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Cureus. 2023 Feb 15;15(2):e35011. doi: 10.7759/cureus.35011. eCollection 2023 Feb. ABSTRACT The most common cutaneous manifestations of alcoholism include urticarial reaction, flushing, porphyria cutanea tarda, psoriasis, rosacea, seborrheic dermatitis, and pruritus. Here, we present a case of a young male with a history of alcohol abuse who presented with non-blanching, petechial, and perifollicular macular rash secondary to vitamin C deficiency in view of poor oral intake. The rash improved significantly with vitamin C supplementation. Although rare in developed countries, clinicians should keep vitamin C deficiency as a differential diagnosis for skin rash in alcohol consumers. PMID:36938293 | PMC:PMC10021349 | DOI:10.7759/cureus.35011 {url} = URL to article

J Dermatol. 2023 Mar 20. doi: 10.1111/1346-8138.16779. Online ahead of print. ABSTRACT Symptomatic dermographism (SD) is the most common form of chronic inducible urticarias. The etiology of this disease has rarely been reported in the literature. Minocycline is widely used in the treatment of acne, rosacea, and other inflammatory skin diseases. Herein we report four cases of SD onset during minocycline administration. These were young women in their 20s to 30s who were taking minocycline orally for acne vulgaris or rosacea. They all experienced the onset of SD 2-3 weeks after taking the drug, and then the complete disappearance of SD 1 month after stopping the drug. Minocycline was thought to be the culprit drug in these cases as other drugs were ruled out on clinical grounds. Our small series suggests that oral minocycline may induce SD, thus raising the awareness of this association in clinical practice. More research is needed to further confirm this association and reveal the underlying mechanism(s). PMID:36938687 | DOI:10.1111/1346-8138.16779 {url} = URL to article

Arch Dermatol Res. 2023 Mar 20. doi: 10.1007/s00403-023-02602-9. Online ahead of print. ABSTRACT Individuals with rosacea have different facial erythema distribution patterns; however, whether they are related to the skin type is unclear. This study enrolled 201 Chinese patients, including 195 females and six males, diagnosed with rosacea. Facial images were taken using the VISIA® Complexion Analysis System, and red-area images were further analyzed. The erythema distribution pattern of rosacea was divided into peace signs, wing shapes, and neither of the two patterns, according to the distribution location. Skin types were divided according to the Fitzpatrick skin type, and oily-dry skin subtypes were determined according to the Baumann skin-type scale. There were 130 and 44 cases of typical peace signs and typical wing shapes, respectively. The remaining 27 cases were of neither type. Among the 76 patients with peace-sign patterns, the majority (58.5%) had oily combination skin. Among the patients with a typical wing shape, 43 (97.7%) had dry combination skin. Among the 27 patients with no peace-sign or wing-shape pattern, 17 (63.0%) had dry combination skin (p < 0.05). The peace sign pattern was more common in individuals with darker skin tones (p < 0.05). The differences in the immune microenvironment, Demodex habitation, and altered lipid content may explain the presence of the peace-sign pattern in the oily combination skin population. Wing-type patterns are associated with the lateral parts of the cheeks and could be caused by abnormal vessel dilations of the anatomic branches of the zygomatic-facial and facial arteries, which indicates that the main pathogenesis for this type of rosacea may be neurovascular. Our study is the first to report that facial erythema distribution characteristics of rosacea are associated with skin types. PMID:36939880 | DOI:10.1007/s00403-023-02602-9 {url} = URL to article

Front Pharmacol. 2023 Mar 1;14:1092473. doi: 10.3389/fphar.2023.1092473. eCollection 2023. ABSTRACT Background: Rosacea is a common facial skin inflammatory disease featured by hyperactivation of mTORC1 signaling in the epidermis. Due to unclear pathogenesis, the effective treatment options for rosacea remain limited. Methods: Weighted gene co-expression network analysis (WGCNA) analyzed the relationship between epidermis autophagy and mTOR pathways in rosacea, and further demonstrated it through immunofluorescence and qPCR analysis. A potential therapeutic agent for rosacea was predicted based on the key genes of the WGCNA module. In vivo and in vitro experiments were conducted to verify its therapeutic role. Drug-target prediction (TargetNet, Swiss, and Tcmsp) and molecular docking offered potential pharmacological targets. Results: WGCNA showed that epidermis autophagy was related to the activation of mTOR pathways in rosacea. Next, autophagy was downregulated in the epidermis of rosacea, which was regulated by mTOR. In addition, the in vivo experiment demonstrated that autophagy induction could be an effective treatment strategy for rosacea. Subsequently, based on the key genes of the WGCNA module, epigallocatechin-3-gallate (EGCG) was predicted as a potential therapeutic agent for rosacea. Furthermore, the therapeutic role of EGCG on rosacea was confirmed in vivo and in vitro. Finally, drug-target prediction and molecular docking revealed that AKT1/MAPK1/MMP9 could be the pharmacological targets of EGCG in rosacea. Conclusion: Collectively, our findings revealed the vital role of autophagy in rosacea and identified that EGCG, as a therapeutic agent for rosacea, attenuated rosacea-like inflammation via inducing autophagy in keratinocytes. PMID:36937834 | PMC:PMC10014537 | DOI:10.3389/fphar.2023.1092473 {url} = URL to article

