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Dermatol Reports. 2022 Mar 23;14(3):9339. doi: 10.4081/dr.2022.9339. eCollection 2022 Sep 14. ABSTRACT Demodex mites are common ectoparasites of the human pilosebaceous units. Most adults are infested with Demodex mites without clinical symptoms. Demodex mite will only become a pathogenic organism when there is an abnormal increase in the number of Demodex mite density. This situation happens when the equilibrium between Demodex mites, skin microenvironment and human immunity system changes. Demodex infestation can cause multiple skin disorders, which are grouped under the term demodicosis or demodicidosis. Clinical manifestations of demodicosis can mimic other known skin diseases such as folliculitis, rosacea, perioral dermatitis, which is why it is often misdiagnosed. Diagnosis criteria consists of relevant correlation of suspected clinical skin lesions, confirmed by the presence of abnormal proliferation of Demodex mites and by clinical cure after acaricidal treatment together with normalization of Demodex mite density. Dermatologists should be aware that demodicosis is not an uncommon skin disease, and there are still many unknowns about it that should be researched further. PMID:36199896 | PMC:PMC9527693 | DOI:10.4081/dr.2022.9339 {url} = URL to article

Dermatol Ther. 2022 Oct 6:e15905. doi: 10.1111/dth.15905. Online ahead of print. ABSTRACT Rosacea is a kind of chronic inflammatory skin disease that usually occurs in the middle of the face. Diammonium glycyrrhizinate (DG), an effective monomer component extracted from licorice, has extensive anti-inflammatory, antioxidant, anti-allergic, and immunomodulatory effects. There is no research on its therapeutic effect on rosacea. In this study, we divided rosacea patients mainly characterized by papules and pustules randomly into 3 groups. Group A received clarithromycin 500 mg once a day, isotretinoin 10 mg once a day; Group B received DG 150 mg three times a day, other medicines were the same as Group A; Group C received clarithromycin 250 mg once a day, isotretinoin 10 mg once every two days, and DG 150 mg three times a day. All patients' symptom scores and laboratory tests were evaluated when followed up. We found that DG combined with clarithromycin and isotretinoin in the treatment of rosacea was more effective and quicker than clarithromycin and isotretinoin alone. Moreover, half common dosage of clarithromycin and isotretinoin combined with DG could achieve the same therapeutic effect as the conventional dose, and brought about lower incidences of adverse events (AEs). Therefore, it is recommended to use half common dosage of routine medication combined with DG for rosacea patients mainly characterized by papules and pustules. PMID:36200523 | DOI:10.1111/dth.15905 {url} = URL to article

Am J Dermatopathol. 2022 Sep 27. doi: 10.1097/DAD.0000000000002235. Online ahead of print. ABSTRACT Histoplasmosis is a dimorphic fungal infection, which is rare outside endemic pockets in North, Central, and South America, Asia, and Africa. Herein, we describe a woman in her 80s living in the Scottish Borders region of the United Kingdom with a recent diagnosis of granulomatous rosacea, who on receiving escalating immunosuppression for suspected sarcoidosis, and long-standing rheumatoid arthritis developed a striking eruption involving her eyelids along with painful ulceration of the oral and nasal mucosa. Histopathologic examination of the skin and mucosal lesions demonstrated granulomatous inflammation with numerous yeast forms of fungal organisms with morphological characteristics of Histoplasma species. This was confirmed to be H. capsulatum on fungal culture and direct panfungal polymerase chain reaction assay. Although the patient had not left the United Kingdom for more than 20 years, she gave a travel history involving multiple trips to countries where histoplasmosis is known to occur, before that. This case exemplifies the challenges involved in making a diagnosis of histoplasmosis in nonendemic regions for both clinicians and pathologists alike. In this particular patient, the diagnostic difficulties were compounded by the clinicopathological overlap with other cutaneous and systemic granulomatous disorders like granulomatous rosacea and suspected sarcoidosis and also the exceptionally long latency period between the purported historical primary infection and recent recrudescence. We highlight this unusual case to increase an awareness of histoplasmosis, which is very rare in nonendemic regions like the United Kingdom and involves cases acquired during residence in or travel to endemic areas, to ensure its prompt recognition and treatment. PMID:36197058 | DOI:10.1097/DAD.0000000000002235 {url} = URL to article

