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Re. Inflammation in rosacea and acne: implications for patient care. J Drugs Dermatol. 2012 Jan;11(1):20 Authors: Gottschalk RW PMID: 22303551 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22303551&dopt=Abstract = URL to article

Blushing in rosacea sufferers. J Psychosom Res. 2012 Feb;72(2):153-8 Authors: Drummond PD, Su D Abstract OBJECTIVE: Rosacea is characterized by extremely sensitive skin and persistent facial flushing, perhaps initiated or exacerbated by frequent or intense blushing. To investigate this, blushing was assessed in rosacea sufferers and controls during embarrassing laboratory tasks. METHODS: Changes in forehead blood flow were monitored with laser Doppler fluxmetry in 31 rosacea sufferers (12 with severe symptoms and 19 with mild symptoms) and 86 controls while singing, giving an impromptu speech, and listening to recordings of these activities. RESULTS: Changes in forehead blood flow were similar in rosacea sufferers and controls, and were similar in subgroups with mild and severe rosacea. Even so, rosacea sufferers thought that that they blushed more intensely and were more embarrassed than controls during most of the tasks. Likewise, changes in forehead blood flow were similar in participants with mild and severe rosacea. Nevertheless, ratings of embarrassment and blushing were greater in those with severe than mild symptoms. Within the rosacea group, increases in blood flow while singing were greatest in participants with the highest blushing ratings, whereas increases in blood flow while listening to the speech were greatest in the most embarrassed participants. CONCLUSIONS: These findings do not support the hypothesis that blushing is abnormal in rosacea but, nevertheless, suggest that rosacea sufferers are more aware of and embarrassed by blushing than controls. This might contribute to social anxiety in rosacea sufferers. PMID: 22281458 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22281458&dopt=Abstract = URL to article

[Differential diagnosis of red faces]. Ann Dermatol Venereol. 2011 Sep;138 Suppl 2:S148-53 Authors: Doutre MS, Beylot-Barry M Abstract The term "red face" is reserved for lesions located exclusively or very predominantly on the face. Diagnosis is based on different data: date and mode of appearance, characteristics of the erythema, functional signs, and associated systemic manifestations. A case of red face can have an infectious origin, caused by vascular, congenital, or acquired lesions, or be caused by photodermatosis, or be the main location of inflammatory dermatosis or collagenosis, but depending on the clinical context, many other diagnoses can be suggested. A few observations are presented so as to discuss the management of red face in the atopic patient, the role played by ultraviolet rays in the cutaneous lesions of dermatomyositis, as well as the diagnostic criteria of polymorphous light eruption, and lupus erythematosus. PMID: 21907874 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=21907874&dopt=Abstract = URL to article

Pediatric ocular rosacea: 2 cases. Eur J Ophthalmol. 2012 Jan 3;:0 Authors: Miguel AI, Salgado MB, Lisboa MS, Henriques F, Paiva MC, Castela GP Abstract Purpose. To report the clinical course of 2 pediatric ocular rosacea cases with a significant delay until diagnosis. Methods. We report 2 interventional case reports. Case 1 is a 10-year-old boy with 2 years of recurrent bilateral blepharitis, repetition chalazion, conjunctival hyperemia, and corneal ulcers, without response to topical antibiotics or topical and systemic steroids. Case 2 is a 9-year-old girl with keratoconjunctivitis and repetition chalazion since she was 2 years old, without improvement after consulting several ophthalmologists and performing several treatments throughout those years. Results. Rapid response to systemic erythromycin with marked improvement of both cases within a few weeks. Conclusions. Ocular rosacea is frequently misdiagnosed, particularly in the pediatric population. To our knowledge, this report demonstrates a case with the longest history before diagnosis (7 years) and another case in which a conjunctival biopsy was performed. PMID: 22267454 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22267454&dopt=Abstract = URL to article