Photobiomodul Photomed Laser Surg. 2023 Mar;41(3):104-119. doi: 10.1089/photob.2022.0120. ABSTRACT Objective: To evaluate relevant clinical outcomes and conclude possible mechanisms of intense pulsed light (IPL) in eyelid inflammation. Background: IPL devices were primarily applied in cutaneous vascular malformations and have been used in ocular diseases for about 20 years, mostly including meibomian gland dysfunction (MGD), blepharitis, and ocular rosacea. Recent findings: Seventy-two original clinical researches were included, 57 for MGD, 4 for blepharitis or blepharitis-related keratoconjunctivitis, and 11 for rosacea. Dry eye symptoms, (tear) break-up time (BUT), and meibomian structure and/or functions were improved in most patients, but production of reactive oxygen species is an important link in the photobiomodulation mediated by IPL, which can influence numerous signal pathways to achieve anti-inflammatory, anti-infective, and prodifferentiation effects. Conclusions: The evidence suggests that IPL is an effective therapeutic tool for most patients with MGD, but more clinical evidence is needed for other indications. PMID:36927050 | DOI:10.1089/photob.2022.0120 {url} = URL to article

Gland Surg. 2023 Feb 28;12(2):302-308. doi: 10.21037/gs-22-482. Epub 2023 Feb 3. ABSTRACT BACKGROUND: Black thyroid is a rare incidental finding during surgery. We report the case of a patient with papillary thyroid cancer who was incidentally found to have minocycline-induced black thyroid. CASE DESCRIPTION: A 29-year-old woman presented with a left thyroid nodule and metastatic papillary thyroid cancer involving the left neck level IV lymph nodes. She had a medical history of anxiety disorder with depression, severe acne, and rosacea, and had been taking benzodiazepines, selective serotonin reuptake inhibitors, isotretinoin, and minocycline for a few years. The patient underwent a total thyroidectomy with left central compartment neck dissection and ipsilateral modified radical neck dissection. A black thyroid gland was identified during thyroidectomy. During level IV dissection, we noticed a similar black discoloration in the adipose tissue of the lower neck. Pathological examination revealed brown pigmentation with few macrophages on several foci of the thyroid parenchyma. Brown pigmentation was not identified in the thyroid tumor, metastatic and normal lymph nodes, or background adipose tissue. CONCLUSIONS: We report a case of papillary thyroid microcarcinoma with cervical lymph node metastases in a black thyroid. The clinical findings were consistent with those of previous reports. Based on the literature, it remains unclear if this minocycline triggered finding is associated with an increased frequency and/or aggressiveness of thyroid carcinomas. In the absence of adequate evidence, prolonged minocycline users should ideally undergo routine thyroid assessment to identify possible malignancy. PMID:36915821 | PMC:PMC10005984 | DOI:10.21037/gs-22-482 {url} = URL to article

