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  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. Expressions of glutathione S-transferases alpha, mu, pi and theta in the skin samples of patients with acne rosacea. J Cosmet Dermatol. 2020 May 20;: Authors: Takci Z, Bilgili SG, Kilic M, Oguztuzun S, Moran B, Simsek GG, Akbayrak A, Seckin HY, Karadag AS Abstract BACKGROUND: Data point to the importance of oxidative stress in rosacea. Glutathione S-transferases (GSTs) have substantial roles in a wide variety of oxidative stress-related conditions. AIM: To evaluate the immunohistochemical staining characteristics of GST alpha (GSTA), mu (GSTM), pi (GSTP), and theta (GSTT) in patients with rosacea. PATIENTS/METHODS: The study included 23 women and 7 men with rosacea (mean ± SD age 49 ± 11 yr) and 15 healthy control subjects (10 women, 5 men; mean ± SD age 47.86 ± 10.88 yr). For each patient, the average disease duration, disease subtype, ocular involvement, and severity score were recorded. A 3-mm punch biopsy was taken from the facial skin of each patient and control. Expression of GST isoenzymes was analyzed immunohistochemically. RESULTS: Expressions of GSTM1, GSTP1, and GSTT1 were significantly elevated in patients with rosacea compared to those in the control group (p = 0.0001, p = 0.0002, p < 0.0001, respectively). In the rosacea group, GSTT1 expression was significantly stronger than GSTP1 and GSTA1 expressions (p = 0.019, p < 0.0001, respectively). There were no significant associations between expressions of GST isoenzymes and gender, age, average duration of illness, disease subtype, ocular involvement, or severity score in the patient group (all p > 0.05). CONCLUSIONS: In rosacea, the significant increase of GSTT1, GSTP1, and GSTM1 expressions might result from activation of GST as an outcome of extreme free radical generation from triggered neutrophils or ultraviolet vulnerability. These findings support the relevance of oxidant stress in the pathogenesis of rosacea. PMID: 32433803 [PubMed - as supplied by publisher] {url} = URL to article
  8. Radiofrequency irradiation attenuates angiogenesis and inflammation in UVB-induced rosacea in mouse skin. Exp Dermatol. 2020 May 20;: Authors: Son M, Park J, Oh S, Choi J, Shim M, Kang D, Byun K Abstract Rosacea is a skin inflammatory condition accompanied by cutaneous signs such as edema, flushing, erythema, telangiectasia, and pustules. Generally, rosacea is triggered by ultraviolet B (UVB) exposure. When exposed to UVB, skin epidermis thickens and produces elevated levels of pro-inflammatory cytokines, especially keratinocyte-related VEGF, a potent angiogenic factor. The upregulations of VEGF expression and its secretion promote the formation of new blood vessels and exacerbates rosacea. In this study, radiofrequency (RF) irradiation reduced keratinocyte proliferation in the epidermal layer, the expressions of pro-inflammatory cytokines, angiogenesis-related inflammatory factors, and VEGF in our UVB-induced model of rosacea in vitro and in vivo. RF irradiation attenuated VEGF-induced angiogenesis-associated-processes such as tube formation, cell migration, and endothelial cell proliferation. Notably, blood vessel densities in the skins of UVB-treated mice and rosacea patients were significantly decreased by RF irradiation. These results provide experimental and molecular evidence regarding the effectiveness of RF irradiation for the treatment of rosacea. PMID: 32434270 [PubMed - as supplied by publisher] {url} = URL to article Sunny Beach Treatment Increases RF Irradiation in Rosacea Does a vacation to the South Pacific which includes snorkeling improve rosacea?