Cornea. 2022 Sep 30. doi: 10.1097/ICO.0000000000003157. Online ahead of print. ABSTRACT PURPOSE: Management of ocular rosacea is challenged by the limited evidence-based systemic treatment guidelines and lack of elucidated mechanisms of treatment efficacy. METHODS: We conducted an online survey of clinicians who regularly treat ocular rosacea to elicit their opinions on treatment algorithms and understanding of the treatment's primary mechanism of action. Descriptive statistics and univariate comparisons were reported. RESULTS: One hundred thirty-two participants completed the online survey. Of the 132 respondents, 74% were cornea specialists. Most respondents (85%) favored systemic tetracyclines over macrolides. Providers' specialty training did not significantly influence preference between tetracyclines and macrolides for ocular rosacea management. Among tetracycline prescribers, there was no consensus regarding initial dosage and duration prescribing patterns. Most macrolide prescribers (88%) initiated a 3-week course of 1 gram of azithromycin weekly. Long-term management strategy for treatment-responsive patients varied: 46% preferred to half the initial dose, 29% discontinued pharmacotherapy, and 16% chronically pulse-dosed patients. Most tetracycline prescribers (90%) and macrolide prescribers (73%) postulate their chosen agents' primary mechanism of effect for ocular rosacea is anti-inflammatory. However, there was no consensus in identifying anti-inflammatory doses of either drug class. Furthermore, there is discordance between prescribers' intended mechanistic effect with the selection of initial dosages for both tetracycline and macrolides for ocular rosacea. CONCLUSIONS: Among clinicians who commonly treat ocular rosacea, there is significant community equipoise regarding which dose of tetracycline is best for initial systemic treatment of this disease. In addition, a consensus understanding regarding mechanism of action of this treatment is lacking. PMID:36197332 | DOI:10.1097/ICO.0000000000003157 {url} = URL to article

Lasers Surg Med. 2022 Nov;54(9):1217-1225. doi: 10.1002/lsm.23605. Epub 2022 Oct 2. ABSTRACT OBJECTIVES: To compare the effectiveness of long-pulsed alexandrite laser (LPAL) with that of pulsed-dye laser (PDL) for rosacea. METHODS: This was a single-blind randomized controlled trial on 27 patients who were clinically diagnosed with rosacea. Randomly assigned split face in each patient received four times monthly treatment of LPAL plus low-fluence Nd:YAG with the contralateral side serving as the control treated with PDL. At every visit, the erythema index (EI) was measured with skin analysis systems, and two independent dermatologists evaluated digital photographs for five-point global aesthetic improvement scale (GAIS). RESULTS: The EI significantly decreased on both treated sides (LPAL 366.5 ± 101.0 vs. 295.8 ± 90.2, p < 0.001, PDL 369.0 ± 124.3 vs. 302.7 ± 92.1, p < 0.001) 1 month after fourth treatment (visit 5). Also 3 months after the fourth treatment (visit 6), the reduction in the EI was well maintained on both sides (LPAL 360.3 ± 96.8 vs. 282.0 ± 89.2, p < 0.001, PDL 364.3 ± 121.6 vs. 281.6 ± 97.8, p < 0.001). When comparing the improvement in the EI between the two groups, the percentage reduction in the EI on the LPAL-treated side was not inferior to the PDL-treated side (visit 5: LPAL 18.7 ± 15.7% vs. PDL 16.4 ± 12.9%, p = 0.501 and visit 6: LPAL 21.7 ± 13.9% vs. PDL 21.9 ± 15.2%, p = 0.943). The GAIS and patient satisfaction were comparable between the LPAL and PDL sides and did not show any significant difference. No serious adverse events occurred on either of the treated sides. CONCLUSION: This study showed that the decrease in EI in the treatment of rosacea was comparable between PDL and LPAL. Therefore, LPAL could be a promising alternative treatment option with good merits for rosacea, considering no consumables are required for device maintenance. PMID:36183378 | DOI:10.1002/lsm.23605 {url} = URL to article

