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Related Articles Photodynamic therapy for the treatment of erythema, papules, pustules, and severe flushing consistent with rosacea. J Drugs Dermatol. 2006 Feb;5(2 Suppl):6-8 Authors: Katz B, Patel V We report a case of a 45-year-old woman who presented with facial erythema, papules, pustules, and severe flushing consistent with rosacea. The patient had failed standard pharmacologic treatments. The patient's flushing was so severe that she had undergone an elective sympathectomy. She received 6 sessions of photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA as Levulan Kerastick, Dusa Pharmaceuticals) given at 2-week intervals. Improvement was evident after the second treatment and was considered "excellent" after the sixth treatment. Improvement continued and no flares were observed 1 month after the final treatment. PMID: 16485874 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Laser and light therapies for acne rosacea. J Drugs Dermatol. 2006 Jan;5(1):35-9 Authors: Butterwick KJ, Butterwick LS, Han A Acne rosacea is a multifactorial, somewhat mercurial disorder that can be a challenge to control with standard pharmacologic agents. Laser and light sources have been increasingly utilized, particularly for control of the generalized erythema, flushing, and telangiectasia of rosacea. This paper will review the clinical studies presented in the literature specifically treating patients with rosacea. Long-pulsed dye lasers and intense pulsed light devices can offer patients effective treatment without the purpura of short-pulsed dye lasers. Long-term efficacy has not been studied but maintenance therapy may be necessary to control the vascular manifestations of this disease. PMID: 16468290 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Treatment of rosacea with herbal ingredients. J Drugs Dermatol. 2006 Jan;5(1):29-32 Authors: Wu J Since rosacea is a chronic disease and many patients find prescription therapies unsatisfactory, they frequently turn to herbal ingredients for relief of their persistent facial redness. The most useful and frequently used herbal compounds include licorice, feverfew, green tea, oatmeal, lavender, chamomile, tea tree oil, and camphor oil. The utility of most of these herbs is based on their purported anti-inflammatory properties. Some of these herbs have proven effects, many have potential benefits, and some may aggravate rosacea. Due to the fact that many patients fail to inform their physicians about their use of herbal ingredients, dermatologists should be aware of what patients may be using and be able to advise them about the efficacy of these ingredients or the potential for adverse effects. PMID: 16468289 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Topical therapies for rosacea. J Drugs Dermatol. 2006 Jan;5(1):23-6 Authors: Nally JB, Berson DS Therapeutic options for rosacea include topical agents, oral therapies, laser and light treatments, and surgical procedures. Topical therapies play a critical role in the treatment of patients with papulopustular rosacea and erythematotelangiectatic rosacea, and have the ability to effectively minimize certain manifestations of the disease, including papules, pustules, and erythema. The 3 primary agents for the topical treatment of rosacea are metronidazole, azelaic acid, and sodium sulfacetamide-sulfur. Each of these therapies is approved for the treatment of rosacea and has been validated by multiple studies. Additional topical therapies including benzoyl peroxide, clindamycin, retinoids, topical steroids, calcineurin inhibitors, and permethrin are not approved for the treatment of rosacea and play variable roles in the management of this condition. PMID: 16468288 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Clinical management of chronic disease. J Drugs Dermatol. 2006 Jan;5(1):7 Authors: Lupo M PMID: 16468285 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Laser treatment of vascular lesions. Clin Dermatol. 2006 Jan-Feb;24(1):8-15 Authors: Railan D, Parlette EC, Uebelhoer NS, Rohrer TE Laser treatment of vascular lesions remains one of the more common applications of lasers in dermatology. In fact, lasers have largely become the treatment of choice for vascular birthmarks such as hemangiomas and port-wine stains and the definitive treatment of the telangiectatic form of rosacea. The range of congenital and acquired vascular lesions effectively treated with lasers continues to expand. PMID: 16427501 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Tear fluid levels of MMP-8 are elevated in ocular rosacea--treatment effect of oral doxycycline. Graefes Arch Clin Exp Ophthalmol. 