  9. Effectiveness of benzyl benzoate treatment on clinical symptoms and Demodex density over time in patients with rosacea and demodicosis: a real life retrospective follow-up study comparing low- and high-dose regimens. J Dermatolog Treat. 2020 May 19;:1-28 Authors: Forton FMN, De Maertelaer V Abstract Background: Patients with rosacea and demodicosis have high facial skin Demodex densities (Dds), which decrease with benzyl benzoate (BB) treatment.Objectives: To evaluate the impact of topical BB (+crotamiton) treatment on Dds and clinical symptoms during prolonged follow-up and to compare low (12% once daily) and high (12% twice daily or 20-24% once daily) BB dose regimens.Methods: This retrospective study included 344 patients (103 rosacea, 241 demodicosis) observed for 7.1 ± 0.5 months. Dds were measured on two consecutive standardized skin surface biopsies and symptoms evaluated using investigator global assessment. Compliance was considered good if patients correctly followed treatment instructions.Results: At final follow-up, in the 248 patients with good compliance, Demodex density had normalized in 217 (88%) and symptoms cleared in 204 (82%). The high dose was associated with better compliance and faster results than the low-dose. The higher the initial Dd, the longer it took to normalize. In the 96 poorly compliant patients, treatment was less effective and slower.Conclusion: These findings indirectly support a key role of the mite in rosacea and suggest that topical treatment with BB (+crotamiton), especially the higher dose, may be a useful alternative treatment for rosacea as well as for demodicosis. PMID: 32427504 [PubMed - as supplied by publisher] {url} = URL to article Crotamiton for Demodectic Rosacea According to Wikipedia, benzyl benzoate "is not available for medical use in the United States." It is available in the UK, Australia, China and other countries. Treatment of Rosacea and Demodicosis With Benzyl Benzoate: Effects of Different Doses on Demodex Density and Clinical Symptoms
  10. Related ArticlesRosacea is associated with conjoined interactions between physical barrier of the skin and microorganisms: A pilot study. J Clin Lab Anal. 2020 May 17;:e23363 Authors: Yuan C, Ma Y, Wang Y, Wang X, Qian C, Hocquet D, Zheng S, Mac-Mary S, Humbert P Abstract BACKGROUND: Rosacea is a common condition characterized by transient or persistent central facial erythema, and often papules and pustules. Currently, the role of bacterium in the development and progression of rosacea remains controversial. This study aimed to investigate the difference in the physiological conditions and microorganisms between the lesional and non-lesional areas of papulopustular rosacea. METHODS: Twenty-five French patients with papulopustular rosacea were enrolled in this pilot study. Each patient was subjected to clinical assessment, and the skin barrier function was tested in lesional and non-lesional areas. In addition, samples from the lesional and non-lesional areas were collected for bacterial culturing. RESULTS: Of all subjects included in the study, a lower skin conductivity was measured in lesional areas than in non-lesional areas (43.5 ± 12.4 vs. 57.2 ± 11.6 U, P < .05), and a higher transepidermal water loss (TEWL) value was found in lesional areas than in non-lesional areas (17.2 ± 5.9 vs. 14.2 ± 4.1 g/(m2 h), P < .05). We found a lower TEWL in lesions in rosacea patients with bacterial dysbiosis than in those with bacterial balance (P < .05). In addition, there were significant differences in the skin conductivity and TEWL between lesional and non-lesional areas in patients with bacterial dysbiosis (P < .001), and no significant differences were seen in patients with bacterial balance (P < .05). CONCLUSION: The results of the present study demonstrate that the physiological features of rosacea are closely associated with the interactions between the host and the microorganisms. PMID: 32419294 [PubMed - as supplied by publisher] {url} = URL to article