J Clin Aesthet Dermatol. 2023 Feb;16(2):24-28. ABSTRACT BACKGROUND: Photobiomodulation therapy (PBMT) can significantly reduce inflammation and relieve pain, including postoperative pain and edema. The study aimed to evaluate the performance of a photobiomodulation-based device that includes a static magnetic field (SMF) to treat laser- or intensive and fractional radiofrequency-related side effects, such as pain, redness, and edema in patients treated for different dermatological conditions. METHODS: The study had a prospective, non-randomized, single-center design. Male and female patients aged 18 years or older underwent one or two PBMT-SMF (anti-inflammatory or anti-edematous) sessions on the same day, once or twice a week, after laser or radiofrequency facial treatments due to various dermatological disorders. Variables and efficacy assessments were pain, redness, edema, and their reduction from baseline to the last visit. RESULTS: Twenty-seven patients were included, seven (25.9%) men and 20 (74.1%) women, with a mean (SD) age of 43.7 (14.1) years. Seven (25.9%) patients were treated with radiofrequency, and 20 (74.1%) patients with a vascular laser (three [15%] for angioma, two [10%] for scars, three [15%] for erythrosis, and 12 [60%] for rosacea). After the PBMT-SMF protocol, overall mean pain reduction was 40 percent, and redness and edema reduction were shown by the pictures taken before and after the PBMT-SMF procedure. LIMITATIONS: The primary limitations were the small number of patients and no quantitative variables for redness and edema. CONCLUSION: PBMT-SMF reduced edema and inflammation after treatment with lasers or intensive or fractional radiofrequency for facial conditions, and probably, analgesic and anti-inflammatory drugs. PMID:36909868 | PMC:PMC10005803 {url} = URL to article

Int J Pharm. 2023 Mar 11;636:122816. doi: 10.1016/j.ijpharm.2023.122816. Online ahead of print. ABSTRACT The repurposed oral use of spironolactone (SP) as an anti-rosacea drug faces many challenges that hinder its efficacy and compliance. In this study, a topically applied nanofibers (NFs) scaffold was evaluated as a promising nanocarrier that enhances SP activity and avoids the friction routine that exaggerates rosacea patients' inflamed, sensitive skin. SP-loaded poly-vinylpyrrolidone (40% PVP) nanofibers (SP-PVP NFs) were electrospun. Scanning electron microscopy showed that SP-PVP NFs have a smooth homogenous surface with a diameter of about 426.60 nm. Wettability, solid state, and mechanical properties of NFs were evaluated. Encapsulation efficiency and drug loading were 96.34% ± 1.20 and 11.89% ± 0.15, respectively. The in vitro release study showed a higher amount of SP released over pure SP with a controlled release pattern. Ex vivo results showed that the permeated amount of SP from SP-PVP NFs sheets was 4.1 times greater than that of pure SP gel. A higher percentage of SP was retained in different skin layers. Moreover, the in vivo anti-rosacea efficacy of SP-PVP NFs using croton oil challenge showed a significant reduction in erythema score compared to the pure SP. The stability and safety of NFs mats were proved, indicating that SP-PVP NFs are promising carriers of SP. PMID:36907278 | DOI:10.1016/j.ijpharm.2023.122816 {url} = URL to article

J Affect Disord. 2023 Mar 9:S0165-0327(23)00333-6. doi: 10.1016/j.jad.2023.03.003. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a skin disease characterized by facial erythema and inflammatory pustules that may result in emotional distress. Social Phobia and Self-Esteem appear to be linked to the development of higher levels of distress in dermatological conditions, while Trait Emotional Intelligence (Trait EI) has been consistently associated with greater levels of adaptation to one's chronic condition. Hence, it seems extremely relevant to observe the interplay between these dimensions in the context of Rosacea. The goal of the current study is to test the hypothesis that an association between Trait EI and General Distress, in individuals with Rosacea would be mediated by Self-Esteem and Social Phobia. METHODS: Questionnaires were administered to 224 individuals suffering from Rosacea to assess Trait EI, Social Phobia, Self-Esteem, and General Distress. RESULTS: Results highlighted that Trait EI was positively related to Self-Esteem and negatively related to Social Phobia and General Distress. In addition, both Self-Esteem and Social Phobia showed a mediating role in the relationship between Trait EI and General Distress. LIMITATIONS: The main limitations of this work consist in the cross-sectional nature of the data, the small number of participants, also it was not possible to differentiate the participants according to the type of rosacea. DISCUSSION: These results emphasize how individuals with Rosacea may be vulnerable to internalizing states and how high levels of Trait EI may constitute a protective factor for the onset of distressing states and it would be useful to create programs aimed at fostering Trait EI in Rosacea sufferers. PMID:36906111 | DOI:10.1016/j.jad.2023.03.003 {url} = URL to article