Exp Ther Med. 2022 Aug 8;24(4):618. doi: 10.3892/etm.2022.11555. eCollection 2022 Oct. ABSTRACT To develop an animal model of rosacea-like skin lesions caused by Demodex mites, a suspension of Demodex mites was injected into the skin of Japanese rabbits. The pathology of the skin lesion was assessed using H&E staining after 4 weeks of modeling. The skin lesions observed after 4 weeks were further treated with the recombinant bovine basic fibroblast growth factor (rbFGF) gel. Untreated lesions in the same rabbit were considered as the blank control. Erythema papules were observed in the model rabbit skin and could be observed most clearly in the 2nd week. Lumpy foreign bodies, telangiectasia and granuloma-like structure were observed in the model rabbit in the 1st, 2nd, and 3rd weeks, respectively. An organized granuloma-like structure was observed in the 4th week. The color of the skin lesions became lighter than that of the self-control after 4 weeks of rbFGF treatment. In conclusion, the model of Demodex-induced rosacea-like skin lesions can be developed through intradermal injection of suspension of Demodex mites into Japanese rabbits. The model can mimic the phenotype of skin lesions and histopathological manifestations in the Demodex mite-positive patient with rosacea. PMID:36177392 | PMC:PMC9501744 | DOI:10.3892/etm.2022.11555 {url} = URL to article

J Dermatol. 2022 Sep 30. doi: 10.1111/1346-8138.16595. Online ahead of print. ABSTRACT Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a typical type-2 inflammation involving T-helper type-2 cells and impairing quality of life due to nasal obstruction, discharge and reduced sense of smell. Recently, the anti-IL4Rα antibody dupilumab was approved for CRSwNP. While dermatologic side effects in patients treated with dupilumab for atopic dermatitis are frequently observed, there is limited knowledge about these effects in patients with CRSwNP. We aimed to investigate frequency and characteristics of dermatologic side effects following initiation of dupilumab treatment in a cohort of Austrian CRSwNP patients. Therefore, CRSwNP patients presenting at the Department of Otorhinolaryngology, Head and Neck Surgery at the Vienna General Hospital were retrospectively evaluated for newly developed skin eruptions while under dupilumab treatment. Incidence was calculated and details on clinical symptoms were collected. One hundred and ninety-two CRSwNP patients receiving dupilumab treatment were included, comprising a cumulative follow-up of 89.65 years (median: 5.5, IQR: 5.9). We observed dermatologic side effects in four patients starting at a median time of 15.5 (range 4-23) weeks after dupilumab initiation corresponding to an incidence-rate of 4.46 (95%-confidence interval 1.39-11.23) events per 100 patient-years follow-up. The majority (75%, 3/4) of affected patients developed psoriasis-like dermatitis, whereas one individual experienced rosacea-like folliculitis and alopecia areata. While dupilumab dosing was reduced in 3/4 CRSwNP patients, one patient completely stopped dupilumab therapy. Our study provides the first comprehensive evaluation of both frequency and characteristics of dermatologic side effects caused by dupilumab in CRSwNP patients. All affected patients developed Th1-inflammatory associated skin disorders - previously observed only in individuals with prior affections of the skin (i.e. atopic dermatitis). Thus, individuals receiving dupilumab for CRSwNP may develop novel symptoms that require interdisciplinary management. Future studies on dupilumab in a real-world setting will be required to further explore its spectrum of side effects. PMID:36177732 | DOI:10.1111/1346-8138.16595 {url} = URL to article

