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Ann Dermatol. 2020 Aug;32(4):265-272. doi: 10.5021/ad.2020.32.4.265. Epub 2020 Jun 30. ABSTRACT The human microbiome is a rich environment consisting of bacteria, fungi and other commensal microorganisms of the gut, mucosa and skin. The functional role of the gut microbiome includes facilitation in metabolism of macronutrients, maturation of the immune system, and production of pro- or anti-inflammatory signaling molecules and peptides. The identification of these resident organisms has brought about a new understanding of disease processes. Nevertheless, more questions remain regarding the interactions within the microbiome, its interactions with the host, and its contributions to the pathophysiology of disease. The purpose of this review is to examine the existing medical literature to highlight the role of the gut microbiome in human health, also paying attention to its role in several inflammatory skin diseases, namely atopic dermatitis, psoriasis, and rosacea. PMID:33911753 | PMC:PMC7992658 | DOI:10.5021/ad.2020.32.4.265 {url} = URL to article Etcetera Microorganisms of the Human Microbiome in Rosacea

Ann Dermatol. 2020 Aug;32(4):298-305. doi: 10.5021/ad.2020.32.4.298. Epub 2020 Jun 30. ABSTRACT BACKGROUND: The clinical features of inflammatory papular dermatoses of the face are very similar. Their clinical manifestations have been described on the basis of a small number of case reports and are not specific. OBJECTIVE: This study aimed to use computer-aided image analysis (CAIA) to compare the clinical features and parameters of inflammatory papular dermatoses of the face and to develop a formalized diagnostic algorithm based on the significant findings. METHODS: The study included clinicopathologically confirmed inflammatory papular dermatoses of the face: 8 cases of eosinophilic pustular folliculitis (EPF), 13 of granulomatous periorificial dermatitis-lupus miliaris disseminatus faciei (GPD-LMDF) complex, 41 of granulomatous rosacea-papulopustular rosacea complex (GR-PPR) complex, and 4 of folliculitis. Clinical features were evaluated, and area density of papular lesions was quantitatively measured with CAIA. Based on these variables, we developed a predictive model for differential diagnosis using classification and regression tree analysis. RESULTS: The EPF group showed lesion asymmetry and annular clusters of papules in all cases. The GPD-LMDF complex group had significantly higher periocular density. The GR-PPR complex group showed a higher area density of unilateral cheek papules and the highest total area density. According to the predictive model, 3 variables were used for differential diagnosis of the 4 disease groups, and each group was diagnosed with a predicted probability of 67%~100%. CONCLUSION: We statistically confirmed the distinct clinical features of inflammatory papular dermatoses of the face and proposed a diagnostic algorithm for clinical diagnosis. PMID:33911757 | PMC:PMC7992653 | DOI:10.5021/ad.2020.32.4.298 {url} = URL to article

Ann Dermatol. 2020 Dec;32(6):466-472. doi: 10.5021/ad.2020.32.6.466. Epub 2020 Nov 11. ABSTRACT BACKGROUND: A recent study suggested a possible role of skin barrier dysfunction in the pathogenesis of rosacea, which leads to irritation symptoms. Gamma linolenic acid (GLA) is an essential omega-6 fatty acid that is known to restore defective epidermal skin barrier. GLA supplementation has not previously been performed in rosacea patients. OBJECTIVE: To investigate the efficacy and safety of adding GLA to minocycline compared to minocycline alone in rosacea patients. METHODS: This prospective, double-blind, randomized, placebo-controlled trial enrolled 31 rosacea patients. They were randomly assigned to receive 320 mg/day of GLA (Evoprim®) (n=16) or placebo (n=15) in addition to 100 mg/day of minocycline for 8 weeks. Investigator's global assessment (IGA) and patient's global assessment (PGA) were used to assess clinical severity at weeks 0, 4, 8, and 12. Biophysical parameters including melanin index, erythema index, transepidermal water loss (TEWL), lipid concentration, and stratum corneum hydration were measured. RESULTS: In the GLA group, a higher proportion of patients achieved treatment success (IGA≤1) at week 8 (68.75% vs. 33.33%) and patient satisfaction (PGA≥3) at weeks 8 (75.0% vs. 40.0%) and 12 (81.3% vs. 46.6%). Both groups, throughout 12 weeks of treatment, revealed a trend toward improvement in erythema index, melanin index, TEWL, and stratum corneum hydration. Particularly, there was a significant difference in TEWL and stratum corneum hydration over time between the two groups (p=0.033, p=0.003, respectively). No serious adverse event was observed in both groups. CONCLUSION: GLA is beneficial as an additional therapeutic option for rosacea patients treated with minocycline. PMID:33911789 | PMC:PMC7875229 | DOI:10.5021/ad.2020.32.6.466 {url} = URL to article