Int J Mol Sci. 2023 Mar 5;24(5):5001. doi: 10.3390/ijms24055001. ABSTRACT The skin, including the hypodermis, is the largest body organ and is in constant contact with the environment. Neurogenic inflammation is the result of the activity of nerve endings and mediators (neuropeptides secreted by nerve endings in the development of the inflammatory reaction in the skin), as well as interactions with other cells such as keratinocytes, Langerhans cells, endothelial cells and mast cells. The activation of TRPV-ion channels results in an increase in calcitonin gene-related peptide (CGRP) and substance P, induces the release of other pro-inflammatory mediators and contributes to the maintenance of cutaneous neurogenic inflammation (CNI) in diseases such as psoriasis, atopic dermatitis, prurigo and rosacea. Immune cells present in the skin (mononuclear cells, dendritic cells and mast cells) also express TRPV1, and their activation directly affects their function. The activation of TRPV1 channels mediates communication between sensory nerve endings and skin immune cells, increasing the release of inflammatory mediators (cytokines and neuropeptides). Understanding the molecular mechanisms underlying the generation, activation and modulation of neuropeptide and neurotransmitter receptors in cutaneous cells can aid in the development of effective treatments for inflammatory skin disorders. PMID:36902434 | PMC:PMC10003326 | DOI:10.3390/ijms24055001 {url} = URL to article

Molecules. 2023 Feb 24;28(5):2134. doi: 10.3390/molecules28052134. ABSTRACT Azelaic Acid (AzA) is a 9-carbon atom dicarboxylic acid, with numerous pharmacological uses in dermatology. Its effectiveness in papulopustular rosacea and acne vulgaris, among other dermatological disorders such as keratinization and hyper-pigmentation, is thought to be related to its anti-inflammatory and antimicrobial properties. It is a by-product of Pityrosporum fungal mycelia metabolism but also it is found in different cereals such as barley, wheat, and rye. Diverse topical formulations of AzA exist in commerce, and it is mainly produced via chemical synthesis. In this study we describe the extraction of AzA from whole grains and whole-grain flour (Triticum durum Desf.) through green methods. Seventeen different extracts were prepared and analyzed for their AzA content by HPLC-MS methods and then screened for their antioxidant activity using spectrophotometric assays (ABTS, DPPH, and Folin-Ciocalteu). Minimum-inhibitory-concentration (MIC) assays against several bacterial and fungal pathogens were performed, to validate their antimicrobial activity. The obtained results indicate that whole grain extracts provide a wider spectrum of activity than the flour matrix; in particular, the Naviglio® extract showed higher AzA content, while the hydroalcoholic ultrasound-assisted extract provided better antimicrobial and antioxidant activity. The data analysis was performed using principal component analysis (PCA), as an unsupervised-pattern-recognition technique, to extract useful analytical and biological information. PMID:36903378 | PMC:PMC10003986 | DOI:10.3390/molecules28052134 {url} = URL to article

Front Pain Res (Lausanne). 2023 Feb 20;4:1122134. doi: 10.3389/fpain.2023.1122134. eCollection 2023. NO ABSTRACT PMID:36890854 | PMC:PMC9986523 | DOI:10.3389/fpain.2023.1122134 {url} = URL to article

Dermatol Pract Concept. 2023 Jan 1;13(1):e2023029. doi: 10.5826/dpc.1301a29. ABSTRACT INTRODUCTION: Skin diseases have negative psychological and social consequences, especially when they are chronic and affect a visible area of the body, such as the face. OBJECTIVES: The purpose of this study is to investigate and compare the psychosocial impact of three common chronic dermatoses of the face: acne, rosacea, and seborrheic dermatitis. METHODS: The Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and Social Appearance Anxiety Scale (SAAS) were used to compare acne, rosacea, and seborrheic dermatitis patients and healthy controls. The relationships between DLQI, HADS, and SAAS results were investigated, as well as their associations with disease duration and severity. RESULTS: The study included 166 acne patients, 134 rosacea patients, 120 seborrheic dermatitis patients, and 124 controls. The patient groups had significantly higher DLQI, HADS, and SAAS scores than the control group. Rosacea patients had the highest DLQI and SAAS scores, as well as the highest anxiety prevalence. Patients with seborrheic dermatitis had the highest rate of depression. The DLQI, HADS, and SAAS results were moderately correlated with each other, but their relationship with disease duration and severity was insignificant or weak at best. CONCLUSIONS: Chronic facial dermatoses have a detrimental impact on mood and quality of life. Although patients with acne, rosacea, and seborrheic dermatitis have distinct lesions, the outcomes in terms of quality of life, anxiety, and depression are largely similar. Furthermore, these patients report similar levels of social anxiety as a result of their overall appearance. PMID:36892338 | PMC:PMC9946076 | DOI:10.5826/dpc.1301a29 {url} = URL to article

