, inflammatory bowel disease, and cardiovascular diseases has been reported.[1][2][3][4] PMID: 32491506 {url} = URL to article
  3. Related ArticlesAssessment of the abdominal fat index by ultrasonography in patients with rosacea. Australas J Dermatol. 2020 Jun 03;: Authors: Özkur E, Bülbün G, Karataş D, Kıvanç Altunay İ PMID: 32491195 [PubMed - as supplied by publisher] {url} = URL to article
  4. Related ArticlesStudy of Clinical Profile of Patients Presenting with Topical Steroid-Induced Facial Dermatosis to a Tertiary Care Hospital. Indian Dermatol Online J. 2020 Mar-Apr;11(2):208-211 Authors: Jain S, Mohapatra L, Mohanty P, Jena S, Behera B Abstract Background: Topical corticosteroids (TCs) are widely used for various indications in dermatology. However, these can cause a plethora of symptoms if overused or abused. Topical steroid damaged face is a relatively new entity which was described in 2008. TC abuse cause a myriad of side effects viz, erythema, telangiectasia, acne, acneiform eruption, hyper/hypopigmentation, rosacea, and photosensitivity when used inappropriately. Aim: The aim of the study was to ascertain the prevalence, demographics, and clinical presentations of TC abuse on faceamong our population. Materials and Methods: This was a cross-sectional study performed at dermatology department of a tertiary care teaching hospitallocated in eastern India for 1 year. All patients with facial dermatoses attending the outpatient department were asked about use of TC in recent past and those with positive history were included. A detailed clinical evaluation was undertaken and various demographic and clinical data were recorded. Results: A total of 316 patients (53 males, 263 females) presented with topical steroid-induced facial dermatoses during the entire study period. Majority of them used these agents on suggestion of close friends and relatives, pharmacists, television commercials, and doctors. Mometasone in the form "No-Scar" preparation was the most commonly abused topical steroid in our study. The most common side effects encountered were steroid-induced acne (45.2%) or flare of pre-existing acne followed by erythema and telangiectasia (21.2%), hypertrichosis (6.6%), rosacea (2.2%), and atrophy (1.5%). The most common reason for abusing TC was to get a fairer skin tone. Conclusion: Our study reports the clinical patterns of TC abused facial dermatoses. The fantasy to get a fairer skin among the people of our country has led to the abuse of topical corticosteroids. We conducted this study to create awareness among these patients about the dreadful effects of steroid misuse. PMID: 32477980 [PubMed] {url} = URL to article
  5. Related ArticlesOut of the Blue: A Case of Blue Subungual Discoloration Associated with Prolonged Tetracycline Use. Cureus. 2020 Apr 24;12(4):e7810 Authors: Ahmad Y, Boutros H, Hanna K Abstract Tetracycline derivatives are antibiotics such as minocycline and doxycycline that have been commonly utilized for inflammatory dermatological conditions such as acne and rosacea. Hyperpigmentation of the skin, nails, thyroid, oral mucosa, teeth, and bones is a known but rare side effect of prolonged tetracycline use. The hyperpigmentation typically takes months to years to develop. There may also be residual changes to the skin after discontinuation of the medication. For this reason, the time tetracyclines are used should be minimized and patients should be monitored for the skin findings. Subungual discoloration carries a broad differential including infectious, inflammatory, metabolic, malignant or systemic diseases. Knowledge of this side effect is crucial in order to avoid unnecessary testing in determining the etiology of the subungual discoloration. We report on a case of a patient who has been on long-term minocycline use for adult acne management. He was initially on minocycline for six years, but due to minocycline-induced hyperpigmentation of his ears and fingernails, he had switched to doxycycline. One year later, the skin hyperpigmentation of the ears regressed; however, the blue subungual hyperpigmentation of his hands progressively become more prominent without any other significant symptoms. PMID: 32467786 [PubMed] {url} = URL to article