Dermatol Ther. 2022 Sep 30:e15869. doi: 10.1111/dth.15869. Online ahead of print. ABSTRACT Rosacea lessens patients' quality of life not only by visible symptoms like erythema, papules, and pustules but also by invisible symptoms like stinging, burning, and dryness. Ivermectin 1% cream has recently been introduced as an efficient therapy for papules and pustules in rosacea patients. To investigate the potential of ivermectin 1% cream to improve rosacea-associated erythema and invisible symptoms by combining established questionnaires with the novel photography and analysis tool Scarletred®Vision. We performed an open monocentric pilot study including 25 Caucasian patients presenting with moderate to severe rosacea with erythema, less than 10 papules and/or pustules, and ≥ 15 Demodex mites/cm2 . Patients applied 1 g of ivermectin 1% cream (Soolantra®) once a day for ≥16 weeks. Skin symptoms were recorded at baseline, week 8 and ≥ week 16. Grade of erythema was determined by clinician erythema assessment (CEA) and patient self-assessment (PSA). Severity of invisible skin symptoms (stinging and/or burning, dryness, itching) were assessed by questionnaire. Erythema and skin texture were additionally quantified using Scarletred®Vision. Ivermectin 1% cream significantly reduced invisible symptoms of rosacea (stinging and/or burning, dryness: p < 0.0001; itching p < 0.001; at ≥16 weeks). Analysis with Scarletred®Vision confirmed CEA and PSA results for improvement of erythema (p < 0.0001; at ≥16 weeks) and skin roughness (p < 0.001; at ≥16 weeks). Treatment with ivermectin 1% cream is efficient in treating not only rosacea-associated papules and pustules but also erythema and invisible skin symptoms. PMID:36177738 | DOI:10.1111/dth.15869 {url} = URL to article

J Dermatol. 2022 Sep 30. doi: 10.1111/1346-8138.16596. Online ahead of print. ABSTRACT There is a lack of contemporary data on rosacea originating in Japan. Using baseline data from a randomized, phase 3 study of 130 Japanese patients with rosacea treated with metronidazole gel (0.75%) or vehicle, the authors evaluated demographic and clinical characteristics, pretreatment quality of life, and exacerbating factors. In line with global data, most patients were women (82.3%; 107/130) and aged between 30 and 50 years (60.7%; 79/130). Patient-reported quality of life scores indicated that rosacea had an impact similar to that of other debilitating and disfiguring skin conditions (such as psoriasis), particularly in terms of the emotional burden. Anxiety or depression was reported by 30% of patients (39/130), with 6.9% (9/130) reporting moderate levels and 0.8% (1/130) reporting severe levels. The top five exacerbating factors reported to trigger worsening of rosacea were temperature changes, sun exposure, hot weather, seasonal variation, and heavy exercise. In addition, pollen exposure and menstruation were noted as triggers of rosacea symptoms; these are novel findings that require further investigation to fully understand the implications for patients and treatment. Rosacea is likely to be underdiagnosed and undertreated in Japan because of the current lack of consensus guidelines and standardized therapy. The authors anticipate that the results of this analysis will provide much needed information to help improve diagnosis and facilitate the management of rosacea in patients. PMID:36177741 | DOI:10.1111/1346-8138.16596 {url} = URL to article

Dermatol Ther. 2022 Sep 29:e15848. doi: 10.1111/dth.15848. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory skin disease characterized by facial erythema, papules, pustules, telangiectasia and flushing. The Janus kinase (JAK) signal transducer and activator of transcription (STAT) pathway appears to play a role in the pathogenesis of rosacea. Our study preliminarily explored the efficacy of JAK inhibitor tofacitinib in the treatment of rosacea. We retrospectively reviewed the cases of 21 patients with rosacea who were treated with oral tofacitinib. Patients received oral tofacitinib 5 mg as either monotherapy or adjunctive therapy. We have observed that 15 out of 21 patients (71.4%) patients experienced significant regression of erythema on the face (IGA≤1), and a mean change of -2.24 in the Investigator's Global Assessment (IGA) score was significant improvement from baseline. Treatment with oral tofacitinib might be a potentially effective treatment to ameliorate the symptoms of rosacea. PMID:36175135 | DOI:10.1111/dth.15848 {url} = URL to article