Antimicrobial implications of vitamin D. Dermatoendocrinol. 2011 Oct;3(4):220-9 Authors: Youssef DA, Miller CW, El-Abbassi AM, Cutchins DC, Cutchins C, Grant WB, Peiris AN Abstract Evidence exists that vitamin D has a potential antimicrobial activity and its deficiency has deleterious effects on general well-being and longevity. Vitamin D may reduce the risk of infection through multiple mechanisms. Vitamin D boosts innate immunity by modulating production of anti-microbial peptides (AMPs) and cytokine response. Vitamin D and its analogues via these mechanisms are playing an increasing role in the management of atopic dermatitis, psoriasis, vitiligo, acne and rosacea. Vitamin D may reduce susceptibility to infection in patients with atopic dermatitis and the ability to regulate local immune and inflammatory responses offers exciting potential for understanding and treating chronic inflammatory dermatitides. Moreover, B and T cell activation as well as boosting the activity of monocytes and macrophages also contribute to a potent systemic anti-microbial effect. The direct invasion by pathogenic organisms may be minimized at sites such as the respiratory tract by enhancing clearance of invading organisms. A vitamin D replete state appears to benefit most infections, with the possible noteworthy exception of Leishmaniasis. Antibiotics remain an expensive option and misuse of these agents results in significant antibiotic resistance and contributes to escalating health care costs. Vitamin D constitutes an inexpensive prophylactic option and possibly therapeutic product either by itself or as a synergistic agent to traditional antimicrobial agents. This review outlines the specific antimicrobial properties of vitamin D in combating a wide range of organisms. We discuss the possible mechanisms by which vitamin D may have a therapeutic role in managing a variety of infections. PMID: 22259647 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22259647&dopt=Abstract = URL to article

Nicotinamide in dermatology and photoprotection. Skinmed. 2011 Nov-Dec;9(6):360-5 Authors: Surjana D, Damian DL Abstract Nicotinamide (the amide form of vitamin B3) has been used in dermatology for more than 40 years for a diverse range of conditions including acne, rosacea, autoimmune bullous dermatoses, and now the treatment and prevention of photoaging and photoimmunosuppression. The broad clinical effects of nicotinamide may be explained by its role as a cellular energy precursor, a modulator of inflammatory cytokines, and an inhibitor of the nuclear enzyme poly(adenosine diphosphate-ribose) polymerase-1, which plays a significant role in DNA repair, maintenance ofgenomic stability, and cellular response to injury including inflammation and apoptosis. This review outlines the use of nicotinamide for inflammatory dermatoses and photoaging and focuses on its emerging role in photoprotection. PMID: 22256624 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22256624&dopt=Abstract = URL to article

[Dapsone efficacy in lupus miliaris disseminatus faciei: two cases]. Ann Dermatol Venereol. 2011 Aug-Sep;138(8-9):597-600 Authors: El Benaye J, Oumakhir S, Ghfir M, Sedrati O Abstract BACKGROUND: Lupus miliaris disseminatum faciei (LMDF) is a rare, chronic and benign facial dermatosis that is regarded as an enigmatic diagnostic and therapeutic entity with spontaneous regression in 2 to 4 years leaving pock-like scars. CASE REPORT: We present two cases of LMDF: the first concerns a 46-year-old woman who 6 months earlier presented a papular and pustular eruption on her face leaving small pitted scars. The inefficacy of treatment with cyclines, metronidazole and crotamiton as well as the clinical and histological examination results allowed a diagnosis of lupus miliaris disseminatus faciei to be made. The patient was placed on dapsone 100mg per day, which led to a remarkable improvement in the second week, but with depressed scars. The second case concerned an 18-year-old man who for 3 months had been presenting red-brown papules of the face that were resistant to cyclines and to topical retinoids and caused scarring. This clinical aspect, consolidated by the histological result, allowed the diagnosis of LMDF to be made. Administration of dapsone 100mg per day resulted in improvement from the first month, although there were residual cupuliform scars. DISCUSSION: Dapsone appears to be effective in the management of this disease, as illustrated in our two case reports. However, further studies are needed to confirm these results. PMID: 21893234 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=21893234&dopt=Abstract = URL to article