2006 Aug;244(8):957-62 Authors: Määttä M, Kari O, Tervahartiala T, Peltonen S, Kari M, Saari M, Sorsa T BACKGROUND: Ocular rosacea (OcR) is a chronic inflammatory disease especially affecting lid margins. Previous studies have shown that it is accompanied by increased levels and activation of tear fluid gelatinases. Matrix metalloproteinase 8 (MMP-8; collagenase 2) levels and activation are commonly elevated in many inflammatory conditions. Therefore we studied here whether MMP-8 concentration and activation in tear fluid are increased also in OcR, and if an oral doxycycline regimen could rectify the situation. METHODS: Tear fluid samples were collected from 22 OcR patients and 22 healthy controls. The OcR patients were then treated with an oral doxycycline regimen for 8 weeks and tear fluid samples collected again after 4 and 8 weeks. Conjunctival brush cytology and patients' subjective symptoms were scored. MMP-8 concentrations in the tear fluid were assessed by immunofluorometric assay and the molecular forms and isoenzyme expression of MMP-8 were studied by Western immunoblotting. RESULTS: The mean MMP-8 concentration was statistically significantly higher in OcR (156.8+/-207.4 mug/ml) than in the normal subjects (53.5+/-66.7 mug/ml) (P=0.036), but decreased to 79.2+/-141.6 mug/l and 53.6+/-75.2 mug/l after 4 and 8 weeks doxycycline treatment, respectively. There was a statistically significant difference between the untreated OcR and the MMP-8 results after 4 or 8 weeks of oral doxycycline (P=0.041 and 0.069, respectively) and the OcR patients experienced statistically significant relief of their subjective symptoms (P=0.0001) after the doxycycline regimen. Both the normal and OcR tear fluid contained the larger, 60-80 kDa highly- glycosylated polymorphonuclear leukocyte-type MMP-8 isoform in Western immunoblotting, but not the 45-55 kDa less glycosylated mesenchymal-type isoform. MMP-8 activation was in practice present only in the OcR samples, and was inhibited by oral doxycycline. CONCLUSIONS: MMP-8 concentration and activation degree in tear fluid are increased in OcR, probably reflecting increased inflammatory activity. Doxycycline effectively reduces these pathologically excessive levels and activation of MMP-8, and relieves patients' subjective symptoms. PMID: 16411105 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles [staphylococcal endophthalmitis following cataract surgery in a patient with ocular rosacea] J Fr Ophtalmol. 2005 Nov;28(9):981 Authors: Gicquel JJ, Quinton J, Salama B, Pommeraud D, Dighiero P PURPOSE: To report staphylococcal endophthalmitis following cataract surgery in a patient with ocular rosacea. OBSERVATION: A 69-year-old man presented with decreased visual acuity in the right eye, a corneal abscess on the incision and hypopyon 2 weeks after phacoemulsification with intraocular lens placement. The patient was hospitalized. A diagnostic vitreous tap was performed. Antibiotic therapy was initiated both locally (two intravitreal shots + topical administration) and intravenously. RESULTS: Vitreal tap cultures indicated Staphylococcus aureus. The patient's clinical status improved 48 hours after the second intravitreal shot. The same bacterium was cultured from the patient's eyelids and incision abscess. Multilayer amniotic membrane transplantation enabled satisfactory healing of the corneal abscess, which had become perforative. CONCLUSIONS: The source of the S. aureus was the skin lesions on the patient's eyelids. Rosacea is a skin disease that frequently affects the face, nose and eyelids. Although good surgical techniques were performed, with the incision requiring suture, the risk of endophthalmitis after intraocular surgery was increased in the absence of proper preoperative treatment of the dermatological condition. PMID: 16395213 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Granulomatous rosacea mimicking eyelid dermatitis. Indian J Dermatol Venereol Leprol. 2005 Sep-Oct;71(5):366-5 Authors: Ajith C, Dogra S, Radotra BD, Handa S PMID: 16394471 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Rosacea: a potential complication of expanded flaps. Dermatol Surg. 2006 Jan;32(1):167-8 Authors: Scevola S, Nicoletti G, Faga A PMID: 16393621 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Morbidity of over-the-counter topical steroids. J Am Acad Dermatol. 2006 Jan;54(1):182; author reply 182-3 Authors: Tackett BN, Smith MC, Nedorost ST PMID: 16384783 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006 Jan;54(1):1-15; quiz 16-8 Authors: Hengge UR, Ruzicka T, Schwartz RA, Cork MJ Topical corticosteroids were introduced into medicine about 50 years ago. They represent a significant milestone in dermatologic therapy. Despite encouragement to report observed adverse drug reactions, the clinical practice of reporting is poor and incomplete. Likewise, adverse effects and safety of topical corticosteroids are neglected in the medical literature. The authors provide an updated review of their adverse-effect profile. Children are more prone to the development of systemic reactions to topically applied medication because of their higher ratio of total body surface area to body weight. Cutaneous adverse effects occur regularly with prolonged treatment and are dependent on the chemical nature of the drug, the vehicle, and the location of its application. The most frequent adverse effects include atrophy, striae, rosacea, perioral dermatitis, acne, and purpura. Those that occur with lower frequency include hypertrichosis, pigmentation alterations, delayed wound healing, and exacerbation of skin infections. Of particular interest is the rate of contact sensitization against corticosteroids, which is considerably higher than generally believed. Systemic reactions such as hyperglycemia, glaucoma, and adrenal insufficiency have also been reported to follow topical application. The authors provide an updated review of local and systemic adverse effects upon administration of topical corticosteroids, including the latest FDA report on the safety of such steroids in children. LEARNING OBJECTIVE: At the completion of this learning activity, participants should be familiar with topical corticosteroids and their proper use. PMID: 16384751 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Azithromycin in the treatment of papulopustular rosacea. J Dermatol. 