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  1. Related Articles Minocycline-Induced Hyperpigmentation. J Am Osteopath Assoc. 2018 Jul 01;118(7):492 Authors: Skorin L, Norberg S PMID: 29946676 [PubMed - indexed for MEDLINE] {url} = URL to article
  2. Related Articles A case series of demodicosis in children. Pediatr Dermatol. 2019 Jun 13;: Authors: Douglas A, Zaenglein AL Abstract Demodex mites are commensal inhabitants of the pilosebaceous unit that are typically absent or at low numbers in childhood. When they are present, they can cause a primary eruption or exacerbate an underlying facial dermatosis. Here we report five cases of demodicosis occurring in childhood, the clinical presentations, and responses to treatment. Papulopustular lesions predominate, prompting the advice "pustules on noses, think demodicosis!" PMID: 31197860 [PubMed - as supplied by publisher] {url} = URL to article
  3. Response to 'Letter to the editor' by Wienholtz et al. entitled 'The many faces of rosacea: liberal diagnostic criteria have ramifications on disease prevalence and accuracy'. J Eur Acad Dermatol Venereol. 2019 Jun 14;: Authors: Tizek L, Schielein MC, Seifert F, Biedermann T, Böhner A, Zink A Abstract We thank Wienholtz et al.1 for their comments on our article entitled 'Skin disease are more common than we think: screening results of an unreferred population at the Munich Oktoberfest'. Rosacea is a common inflammatory skin disease with a widely ranging prevalence in different countries (less than 1% to 22%), but even within Germany (2.3% to 12.3%).There might be several reasons for these different findings: examined study population, primary or secondary data source, or as mentioned by Wienholtz et al., a lacking research-based classification system. This article is protected by copyright. All rights reserved. PMID: 31199525 [PubMed - as supplied by publisher] {url} = URL to article
  4. The many faces of rosacea: liberal diagnostic criteria have ramifications on disease prevalence and accuracy. J Eur Acad Dermatol Venereol. 2019 Jun 14;: Authors: Wienholtz N, Egeberg A, Thyssen JP Abstract We read with great interest the article by Tizek et al., which suggests that certain skin diseases are more common in Germany than previously thought. We were particularly interested in the finding that 25.5% of study participants fulfilled the criteria for rosacea based on dermatologist examination. The authors rightfully suggest that the high rosacea prevalence may be explained by the effect of intense (acute or chronic) ultraviolet exposure and high age of study participants. This article is protected by copyright. All rights reserved. PMID: 31199527 [PubMed - as supplied by publisher] {url} = URL to article
  5. Related Articles Vascular endothelial growth factor gene polymorphisms in patients with rosacea: A case-control study. J Am Acad Dermatol. 2019 Jun 07;: Authors: Hayran Y, Lay I, Mocan MC, Bozduman T, Ersoy-Evans S Abstract BACKGROUND: Rosacea is a chronic disease that is characterized by facial skin inflammation and vascular abnormality. Vascular endothelial growth factor (VEGF) is a potent mediator of vascular permeability and inflammation that might play a role in the pathogenesis of rosacea. OBJECTIVE: This study aimed to determine the association between VEGF gene polymorphisms and rosacea. METHODS: A case-control study design was used to compare 100 patients with rosacea and 100 age- and gender-matched control subjects in terms of VEGF polymorphisms based on polymerase chain reaction and the serum level of VEGF and VEGF receptors based on enzyme-linked immunosorbent assay. RESULTS: Heterozygous and homozygous +405C/G polymorphism of the VEGF gene was observed to increase the risk of rosacea 1.7-fold (95% confidence interval 1.2-4.2) and 2.3-fold (95% confidence interval 1.2-4.2), respectively. There was a significant positive correlation between the severity of rosacea and +405C/G polymorphism of the VEGF gene in patients with erythematotelangiectatic rosacea. LIMITATIONS: Serum VEGF and VEGF receptor levels were measured in the limited number of patients. CONCLUSION: The present findings indicate that +405C/G polymorphism of the VEGF gene increases the risk of rosacea. PMID: 31182382 [PubMed - as supplied by publisher] {url} = URL to article