Br J Dermatol. 2021 Apr 29. doi: 10.1111/bjd.20411. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory disease that primarily affects young and middle-aged Caucasian women. Its etiology is multifactorial and appears to be determined by genetic predisposition, alteration of the neurovascular and immune response, as well as an altered dialogue with the microbiota. Additionally, the disease has been linked to gastrointestinal disorders such as Helicobacter pylori infection or small intestine bacterial overgrowth and even neurological disorders such as Parkinson's disease, revealing the existence of a brain-gut-skin axis. PMID:33913159 | DOI:10.1111/bjd.20411 {url} = URL to article

J Cosmet Dermatol. 2021 Apr 26. doi: 10.1111/jocd.14178. Online ahead of print. ABSTRACT BACKGROUND: Patients with rosacea often complained of low-tolerance to skincare. AIM: To examine if the preexisted low-tolerance to skincare is associated with rosacea the occurrence of the Chinese population. METHODS: A retrospective case-control survey of 997 rosacea cases and 1,012 skin-healthy controls was carried out in China. Low-tolerance to skincare was evaluated based on the history of facial skin allergic reactions related to skincare in the past five years before the onset of rosacea. A comparative analysis was performed between the case and control groups by the chi-square test and the logistic regression analysis. RESULTS: History of facial skin allergic reaction due to skin care products (OR=5.110, 95%CI=3.893-6.706) and skin care in beauty salons (OR=3.002, 95%CI=1.506-5.981) both presented a positive correlations with the occurrence of rosacea. Facial masks and cosmetics were two of the most common products causing facial allergic reaction. The OR values increased with the increased frequency of allergic reactions related to facial mask and cosmetics. In addition, the history of facial skin allergic reaction had a significantly associated with the severity of self-reported symptoms of rosacea including dryness, burning, stinging and itching. CONCLUSIONS: The condition of low-tolerance of the facial skin to skincare was closely associated with the occurrence of rosacea. PMID:33901342 | DOI:10.1111/jocd.14178 {url} = URL to article

Actas Dermosifiliogr. 2021 Apr 19:S0001-7310(21)00139-3. doi: 10.1016/j.ad.2021.04.002. Online ahead of print. ABSTRACT This series of 2 articles on dermatopathologic diagnoses reviews conditions in which granulomas form. Part 1 clarifies concepts, discusses the presentation of different types of granulomas and giant cells, and considers a large variety of noninfectious diseases. Some granulomatous diseases have a metabolic origin, as in necrobiosis lipoidica. Others, such as granulomatous mycosis fungoides, are related to lymphomas. Still others, such as rosacea, are so common that dermatologists see them nearly daily in clinical practice. PMID:33887235 | DOI:10.1016/j.ad.2021.04.002 {url} = URL to article