2005 Nov;32(11):926-8 Authors: Dereli T, Inanir I, Kilinç I, Genço√Ñ≈âˆlan G PMID: 16361757 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Rosacea, acne rosacea, and actinic telangiectasia: in reply. J Am Acad Dermatol. 2005 Dec;53(6):1103-4 Authors: Odom R, PMID: 16310093 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles [Periorbital contact eczema] Klin Monatsbl Augenheilkd. 2005 Nov;222(11):853-5 Authors: Worm M, Sterry W Periorbital contact eczema is most commonly the result of an allergic contact dermatitis whereas other eczematous skin diseases like atopic eczema or seborrheic eczema occur less frequently. Also, other diseases like autoimmune disorders or rosacea need to be considered. Allergic contact dermatitis is a T-cell-mediated immunological response towards ubiquitous contact allergens. Activated T-cells migrate through the vessels into the skin and produce several inflammatory mediators. Epicutaneous patch testing is an important tool for the diagnosis of contact allergy whereby the allergens are analysed in terms of their ability to induce eczematous skin reaction. Until now the short-term use of corticosteroids are is employed for the treatment of allergic contact eczema. Modern substances with an optimal therapeutic index should rather be used. PMID: 16308815 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Treatment of erythematotelangiectactic rosacea with a KTP YAG laser. J Drugs Dermatol. 2005 Nov-Dec;4(6):760-2 Authors: Miller A The flushing and telangiectasias associated with rosacea are notoriously difficult to treat with standard medications. Newer technologies, namely medical lasers and light sources, have made it possible to control and improve erythematotelangietatic signs of rosacea. The potassium-titanyl-phosphate laser in particular is an efficacious and safe tool for treatment of this disease. PMID: 16302564 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Therapeutic response of rosacea to dobesilate. Eur J Med Res. 2005 Oct 18;10(10):454-6 Authors: Cuevas P, Arrazola JM Despite an incomplete understanding of the pathogenesis of rosacea, therapeutic modalities continue to expand. The principal subtype of rosacea includes erythematotelangiestatic rosacea, which is characterized by uncontrolled angiogenesis. Angiogenic growth factors such as fibroblast growth factors (FGF) and vascular endothelial growth factor (VEGF) are currently targets of intense effort to inhibit deregulated blood vessel formation in diseases such as cancer. Here we report a 33-years-old woman with erythematotelangestatic rosacea who responds to a daily treatment of topically applied dobesilate, an inhibitor of FGF, with an improvement in erythema and telangectasia after two weeks. Thus, dobesilate might be useful in the treatment of rosacea and other diseases that depend on pathologic angiogenesis. PMID: 16287608 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Autosomal dominant familial chronic mucocutaneous candidiasis associated with acne rosacea. Ann Acad Med Singapore. 2005 Oct;34(9):571-4 Authors: Ee HL, Tan HH, Ng SK INTRODUCTION: Autosomal dominant chronic mucocutaneous candidiasis (CMC) without endocrinopathy (OMIM 114580) is a well-described entity. The associations recorded with this disorder to date are intercellular adhesion molecule-1 (ICAM-1) deficiency and hyper-immunoglobulin E syndrome. CLINICAL PICTURE: We report a new association in a family (mother and nonidentical twin sons) where acne rosacea is a prominent feature together with CMC. In addition, antibodies to thyroid microsomal and antiparietal cell were also isolated. The autoantibodies might be associated with a current "latent" endocrinopathy in particular autoimmune thyroiditis. TREATMENT: The patient was treated with intermittent pulses of itraconazole for the candidiasis and doxycycline initially before being substituted with isotretinoin 6 months later for the rosacea. OUTCOME: The patient's candidiasis responded well and has been in remission for 3 months while his rosacea continues to improve. PMID: 16284681 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Pseudomonas aeruginosa keratitis in an atopic silicone hydrogel lens wearer with rosacea. Eye Contact Lens. 2005 Nov;31(6):254-6 Authors: Robertson DM, Cavanagh HD PURPOSE: This case report documents Pseudomonas aeruginosa corneal infection associated with daily wear of a silicone contact lens in a patient who also had bilateral, preexisting biomicroscopic findings of ocular rosacea, seborrheic blepharitis, keratoconjunctivitis sicca, and chronic punctate corneal epitheliopathy. CONCLUSIONS: Collectively, these problems produce increased risk of infection for wear of any contact lens; and underscore the importance of proper patient selection, education and post-fit monitoring even when hyper-oxygen transmitting silicone hydrogels are utilized. PMID: 16284503 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles MetroGel (metronidazole) topical gel, 1%. Skinmed. 