  6. Related Articles Rosacea Fulminans: two case reports and review of the literature. J Dermatolog Treat. 2019 Jun 06;:1-11 Authors: Angileri L, Veraldi S, Barbareschi M Abstract Rosacea Fulminans is a rare and severe inflammatory dermatosis which affects predominantly childbearing women. It is characterized by sudden onset and it usually localizes exclusively on the centrofacial areas, presenting with numerous fluctuant inflammatory nodules and papules which may coalesce. Treatment with isotretinoin in combination with topical and systemic corticosteroids is successful. Clearance of lesions may be obtained under systemic treatment with no or minimal scarring outcomes. Due to rare incidence its pathophysiological mechanisms, diagnosis and management remain controversial. We report two cases of Rosacea Fulminans arised in otherwise healthy people and completely healed after treatment. Our aim is to share our experience about this disease in order to increase knowledge about its diagnosis, management and its treatment. We also make a review of the literature of this peculiar dermatosis. PMID: 31169436 [PubMed - as supplied by publisher] {url} = URL to article
  7. Related Articles A randomized phase 3b/4 study to evaluate concomitant use of topical ivermectin 1% cream and doxycycline 40 mg modified-release capsules versus topical ivermectin 1% cream and placebo in the treatment of severe rosacea. J Am Acad Dermatol. 2019 May 28;: Authors: Schaller M, Kemeny L, Havlickova B, Jackson JM, Ambroziak M, Lynde C, Gooderham M, Remenyik E, Del Rosso J, Weglowska J, Chavda R, Kerrouche N, Dirschka T, Johnson S Abstract BACKGROUND: Randomized controlled studies of combination therapies in rosacea are limited. OBJECTIVE: Evaluate efficacy and safety of combining ivermectin 1% cream (IVM) and doxycycline 40 mg modified-release capsules∗ (DMR) versus IVM and placebo (PBO) for treatment of severe rosacea. METHODS: This 12-week, multicenter, randomized, investigator-blinded, parallel-group comparative study randomized adult subjects with severe rosacea (Investigator's Global Assessment [IGA]=4) to either IVM and DMR (combination arm) or IVM and PBO (monotherapy). RESULTS: A total of 273 subjects participated. IVM and DMR displayed superior efficacy in reduction of inflammatory lesions (-80.3% vs. -73.6% for monotherapy, p=0.032) and IGA score (p=0.032). Combination therapy had a faster onset of action as of week 4; it significantly increased the number of subjects achieving IGA 0 (11.9% vs. 5.1%, p=0.043)† and 100% lesion reduction (17.8% vs. 7.2%, p=0.006) at week 12. Both treatments reduced the Clinician's Erythema Assessment score, stinging/burning, flushing episodes, Dermatology Life Quality Index and ocular signs/symptoms, and were well-tolerated. LIMITATIONS: The duration of study prevented evaluation of potential recurrences or further improvements. CONCLUSION: Combining IVM and DMR can produce faster responses, improve response rates, and increase patient satisfaction in severe rosacea. PMID: 31150711 [PubMed - as supplied by publisher] {url} = URL to article
  8. Data augmentation in dermatology image recognition using machine learning. Skin Res Technol. 2019 May 29;: Authors: Aggarwal SLP Abstract BACKGROUND: Each year in the United States, over 80 million people are affected by acne, atopic dermatitis, rosacea, psoriasis, and impetigo. Artificial intelligence and machine learning could prove to be a good tool for assisting in the diagnosis of dermatological conditions. The objective of this study was to evaluate the use of data augmentation in machine learning image recognition of five dermatological disease manifestations-acne, atopic dermatitis, impetigo, psoriasis, and rosacea. MATERIALS AND METHODS: Open-source dermatological images were gathered and used to retrain TensorFlow Inception version-3. Retraining was done twice-once with and once without data augmentation. Both models were tested with the same images, and R software was used to perform statistical analysis. RESULTS: The average of each of the statistical measures (sensitivity, specificity, PPV, NPN, MCC, and F1 Score) increased when data augmentation was added to the model. In particular, the average Matthews correlation coefficient increased by 7.7%. Each of the five dermatological manifestations had an increase in area under the curve (AUC) after data augmentation with the average increase in AUC of 0.132 and a standard deviation of 0.033. Atopic dermatitis had the highest increase in AUC of 0.18. With data augmentation, the lowest AUC was 0.87 for psoriasis and the highest was 0.97 for acne, indicating that the model performs well. CONCLUSION: With a deep learning-based approach, it is possible to differentiate dermatological images with appreciable MCC, F1 score, and AUC. Further, data augmentation can be used to increase the model's accuracy by a significant amount. PMID: 31140653 [PubMed - as supplied by publisher] {url} = URL to article