Iran J Parasitol. 2020 Oct-Dec;15(4):596-601. doi: 10.18502/ijpa.v15i4.4870. ABSTRACT BACKGROUND: Adenosine deaminase (ADA) is an aminohydrolase involved in the catabolism of purine nucleotides and irreversibly deaminizes adenosine and deoxyadenosine to inosine and deoxyinosine. ADA enzyme deficiency results in the loss of functional properties of B and T lymphocytes. Demodex species have been reported to be transmitted between humans through close contact and to play a role in the pathogenesis of rosacea, acne vulgaris, perioral dermatitis, seborrhoeic dermatitis, micropapillary-pruritic dermatitis and blepharitis. The present study aimed to compare serum ADA levels in D. folliculorum positive patients with the healthy control individuals. METHODS: Serum ADA levels were examined for 30 patients diagnosed with erythematotelangiectatic rosacea and 40 healthy individuals in Malatya Inonu University in 2017. Standardized skin surface biopsy (SSSB) method was used to diagnose D. folliculorum. A significant decrease was found in the ADA levels of Demodex-positive rosacea patients when compared to the control group. RESULTS: ADA levels were decreased in the Demodex-positive group. The mean ADA level in patient group was significantly lower than the mean in the control group (P<0.001). There was no significant difference between the patient and control groups in terms of age and gender. CONCLUSION: During and after treatment of Demodex-positive rosacea patients, determination of ADA levels may give more detailed information on the immune mechanisms. PMID:33884017 | PMC:PMC8039488 | DOI:10.18502/ijpa.v15i4.4870 {url} = URL to article

Pediatrics. 2021 Apr 20:e2020029520. doi: 10.1542/peds.2020-029520. Online ahead of print. ABSTRACT Two adolescent boys presented with acute acneiform eruptions in the setting of recent dupilumab administration. Subsequent investigation via direct scraping of pustules revealed live Demodex mite colonization of the face. These adolescent patients represent a population not commonly associated with Demodex folliculitis, and we theorize their baseline commensal Demodex mite population may have increased as a consequence of dupilumab-induced, focused immunomodulation. We recommend that pediatricians consider Demodex potentially etiologic in patients presenting with new onset acneiform or rosacea-like dermatoses in patients treated with dupilumab. PMID:33879520 | DOI:10.1542/peds.2020-029520 {url} = URL to article

J Cosmet Dermatol. 2021 Apr 20. doi: 10.1111/jocd.14169. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin disease characterized with increased serum and tissue inflammatory mediators. IL-17 is a well-known inflammatory mediator that plays important roles in pathogenesis of inflammatory skin diseases. Previous studies reported that Th17 pathway is activated in rosacea and IL-17, one of Th17 signature cytokines, is elevated in tissue samples of rosacea patients. OBJECTIVES: The aim of this study was to investigate serum IL-17 levels in rosacea patients and to study its relationship with disease characteristics. METHODS: Sixty patients diagnosed with rosacea and 60 healthy controls were included in the study. Serum IL-17 concentrations were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS: The mean serum IL-17 level was 8.03 pg/mL (sd=1.47) in rosacea patients and 7.37 pg/mL (sd=1.19) in controls. Serum IL-17 levels were significantly higher in rosacea (p=0.002). Serum IL-17 levels were similar among patients with erythematotelangiectatic (ET) and papulopustular (PP) rosacea (8.02 vs 8.06, p=0.83). Serum IL-17 levels did not correlate with rosacea severity (p=0.59, r=0.07 in ET rosacea; p=0.88, r=0.02 in PP rosacea), age of onset (p=0.58, r=-0.07) and disease duration (p=0.37, r=-0.11). Primary features and global assessments did not correlate with serum IL-17 levels (all p>0.05). Among secondary features, edema showed a significant negative correlation with serum IL-17 concentrations (p=0.037, r=-0.26). CONCLUSIONS: Our study showed increased serum IL-17 levels in rosacea patients and a significant correlation between IL-17 concentrations and secondary features of the disease suggesting IL-17 may contribute to pathogenesis of rosacea and may be a new target for rosacea treatment. PMID:33877738 | DOI:10.1111/jocd.14169 {url} = URL to article