  6. Related ArticlesSurgical mask dermatitis caused by formaldehyde (releasers) during the COVID-19 pandemic. Contact Dermatitis. 2020 May 28;: Authors: Aerts O, Dendooven E, Foubert K, Stappers S, Ulicki M, Lambert J PMID: 32468589 [PubMed - as supplied by publisher] {url} = URL to article
  7. Related ArticlesRosacea and perioral dermatitis: a single-center retrospective analysis of the clinical presentation of 1032 patients. J Dtsch Dermatol Ges. 2020 May 29;: Authors: Hoepfner A, Marsela E, Clanner-Engelshofen BM, Horvath ON, Sardy M, French LE, Reinholz M Abstract BACKGROUND: Rosacea is a common chronic inflammatory cutaneous disorder affecting nearly 5.5 % of the adult population. Our aim was to evaluate the prevalence and epidemiology of rosacea and perioral dermatitis (POD) in an ambulatory care setting. METHODS: We retrospectively analyzed medical data of patients with a confirmed diagnosis of rosacea or perioral dermatitis (POD) presenting at our university hospital outpatient clinic during a 3-year period. RESULTS: Out of 1032 patients, 81.5 % were diagnosed with rosacea and 18.5 % with POD. Overall prevalence was 1.4 % for rosacea and 0.3 % for POD. 69.3 % of the analyzed patients were female. Overall mean age was 49.3 ± 7.7 (1-92) years; the women's average age was less than the men's. Patients with POD were younger and predominantly female, whereas patients with phymatous rosacea were older and predominantly male. The most common phenotypes were papulopustular rosacea (68.4 %), erythematotelangiectatic rosacea (22.5 %), and phymatous rosacea (8.0 %). Special forms of rosacea were diagnosed in 15.8 % of the patients; the most frequent were ocular rosacea (6.9 %) and steroid-induced rosacea (5.4 %). CONCLUSIONS: The large patient cohort analyzed in our study provides a good estimate of the frequency of the rosacea subtypes, special forms and of perioral dermatitis in a hospital-based outpatient care setting. PMID: 32469453 [PubMed - as supplied by publisher] {url} = URL to article
  8. Related ArticlesTopical ivermectin-metronidazole gel therapy in the treatment of blepharitis caused by Demodex spp.: A randomized clinical trial. Cont Lens Anterior Eye. 2020 May 24;: Authors: Ávila MY, Martínez-Pulgarín DF, Rizo Madrid C Abstract PURPOSE: To evaluate the efficacy of topical ivermectin-metronidazole combined therapy in the management of Demodex-associatedblepharitis. METHODS: Sixty patients with a diagnosis of Demodex-associatedblepharitis were recruited in a randomized clinical trial. Thirty receiving topical ivermectin (0.1%)-metronidazole (1%) gel treatment on days 0, 15 and 30. Thirty additional patients were used as a control group receiving vehicle on days 0, 15 and 30. The primary efficacy measure was the number of Demodex spp. mitesin the eyelashes of patients. The secondary outcomes included clinical improvement of signs and adverse events. RESULTS: Complete eradication of Demodex spp. was found in 96.6% of patients in the treatment group. Furthermore, a significant reduction of inflammation signs were found in all treated patients versus controls. None of the patients experienced any adverse effects associated with the treatment. CONCLUSION: Demodex infection was controlled satisfactorily with the ivermectin (0.1%)-metronidazole (1%) gel, and no adverse effects were observed. Application of this gel for the treatment of different parasitic infections of the eyelids could be feasible, and this requires further exploration. PMID: 32461053 [PubMed - as supplied by publisher] {url} = URL to article
  9. Related ArticlesCutaneous Exophiala oligosperma infection presenting with multiple, rosacea-like papules on the cheek in a healthy individual. J Dermatol. 2020 May 28;: Authors: Demitsu T, Umemoto N, Maeda T, Kakurai M, Harada K PMID: 32463524 [PubMed - as supplied by publisher] {url} = URL to article