  11. Related ArticlesFrontal Fibrosing Alopecia: A Retrospective Study of 75 Patients. Actas Dermosifiliogr. 2020 May 14;: Authors: Maldonado Cid P, Leis Dosil VM, Garrido Gutiérrez C, Salinas Moreno S, Thuissard Vasallo IJ, Andreu Vázquez C, Díaz Díaz RM Abstract BACKGROUND AND OBJECTIVE: Frontal fibrosing alopecia is an increasingly common form of scarring alopecia. The aim of this study was to describe the demographic and clinical characteristics of patients with FFA seen at the trichology unit of a medium-sized regional hospital and to report on treatments used. MATERIAL AND METHODS: We reviewed the medical records of all patients with FFA seen at the trichology unit of Hospital Universitario Infanta Sofía in Madrid, Spain between May 2016 and May 2018. We analyzed associations between disease severity, clinical patterns, need for oral medications, and other characteristics. RESULTS: Seventy-five patients (73 women and 2 men) were studied. Diagnosis was clinical in most cases and 13 cases (17.3%) were confirmed histologically. Median (interquartile range) age at reported onset of symptoms was 61 (12) years. Involvement of the eyebrows was recorded in 70 patients (93.3%) and signs of oral and genital lichen planus in 7 (9.6%). Eleven patients (14.7%) had hypothyroidism and 15 (20.0%) had signs of rosacea. Only 5 of the patients who presented a linear pattern (21.7%) had severe hairline recession. Patients with unstable and/or symptomatic disease (n = 24) were treated with oral medications (5-alpha reductase inhibitors, hydroxychloroquine, corticosteroids, and isotretinoin) or intralesional corticosteroids. Eighteen patients (75.0%) achieved disease stability. Ten of the 15 patients with signs of rosacea and 10 of those with facial papules required systemic treatment. CONCLUSIONS: Most of the patients in this series of FFA were postmenopausal women. The prevalence of oral and genital lichen planus was higher than that observed in the general population. Patients with a linear pattern had less severe disease. Facial papules were more common in younger patients and both facial papules and rosacea were associated with a greater need for oral treatment. PMID: 32417453 [PubMed - as supplied by publisher] {url} = URL to article
  12. Cigarette smoking and risk of rosacea: A nationwide population-based cohort study. J Eur Acad Dermatol Venereol. 2020 May 13;: Authors: Dai YX, Yeh FY, Chou YJ, Chang YT, Chen TJ, Li CP, Wu CY Abstract BACKGROUND: Most evidence regarding the relationship between cigarette smoking and risk of rosacea are obtained from cross-sectional or case-control studies. OBJECTIVE: To examine the association between smoking and risk of developing rosacea. METHODS: Participants were collected from four rounds (2001, 2005, 2009, and 2013) of the Taiwan National Health Interview Survey. Incident cases of rosacea were identified from the National Health Insurance database. Cox proportional hazards model was used to for the analyses. RESULTS: Of the 59,973 participants, 379 developed rosacea during a mean follow-up of 10.8 years. After adjustment for potential confounders, current smokers had a lower risk of rosacea than never smokers (adjusted hazard ratio [aHR] 0.60; 95% confidence interval [CI] 0.39-0.92). An increase in smoking intensity was associated with a decreased risk of rosacea among current smokers (Ptrend = 0.0101). Compared with never smokers, current smokers of >15 cigarettes/day had an aHR of 0.51 (95% CI 0.26-0.99) for rosacea. For incident rosacea, the aHRs (95% CIs) of current smokers of ≤10 years of smoking and ≤10 pack-years of smoking were 0.44 (0.22-0.88) and 0.51 (0.29-0.89), respectively. Former smoking was not associated with rosacea risk. CONCLUSION: Current smoking was significantly associated with a decreased risk of rosacea. PMID: 32401404 [PubMed - as supplied by publisher] {url} = URL to article