J Cosmet Dermatol. 2021 Apr 19. doi: 10.1111/jocd.14162. Online ahead of print. ABSTRACT BACKGROUND: Lasers have great importance in the management of vascular skin lesions. AIM: To determine the efficacy of 577-nm pro-yellow laser in cure of certain vascular skin diseases. MATERIAL AND METHODS: Seventy-four patients who are diagnosed as vascular skin diseases were involved in this study. All participants treated with 577-nm pro-yellow laser with 4 weeks intervals. The photographs that were taken before and at every following visit used to evaluate improvement. RESULTS: A significant improvement occurred in portwine stain, rosacea, facial telangiectasia, venous lake, scrotal angikeratoma and cherry angioma cases. CONCLUSION: Vascular skin lesions can be treated with 577-nm pro-yellow laser with a minimal adverse effect and great success rate. PMID:33872451 | DOI:10.1111/jocd.14162 {url} = URL to article

J Cosmet Dermatol. 2021 Apr 19. doi: 10.1111/jocd.14164. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory disease characterized by facial flushing, erythema, telangiectasia, papules, and pustules. Its pathogenesis has not been fully understood. In 2017, the global ROSacea COnsensus (ROSCO) panel updated the diagnosis, classification and assessment of rosacea. Phenotype-based treatments and long-term managements have also been recommended. Murine models are a powerful tool in unveiling and dissecting the mechanisms of human diseases. Here, we summarized murine models of rosacea developed or used in previous research, including LL-37 intradermal injection model, KLK-5-induced inflammation model, croton oil inflammation model, 12-O-Tetradecanoylphorbol-13-acetate inflammation model, arachidonic acid inflammation model, RTX-induced vasodilation model, and UVB-induced model. LL-37 injection model has become the most intensively used model in rosacea research. Each model could show the pathophysiological and clinical features of rosacea to some extent. However, no model can show the full picture of the characteristics of rosacea. Improving existed murine models, developing new murine models, and applying them to pathogenesis and treatment research on rosacea are highly warranted in the future. PMID:33872453 | DOI:10.1111/jocd.14164 {url} = URL to article

J Drugs Dermatol. 2021 Apr 1;20(4):384-392. doi: 10.36849/JDD.2021.5861. ABSTRACT BACKGROUND: Rosacea, an inflammatory skin disease that leads to an impaired skin barrier function commonly involves the face. Symptoms of rosacea can be bothersome and include pain, stinging, burning, itching, and facial flushing. This review explored skin barrier impairment in rosacea and reduced symptomatology when using over the counter (OTC) skincare products. METHODS: Nine dermatologists (the panel) completed a survey on OTC products they recommend for rosacea. The survey results were summarized, presented, and discussed during the online meeting, together with the results of a literature review. The outcome of these discussions, coupled with the panel's expert opinion and experience, is shown in the current review. RESULTS: Addressing barrier dysfunction by use of moisturizer and cleanser formulations that restore skin hydration, normalize skin pH, restore the microbiome, and skin lipids can assist in improving rosacea signs and symptoms. The panel's consensus was that in addition to the use of prescription medications, skincare recommendations are a crucial part of successful rosacea therapy. In addition to occlusives and humectants, barrier restoring ingredients such as ceramides, hyaluronic acid, and niacinamide were considered beneficial. Equally important was the absence of potentially irritating substances. CONCLUSIONS: The use of OTC products can improve rosacea symptomatology and signs. As adjuncts, these products are recommended before and during prescription therapy and as part of a maintenance regimen. J Drugs Dermatol. 20(4):384-392. doi:10.36849/JDD.5861 THIS ARTICLE HAD BEEN MADE AVAILABLE FREE OF CHARGE. PLEASE ACCESS THE FULL TEXT OF THIS ARTICLE WITHOUT LOGGING IN. NO PURCHASE NECESSARY. PLEASE CONTACT THE PUBLISHER WITH ANY QUESTIONS. PMID:33852244 | DOI:10.36849/JDD.2021.5861 {url} = URL to article