  10. Psychological Consequences of the Most Common Dermatoses: Data from the Objectifs Peau Study. Acta Derm Venereol. 2020 May 25;: Authors: Misery L, Taïeb C, Schollhammer M, Bertolus S, Coulibaly E, Feton-Danou N, Michel L, Seznec JC, Versapuech J, Joly P, Corgibet F, Ezzedine K, Richard MA Abstract The prevalence of psychological disorders in patients with common skin diseases was assessed in a large representative sample of the French adult population. General health, as measured by the EQ5D score, was significantly lower if patients reported having rosacea, atopic dermatitis, urticaria, fungal infections, psoriasis or acne. The proportions of participants reporting being extremely anxious or depressed were higher in those who reported having rosacea, atopic dermatitis or contact dermatitis. Difficulties in sexual or conjugal life were frequently reported by people with psoriasis, atopic dermatitis, contact dermatitis, urticaria and, in particular, acne. Sleep disorders were present in 30-50% of those who reported having acne, rosacea, eczema, psoriasis or urticaria. Sleep disorders may be related not only to pruritus, but also to disfiguring skin diseases. Anxiety and depression complications were mainly reported by those with disfiguring diseases. Sexual/conjugal dysfunctions were associated with all dermatoses (with the exception of warts). PMID: 32449783 [PubMed - as supplied by publisher] {url} = URL to article
  11. An altered fecal microbial profiling in rosacea patients compared to matched controls. J Formos Med Assoc. 2020 May 20;: Authors: Chen YJ, Lee WH, Ho HJ, Tseng CH, Wu CY Abstract BACKGROUND/PURPOSE: Rosacea has been linked to inflammatory bowel disease and small bowel bacterial overgrowth. We aimed to investigate the fecal microbial profiling and the potential gene functions between rosacea and non-rosacea subjects. METHODS: A case-control study. Fecal microbiome and predicted genetic function inferred from high-throughput 16S ribosomal RNA sequencing were analyzed between rosacea (n = 11) and age-, gender- and body mass index-matched non-rosacea subjects (n=110). The correlation between altered microbiome as well as lifestyle and diet were also investigated. RESULTS: A significant reduction of fecal microbial richness was found in rosacea patients. A distinct fecal microbial community structure was demonstrated in rosacea patients. The discriminating enriched genera in rosacea patients included Rhabdochlamydia, CF231, Bifidobacterium, Sarcina, Ruminococcus, belonging to the phylum of Chlamydiae, Bacteroidetes, Actinobacteria, and Lentisphaerae. The discriminating reduced abundant genera included Lactobacillus, Megasphaerae, Acidaminococcus, Hemophilus, Roseburia, Clostridium, belong to the phylum of Firmicutes; and Citrobacter, belonging to the phylum of Proteobacteria. The distinct fecal microbial composition might be related to sulfur metabolism, cobalamin, and carbohydrate transport. CONCLUSION: An altered fecal microbial richness and composition were observed in rosacea patients. The distinct microbial composition might be related to sulfur metabolism, cobalamin and carbohydrate transport. PMID: 32446756 [PubMed - as supplied by publisher] {url} = URL to article Full Text
  12. Related Articles Efficacy and safety of hydroxychloroquine for treatment of patients with rosacea: a multi-center, randomized, double-blind, double-dummy, pilot study. J Am Acad Dermatol. 2020 May 18;: Authors: Wang B, Yuan X, Huang X, Tang Y, Zhao Z, Yang B, Yang B, Zheng Y, Yuan C, Xie H, Li J PMID: 32439466 [PubMed - as supplied by publisher] {url} = URL to article More info on hdroxychloroquine and rosacea
  13. Related ArticlesRole of ferritin in pathogenesis of rosacea and its value in efficacy of 595 nm pulsed dye laser in treatment of different variants of rosacea: a clinical and immunohistochemical study. J Cosmet Laser Ther. 2020 May 22;:1-7 Authors: Elwan NM, Salah SM, Abdelsalam SF, Elfar NN Abstract BACKGROUND: Current rosacea treatment focused on symptom suppression to improve patient's quality of life, prevent progression, and sustain remission. The progress of laser therapy has brought about a paradigm shift in the world of treating erythema and telangiectasia. We appraised role of ferritin in pathogenesis of rosacea and consider its value in efficacy of 595 nm pulsed dye laser (PDL) in treatment of rosacea. MATERIALS/METHODS: 20 patients had rosacea were treated with PDL; received 4 sessions, 4 weeks apart. They were assessed before and after treatment by rosacea grading scale and skin biopsies were taken to detect changes in ferritin expression