Acta Derm Venereol. 2023 Mar 8;103:adv00882. doi: 10.2340/actadv.v103.4447. ABSTRACT The majority of registry studies on atopic dermatitis include only patients and diagnoses from specialized healthcare. The aim of this retrospective, real-world cohort study was to evaluate the effect of atopic dermatitis severity on comorbidities and total morbidity, with comprehensive data from both primary and specialty healthcare registries covering the entire Finnish adult population. In total, 124,038 patients were identified (median age 46 years; 68% female) and stratified by disease severity. All regression analyses (median follow-up 7.0 years) were adjusted at a minimum for age, sex, obesity, and educational level. Compared with mild atopic dermatitis, severe atopic dermatitis was significantly associated with multiple morbidities, including neurotic, stress-related and somatoform disorders, abscesses, erysipelas/cellulitis, impetigo, herpes zoster, extragenital herpes, bacterial conjunctivitis, septicaemia, lymphomas, alopecia areata, urticaria, other dermatitis, contact allergy, osteoporosis, and intervertebral disc disorders (p < 0.001). In addition, there were significant associations with alcohol dependence, depression, condylomas, rosacea, migraine, sleep apnoea, hypertension, enthesopathies, atherosclerosis, and drug-induced cataract (p < 0.05). Odds ratios were modest and mostly were between 1.10 and 2.75. Furthermore, patients with severe atopic dermatitis had lower incidences of prostate cancer, cystitis, and anogenital herpes than patients with mild atopic dermatitis (p < 0.05). These results suggest that severe atopic dermatitis results in significant overall morbidity. PMID:36883876 | PMC:PMC10010184 | DOI:10.2340/actadv.v103.4447 {url} = URL to article

Dermatologie (Heidelb). 2023 Mar 7. doi: 10.1007/s00105-023-05123-8. Online ahead of print. ABSTRACT Dermoscopy is an easily accessible, noninvasive diagnostic tool, originally used in the differentiation of benign and malignant skin tumors. Other structures beside pigment content observed by dermoscopy, e.g., scaling, follicles, or vessels, may present in a specific pattern in different dermatoses. Recognition of these patterns may aid the diagnosis of inflammatory and infectious dermatological conditions. The aim of this article is to review the distinct dermoscopic features of granulomatous and autoimmune skin diseases. Diagnosis of granulomatous skin disorders is based on the histopathological examination. The dermoscopic picture of these diseases (cutaneous sarcoidosis, granuloma annulare, necrobiosis lipoidica, and granulomatous rosacea) show many similarities; however, there are some differences to note between the dermatoses, mainly in granuloma annulare. The cornerstones of the diagnostic process of autoimmune skin diseases (morphea, systemic sclerosis, dermatomyositis, cutaneous lupus erythematosus) include the clinical picture, immunoserology, and histology; however, dermoscopy may aid the diagnostic process and follow-up of the patients. For those diseases, where vascular abnormalities play an important role in the pathogenesis, videocapillaroscopy is used for examination of the microcirculation at the nailfold capillaries. Dermoscopy can be an easy-to-use everyday diagnostic tool in clinical practice regarding granulomatous and autoimmune skin diseases. Although punch biopsy is inevitable in many cases, the distinct dermoscopic structures can aid the diagnostic process. PMID:36881125 | DOI:10.1007/s00105-023-05123-8 {url} = URL to article

Front Pharmacol. 2023 Feb 15;14:1037925. doi: 10.3389/fphar.2023.1037925. eCollection 2023. ABSTRACT TRPV1 is a non-selective channel receptor widely expressed in skin tissues, including keratinocytes, peripheral sensory nerve fibers and immune cells. It is activated by a variety of exogenous or endogenous inflammatory mediators, triggering neuropeptide release and neurogenic inflammatory response. Previous studies have shown that TRPV1 is closely related to the occurrence and/or development of skin aging and various chronic inflammatory skin diseases, such as psoriasis, atopic dermatitis, rosacea, herpes zoster, allergic contact dermatitis and prurigo nodularis. This review summarizes the structure of the TRPV1 channel and discusses the expression of TRPV1 in the skin as well as its role of TRPV1 in skin aging and inflammatory skin diseases. PMID:36874007 | PMC:PMC9975512 | DOI:10.3389/fphar.2023.1037925 {url} = URL to article