J Drugs Dermatol. 2021 Apr 1;20(4):426-431. doi: 10.36849/JDD.2021.5923. ABSTRACT BACKGROUND: Cutaneous rosacea is a common inflammatory skin disorder that often presents with facial papulopustular lesions that are frequently bothersome to patients. Broad-spectrum oral tetracyclines, such as doxycycline and minocycline, have been well established over several years of real-world use as effective agents for papulopustular rosacea. Sarecycline is a third-generation narrow-spectrum oral tetracycline that was approved for the treatment of acne in the United States in 2018. OBJECTIVE: Studies have shown sarecycline to be effective and safe for acne, with low risk of side effects that are historically associated with oral tetracyclines, in addition to offering a reduced risk of emergence of resistant bacteria due to a narrower spectrum of antibiotic activity. METHODS: A 12-week, investigator-blinded, controlled pilot study was completed evaluating once daily sarecycline, using weight-based oral dosing as recommended for acne, for the treatment of papulopustular rosacea in adult subjects. RESULTS: Sarecycline was shown to be effective and safe for the treatment of papulopustular rosacea in adults with marked superiority in efficacy as compared to subjects in the control group. This article reviews the results of this pivotal study. PMID:33852248 | DOI:10.36849/JDD.2021.5923 {url} = URL to article

J Am Acad Dermatol. 2021 Apr 10:S0190-9622(21)00753-2. doi: 10.1016/j.jaad.2021.04.006. Online ahead of print. NO ABSTRACT PMID:33848606 | DOI:10.1016/j.jaad.2021.04.006 {url} = URL to article

J Clin Aesthet Dermatol. 2021 Mar;14(3):32-37. Epub 2021 Mar 1. ABSTRACT BACKGROUND: Rosacea is a chronic, multisymptom, inflammatory condition that affects the centrofacial skin. Facial erythema associated with rosacea can negatively impact a patient's quality of life and is often hard to treat. OBJECTIVE: We sought to review the literature on the role of alpha-adrenergic receptors (α-adrenoceptors) in the context of persistent facial erythema in patients with rosacea and the use of oxymetazoline hydrochloride cream 1% as a topical treatment. METHODS: PubMed was searched; search terms included "alpha adrenoceptor," "oxymetazoline," and "rosacea." Additional articles were identified from the reference lists of the results. RESULTS: Some α-adrenoceptor agonists have vasoconstrictive properties and may be used topically to treat persistent facial erythema in rosacea. Oxymetazoline hydrochloride cream 1% is an α1A-adrenoceptor agonist approved for the treatment of persistent facial erythema associated with rosacea. Based on our review, we discuss the role of the α-adrenoceptor in persistent facial erythema; provide an overview of the mechanism of action of α-adrenoceptor agonists, such as oxymetazoline, in the treatment of persistent facial erythema; and summarize the clinical development and data to date demonstrating the efficacy and safety of oxymetazoline in the treatment of persistent facial erythema associated with rosacea. CONCLUSION: The review of available literature suggests that oxymetazoline cream is well-tolerated, safe, and effective for the treatment of persistent facial erythema in rosacea and is an important component of combination treatment regimens, which are likely to become the standard of treatment for rosacea in the future. PMID:33841614 | PMC:PMC8021401 {url} = URL to article

J Clin Aesthet Dermatol. 2021 Mar;14(3):42-45. Epub 2021 Mar 1. ABSTRACT Botulinum toxin has been used to treat persistent erythema and flushing in rosacea for several years. Here, we describe two women and one man, each with rosacea with flushing and permanent erythema refractory to conventional treatment, who achieved satisfactory and lasting results following intradermal application of botulinum toxin. Two different botulinum toxin types were used. Toxin concentrations of 3.75U per 0.1 mL (abobotulinum) and 1.25U per 0.1 mL (incobotulinum) were used for each patient were used for each patient. The outcomes were measured using polarized photography to evaluate the decrease in vascular involvement. In the three cases presented here, botulinum toxin was effective for controlling erythema and flushing associated with rosacea; we also observed a prolonged duration of these improvements without the rebound effect of topical therapies. PMID:33841616 | PMC:PMC8021409 {url} = URL to article More on Botox for Rosacea