Biochim Biophys Acta Mol Basis Dis. 2022 Sep 27;1868(12):166563. doi: 10.1016/j.bbadis.2022.166563. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin disorder with unclear etiology. Evidence showed that immunoinflammatory dysregulation was involved in the pathogenesis. Bile acids, as important participants of hepatoenteric circulation, play a vital role in immunoinflammatory regulation through peripheral blood circulation. However, whether it has effects on rosacea remains unknown. METHODS: Here, we performed a bile acid analysis on the serum samples of rosacea patients and healthy controls. Then we gavage G protein-coupled bile acid receptor 1 (TGR5) knockout mice with lithocholic acid (LCA) based on a LL37-induced rosacea-like model. We further overexpress TGR5 in HaCaT keratinocytes to figure out the downstream pathway. RESULTS: We found varied bile acid profile in the peripheral blood circulation of patients, especially the most significant increase in LCA. LCA promoted skin inflammation in LL37-induced rosacea-like mouse model. Our in vivo and in vitro results further demonstrated that LCA induced inflammatory cytokines and chemokines, thus exacerbated rosacea-like skin inflammation, via TGR5 in keratinocytes and LL37-induced rosacea-like mouse model. CONCLUSIONS: Therefore, we conclude that LCA promotes skin inflammation of rosacea via TGR5, and LCA-TGR5 axis may be a novel therapeutic target for rosacea. PMID:36174876 | DOI:10.1016/j.bbadis.2022.166563 {url} = URL to article

J Dermatolog Treat. 2022 Oct 5:1-3. doi: 10.1080/09546634.2022.2129953. Online ahead of print. ABSTRACT Papulopustular rosacea is notoriously a challenge to treat, and treatment options are scarce. Only limited data exist on the use of azithromycin in treatment of papulopustular rosacea. However, the unique pharmacokinetics of azithromycin may have several indications in the treatment of papulopustular rosacea. We here report a case of hard-to-treat papulopustular rosacea which was successfully treated with pulsed oral azithromycin in addition to maintenance isotretinoin. PMID:36165496 | DOI:10.1080/09546634.2022.2129953 {url} = URL to article

J Eur Acad Dermatol Venereol. 2022 Sep 27. doi: 10.1111/jdv.18616. Online ahead of print. ABSTRACT BACKGROUND: The composition of the skin microbiome varies from infancy to adulthood and becomes most stable in adulthood. Adult acne patients harbour an 'acne microbiome' dominated by specific strains of Cutibacterium acnes. However, the precise timing of skin microbiome evolution, the development of the acne microbiome, and the shift to virulent C. acnes strain composition during puberty is unknown. OBJECTIVES: We performed a cross-sectional pilot study in a paediatric population to understand how and when the skin microbiome composition transitions during puberty and whether a distinct 'acne microbiome' emerges in paediatric subjects. METHODS: Forty-eight volunteers including males and females, ages 7-17 years, with and without acne were enrolled and evaluated for pubertal development using the Tanner staging criteria. Sebum levels were measured, and skin microbiota were collected by sterile swab on the subject's forehead. DNA was sequenced by whole genome shotgun sequencing. RESULTS: A significant shift in microbial diversity emerged between early (T1-T2) and late (T3-T5) stages of puberty, coinciding with increased sebum production on the face. The overall relative abundance of C. acnes in both normal and acne skin increased during puberty and individual C. acnes strains were uniquely affected by pubertal stage and the presence of acne. Further, an acne microbiome signature associated with unique C. acnes strain composition and metabolic activity emerges in late puberty in those with acne. This unique C. acnes strain composition is predicted to have increased porphyrin production, which may contribute to skin inflammation. CONCLUSIONS: Our data suggest that the stage of pubertal development influences skin microbiome composition. As children mature, a distinct acne microbiome composition emerges in those with acne. Understanding how both puberty and acne influence the microbiome may support novel therapeutic strategies to combat acne in the paediatric population. PMID:36165604 | DOI:10.1111/jdv.18616 {url} = URL to article