  9. Related Articles Facial Neutrophilic Dermatosis Mimicking Iododerma and Associated With Inflammatory Bowel Disease. JAMA Dermatol. 2018 05 01;154(5):619-621 Authors: Matthews NH, Wong V, Robinson-Bostom L, Lajevardi N PMID: 29516091 [PubMed - indexed for MEDLINE] {url} = URL to article
  10. Related Articles Skin-homing T-cell responses associated with Demodex infestation and Rosacea. Parasite Immunol. 2019 May 24;:e12658 Authors: Gazi U, Gureser AS, Oztekin A, Karasartova D, Kosar-Acar N, Derici MK, Artuz F, Mumcuoglu KY, Taylan-Ozkan A Abstract AIMS: Our aim was to investigate the skin-homing T-cell immune responses triggered in patients with Demodex infestation and/or rosacea. METHODS: Collected whole blood samples were divided into four groups: control subjects; non-rosacea patients with Demodex infestation (Demodex group); papulopustular rosacea (PPR) patients without Demodex infestation (Rosacea group); and PPR patients with Demodex infestation (Rosacea/Demodex group). Following ex vivo activation, skin-homing CLA+CD4+ T-cell subset levels were monitored by flow cytometry. RESULTS: When compared with control subjects, among skin homing CD4+ T-cell subsets analyzed, Demodex patients had higher TH 9 and Treg cell levels; Rosacea subjects displayed elevated TH 1 cell levels; and Rosacea/Demodex patients exhibited increased frequencies of TH 9, and TH 22 cells.In contrast to Rosacea subjects, Rosacea/Demodex group members displayed higher TH 2 cell levels; and when compared with Demodex groups they had higher TH 1 and TH 2 but lower Treg cell levels. Demodex group members also exhibited higher Treg but lower TH 1 and TH 22 levels than Rosacea/Demodex group subjects. CONCLUSIONS: The skin-homing T-cell responses associated with Demodex infestation and rosacea formation seems to influence each other. The present as well as future studies could contribute to development of effective treatment strategies for demodicosis and rosacea. This article is protected by copyright. All rights reserved. PMID: 31125450 [PubMed - as supplied by publisher] {url} = URL to article
  11. Related Articles Thalidomide ameliorates rosacea-like skin inflammation and suppresses NF-κB activation in keratinocytes. Biomed Pharmacother. 2019 May 24;116:109011 Authors: Chen M, Xie H, Chen Z, Xu S, Wang B, Peng Q, Sha K, Xiao W, Liu T, Zhang Y, Li J, Deng Z Abstract BACKGROUND: Rosacea is a chronic inflammatory skin disorder of uncertain etiology. Evidence suggests the underlying pathogenesis is modulated by abnormal inflammatory and vascular responses. Thalidomide is a synthetic derivative acid with anti-inflammatory and anti-angiogenic properties. However, its effects on rosacea remain unknown. OBJECTIVES: To investigate the effects of thalidomide on the lesional alterations and molecular mechanisms in rosacea. METHODS: Mice were intradermally injected with LL37 to induce rosacea-like features and intraperitoneally administered with thalidomide. The severity of skin inflammation was evaluated. The mRNA levels of cytokines and chemokines associated with rosacea were assessed by qPCR. The number of CD4 positive infiltrated T helper cells and CD31 positive microvessels, and related-genes were measured by immunofluorescence, qPCR and ELISA. Moreover, the effect of thalidomide on inhibiting NF-κB activation was determined by immunofluorescence and western blot. RESULTS: Our results showed that thalidomide significantly alleviated erythema and reduced inflammatory cell infiltration in dermis of LL37-induced rosacea-like mice. The production of cytokines and chemokines induced by LL37 was decreased by thalidomide in mice skin and HaCaT keratinocytes. Particularly, we showed thalidomide reduced CD4+ T helper cell infiltration and downregulated Th1- and Th17-polarizing genes. In addition, thalidomide treatment lowered the microvessel density and vascular endothelial growth factor (VEGF) expression. We further demonstrated that thalidomide suppressed NF-κB activation in LL37-treated skin and in TNF-α-stimulated HaCaT keratinocytes in vitro. CONCLUSIONS: Our findings suggest thalidomide attenuates the inflammation and represses NF-κB activation in skin, which leads to assumptions that thalidomide may be a new therapeutic agent for rosacea. PMID: 31132668 [PubMed - as supplied by publisher] {url} = URL to article