  13. Related Articles Osthole, a Natural Plant Derivative Inhibits MRGPRX2 Induced Mast Cell Responses. Front Immunol. 2020;11:703 Authors: Callahan BN, Kammala AK, Syed M, Yang C, Occhiuto CJ, Nellutla R, Chumanevich AP, Oskeritzian CA, Das R, Subramanian H Abstract Mast cells are tissue-resident innate immune cells known for their prominent role in mediating allergic reactions. MAS-related G-protein coupled receptor-X2 (MRGPRX2) is a promiscuous G-protein coupled receptor (GPCR) expressed on mast cells that is activated by several ligands that share cationic and amphipathic properties. Interestingly, MRGPRX2 ligands include certain FDA-approved drugs, antimicrobial peptides, and neuropeptides. Consequently, this receptor has been implicated in causing mast cell-dependent pseudo-allergic reactions to these drugs and chronic inflammation associated with asthma, urticaria and rosacea in humans. In the current study we examined the role of osthole, a natural plant coumarin, in regulating mast cell responses when activated by the MRGPRX2 ligands, including compound 48/80, the neuropeptide substance P, and the cathelicidin LL-37. We demonstrate that osthole attenuates both the early (Ca2+ mobilization and degranulation) and delayed events (chemokine/cytokine production) of mast cell activation via MRGPRX2 in vitro. Osthole also inhibits MrgprB2- (mouse ortholog of human MRGPRX2) dependent inflammation in in vivo mouse models of pseudo-allergy. Molecular docking analysis suggests that osthole does not compete with the MRGPRX2 ligands for interaction with the receptor, but rather regulates MRGPRX2 activation via allosteric modifications. Furthermore, flow cytometry and confocal microscopy experiments reveal that osthole reduces both surface and intracellular expression levels of MRGPRX2 in mast cells. Collectively, our data demonstrate that osthole inhibits MRGPRX2/MrgprB2-induced mast cell responses and provides a rationale for the use of this natural compound as a safer alternative treatment for pseudo-allergic reactions in humans. PMID: 32391014 [PubMed - in process] {url} = URL to article Osthole: A Review on Its Bioactivities, Pharmacological Properties, and Potential as Alternative Medicine Pharmacological features of osthole
  14. Effect of treatment with silver(I) complex of metronidazole on ocular rosacea: Design and formulation of new silver drug with potent antimicrobial activity. J Trace Elem Med Biol. 2020 Apr 17;61:126531 Authors: Waszczykowska A, Żyro D, Jurowski P, Ochocki J Abstract BACKGROUND: Metronidazole with well-soluble silver nitrate forms a complex with potent activity (synergism) against bacterial strains and fungi with simultaneous lower side effect than in the case of the two agents administered separately. This study aimed to establish effectiveness in the treatment of ocular rosacea with new formulation of drops and ointment with silver(I) complex of metronidazole. METHODS: Three patients suffering from serious ophthalmic complications of acne rosacea were treated with drops and ointments applied 3 times a day for 3 months. The uncorrected visual acuity testing (UCVA), pachymetry as well as subjective and objective tear film assessment were evaluated. RESULTS: In all patients, we have improved UCVA as well as objective and subjective evaluation of the tear film parameters. No significant differences in corneal thickness were observed. CONCLUSION: Well soluble silver(I) complex of metronidazole might be an alternative method in ophthalmic complications of acne rosacea treatment. PMID: 32388103 [PubMed - as supplied by publisher] {url} = URL to article
  15. Relationship between the incidence of rosacea and drinking or smoking in China. Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2020 Feb 28;45(2):165-168 Authors: Wang Y, Zhao Z, Liu F, Xie H, Li J, Wang B Abstract OBJECTIVES: To explore the relationship between the incidence of rosacea and drinking, smoking, gender or age, and to provide some basis for the diagnosis, treatment and mechanism of rosacea. METHODS: A total of 1 180 patients with rosacea and 1 008 non-rosacea patients diagnosed in the Department of Dermatology of Xiangya Hospital were included in the study. Logistic analysis was performed on the incidence factors, and the differences between the two groups in different age groups were compared. RESULTS: There was no significant difference in gender between the two groups (P>0.05). Logistic analysis showed that drinking had no effect on the incidence of rosacea (P>0.05); while smoking, gender, and age had an effect on the incidence of rosacea (P<0.05). The highest proportion of patients with rosacea was 25-34 years old. CONCLUSIONS: The incidence of rosacea has nothing to do with alcohol consumption; while smoking, gender, and age affect the incidence. Smoking and women are the risk factors, and the most common age of rosacea is at 25-34 years old. PMID: 32386042 [PubMed - as supplied by publisher] {url} = URL to article