Letter: Tetracycline-induced hepatotoxicity. Dermatol Online J. 2011;17(12):14 Authors: Glenn C, Feldman SR Abstract BACKGROUND: Tetracycline is a commonly used drug for rosacea and subantimicrobial doses may resolve the disease in many cases. Although this class of antibiotics has been linked to adverse effects, tetracycline is considered a safe drug. It can be associated with hepatotoxicity, but its role in these rare cases is unclear. PURPOSE: To report the case of a patient with rare tetracycline-induced hepatotoxicity. CASE PRESENTATION: A 49-year-old female with a history of multiple prednisone and methotrexate trials for relapsing polychondritis took oral tetracycline for rosacea. She developed facial and extremity swelling, weakness, and fatigue that corresponded with liver function test (LFT) abnormalities including hypoalbuminemia, low total protein, and elevated alkaline phosphatase. Tetracycline was discontinued and rapid resolution of symptoms and LFT abnormalities occurred after cessation of the drug. CONCLUSIONS: The dose-dependency of rare tetracycline hepatotoxicity and the desire to reduce antibiotic resistance may prompt safe, yet effective, subantimicrobial doses for rosacea. PMID: 22233750 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22233750&dopt=Abstract = URL to article

[What's new in dermatological research?]. Ann Dermatol Venereol. 2011 Dec;138 Suppl 4:S233-40 Authors: Aubin F Abstract Dermatological research has been very active this year. Most of the numerous fields investigated involve the mechanisms of cutaneous regeneration and barrier function. A novel target of early ultraviolet-induced skin photodamage, the Syk kinase, has been recently identified. Synergistic relationship between telomere damage and cutaneous progerin production during cell senescence may also participate in the natural skin aging process. Interestingly, ultraviolet radiation induces an inhibitory effect on subcutaneous lipogenesis. Androgenetic alopecia or common baldness is not characterized by loss of hair follicle stem cells but by a defect in the conversion of hair follicle stem cells into active progenitor cells. It has been shown that the cornified envelope functions not only as a physicomechanical barrier, but also as both a biochemical line of antoxidant defense and an immunological line of defense. Like human papillomaviruses, Merckel cell polyomavirus belongs to the skin microbiome and different studies have demonstrated the protective role of epidermal resident microflora through the activation of innate immunity. Production of antimicrobial peptides and the activation of inflammasome and plasmacytoid dendritic cells are involved in the modulation of the cutaneous barrier function. Results from different studies suggest that IL-22 and IL-36 may be common mediators of both innate and adaptive immune responses. All these pathways interact not only to maintain cutaneous homeostasis and integrity (wound healing) but also to regulate autoinflammatory and autoimmune dermatoses (psoriasis, lupus, rosacea, atopic dermatitis, etc…). In addition, molecular mechanisms that regulate T helper type 2 differentiation and the retention at the site of inflammation of Th2 cells have been identified. New promising therapeutic targets for different chronic dermatosis are thus suggested. Mechanobiology and mechanotransduction are also emerging fields that investigate mechanical interactions between living cells and their environment and the conversion of mechanical cues into biochemical signals. Electronic second skin is now a current concept through bio-integrated epidermal electronics platforms used for different monitoring and stimulations of body functions. PMID: 22202644 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22202644&dopt=Abstract = URL to article

Laser and intense pulsed light management of couperose and rosacea. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S219-22 Authors: Dahan S Abstract Management of couperosis and rosacea has been totally renewed by laser and vascular laser techniques, with efficacy targeted on the telangiectases and to a lesser extent on the erythrosis. Laser management of hypertrophic rosacea or rhinophyma depends on surgical treatment with decortication, continuous CO(2) ablative laser or Erbium, fractionated at high power, then vascular laser treatment for the telangiectases: lasers with pulsed dye, KTP, or pulsed lights for red laser telangiectases and long pulse Nd-Yag laser for blue telangiectases. For papulopustular rosacea, vascular laser treatment (pulsed dye and KTP) and intense pulsed light will be begun once the inflammation has been treated. The major indication for vascular lasers and intense pulsed light is found in erythematotelangiectatic rosacea, with high efficacy for the telangiectases. Diffuse erythrosis is difficult to treat, requiring a high number of laser and/or intense pulsed light sessions. PMID: 22183103 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183103&dopt=Abstract = URL to article