  12. Non-invasive objective skin measurement methods for rosacea assessment: a systematic review. Br J Dermatol. 2019 May 23;: Authors: Logger JGM, de Vries FMC, van Erp PEJ, de Jong EMGJ, Peppelman M, Driessen RJB Abstract BACKGROUND: Rosacea assessment and therapy monitoring can be challenging to standardize, as most clinical evaluation systems are prone to interobserver variability and not always validated. Objective, reliable and preferably non-invasive measurement tools are therefore needed. OBJECTIVES: To give insight into available non-invasive imaging techniques and biophysical methods in rosacea by performing a systematic review. METHODS: PubMed, EMBASE, Cochrane and Web of Science databases were searched until 1 September 2018 in accordance with PRISMA guidelines, identifying studies providing original data about objective non-invasive imaging and/or biophysical skin measurement techniques for diagnosis, assessing severity or therapy monitoring of adult patients with cutaneous facial rosacea. Risk of bias of included articles was assessed with the Cochrane Risk of Bias tool, Newcastle Ottawa Scale and Quality in Prognosis Studies tool. RESULTS: A total of 78 studies was included, describing 14 imaging and biophysical methods. Widespread information about (sub)surface cutaneous morphology and functionality was obtained. Methodological study quality was relatively low and interstudy outcome variability was large. Several tools show promising value in research settings; for treatment follow-up, Demodex mites are countable with reflectance confocal microscopy, spectrometry can quantify erythema, and rosacea severity could be objectified with skin hydration and transepidermal water loss measurements. CONCLUSIONS: This systematic review describes the spectrum of non-invasive imaging and biophysical methods in rosacea assessment, giving multifaceted information about structure and properties of rosacea skin, especially useful for research purposes. Larger studies with good methodological quality are needed to create validated protocols for further implementation into research. This article is protected by copyright. All rights reserved. PMID: 31120136 [PubMed - as supplied by publisher] {url} = URL to article
  13. Potential association between rosacea and cancer: A study in a medical center in southern China. J Dermatol. 2019 May 23;: Authors: Long J, Li J, Yuan X, Tang Y, Deng Z, Xu S, Zhang Y, Xie H Abstract Growing evidence suggests that rosacea increases the risk of systemic diseases, but studies of the relationships between rosacea and cancer are rare. Aimed to assess the relationship between rosacea and cancer, a total of 7548 patients with confirmed internal malignancies and 8340 cancer-free individuals aged 18 years or more were included in this study from November 2015 to October 2017. Clinical characteristics, personal history and laboratory data were recorded when patients were diagnosed with rosacea. Logistic regression analyses were performed to analyze associations between cancer and rosacea. We found rosacea significantly affected more women than men in both cancer and cancer-free group. The data showed there was no relationship between rosacea and lung, gastrointestinal, nasopharyngeal and gynecological cancer. However, rosacea was significantly associated with the increased risk of breast cancer and glioma, but negatively associated with the risk of hematological cancer. Of the 190 female breast cancer patients with rosacea, 98.95% had the erythematotelangiectatic subtype of rosacea, 48.42% had chloasma and 76.31% of them were Fitzpatrick skin type III and IV. In our binary regression model, breast cancer patients with rosacea had a higher prevalence of estrogen receptor-positive status, lower high-density lipoprotein levels and higher low-density lipoprotein than patients with breast cancer but no rosacea. Our findings indicate that rosacea is significantly associated with higher incidence of breast cancer, glioma and lower prevalence of hematological cancer. PMID: 31120152 [PubMed - as supplied by publisher] {url} = URL to article
  14. Characterizing high-burden rosacea subjects: A multivariate risk factor analysis from a global survey. J Dermatolog Treat. 