  16. Related ArticlesImpact of Fractional Ablative Carbon Dioxide Laser on the Treatment of Rhinophyma. Aesthet Surg J. 2019 Mar 14;39(4):NP68-NP75 Authors: Amaral MTSSD, Haddad A, Nahas FX, Juliano Y, Ferreira LM Abstract BACKGROUND: Rhinophyma results in nasal deformity, which may lead to significant distress, embarrassment, social isolation, and low self-esteem. Fractional carbon dioxide (CO2) laser treatment is a simple, noninvasive, outpatient procedure with a low complication rate that has proved useful in rhinophyma treatment. OBJECTIVES: The aim of this study was to assess the impact of fractional ablative CO2 laser treatment on self-esteem in patients with rhinophyma. METHODS: Twelve patients with rhinophyma, between 50 and 80 years of age, received 4 monthly treatment sessions with a fractional ablative CO2 laser. The laser parameters were chosen based on the severity of the condition of each patient. Patient satisfaction was assessed through a study-specific questionnaire administered 1 month after treatment. Self-esteem was assessed by the Rosenberg Self-Esteem (RSE) Scale, which was administered before treatment, and at 1, 6, and 12 months after treatment. RESULTS: A decrease in RSE scores was observed in the post-treatment period, indicating an improvement in self-esteem among patients. All patients were satisfied with the aesthetic results and would recommend the treatment to a friend. CONCLUSIONS: Fractional ablative CO2 laser treatment is associated with high levels of rhinophyma patient satisfaction, and significant improvements in self-esteem. LEVEL OF EVIDENCE: 4: PMID: 30204832 [PubMed - indexed for MEDLINE] {url} = URL to article
  17. Related ArticlesPrevalence and risk factors of dry eye in 79,866 participants of the population-based Lifelines cohort study in the Netherlands. Ocul Surf. 2020 May 03;: Authors: Vehof J, Snieder H, Jansonius N, Hammond CJ Abstract PURPOSE: To investigate the prevalence of dry eye among all adult age categories and to discover independent risk factors by investigating a wide range of etiological categories. METHODS: A cross-sectional association study including 79,866 voluntary participants aged 20-94 years of the population-based Lifelines Cohort Study in the Netherlands. RESULTS: Overall, 9.1% of participants had dry eye disease as measured by the Women's Health Study dry eye questionnaire. Prevalence of dry eye symptoms were particularly prevalent in 20-30 years old. Dry eye was associated with comorbidities in almost all body systems, including musculoskeletal, gastro-intestinal, ophthalmic, autoimmune, psychiatric, pain, functional, dermatological and atopic disorders. Numerous independent risk factors were discovered or confirmed, with strong associations for female sex, contact lens use, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, eye surgery including cataract and laser refractive surgery, keratoconus, osteoarthritis, connective tissue diseases, atherosclerosis, Graves' disease, autistic disorder, depression, 'burnout', Crohn's disease, sarcoid, lichen planus, rosacea, liver cirrhosis, sleep apnea, sinusitis, thyroid function, and air pollution (NO2). High blood pressure and high BMI were strongly associated with less dry eye, as was current smoking, while ex-smokers had more dry eye. No clear link between dry eye and lipid or blood glucose levels was found. CONCLUSIONS: This study on dry eye confirmed but also refuted many risk factors from smaller epidemiological studies, and discovered numerous new risk factors in multiple etiological categories. The finding that dry eye symptoms are particularly common in young adults is concerning, and warrants further study. PMID: 32376389 [PubMed - as supplied by publisher] {url} = URL to article