before and after treatment. RESULTS: Ferritin expression in lesional skin was positively expressed in all patients proportional to severity of rosacea that showed statistically significant reduction of ferritin expression after PDL. There was a statistically significant reduction in rosacea grading scale after PDL (p value = .005*); the highest efficacy was in phymatous then papulopustular and erythrotelangiectatic types. CONCLUSIONS: The reduction of ferritin expression after PDL opens a new era for antioxidant agents to be added as a relevant approach for the therapy of rosacea via attenuation of oxidative stress. PMID: 32441163 [PubMed - as supplied by publisher] {url} = URL to article
  14. Related ArticlesLupus miliaris disseminatus faciei in a young male. G Ital Dermatol Venereol. 2019 Dec;154(6):714-716 Authors: Manganoni AM, Farisoglio C, Pavoni L, Chiudinelli M, Stillitano G, Ungari M, Calzavara-Pinton P Abstract We report a case of a healthy 26-year-old male with multiple asymptomatic reddish papules and papule-nodules on the central area of the face, persisting from more than 2 months and gradually increasing in number. An incisional skin biopsy revealed a confluent dense granulomatous infiltrate centred by large areas of eosinophilic necrosis consistent with the diagnosis of lupus miliaris disseminatus faciei (LMDF). This is a rare dermatosis first described in 1878 by Fox, that often poses a clinical challenge as it is a disease process which is difficult to diagnose. In fact, in our case, a diagnosis of LMDF was made on skin biopsy. We think that collaboration among dermatologists and General Practitioners is very important for diagnosis of rare dermatosis and especially for management of it, in order to prevent the development of depressed scars. PMID: 26349925 [PubMed - indexed for MEDLINE] {url} = URL to article
  15. Magnitude, characteristics and consequences of topical steroid misuse in rural North India: an observational study among dermatology outpatients. BMJ Open. 2020 May 18;10(5):e032829 Authors: Thomas M, Wong CC, Anderson P, Grills N Abstract INTRODUCTION: Current evidence indicates an alarming increase in topical steroid (TS) misuse in India. Data regarding the magnitude and characteristics of this problem in rural India, where 68% of the population resides, are insufficient. This study analyses the magnitude, causes, characteristics and consequences of TS misuse in rural India. It also examines the association between TS misuse and patients' perception of skin disease. METHODS: A mixed-method observational study was conducted among the attendees of the dermatology outpatient department in a rural North Indian hospital. Those with a history of TS misuse were analysed for behaviour patterns and outcome. RESULTS: Out of 723 patients, 213 (29.2%) misused TS. Clobetasol propionate (58.2%) was most commonly misused. Seventy brands of inappropriate fixed drug combination steroid creams were recovered from the patients. Pharmacists and local healers together contributed to 78% of the sources for steroid misuse. Almost 58% of participants perceived their skin conditions to be allergic reactions to food, when in fact 70.1% were tinea, 10% scabies and 9% acne. Eighty per cent of the respondents having tinea had tinea incognito and 97% had extensive lesions. Eighty-five per cent of the participants with scabies had atypical lesions and 80% with acne had steroid rosacea or aggravation of acne. The median expenditure incurred in purchasing these potentially harmful steroid creams was Rs 1000 (US$14.1, equivalent to 3 days' wages of a labourer). CONCLUSION: Steroid misuse is a problem of epidemic proportion in rural India. This practice is changing the profile of many common and infective skin conditions, which portends diagnostic dilemmas and therapeutic challenges for clinicians. Misconceptions about skin disease drive the public to seek 'quick fixes' from non-allopathic providers who have unrestricted access to potent steroids. There is an urgent need to tighten regulatory controls over the manufacturing, sale and prescription of irrational TS combinations. PMID: 32430446 [PubMed - in process] {url} = URL to article
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