Indian J Dermatol. 2022 Sep-Oct;67(5):625. doi: 10.4103/ijd.ijd_353_21. ABSTRACT BACKGROUND: Thirty per cent supramolecular salicylic acid (SSA) is a water-soluble, sustained release salicylic acid (SA) modality, which is well tolerated by sensitive skin. Anti-inflammatory therapy plays an important role in papulopustular rosacea (PPR) treatment. SSA at a 30% concentration has a natural antiinflammatory property. AIMS: This study aims to investigate the efficacy and safety of 30% SSA peeling for PPR treatment. METHODS: Sixty PPR patients were randomly divided into two groups: SSA group (30 cases) and control group (30 cases). Patients of the SSA group were treated with 30% SSA peeling three times every 3 weeks. Patients in both groups were instructed to topically apply 0.75% metronidazole gel twice daily. Transdermal water loss (TEWL), skin hydration and erythema index were assessed after 9 weeks. RESULTS: Fifty-eight patients completed the study. The improvement of erythema index in the SSA group was significantly better than that in the control group. No significant difference was found in terms of TEWL between the two groups. The content of skin hydration in both the groups increased, but there was no statistical significance. No severe adverse events were observed in both the groups. CONCLUSION: SSA can significantly improve the erythema index and overall appearance of skin in rosacea patients. It has a good therapeutic effect, good tolerance and high safety. PMID:36865859 | PMC:PMC9971792 | DOI:10.4103/ijd.ijd_353_21 {url} = URL to article

Medicine (Baltimore). 2023 Mar 3;102(9):e33023. doi: 10.1097/MD.0000000000033023. ABSTRACT Rosacea is a chronic erythematous disease with telangiectasia that affects the central area of the face. However, because of the ambiguity in the pathophysiology of rosacea, its treatment has not been clearly elucidated; therefore, new therapeutic options need to be developed. Gyejibokryeong-hwan (GBH) is widely used in clinical practice for various blood circulation disorders, including hot flushes. Therefore, we explored the potential pharmaceutical mechanism of GBH on rosacea and investigated the therapeutic points exclusive to GBH through comparative analysis with chemical drugs recommended in 4 guidelines for rosacea based on network analysis. The active compounds in GBH were identified, and the proteins targeted by these compounds and the genes related to rosacea were searched. Additionally, the proteins targeted by the guideline drugs were also searched to compare their effects. And the pathway/term analysis of common genes was conducted. Ten active compounds were obtained for rosacea. There were 14 rosacea-related genes targeted by GBH, with VEGFA, TNF, and IL-4, which were suggested as core genes. The pathway/term analysis of the 14 common genes revealed that GBH could potentially act on rosacea via 2 pathways: the "interleukin 17 signaling pathway" and the "neuroinflammatory response." Comparison and analysis of the protein targets between GBH and guideline drugs revealed that only GBH separately acts on the "vascular wound healing pathway." GBH has the potential to act on IL-17 signaling pathway, neuroinflammatory response and vascular wound healing pathway. Further studies are needed to determine the potential mechanism of GBH in rosacea. PMID:36862896 | PMC:PMC9981404 | DOI:10.1097/MD.0000000000033023 {url} = URL to article

Eur J Dermatol. 2022 Nov 1;32(6):716-723. doi: 10.1684/ejd.2022.4358. ABSTRACT BACKGROUND: Contact hypersensitivity or Demodex mite infestation is commonly reported in patients with rosacea. However, the associations and clinical implications of these two phenomena are poorly described in the literature. OBJECTIVES: This study aimed to investigate the association between clinical characteristics, contact sensitization profiles, and Demodex mite infestation in patients with rosacea. MATERIALS & METHODS: We retrospectively reviewed 189 patients diagnosed with rosacea, and categorized the patients into a rosacea-contact hypersensitivity or rosacea-non-contact hypersensitivity group. RESULTS: The rosaceacontact hypersensitivity group had older age (median: 45.5 vs. 37.0 years; p = 0.006), a higher frequency of itching (63.0% vs. 45.1%; p = 0.040), and a higher Demodex mite density (15.0/cm2 vs. 7.0/cm2; p = 0.002) than the rosacea-non-contact hypersensitivity group. Nickel sensitization was correlated with a higher Demodex mite density, female sex, and papulopustular subtype of rosacea. Based on the multivariate regression model, a favourable clinical outcome was correlated with nickel sensitization alone (odds ratio: 2.20, 95% confidence interval: 1.01-4.81). CONCLUSION: Patients with rosacea and contact hypersensitivity showed distinctive clinical features and a higher Demodex mite density. The association between nickel sensitization, Demodex mite infestation, and treatment response may reflect the role of allergen-specific TH polarization in the pathogenesis of rosacea. PMID:36856381 | DOI:10.1684/ejd.2022.4358 {url} = URL to article