Dermatol Pract Concept. 2022 Jul 1;12(3):e2022113. doi: 10.5826/dpc.1203a113. eCollection 2022 Jul. ABSTRACT INTRODUCTION: The relationship between facial dermatoses and blepharitis has been known for a long time. OBJECTIVES: We aimed to investigate the frequency of accompanying facial dermatoses in patients with blepharitis and their relationship with the severity of blepharitis. METHODS: In this cross-sectional study, 95 patients with blepharitis were examined for attending facial dermatoses. The type of blepharitis, the severity of blepharitis, and the degree of dry eye were determined in the patients. Dermoscopic and microscopic examinations were used in the diagnosis of facial dermatoses. The history of allergic rhinitis was questioned because Demodex species frequently accompany blepharitis, facial dermatoses, and allergic rhinitis patients. Mann-Whitney U test was used compare 2 independent groups. In comparing categorical variables, Pearson chi-Squared, Fishere Exact, and Fisher-Freeman-Holton tests were used. RESULTS: At least 1 facial dermatosis was detected in 84.2% patients, and we did not see any facial dermatosis in 15.8% ones. No patients had acne, which is one of the most common facial dermatoses. The most common facial dermatosis detected in our patients was facial demodicosis (57.9%). It was followed by seborrheic dermatitis (22.1%) and rosacea (12.6%), respectively. In addition, 2.1% of the patients had atopic eyelid dermatitis, 23.2% had a history of allergic rhinitis, and 63.2% had ocular demodicosis. CONCLUSIONS: It is essential to perform dermatological examinations of all patients with blepharitis in terms of accompanying facial dermatoses and their early diagnosis. PMID:36159148 | PMC:PMC9464537 | DOI:10.5826/dpc.1203a113 {url} = URL to article

Dermatol Ther (Heidelb). 2022 Sep 24. doi: 10.1007/s13555-022-00808-9. Online ahead of print. ABSTRACT Benzoyl peroxide (BPO) has been used extensively in dermatology, often for the treatment of acne vulgaris. In a 20-year period, dermatologists in the United States used over-the-counter BPO more than 13 million times. However, skin irritation and other adverse events (AEs) are associated with the use of BPO. AEs associated with BPO were identified using the Galderma pharmacovigilance system, which collects AE reports from multiple sources. Over approximately 20 years, 558 AE reports were collected from the database, ranging from application site reactions to systemic hypersensitivity reactions, resulting in a reporting rate of under 1%. These data show that the risk of OTC topical acne drug products containing BPO is low. PMID:36152215 | DOI:10.1007/s13555-022-00808-9 {url} = URL to article

J Am Acad Dermatol. 2022 Sep 21:S0190-9622(22)02769-4. doi: 10.1016/j.jaad.2022.08.063. Online ahead of print. NO ABSTRACT PMID:36152697 | DOI:10.1016/j.jaad.2022.08.063 {url} = URL to article

Acta Dermatovenerol Alp Pannonica Adriat. 2022 Sep;31(3):105-109. ABSTRACT The human body is inhabited by complex communities of microorganisms. Changes in the composition and function of the skin and gut microbiota are linked to various skin diseases. The microbiota is an important modulator of the immune system and thus maintains homeostasis. Conversely, the immune system can also change the composition of the microorganism community. Thus, it is still unknown whether certain skin diseases are caused by primary changes in the local and/or remote microbiota, or whether dysbiosis is only a secondary consequence of the dermatoses themselves. Expanding knowledge of skin and gut microbiota dysbiosis in skin diseases may possibly lead to better understanding of their pathophysiologies and to the discovery of new molecular markers for their earlier diagnosis and targeted treatment; for example, using specific microbes to replace missing ones. This narrative review provides an overview of current knowledge about skin and gut microbiota dysbiosis in psoriasis, atopic dermatitis, hidradenitis suppurativa, seborrheic dermatitis, acne vulgaris, rosacea, and lichen sclerosus. PMID:36149040 {url} = URL to article