Dermocosmetic management of the red face and rosacea. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S215-8 Authors: Guerrero D Abstract Erythematotelangiectatic rosacea is a frequent condition and affected patients benefit from medical treatments and dermatological procedures but also a complementary dermocosmetic assistance that aims at obtaining optimal skin comfort and preventing irritation of these particularly overreactive skins. Choice of dermocosmetics is crucial - especially in respect to their texture and the simplicity in ingredients - in order to optimize the application of the products and their tolerance. The addition of soothing and decongestant active ingredients is particularly important. Finally, photoprotection and a specific medical make-up are useful to attenuate the unattractive appearance of "red faces". PMID: 22183102 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183102&dopt=Abstract = URL to article

Treatment of rosacea. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S211-4 Authors: Parodi A, Drago F, Paolino S, Cozzani E, Gallo R Abstract A range of treatment options are available in rosacea, which include several topical (mainly metronidazole, azelaic acid, other antibiotics, sulfur, retinoids) and oral drugs (mainly tetracyclines, metronidazole, macrolides). In some cases, the first choice is a systemic therapy because patients may have sensitive skin and topical medications can be irritant. Isotretinoin can be used in resistant cases of rosacea. Unfortunately, the majority of studies on rosacea treatments are at high or unclear risk of bias. A recent Cochrane review found that only topical metronidazole, azelaic acid, and oral doxycycline (40mg) had some evidence to support their effectiveness in moderate to severe rosacea and concluded that further well-designed, adequately-powered randomised controlled trials are required. In our practice, we evaluate our patients for the presence of two possible triggers, Helicobacter pylori infection and small intestinal bacterial overgrowth. When they are present we use adapted antibiotic protocols. If not, we use oral metronidazole or oral tetracycline to treat papulopustolar rosacea. We also look for Demodex folliculorum infestation. When Demodex concentration is higher than 5/cm(2) we use topical crotamiton 10% or metronidazole. PMID: 22183101 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183101&dopt=Abstract = URL to article

Sensitive skin and rosacea: nosologic framework. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S207-10 Authors: Misery L Abstract Flushing due to rosacea may be mistaken for sensitive skin, which can manifest as abnormal sensations during fairly acute reactions to a variety of triggers, many of which are shared by rosacea and sensitive skin. Nevertheless, the two conditions are clearly different. Rosacea is a vascular disease, worsens gradually over time, manifests as flares triggered chiefly by systemic factors, is largely confined to the facial and/or ocular regions, and responds to specific treatments. Sensitive skin, in contrast, is an epidermal cosmetic problem that runs a variable course, with diffuse skin involvement and flares triggered mainly by contact factors. The flares respond to specific cosmetics and are usually worsened by treatments for rosacea. PMID: 22183100 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183100&dopt=Abstract = URL to article

Clinical presentations and classification of rosacea. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S192-200 Authors: Jansen T Abstract Rosacea is a chronic skin disease affecting up to 10% of the population in some European countries. Rosacea manifests as various combinations of characteristic signs and symptoms in a centrofacial distribution. At present, there is no consensus about the definition or classification of the clinical patterns of rosacea. Initially, four stages were differentiated (pre-rosacea then stages I through III), with several variants (e.g., persistent erythema and edema, rosacea conglobata, and rosacea fulminans). The National Rosacea Society (NRS) in the USA has classified rosacea into four subtypes (erythematotelangiectatic, papulopustular, phymatous, and ocular) and one variant (lupoid or granulomatous rosacea). This classification scheme does not mention progression from one type to another and makes no reference to pathophysiological considerations. It uses major and minor diagnostic criteria based on the physical findings and symptoms. The NRS has also developed criteria for grading disease severity. The classification of rosacea into stages or subtypes, without considering the possibility of progression from one to another, will probably remain controversial until additional knowledge on the pathophysiology of rosacea is obtained. PMID: 22183098 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183098&dopt=Abstract = URL to article