2019 May 23;:1-27 Authors: Tan J, Steinhoff M, Bewley A, Gieler U, Rives V Abstract Objective: To characterize rosacea features suitable for identification of high-burden (HB) subjects in clinical practice. Design: Global online survey with subjects recruited using an online panel from the United States, Canada, Italy, United Kingdom, Germany and France. Subjects self-reported a physician's diagnosis of rosacea. Measurements: HB subjects were defined as those with ≥3/4 domains (quality of life, lifestyle adaptation, time trade-off, willingness to pay) greater than the median. Group characteristics were analyzed and multivariate-logistic modeling used to investigate factors most associated with HB. Results: 710 subjects completed the survey, including 158 HB subjects. HB was observed in all self-declared rosacea severities. HB subjects were more likely to spend more time daily on skin care and experienced approximately double the impact of health problems on work productivity in the past 7 days (p < 0.01). In the past 12 months, HB subjects were more likely to have at least one visit to the emergency room (41.8% vs 11.2%; p < 0.01). In the multivariate risk analysis, factors most associated with HB included rosacea severity, impact of health problems on regular daily activities and age at first symptoms. Conclusion: Rosacea has a distinct subset of HB subjects who can be successfully characterized. PMID: 31120382 [PubMed - as supplied by publisher] {url} = URL to article
  15. Related Articles Clinical pearls in dermatology 2018. Dis Mon. 2018 Aug;64(8):350-360 Authors: Davis MD, Litin SC, Bundrick JB PMID: 29880264 [PubMed - indexed for MEDLINE] {url} = URL to article
  16. Contact sensitization to cosmetic series of allergens in patients with rosacea: A prospective controlled study. J Cosmet Dermatol. 2019 May 20;: Authors: Ozbagcivan O, Akarsu S, Dolas N, Fetil E Abstract BACKGROUND: Previous studies have documented the cosmetic allergic contact dermatitis due to common cosmetic allergens in standard series and various cosmetic products used in rosacea patients; however, the prevalence of contact sensitization to other cosmetic allergens other than those in standard series is largely unknown. AIMS: To assess the prevalence of contact sensitization to a European cosmetic series of allergens (Chemotechnique Diagnostics AB, Malmö, Sweden) in rosacea patients and to compare this with the prevalence observed in general population. METHODS: In this prospective monocenter study, 103 patients with rosacea and 104 control subjects were investigated for contact sensitizations via patch testing the cosmetic series including 49 allergens. RESULTS: At least one positive allergic reaction was observed in 62 (60.2%) rosacea patients, and in 25 (24.0%) control subjects. Compared with control subjects, rosacea patients were statistically more likely to have positive patch tests. The most common allergens giving positive results were octyl gallate (10.68%), dodecyl gallate (8.74%), tert-Butylhydroquinone (7.77%), thimerosal (6.80%), euxyl K400 (6.80%), cocamidopropyl betaine (5.83%), and 2,6-Di-tert-butyl-4-cresol (4.85%). CONCLUSIONS: This study shows that rosacea patients show a strikingly high prevalence of contact sensitization to cosmetic allergens. We recommend the additional use of cosmetic series for patch testing, and the careful use of cosmetics in rosacea patients if cosmetic contact sensitivity is suspected. PMID: 31106952 [PubMed - as supplied by publisher] {url} = URL to article
  17. Koebnerisin (S100A15): A novel player in the pathogenesis of rosacea. J Am Acad Dermatol. 2019 Jun;80(6):1753-1755 Authors: Batycka-Baran A, Hattinger E, Marchenkov A, Koziol M, Bieniek A, Szepietowski J, Ruzicka T, Wolf R PMID: 31103159 [PubMed - in process] {url} = URL to article
  18. Related Articles Combined treatment of recalcitrant papulopustular rosacea involving pulsed dye laser and fractional microneedling radiofrequency with low-dose isotretinoin. J Cosmet Dermatol. 2019 May 18;: Authors: Kwon HH, Jung JY, Lee WY, Bae Y, Park GH Abstract BACKGROUND: While a considerable number of cases with papulopustular rosacea (PPR) are resistant to conventional medications, therapeutic regimens are not currently established. Pulsed dye laser (PDL) and fractional microneedling radiofrequency (FMR) have previously demonstrated satisfactory results for anti-angiogenesis, anti-inflammation, and dermal remodeling. AIMS: To evaluate the efficacy and safety of novel combination regimen with low-dose oral isotretinoin, PDL, and FMR in the treatment of recalcitrant PPR. PATIENTS AND METHODS: A retrospective study was undertaken for recalcitrant PPR patients to evaluate the clinical course of novel combination regimen. Twenty-five PPR patients who had failed in previous first-line therapies were enrolled. They were treated with three sessions of PDL and FMR consecutively at 4-week intervals, maintaining daily oral administration of 10 mg isotretinoin for 8 weeks. Objective assessments, erythema index measurement, and patients' subjective satisfaction were evaluated at each visit and 16 weeks after the final treatment. RESULTS: At the final follow-up visit, the number of papules and pustules decreased by 71%, and erythema index by 54% compared with baseline (P < 0.05 for both). Physician's global assessment based on rosacea severity score and patients' subjective assessments paralleled with these results. No serious side effect was observed during whole study periods. CONCLUSION: This novel combination regimen demonstrated satisfactory efficacy with reasonable safety profiles for the treatment of recalcitrant PPR. PMID: 31102325 [PubMed - as supplied by publisher] {url} = URL to article