Aesthet Surg J. 2023 Mar 1:sjad044. doi: 10.1093/asj/sjad044. Online ahead of print. ABSTRACT BACKGROUND: In the aesthetic clinical practice, botulinum toxin type A (BoNT-A) is best known for its use as a neuromodulator for the treatment of dynamic facial lines; however, when injected intradermally as microdroplets, BoNT-A can improve skin quality and overall skin appearance. OBJECTIVES: To discuss key aspects of microtoxin use in clinical practice and provide expert guidance on use. METHODS: As part of a Continuing Medical Education (CME) lecture series and roundtable, the authors discussed key aspects of microtoxin patient selection, injection technique, and safety. RESULTS: The experiences of expert faculty are shared here. Clinical experience is consistent with reported data. Microtoxin can be used to reduce pore size, sebum production, rosacea, acne, and fine lines, and to improve jawline and neck definition. Intradermal injection can also be used for the improvement of transverse neck lines as well as for the safe prevention and management of scars and keloids. CONCLUSIONS: Expanding the use of BoNT-A, a predictable, minimally invasive, and affordable treatment to address commonly encountered complaints, is appealing. The authors have found that making patients aware of microtoxin as a treatment option results in increased interest, increased use of BoNT-A, and high satisfaction among appropriately selected patients. PMID:36857534 | DOI:10.1093/asj/sjad044 {url} = URL to article

Front Microbiol. 2023 Feb 10;14:1108661. doi: 10.3389/fmicb.2023.1108661. eCollection 2023. ABSTRACT Rosacea is a chronic inflammatory cutaneous disorder of uncertain etiology that mainly affects the centrofacial region, including cheeks, nose, chin, forehead, and eyes. The pathogenesis of rosacea remains unclear because it involves several complex factors. Additionally, the potential treatment methods need to be explored. We reviewed the common bacterial species in the skin microbiota and gut microbiota of rosacea patients such as Demodex folliculorum, Staphylococcus epidermidis, Bacillus oleronius, Cutibacterium acnes, and Helicobacter pylori and identified their role in the pathogenesis. Besides, we summarized the influence factors such as temperature and age on rosacea patients. We also systematically reviewed the commonly used clinical treatment methods, including antibiotics, probiotics. as well as their treatment mechanism and application precautions. PMID:36846769 | PMC:PMC9950749 | DOI:10.3389/fmicb.2023.1108661 {url} = URL to article

J Ayub Med Coll Abbottabad. 2023 Feb-Mar;35(1):88-94. doi: 10.55519/JAMC-01-11442. ABSTRACT BACKGROUND: Cosmetics have been a part of routine body care not only for the upper classes but also for the middle and lower classes since the dawn of civilization. Cosmetic formulations are in more demand as the public's interest in skin whitening grows. The contamination of cosmetics with heavy metals is a major concern as they containing heavy metals and pose a major risk to human health. This study looks in to the effects of Lead on human skin. METHODS: In this cross sectional study different products were examined. The matrices (scalp hair, blood, serum and nails) of reference and dermatitis cosmetic female patients (seborrhoeic dermatitis, rosacea, allergic contact dermatitis, and irritant contact dermatitis) and cosmetic samples were used in a 2:1 mixture of HNO3 (65%) and H2O2 (30%), and oxidation was performed using a microwave. The oxidized beauty and biological specimen underwent electrothermal atomic emission spectrophotometry after microwave-assisted acid digestion. The validity and precision of the methodology were verified using certified reference materials. Cosmetic products (lipstick, face powder, Eye Liner and Eye shadow) of different brands contain Pb concentrations in the ranges of 50.5-120 μg/g, 14.6-30.7 μg/g, 2.87-4.25 μg/g and 15.3-21.6 μg/g, respectively. RESULTS: In the present study, cosmetic products (lipstick (N=15), face powder (N=13), eye liner (N=11), eye shadow (N=15) and female patients with dermatitis (N=252) residing in Hyderabad city, Sindh, Pakistan, was investigated. The outcome of this investigation showed significantly higher levels of Pb in biological samples (blood and scalp hair) of different types of female dermatitis patients than in reference subjects (p<0.001). CONCLUSIONS: The cosmetic products, especially with regard to heavy metals adulteration, are in use by the female population. PMID:36849384 | DOI:10.55519/JAMC-01-11442 {url} = URL to article