Pathophysiology of rosacea: redness, telangiectasia, and rosacea. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S184-91 Authors: Cribier B Abstract The pathophysiology of rosacea involves a large number of factors that are at times difficult to correlate. There is not a single physiopathological model. Nevertheless, today it seems to have been established that two essential factors are involved: vascular and inflammatory. The disease occurs in individuals with a predisposition, mainly a light phototype subjected to substantial variations in climate. On a background of primary vascular anomaly, external factors (climate, exposure to ultraviolet rays, cutaneous flora, etc.) contribute to the development of abnormal superficial blood vessels, with a low permeability. The edema that results undoubtedly favors the colonization and multiplication of Demodex folliculorum. This parasite creates inflammation, directly and indirectly, which is seen in the papules and pustules as well as granulomas. Inflammation from rosacea is also characterized by innate immune system anomalies, with an increase in the expression of epidermal proteases and production of pro-inflammatory cathelicidin peptides. In addition, facial hypersensitivity exists, even though the cutaneous barrier is not altered. Finally, rhinophyma remains poorly explained; the vascular abnormalities induce local production of transforming growth factor β1 (TGF-β1) capable of creating fibrosis and therefore cutaneous thickening. PMID: 22183097 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183097&dopt=Abstract = URL to article

Epidemiology of rosacea: updated data. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S179-83 Authors: Chosidow O, Cribier B Abstract The epidemiological data on rosacea remain fragmentary and the methodological quality debatable. Rosacea affects mainly adults around the age of 30 years and classically predominates in females. Recent Estonian and Irish studies suggest that the female predominance may not be as high as previously believed. However, prevalence does increase with age. The prevalence statistics published in Europe and the United States are highly variable, ranging from less than 1% to more than 20% of the adult population; actually, the methods used and the populations studied vary greatly from one study to another; consequently, they cannot be compared. A family history of the disease is a risk factor, as is the very light skin phototype (Celtic skin type). Alcohol and coffee, classically blamed, are not risk factors; however, tobacco may have a protective effect. New studies are undoubtedly necessary: they should use the diagnostic and severity criteria established in 2002 and 2004. Rosacea has a strong impact on quality of life and can be associated with depressive symptoms. A specific quality-of-life scale, the RosaQol, has been established and validated in the United States, by the same group that elaborated the Skindex scale. Translations of this scale into French, Italian, German, and Spanish have been validated, which may allow future intercultural comparisons. PMID: 22183096 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183096&dopt=Abstract = URL to article

The red face: art, history and medical representations. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S172-8 Authors: Cribier B Abstract For millennia, a red face has been a handicap in social relations, mainly because of the associated bias against alcoholics. The color red is also the color of emotion, betrayal of the person who blushes. Since the color red is one of the main characteristics of rosacea, it contributes to the bad reputation this disorder has, which is therefore the subject of a pressing therapeutic demand, principally in women. Nineteenth-century French novelists such as Balzac and later Proust, admirably described blotchy, red, or sanguine faces, which always announced a difficult, violent temperament, or was simply the mark of the laboring class. The color red remains ambivalent today, on the one hand denoting blood and life and on the other suffering, shame, and death. The history of dermatology shows that the semiology of rosacea was very well described in the earliest reports, notably those written in the Middle Ages. The term "acne rosacea" appeared in Bateman's writings, who made it a clinical form of acne. This confusion lasted throughout the nineteenth century. It was not until Hebra in Austria and Darier in France that the differential diagnosis was clearly made between acne and rosacea. A "couperosis" previously referred to the entire range of the disease, particularly the papules and pustules, and it was not until the twentieth century that the current meaning of rosacea progressively gained ground: this term today designates facial telangiectasia, whether or not it is associated with a characteristic redness. Rosacea is a conspicuous disease, since the lesions involve the central portion of the face.Among the many manifestations of rosacea, redness is the most characteristic [1]. PMID: 22183095 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183095&dopt=Abstract = URL to article