  18. Related ArticlesOxymetazoline and Energy-Based Therapy in Patients with Rosacea: Evaluation of the Safety and Tolerability in an Open-Label, Interventional Study. Lasers Surg Med. 2020 May 06;: Authors: Tanghetti EA, Goldberg DJ, Dover JS, Geronemus RG, Bai Z, Alvandi N, Shanler SD Abstract BACKGROUND AND OBJECTIVES: The objectives of this study were to evaluate the safety, tolerability, and efficacy of oxymetazoline hydrochloride cream, 1% (oxymetazoline) when used as an adjunctive treatment with energy-based therapy for patients with moderate to severe facial erythema associated with rosacea. STUDY DESIGN/MATERIALS AND METHODS: In this Phase 4, multicenter, interventional, open-label study, eligible patients received one of four energy-based therapies (potassium titanyl phosphate laser, intense pulsed light therapy, pulsed-dye laser Vbeam Perfecta, or pulsed-dye laser Cynergy) on day 1 and day 29 and once-daily application of oxymetazoline on days 3 through 27 and days 31 through 56. Improvement from baseline in Clinician Erythema Assessment (CEA) score, patient satisfaction measures, incidence of treatment-emergent adverse events (TEAEs), and worsening from baseline on dermal tolerability assessments and the Clinician Telangiectasia Assessment (CTA) were assessed. Data were summarized using descriptive statistics. RESULTS: A total of 46 patients (mean age, 51.1 years; 78.3% female) enrolled in this study. Similar numbers of patients received each of the energy-based therapies in addition to oxymetazoline. All patients demonstrated an improvement from baseline in CEA during the study with 39 of 43 evaluable patients (90.7%) demonstrating an improvement 6 hours posttreatment on day 56. Most patients were satisfied or very satisfied with treatment at the end of the study. All TEAEs were mild or moderate in severity. Some patients experienced worsening in dermal tolerability assessment symptoms (range: 4-21 patients; 8.7-45.7%). Worsening in CEA and CTA were each reported by three patients (6.5%) at any time during the study. CONCLUSIONS: Treatment with oxymetazoline as adjunctive therapy with energy-based therapy was safe, well tolerated, and reduced facial erythema in patients with moderate to severe persistent facial erythema associated with rosacea. Lasers Surg. Med. © 2020 The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals LLC. PMID: 32378241 [PubMed - as supplied by publisher] {url} = URL to article
  19. Dermatoscopic and ultra-high frequency ultrasound evaluation in cutaneous post-radiation angiosarcoma. J Eur Acad Dermatol Venereol. 2020 May 07;: Authors: Oranges T, Janowska A, Vitali S, Loggini B, Izzetti R, Romanelli M, Dini V Abstract Cutaneous angiosarcoma (cAS) is a rare malignant aggressive vascular tumor and includes three variants: cAS affecting the head and neck (Wilson-Jones type), post-radiation cAS, and cAS associated with chronic lymphoedema (Stewart-Treves syndrome). The diagnosis is often delayed, because cAS is frequently clinically misdiagnosed as hematoma, rosacea, cellulitis or eczema. The diagnosis of cAS may be difficult also for the pathologists and the tumor may be misdiagnosed as a benign vascular lesion. PMID: 32379377 [PubMed - as supplied by publisher] {url} = URL to article
  20. Related ArticlesA Preliminary Clinical Evaluation of a Topical Product for Reducing Slight Rosacea Imperfections. Clin Cosmet Investig Dermatol. 2020;13:299-308 Authors: Maggioni D, Cimicata A, Praticò A, Villa R, Bianchi FM, Busoli Badiale S, Angelinetta C Abstract Introduction: Rosacea is a chronic multifactorial skin disorder mainly affecting facial skin with an estimated prevalence of about 5% worldwide. Its main symptoms, occurring early during pathology development, are skin dehydration, redness, erythema, and telangiectasia. Given the lack of a resolutive cure, therapeutic approaches able to relieve the main symptoms are needed. Purpose: The aim of this research article is to evaluate the beneficial effect of a topical product (Serum BK46) on rosacea symptoms. Patients and Methods: A monocentric single-arm, non-blinded study was performed to assess the clinical effect of Serum BK46 in relieving the main symptoms of rosacea: skin dryness, increased trans epidermal water loss (TEWL), redness, and abnormal vascularization. Twenty patients with mild to moderate rosacea were enrolled in the study and asked to apply the product twice per day for 56 days. Skin moisturization, TEWL, and erythema