  19. Related Articles Intense pulsed light therapy: A promising complementary treatment for dry eye disease. Arch Soc Esp Oftalmol. 2019 May 09;: Authors: Mejía LF, Gil JC, Jaramillo M Abstract OBJECTIVE: To propose the Intense Pulsed Light (IPL) therapy as a helpful supplementary treatment in patients with dry eye disease. MATERIAL AND METHODS: Retrospective cross sectional design. Medical records of patients in whom dry eye disease symptoms were not satisfactorily controlled with medical therapy alone and who underwent additional IPL with at least three sessions completed. Data were analyzed before therapy and 3weeks after its completion to asses improvement. Determination of symptoms, through a visual analog scale; tear film stability, through tear Break Up Time (tBUT); measurement of tear secretion, through Schirmer Test; and ocular surface staining with Van Bijsterveld score were evaluated. SPSS software and nonparametric analysis of repeated measures were used. The study was approved by the ethics committee. RESULTS: 50 eyes from 25 subjects were reviewed. There were 9 males (36%) and 16 females (64%), with a median age of 59years (IQR 52-64). The median of the symptoms scale was 8 (IQR 8-9) and 3 (IQR 2-4) before and after the therapy respectively (P<.05). The median of BUT was 4 (IQR 3-5) and 10 (IQR 8-11), Schirmer test was 13 (IQR 12-15) and 15 (IQR 13-20), and Van Bijsterveld score was 3 (RIC 3-4) and 2 (IQR 2-3) before and after the therapy respectively (P<.05, for all measurements). CONCLUSION: IPL treatment has excellent results regarding both: dry eye disease symptoms improvement and in office objective tests such as tBUT, Schirmer test and Van Bijsterveld score; IPL could be considered as an effective adjunct for dry eye disease. PMID: 31079987 [PubMed - as supplied by publisher] {url} = URL to article
  20. Related Articles Antimicrobial Peptide LL-37 Facilitates Intracellular Uptake of RNA Aptamer Apt 21-2 Without Inducing an Inflammatory or Interferon Response. Front Immunol. 2019;10:857 Authors: Macleod T, Ward J, Alase AA, Bridgewood C, Wittmann M, Stonehouse NJ Abstract RNA aptamers are synthetic single stranded RNA oligonucleotides that function analogously to antibodies. Recently, they have shown promise for use in treating inflammatory skin disease as, unlike antibody-based biologics, they are able to enter the skin following topical administration. However, it is important to understand the inflammatory milieu into which aptamers are delivered, as numerous immune-modulating mediators will be present at abnormal levels. LL-37 is an important immune-modifying protein upregulated in several inflammatory skin conditions, including psoriasis, rosacea and eczema. This inflammatory antimicrobial peptide is known to complex nucleic acids and induce both inflammatory and interferon responses from keratinocytes. Given the attractive notion of using RNA aptamers in topical medication and the prevalence of LL-37 in these inflammatory skin conditions, we examined the effect of LL-37 on the efficacy and safety of the anti-IL-17A RNA aptamer, Apt 21-2. LL-37 was demonstrated to complex with the RNA aptamer by electrophoretic mobility shift and filter binding assays. In contrast to free Apt 21-2, LL-37-complexed Apt 21-2 was observed to efficiently enter both keratinocytes and fibroblasts by confocal microscopy. Despite internalization of LL-37-complexed aptamers, measurement of inflammatory mediators and interferon stimulated genes showed LL-37-complexed Apt 21-2 remained immunologically inert in keratinocytes, fibroblasts, and peripheral blood mononuclear cells including infiltrating dendritic cells and monocytes. The findings of this study suggest RNA aptamers delivered into an inflammatory milieu rich in LL-37 may become complexed and subsequently internalized by surrounding cells in the skin. Whilst the results of this study indicate delivery of RNA aptamers into tissue rich in LL-37 should not cause an unwarranted inflammatory of interferon response, these results have significant implications for the efficacy of aptamers with regards to extracellular vs. intracellular targets that should be taken into consideration when developing treatment strategies utilizing RNA aptamers in inflamed tissue. PMID: 31068939 [PubMed - in process] {url} = URL to article