Facial redness and rosacea…. Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S171 Authors: Cribier B PMID: 22183094 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22183094&dopt=Abstract = URL to article

[Rhinophyma and skin carcinoma: A case report and literature review.] Ann Chir Plast Esthet. 2011 Dec 28; Authors: Qassemyar A, Corbisier N, Poiret G, Mortier L, Martinot-Duquennoy V, Guerreschi P Abstract Rhinophyma, final stage of rosacea is considered as benign pathology. We present the case of a patient with basal cell carcinoma diagnosed on rhinophyma. The removal of all cutaneous nasal unit and its analysis has diagnosed the presence of three basal cell carcinomas and two in situ squamous cell carcinomas. Reconstruction was performed by full-thickness skin graft. The literature reports a few cases of association between rhinophyma and skin cancers but none ever reported the simultaneous presence of basal cell carcinoma and squamous cell carcinomas. The low number of articles does not reveal statistically significant relationship between rhinophyma and skin cancer, which would consider the rhinophyma as a risk factor. Monitoring of these patients should be as rigorous as possible and surgical care requires histologic analysis not to omit the presence of cancerous lesions. PMID: 22209650 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22209650&dopt=Abstract = URL to article

Distribution and Expression of Non-Neuronal Transient Receptor Potential (TRPV) Ion Channels in Rosacea. J Invest Dermatol. 2011 Dec 22; Authors: Sulk M, Seeliger S, Aubert J, Schwab VD, Cevikbas F, Rivier M, Nowak P, Voegel JJ, Buddenkotte J, Steinhoff M Abstract Rosacea is a frequent chronic inflammatory skin disease of unknown etiology. Because early rosacea reveals all characteristics of neurogenic inflammation, a central role of sensory nerves in its pathophysiology has been discussed. Neuroinflammatory mediators and their receptors involved in rosacea are poorly defined. Good candidates may be transient receptor potential (TRP) ion channels of vanilloid type (TRPV), which can be activated by many trigger factors of rosacea. Interestingly, TRPV2, TRPV3, and TRPV4 are expressed by both neuronal and non-neuronal cells. Here, we analyzed the expression and distribution of TRPV receptors in the various subtypes of rosacea on non-neuronal cells using immunohistochemistry, morphometry, double immunoflourescence, and quantitative real-time PCR (qRT-PCR) as compared with healthy skin and lupus erythematosus. Our results show that dermal immunolabeling of TRPV2 and TRPV3 and gene expression of TRPV1 is significantly increased in erythematotelangiectatic rosacea (ETR). Papulopustular rosacea (PPR) displayed an enhanced immunoreactivity for TRPV2, TRPV4, and also of TRPV2 gene expression. In phymatous rosacea (PhR)-affected skin, dermal immunostaining of TRPV3 and TRPV4 and gene expression of TRPV1 and TRPV3 was enhanced, whereas epidermal TRPV2 staining was decreased. Thus, dysregulation of TRPV channels also expressed by non-neuronal cells may be critically involved in the initiation and/or development of rosacea. TRP ion channels may be targets for the treatment of rosacea.Journal of Investigative Dermatology advance online publication, 22 December 2011; doi:10.1038/jid.2011.424. PMID: 22189789 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22189789&dopt=Abstract = URL to article

Interventions for rosacea: a summarised Cochrane review. Clin Exp Dermatol. 2012 Jan;37(1):93-4 Authors: PMID: 22182442 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22182442&dopt=Abstract = URL to article

[The role of oxidative stress and iron in pathophysiology of rosacea]. Lijec Vjesn. 2011 Jul-Aug;133(7-8):288-91 Authors: Tisma VS, Poljak-Blazi M Abstract Rosacea is a common skin disease of unknown etiology. The aim of the present paper is to explain the role of oxidative stress triggered by UV light and iron metabolism in the pathophysiology of rosacea. It was recently described that the number of ferritin positive cells was significantly higher in skin samples of rosacea patients compared to controls of healthy skin samples. The presence of ferritin was significantly higher in patients with the severe stage of disease. In addition, serum peroxide levels were significantly higher and serum total antioxidative potential levels were significantly lower in rosacea patients than in healthy controls. These results support the role of oxidative stress and affected metabolism of iron in etiology of rosacea. The higher presence of ferritin in skin cells of rosacea patients explains the exacerbation of symptoms by exposure to UV light, that releases ferritin free iron, which is fundamental in the generation of oxidative stress. PMID: 22165198 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22165198&dopt=Abstract = URL to article