Int J Mol Sci. 2023 Feb 17;24(4):4039. doi: 10.3390/ijms24044039. ABSTRACT Melatonin is the main hormone that regulates the sleep cycle, and it is mostly produced by the pineal gland from the amino acid tryptophan. It has cytoprotective, immunomodulatory, and anti-apoptotic effects. Melatonin is also one of the most powerful natural antioxidants, directly acting on free radicals and the intracellular antioxidant enzyme system. Furthermore, it participates in antitumor activity, hypopigmentation processes in hyperpigmentary disorders, anti-inflammatory, and immunomodulating activity in inflammatory dermatoses, maintaining the integrity of the epidermal barrier and thermoregulation of the body. Due predominantly to its positive influence on sleep, melatonin can be used in the treatment of sleep disturbances for those with chronic allergic diseases accompanied by intensive itching (such as atopic dermatitis and chronic spontaneous urticaria). According to the literature data, there are also many proven uses for melatonin in photoprotection and skin aging (due to melatonin's antioxidant effects and role in preventing damage due to DNA repair mechanisms), hyperpigmentary disorders (e.g., melasma) and scalp diseases (such as androgenic alopecia and telogen effluvium). PMID:36835450 | PMC:PMC9967801 | DOI:10.3390/ijms24044039 {url} = URL to article

Int J Mol Sci. 2023 Feb 18;24(4):4135. doi: 10.3390/ijms24044135. ABSTRACT cAMP response element binding protein (CREB) functions as a prototypical stimulus-inducible transcription factor (TF) that initiates multiple cellular changes in response to activation. Despite pronounced expression in mast cells (MCs), CREB function is surprisingly ill-defined in the lineage. Skin MCs (skMCs) are critical effector cells in acute allergic and pseudo-allergic settings, and they contribute to various chronic dermatoses such as urticaria, atopic dermatitis, allergic contact dermatitis, psoriasis, prurigo, rosacea and others. Using MCs of skin origin, we demonstrate herein that CREB is rapidly phosphorylated on serine-133 upon SCF-mediated KIT dimerization. Phosphorylation initiated by the SCF/KIT axis required intrinsic KIT kinase activity and partially depended on ERK1/2, but not on other kinases such as p38, JNK, PI3K or PKA. CREB was constitutively nuclear, where phosphorylation occurred. Interestingly, ERK did not translocate to the nucleus upon SCF activation of skMCs, but a fraction was present in the nucleus at baseline, and phosphorylation was prompted in the cytoplasm and nucleus in situ. CREB was required for SCF-facilitated survival, as demonstrated with the CREB-selective inhibitor 666-15. Knock-down of CREB by RNA interference duplicated CREB's anti-apoptotic function. On comparison with other modules (PI3K, p38 and MEK/ERK), CREB was equal or more potent at survival promotion. SCF efficiently induces immediate early genes (IEGs) in skMCs (FOS, JUNB and NR4A2). We now demonstrate that CREB is an essential partaker in this induction. Collectively, the ancient TF CREB is a crucial component of skMCs, where it operates as an effector of the SCF/KIT axis, orchestrating IEG induction and lifespan. PMID:36835547 | PMC:PMC9966046 | DOI:10.3390/ijms24044135 {url} = URL to article

J Clin Med. 2023 Feb 19;12(4):1649. doi: 10.3390/jcm12041649. ABSTRACT Infestation with Demodex mites is a common occurrence, especially in adults and the elderly. More recent attention has been paid to the presence of Demodex spp. mites in children, even ones without comorbidities. It causes both dermatological and ophthalmological problems. The presence of Demodex spp. is often asymptomatic, thus it is suggested to include parasitological investigation tests in dermatological diagnostics, in addition to bacteriological analysis. Literature reports show that Demodex spp. are related to the pathogenesis of numerous dermatoses, including rosacea or demodicosis gravis, and common eye pathologies reported by patients such as dry eye syndrome or ocular surface inflammatory conditions, such as blepharitis, chalazia, Meibomian gland dysfunction, and keratitis. Treatment of patients is a challenge and is usually prolonged, therefore it is important to carefully diagnose and properly select the therapy regimen for the treatment to be successful, and with minimal side effects, especially for young patients. Apart from the use of essential oils, research is ongoing for new alternative preparations active against Demodex sp. Our review was focused on the analysis of the current literature data on the available agents in the treatment of demodicosis in adults and children. PMID:36836184 | PMC:PMC9961532 | DOI:10.3390/jcm12041649 {url} = URL to article