  21. A comparison of the efficacy and tolerability of topical agents used in facial Demodex treatment. J Cosmet Dermatol. 2019 May 08;: Authors: Sarac G Abstract BACKGROUND: Demodex spp. is the most common ectoparasite in humans. This parasite is believed to play a role in the etiology of many dermatological and ocular disorders. AIM: The aim of this study was to compare the efficacy and tolerability of the sulfur-sodium sulfacetamide combination, crotamiton, and permethrin, which are three topical agents commonly used in Demodex treatment. METHODS: A total of 28 patients with primary demodicosis and 44 patients with Rosacea + Demodex were included in the study. The pretreatment and post-treatment Demodex spp. counts, patient satisfaction, and erythema decrease rates were compared. RESULTS: Analysis of the efficacy of these topical agents on Demodex revealed that all three significantly decreased the number of parasites. The patient satisfaction was higher in the sodium acetamide group than the 10% crotamiton and 5% permethrin groups, and clinical evaluation (erythema/ papulopustules and white plugs) was better in the sodium acetamide group than the other groups but no statistically significant difference was found in terms of patient satisfaction and clinical evaluation. CONCLUSION: The sulfur-sodium combination, crotamiton, and permethrin are the three agents commonly used in the treatment of Demodex spp. and all significantly decreased the Demodex count. The three agents were similar in terms of tolerability. Our study needs to be supported with others on larger patient series. PMID: 31066486 [PubMed - as supplied by publisher] {url} = URL to article
  22. Related Articles [Neonatal lupus in an infant of a mother followed up for dermatomyositis: medical images]. Pan Afr Med J. 2018;31:117 Authors: Cisse L, Karabinta Y Abstract Neonatal lupus is rare. It is due to the transmission of maternal autoantibodies across the placenta during pregnancy. We here report the case of a 2-month old female infant treated for erythematous macular cutaneous lesions on the face and the trunk. Her mother was followed up for dermatomyositis diagnosed on the basis of clinical lesions, muscle weakness and elevation in muscle enzyme levels. However she had not underwent antinuclear antibody test (ANA). Clinical examination showed atrophic erythematous lesions distributed like butterfly wings on both sides of the nasal pyramid, satellite lesions on the front, with red hair. The remainder of the physical examination was unremarkable. Laboratory tests were not performed because infant's parents also refused the biopsy. These lesions suggested seborrheic dermatitis, rosacea or atopic dermatitis. However, rosacea is very rare in infants and usually affects fair-skinned people. In seborrheic dermatitis, lesions are not atrophic. The age of onset of atopic dermatitis is usually 3 months. Lesions regressed in 15 days under dermocorticoid therapy. PMID: 31037177 [PubMed - in process] {url} = URL to article
  23. Related Articles Quality of life measurement in hidradenitis suppurativa: position statement of the European Academy of Dermatology and Venereology task forces on Quality of Life and Patient-Oriented Outcomes and Acne, Rosacea and Hidradenitis Suppurativa. J Eur Acad Dermatol Venereol. 2019 Apr 29;: Authors: Chernyshov PV, Zouboulis CC, Tomas-Aragones L, Jemec GB, Svensson A, Manolache L, Tzellos T, Sampogna F, Pustisek N, van der Zee HH, Marron SE, Spillekom-van Koulil S, Bewley A, Linder D, Abeni D, Szepietowski JC, Augustin M, Finlay AY Abstract This paper is organized jointly by the European Academy of Dermatology and Venereology (EADV) Task Force (TF) on Quality of Life (QoL) and Patient-Oriented Outcomes and the EADV TF on acne, rosacea and hidradenitis suppurativa (ARHS). The purpose of this paper was to present current knowledge about QoL assessment in HS, including data on HS-specific health-related (HR) QoL instruments and HRQoL changes in clinical trials, and to make practical recommendations concerning the assessment of QoL in people with HS. HS results in significant quimp that is higher than in most other chronic skin diseases. HS impact in published studies was assessed predominantly (84% of studies) by the Dermatology Life Quality Index (DLQI). There is a lack of high-quality clinical trials in