Acneiform presentation of primary cutaneous follicle center lymphoma. J Am Acad Dermatol. 2011 Oct;65(4):887-9 Authors: Soon CW, Pincus LB, Ai WZ, McCalmont TH PMID: 21920255 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=21920255&dopt=Abstract = URL to article

Overt immune dysfunction after Cushing's syndrome remission: a consecutive case series and review of the literature. J Clin Endocrinol Metab. 2011 Oct;96(10):E1670-4 Authors: da Mota F, Murray C, Ezzat S Abstract CONTEXT: Autoimmune diseases frequently improve during active Cushing's syndrome. Several studies have reported new onset or exacerbation of these conditions upon cortisol normalization. OBJECTIVE: Our objective was to investigate the incidence and clinical characteristics of patients with autoimmune or allergic diseases after Cushing's syndrome remission. METHODS: Consecutive cases of confirmed Cushing's syndrome were characterized. A review of the literature was conducted to identify previous descriptions of immune dysfunction upon remission and evidence of the hypothalamic-pituitary-adrenal axis influence on the immune system. RESULTS: Among 66 patients who achieved Cushing's syndrome remission, the incidence of immune dysfunction was 16.7%, where eight cases (72.7%) were noted for the first time and three (27.3%) were exacerbated. All had an ACTH-dependent cause. Glucocorticoids reduce proinflammatory cytokines and interact with other transcription factors affecting T cell and mast cell survival. CONCLUSION: Hypercortisolism induces a state of immunosuppression. After Cushing's syndrome remission, rebound immunity frequently results in overt conditions extending beyond thyroid dysfunction. PMID: 21816785 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=21816785&dopt=Abstract = URL to article

Facial dermatosis associated with Demodex: a case-control study. J Zhejiang Univ Sci B. 2011 Dec;12(12):1008-15 Authors: Zhao YE, Peng Y, Wang XL, Wu LP, Wang M, Yan HL, Xiao SX Abstract Demodex has been considered to be related with multiple skin disorders, but controversy persists. In this case-control study, a survey was conducted with 860 dermatosis patients aged 12 to 84 years in Xi'an, China to identify the association between facial dermatosis and Demodex. Amongst the patients, 539 suffered from facial dermatosis and 321 suffered from non-facial dermatosis. Demodex mites were sampled and examined using the skin pressurization method. Multivariate regression analysis was applied to analyze the association between facial dermatosis and Demodex infestation, and to identify the risk factors of Demodex infestation. The results showed that total detection rate of Demodex was 43.0%. Patients aged above 30 years had higher odds of Demodex infestation than those under 30 years. Compared to patients with neutral skin, patients with mixed, oily, or dry skin were more likely to be infested with Demodex (odds ratios (ORs) were 2.5, 2.4, and 1.6, respectively). Moreover, Demodex infestation was found to be statistically associated with rosacea (OR=8.1), steroid-induced dermatitis (OR=2.7), seborrheic dermatitis (OR=2.2), and primary irritation dermatitis (OR=2.1). In particular, ORs calculated from the severe infestation (≥5 mites/cm(2)) rate were significantly higher than those of the total rate. Therefore, we concluded that Demodex is associated with rosacea, steroid-induced dermatitis, seborrheic dermatitis, and primary irritation dermatitis. The rate of severe infestation is found to be more correlated with various dermatosis than the total infestation rate. The risk factors of Demodex infestation, age, and skin types were identified. Our study also suggested that good hygiene practice might reduce the chances of demodicosis and Demodex infestation. PMID: 22135150 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?tmpl=NoSidebarfile&db=PubMed&cmd=Retrieve&list_uids=22135150&dopt=Abstract = URL to article