Expert Rev Clin Immunol. 2022 Sep 22. doi: 10.1080/1744666X.2022.2128334. Online ahead of print. ABSTRACT INTRODUCTION: : Recent advances in the understanding of the pathophysiology of rosacea have led to increased focus on the disease's immunologic etiology and to the development of immunologically based treatments. With many patients suffering from incomplete control, addressing the immune components of the disease process may provide a more effective treatment option for rosacea patients that may improve quality of life. AREAS COVERED: : This review will provide a brief overview of the pathophysiology or rosacea, as well as specific immunologic contributions to the disease state. Current standard-of-care treatments will be described, including anti-parasitic, anti-inflammatory agents, and antibiotics. Emphasis will be placed on treatments that target the immune components of the disease process. EXPERT OPINION: : Rosacea remains a difficult dermatologic disease to treat, partially due to an incomplete understanding of the disease pathophysiology. The immune pathophysiology of rosacea, particularly the key role of inflammation, has been clarified over the past decade. Identification of specific molecules, including cytokines and nuclear transcription factors, may allow for the development of targeted rosacea-specific biologic and topical treatments. However, medication nonadherence is a limiting factor to achieving symptomatic control among rosacea patients. Focusing on the development of oral or injectable forms of therapy may circumvent poor adherence. PMID:36137266 | DOI:10.1080/1744666X.2022.2128334 {url} = URL to article

J Cosmet Dermatol. 2022 Sep 20. doi: 10.1111/jocd.15271. Online ahead of print. NO ABSTRACT PMID:36126208 | DOI:10.1111/jocd.15271 {url} = URL to article

JAAD Case Rep. 2022 Jul 19;28:83-86. doi: 10.1016/j.jdcr.2022.07.014. eCollection 2022 Oct. NO ABSTRACT PMID:36105757 | PMC:PMC9467856 | DOI:10.1016/j.jdcr.2022.07.014 {url} = URL to article

Cureus. 2022 Sep 3;14(9):e28726. doi: 10.7759/cureus.28726. eCollection 2022 Sep. ABSTRACT Facial hypervascularity is a condition that manifests as erythema and edema caused by aberrant blood vessels. Often, the cause of these abnormal blood vessels can be attributed to previous trauma or vascular conditions such as rosacea, although sometimes the cause is unknown. Pulsed dye laser (PDL) can be an effective treatment even when the cause is unknown. We present a case of a 24-year-old male presenting with intermittent swelling, redness, and throbbing sensations of the nose and cheeks for the past five years. Physical examination was notable for prominent erythema and swelling of the nasal skin and mild erythema on the cheeks. He underwent treatment with PDL and achieved complete resolution of his symptoms. This case illustrates the effectiveness of PDL in the treatment of facial hypervascularity. PMID:36105901 | PMC:PMC9447474 | DOI:10.7759/cureus.28726 {url} = URL to article

Dermatol Ther (Heidelb). 2022 Sep 13. doi: 10.1007/s13555-022-00798-8. Online ahead of print. NO ABSTRACT PMID:36098878 | DOI:10.1007/s13555-022-00798-8 {url} = URL to article

J Cosmet Dermatol. 2022 Sep 13. doi: 10.1111/jocd.15384. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin disease affecting the face, and the current treatment effect is not satisfactory. Based on the photomodulation of optimal pulse technology (OPT), we developed a novel treatment mode, namely, advanced OPT with low energy, three pulses, and long pulse width (AOPT-LTL). AIMS: We aimed to explore the feasibility and underlying molecular mechanisms of AOPT-LTL treatment in a rosacea-like mouse model. Furthermore, we evaluated the safety and efficacy in patients with erythematotelangiectatic rosacea (ETR). MATERIALS AND METHODS: Morphological, histological, and immunohistochemical analyses were used to investigate the efficacy and mechanisms of AOPT-LTL treatment in the LL-37-induced rosacea-like mouse model. Moreover, twenty-three patients with ETR were included and received different times of treatment at intervals of two weeks depending on the severity of their condition. The treatment effect was assessed by comparing clinical photographs at baseline, one week and three months after treatment, combined with the red value, GFSS, and CEA scores. RESULTS: After the AOPT-LTL treatment of the mice, we observed that the rosacea-like phenotype, inflammatory cell infiltration, and vascular abnormalities were significantly ameliorated, and the expression of the core molecules of rosacea was significantly inhibited. In the clinical study, the AOPT-LTL treatment exerted satisfactory therapeutic effects on erythema and flushing of ETR patients. No serious adverse events were observed. CONCLUSIONS: AOPT-LTL is a safe and effective method for the treatment of ETR. PMID:36099436 | DOI:10.1111/jocd.15384 {url} = URL to article