HS patients where HRQoL instruments have been used as outcome measures. One double-blind randomized placebo-controlled trial on infliximab with low number of participants reported significantly better HRQoL improvement in the treatment group than in the placebo group. Well-designed clinical studies in HS patients to compare different treatment methods, including surgical methods and assessing long-term effects, are needed. Because of lack of sufficient validation, the Task Forces are not at present able to recommend existing HS-specific HRQoL instruments for use in clinical studies. The EADV TFs recommend the dermatology-specific DLQI questionnaire for use in HS patients. The EADV TFs encourage the further development, validation and use of other HS-specific, dermatology-specific and generic instruments but such use should be based on the principles presented in the previous publications of the EADV TF on QoL and Patient-Oriented Outcomes. PMID: 31037773 [PubMed - as supplied by publisher] {url} = URL to article
  24. Successful treatment of facial vascular skin diseases with a 577-nm pro-yellow laser. J Cosmet Dermatol. 2019 Apr 29;: Authors: Mohamed EM, Mohamed Tawfik K, Hassan Ahmad W Abstract BACKGROUND: Treatment of vascular skin diseases is one of the most important indications of the laser. AIMS: To evaluate the effectiveness of 577-nm pro-yellow laser in the treatment of some vascular skin diseases. PATIENTS/METHODS: Ninety-five patients with vascular skin diseases were included in this prospective monocentric study. They were classified into: port-wine stain birthmarks (n = 37), papulopustular rosacea (n = 20), facial telangiectasia (n = 16), and facial erythema (n = 22). All participants received a monthly session of 577-nm pro-yellow laser. Follow-up was done by comparing the photographs before and at every follow-up visit. RESULTS: At the final visit, there was a significant improvement (>50%) occurred in 24/37 (64.82%), 12/20 (60%), 10/16 (62.5%), and 19/22 (86.3%) cases and poor response occurred in 6/37 (16.2%), 2/20 (10%), 2/16 (12.5%), and 0/22 cases after a mean number of sessions 7.76 ± 2.28, 3.1 ± 1.8, 3.63 ± 1.12, and 1.8 ± 0.85 in port-wine stain, rosacea-, facial telangiectasia-, and facial erythema-treated groups, respectively. Transient irritation and erythema during the session were the only complications reported in the study. CONCLUSION: Facial port-wine stains, rosacea, telangiectasia, and erythema can be successfully treated with a single pass of 577-nm pro-yellow laser with a minimal side effect. Facial erythema showed the highest degree of success with the least number of sessions, while more sessions needed for the treatment of port-wine stain. PMID: 31033204 [PubMed - as supplied by publisher] {url} = URL to article
  25. Evaluation of the efficacy and tolerance of artemether emulsion for the treatment of papulopustular rosacea: A randomized pilot study. J Dermatolog Treat. 2019 Apr 24;:1-16 Authors: Wang GJ, Gao XY, Wu Y, He HQ, Yu Y, Qin HH, Shen WT Abstract OBJECTIVE: To assess the efficacy and safety of artemether emulsion in patients with papulopustular rosacea. METHODS: A total of 130 (randomized 1:1) were externally administered either artemether emulsion (1%) or metronidazole emulsion (3%) twice daily for 4 weeks with an open-label 8-week follow-up. The primary endpoints included the proportion of patients who achieved clinical effective responses, as well as erythema and papule and pustule score at week 4. RESULTS: Numerically more patients achieved an effective response at week 4 with artemether emulsion (87.1%) than metronidazole emulsion (80.0%) (P > 0.05). Patients with artemether emulsion had comparable baseline erythema score (2.45 ± 0.67 vs 2.42 ± 0.70, P = 0.809) and papule and pustule score (2.11 ± 0.96 vs 2.32 ± 0.83, P = 0.264), but significantly lower papule and pustule score (0.21 ± 0.52 vs 0.42 ± 0.83, P = 0.001) and comparable erythema score (0.53 ± 0.88 vs 0.62 ± 0.88, P = 0.999) compared to patients with metronidazole emulsion at week 4. There was a significantly higher proportion of patients with metronidazole emulsion relapse compared to metronidazole emulsion during the open-label 8-week follow-up period (21.6% vs 2.4%, P < 0.01). CONCLUSIONS: Artemether emulsion improved papulopustular rosacea in the metronidazole emulsion group as early as 4 weeks, but its beneficial effect was maintained through the 8-week follow-up period compared to metronidazole emulsion. PMID: 31017492 [PubMed - as supplied by publisher] {url} = URL to article
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