index were instrumentally assessed at baseline and following 24 h and 14, 28 and 56 days of treatment. Clinical parameters, including redness and telangiectasia imperfection visibility, were evaluated on a 5-point scale by a specialized dermatologist at baseline and after 14, 28, and 56 days of treatment. Finally, the visibility of vessel diameter was evaluated at baseline and after 28 and 56 days of treatment. Results: Serum BK46 application restored skin hydration and prevented the loss of water by the skin. Long-term treatment with Serum BK46 significantly reduced skin redness, erythema index, and the visibility of telangiectasia imperfections and superficial vessels. The investigated product's clinical effect was demonstrated by both instrumental and clinical evaluation. Furthermore, Serum BK46 was completely tolerated and no adverse effects were recorded. Conclusion: The moisturizing and skin barrier restoring action of Serum BK46 has been clearly proven in patients displaying mild to moderate rosacea; thus, this product is a good candidate for rosacea treatment. PMID: 32368125 [PubMed] {url} = URL to article
  21. Related ArticlesAn exploratory, open-label, investigator-initiated study of interleukin-17A (IL-17A) blockade in patients with moderate to severe papulopustular rosacea. Br J Dermatol. 2020 May 04;: Authors: Kumar AM, Chiou AS, Shih YH, Li S, Chang ALS Abstract Currently, few systemic medications are effective for rosacea.1 Recent research has shown elevation of interleukin (IL)-17A in rosacea.2,3 To assess if the IL-17A inhibitor,4, 5 secukinumab, could improve moderate to severe papulopustular rosacea (PPR), an exploratory, open-label, single-arm investigator initiated clinical trial in adults with moderate to severe PPR was performed after Stanford Human Subjects Panel approval. PMID: 32364247 [PubMed - as supplied by publisher] {url} = URL to article
  22. Related ArticlesAssociation between Rosacea and Cardiometabolic Disease: A Systematic Review and Meta-Analysis. J Am Acad Dermatol. 2020 Apr 28;: Authors: Chen Q, Shi X, Tang Y, Wang B, Xie HF, Shi W, Li J Abstract BACKGROUND: Rosacea is recognized as a chronic inflammatory cutaneous disorder associated with multiple systemic illnesses. However, the association between rosacea and cardiometabolic disease (CMD) remains controversial. OBJECTIVE: To evaluate the association between rosacea and CMD by a systematic review and meta-analysis. METHODS: A comprehensive search of studies published before Oct 16, 2019 was performed in databases of PUBMED, EMBASE, Cochrane Library and Web of Science. The pooled risk ratios (RRs) or standardized mean differences (SMDs) were calculated. RESULTS: Thirteen studies were included, representing 50,442 patients with rosacea. Rosacea cases had higher prevalence of dyslipidemia, higher prevalence of hypertension, higher total cholesterol (TC), higher low-density lipoprotein (LDL), higher triglycerides (TG), higher systolic blood pressure, higher diastolic blood pressure and higher fasting blood glucose (FBG). Rosacea was not associated with ischemic heart disease (IHD), stroke, diabetes and high-density lipoprotein (HDL). LIMITATIONS: No subgroup analysis could be performed according to the subtypes and severity of rosacea. CONCLUSION: Rosacea showed a correlation with hypertension and dyslipidemia, but not with IHD, stroke, nor diabetes. We advocate screening for CMD indicators among rosacea patients, which may be helpful for diagnosis and appropriate treatment at an early stage of disease. PMID: 32360724 [PubMed - as supplied by publisher] {url} = URL to article