2005 Sep-Oct;4(5):319 Authors: Scheinfeld N PMID: 16282758 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Obstructing rhinophyma: a case report. Otolaryngol Head Neck Surg. 2005 Nov;133(5):799-800 Authors: Lomeo PE, McDonald JE, Finneman J PMID: 16274813 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles [Rhinophyma--diagnosis and treatment] Otolaryngol Pol. 2005;59(4):581-4 Authors: Szymańska-Skrzypek A, Burduk PK, Betlejewski S The authors present four cases with rare disease--rhinophyma. These disease occurs mainly in males of middle and old age. It results from long-standing rosacea in some patients. Risk factors are blood vessels disorders, endocrinal abnormality, digestive tract disorder. In laryngological practice there are many methods of non-surgical treatment of rhinophyma. The aim of the treatment is to remove deformation and restore function of the nose and prevent the relapse of rhinophyma. Rhinophyma is removed with the epidermis and the wound is realest to self epithelisation in case of small changes, but in more severe cases of rhinophyma the wound needs to be covered by skin scalp. PMID: 16273866 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Correlates of health-related quality of life in women with severe facial blemishes. Int J Dermatol. 2006 Feb;45(2):111-5 Authors: Balkrishnan R, McMichael AJ, Hu JY, Camacho FT, Shew KR, Bouloc A, Rapp SR, Feldman SR BACKGROUND: Facial appearance plays a large role in self-perception and interaction with others. Visible facial skin lesions are a common condition. Purpose This study assessed factors associated with health-related quality of life (HRQOL) in women with visible facial skin lesions. METHODS: The study included 73 women with one or more of the following conditions: acne, dermatosis papulosis, hypopigmentation, lentigenes, melasma, rosacea, vascular proliferations and other facial scars. The Skindex-16 was used as a measure of HRQOL. Fear of negative evaluation (FNE) was assessed to determine whether self-perception characteristics relate to HRQOL. RESULTS: There were strong correlations in both bivariate and multivariate analyses among increased FNE, heightened perception of QOL without the facial condition and lower overall HRQOL (P< 0.05 and P< 0.01, respectively). There were no differences in HRQOL by type of facial condition, as well as no effects of the area covered by the condition on HRQOL. Interestingly, women not using foundations represented only 10% of the study population and had better HRQOL than women who did use foundations. CONCLUSIONS: Severe facial blemishes of any cause have a significant impact on women's QOL, and the effect of these lesions is mediated in part by psychological characteristics related to self-perception and self-presentation. PMID: 16445498 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Comorbidity of rosacea and depression: an analysis of the National Ambulatory Medical Care Survey and National Hospital Ambulatory Care Survey--Outpatient Department data collected by the U.S. National Center for Health Statistics from 1995 to 2002. Br J Dermatol. 2005 Dec;153(6):1176-81 Authors: Gupta MA, Gupta AK, Chen SJ, Johnson AM BACKGROUND: Psychogenic factors have been considered to be important in the exacerbation and possibly the onset of rosacea. However, there are very few studies that have reported conclusive findings. OBJECTIVES: To examine the association between rosacea and major depressive disease, a common and usually treatable psychiatric disorder. METHODS: Data from 1995 to 2002, collected by the National Ambulatory Medical Care Survey and the outpatient component of the National Hospital Ambulatory Care Survey, which are both nationally representative surveys of healthcare visits in the U.S.A., were studied. The basic sampling unit in both surveys is the patient visit or encounter. A "Rosacea" variable was created by grouping all rosacea (ICD-9-CM code 695.3) visits and a "Depression" variable was created by grouping the patient visits related to major depressive disorder (ICD-9-CM codes 296.2, 296.3 and 311). As alcohol abuse has been implicated in rosacea, and alcohol can confound symptoms of depression, an "Alcohol" variable was created by grouping all ICD-9-CM codes related to alcohol dependence and abuse (codes 303, 303.0, 303.9 and 305.0). All analyses were conducted using the Complex Samples module of SPSS version 13, to account for the multistage probability sampling design used to collect the data. RESULTS: The weighted data were representative of over 608 million dermatology visits between 1995 and 2002. Logistic regression analysis using "Rosacea" as the dependent variable and age, sex, "Alcohol" and "Depression" as independent variables revealed that the odds ratio for depressive disease in the rosacea group was 4.81 (95% confidence interval 1.39-16.62). The association between "Alcohol" and "Rosacea" was not significant. CONCLUSIONS: The comorbidity between major depressive disease and rosacea may have important clinical implications. Alcohol abuse does not appear to play a significant role in this association. PMID: 16307654 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article

Related Articles Perceptions of self in persons with rosacea. Dermatol Nurs. 2005 Aug;17(4):249-54, 314; quiz 263 Authors: Lindow KB, Shelestak D, Lappin J PMID: 16206680 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article