J Dtsch Dermatol Ges. 2022 Sep 13. doi: 10.1111/ddg.14879. Online ahead of print. ABSTRACT This guideline aims to improve the efficiency and safety of lasers and optical radiation sources with similar effects (especially IPL). Laser therapy of skin lesions with an increased amount of melanocytes should be performed with caution. Laser treatment of pigmented melanocytic nevi is not recommended. The guideline contains recommendations regarding the treatment of lentigines and café-au-lait spots, non-pigmented dermal nevi, Becker nevus, nevus of Ota/Hori/Ito and melasma. Further recommendations focus on the treatment of skin lesions without an increased amount of melanocytes (ephelides, postinflammatory hyperpigmentation including berloque dermatitis, seborrheic keratoses, traumatic/decorative tattoos and metallic deposits), hypopigmentation (vitiligo), benign non-pigmented neoplasms (fibrous papule of the nose, nevus sebaceus, epidermal nevus, neurofibroma, sebaceous gland hyperplasia, syringoma, xanthelasma palpebrarum), inflammatory dermatoses (acne papulopustulosa/conglobata, acne inversa, granuloma faciale, lichen sclerosus, lupus erythematosus, psoriasis vulgaris, rosacea, rhinophyma), wrinkles/dermatochalasis/striae, hypertrichosis, scars (atrophic, hypertrophic; keloids, burn/scald scars), laser-assisted skin healing, onychomycosis, precancerous lesions and malignant tumors (actinic keratoses/field cancerization, cheilitis actinica, basal cell carcinoma), vascular skin lesions (angiokeratoma, angioma, hemangioma, malformation, spider veins, granuloma telangiectaticum (pyogenic granuloma), rubeosis (erythrosis interfollicularis colli, ulerythema ophryogenes), nevus flammeus, telangiectasias and Osler's disease (hereditary hemorrhagic telangiectasia) and viral skin lesions (condylomata acuminata, mollusca contagiosa, verrucae planae juveniles/vulgares/ verrucae palmares et plantares). PMID:36098675 | DOI:10.1111/ddg.14879 {url} = URL to article

Dermatol Ther. 2022 Sep 12:e15819. doi: 10.1111/dth.15819. Online ahead of print. ABSTRACT OBJECTIVE: Brimonidine is a vasoconstrictive agent used to treat several dermatologic disorders. Here, we review the uses of brimonidine in different aspects of dermatology. METHODS: We searched keywords including rosacea, erythema, topical brimonidine, dermatology, and skin disease in PubMed, Cochrane, and Google Scholar to collect the related published articles. RESULTS: In a review of 15 articles, we found topical brimonidine improved the facial erythema of rosacea. In addition, it reduced the erythema associated with alcohol flushing syndrome, intense pulsed light therapy, and photodynamic therapy. Furthermore, topical brimonidine was used as a hemostatic agent in dermatosurgery procedures such as Mohs surgery and nail surgery to reduce intra-operative and postoperative bleeding. Some side effects such as erythema, flushing, and burning were reported in a few patients. CONCLUSION: Based on our findings, brimonidine is a beneficial drug that can be used in various dermatologic disorders with negligible side effects. This article is protected by copyright. All rights reserved. PMID:36097378 | DOI:10.1111/dth.15819 {url} = URL to article