  23. Related ArticlesUse of beta-blockers for rosacea-associated facial erythema and flushing: a systematic review and update on proposed mode of action. J Am Acad Dermatol. 2020 Apr 29;: Authors: Logger JGM, Olydam JI, Driessen RJB Abstract BACKGROUND: Flushing and erythema are frequent skin symptoms in rosacea. As their adequate treatment remains a clinical challenge, new treatment options are explored, such as oral β-blockers. OBJECTIVE: To evaluate the efficacy of oral β-blockers for rosacea-associated facial flushing and erythema. METHODS: PubMed, EMBASE, Web of Science, and Cochrane Library were systematically searched, including studies providing original data on the efficacy of oral β-blockers in rosacea patients with facial flushing and/or persistent erythema. Risk of bias was assessed using the Cochrane Risk of Bias tool, Newcastle-Ottawa scale, and Quality in Prognosis Studies tool. RESULTS: Nine studies evaluating the use of carvedilol, propranolol, nadolol, and β-blockers in general were included. Articles studying carvedilol and propranolol showed a large reduction of erythema and flushing during treatment with a rapid onset of symptom control. Bradycardia and hypotension were the most commonly described adverse events. LIMITATIONS: Most studies had a retrospective design with a small sample size, and outcome measurement was often subjective. CONCLUSION: Oral β-blockers could be an effective treatment option for rosacea patients with facial erythema and flushing that does not respond to conventional therapy. Larger prospective trials with objective outcome assessment are needed to validate the promising results of these studies. PMID: 32360760 [PubMed - as supplied by publisher] {url} = URL to article
  24. Related ArticlesPrevalence, clinical characteristics, and health-related quality of life of rosacea in Chinese adolescents: a population-based study. J Eur Acad Dermatol Venereol. 2020 May 03;: Authors: Chen Q, Tang Y, Shi X, Yang X, Shan S, Wang X, Xiao Y, Chen X, Shen M, Li J Abstract Rosacea is a chronic inflammatory dermatosis that may manifest with flushing, erythema, telangiectasia, papules and pustules, or phymatous changes, occasionally with ocular involvement.1 It was widely accepted that rosacea typically occurs in people aged 30-50 years old.2 However, the youngest rosacea patient reported was an eight-year-old girl, inspiring dermatologists to pay more attention to the evaluation of rosacea among younger populations.3 Moreover, evidence supported that not merely adults but also adolescents are subject to the influence caused by their skin conditions.4 Hence, we aimed to explore the prevalence, clinical characteristics and health-related quality of life (HRQoL) of rosacea in Chinese adolescents to establish future guidelines. PMID: 32362044 [PubMed - as supplied by publisher] {url} = URL to article
  25. Related Articles Dupilumab for the Treatment of Atopic Dermatitis in an Austrian Cohort-Real-Life Data Shows Rosacea-Like Folliculitis. J Clin Med. 2020 Apr 24;9(4): Authors: Quint T, Brunner PM, Sinz C, Steiner I, Ristl R, Vigl K, Kimeswenger S, Neubauer K, Pirkhammer D, Zikeli M, Hoetzenecker W, Reider N, Bangert C Abstract Dupilumab is the first biological treatment approved for moderate-to-severe atopic dermatitis (AD). Efficacy and safety have been demonstrated in clinical trials, but real-life data is still limited. The objective of this study was to retrospectively evaluate Dupilumab treatment in AD patients in a real-life clinical setting. Effectiveness and safety outcomes were collected at baseline and after 2, 6, 10, 24, 39, and 52 weeks by using clinical scores for disease activity, as well as serological markers. Ninety-four patients from five dermatological hospitals were included. After 24 weeks of treatment, the median Investigator Global Assessment (IGA) and Eczema Area and Severity Index (EASI) showed a significant reduction compared to baseline (3.9 ± 0.7 vs. 1.4 ± 0.8 and 26.5 ± 12.5 vs. 6.4 ± 6.5). Interestingly, we observed rosacea-like folliculitis as an unexpected side effect in 6.4% of patients. Dupilumab proves to be an effective and well-tolerated treatment under real-life conditions. The occurrence of rosacea-like folliculitis warrants further mechanistic investigation. PMID: 32344789 [PubMed] {url} = URL to article Wikipedia notes about this treatment, "As of 2019 it costs about US$46,000 per year." "In conclusion, dupilumab is a safe and effective treatment option for patients with moderate-to-severe atopic dermatitis and in specific subsets of patients with asthma." Hum Vaccin Immunother. 2019; 15(9): 2129–2139. A review of dupilumab in the treatment of atopic diseases Quinn Thibodeaux, Mary Patricia Smith, Karen Ly, Kristen Beck, Wilson Liao, and Tina Bhutani
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