J Clin Aesthet Dermatol. 2021 Mar;14(3):E53-E57. Epub 2021 Mar 1. ABSTRACT BACKGROUND: FMX103 1.5% is the first and only topical minocycline foam that is approved for the treatment of papulopustular rosacea in adults. OBJECTIVE: We sought to characterize the safety and pharmacokinetics of minocycline under maximal-use conditions of FMX103 1.5% in subjects with moderate-to-severe rosacea. METHODS: This Phase Isingle-center, nonrandomized, open-label, single-period pharmacokinetics and safety evaluation study evaluated multiple-dose, topical administration of FMX103 1.5%. Twenty subjects meeting study inclusion/exclusion criteria had ~2 grams of FMX103 1.5% applied to the full face once per day for 14 days. Blood samples were collected 30 minutes prior to study drug application on treatment Days 1, 2, 6, 9, 11, 12, and 14, and also at 2, 4, 8, 12, 16, and 24 hours post-administration on treatment Days 1 and 14. RESULTS: Following topical application of a 2-gram maximal-use dose of FMX103 1.5% for 14 days, minocycline plasma concentrations were low. Overall, trough levels were approximately 0.5ng/mL from 24 hours after the first dose through 24 hours after the last dose on Day 14, indicating that steady-state levels appear to have been reached within the first day of dosing. Daily application of FMX103 1.5% was generally safe and well-tolerated by all subjects. CONCLUSION: Once-daily topical application of FMX103 1.5% did not lead to appreciable systemic exposure or accumulation of minocycline, suggesting that it is a viable treatment option for papulopustular rosacea. PMID:33841618 | PMC:PMC8021408 {url} = URL to article

J Cosmet Dermatol. 2021 Apr 7. doi: 10.1111/jocd.14130. Online ahead of print. ABSTRACT BACKGROUND: The treatment of facial erythema and subjective symptoms of rosacea patients remains challenging in clinical practice. Cosmeceuticals, care components containing active ingredients such as phytochemicals, play a growing role in treatment plans. However, well-designed studies on their efficacy and limitations are widely missing. OBJECTIVE: A foam and a cream for rosacea patients were assessed based on objective and subjective methodology. The tolerability of skin and eyes was evaluated. METHODS: A randomized, double blind, split-face, vehicle-controlled trial was conducted. At baseline and after four weeks of product use, dermatological and ophthalmological investigations were performed, employing image analysis of facial erythema, clinical assessments and questionnaires. RESULTS: The patient cohort comprised 33 females with persistent facial erythema due to rosacea. No significant differences were found between the vehicle and the verum. According to the analysis of facial erythema, a "less pronounced" or "much less pronounced" appearance was seen in two thirds of patients comparing V1 to V0. Especially the dryness of the skin improved by the use of the vehicle and the verum. Adverse subjective skin sensations decreased by 61.3% for the verum side and by 58.6% for the vehicle side. Subjective and objective analysis of ocular manifestation differed, with subjective manifestations reported more frequently, thus highlighting underdiagnosis of ocular rosacea. CONCLUSIONS: As no clear differences between the verum and the vehicle were found, an optimal skin care regime itself seems to have a superior effect in the relief of facial erythema and foremost of subjective symptoms, rather than certain active ingredients. PMID:33825333 | DOI:10.1111/jocd.14130 {url} = URL to article

Dermatol Online J. 2021 Feb 15;27(2):13030/qt55c0g9wz. ABSTRACT BACKGROUND: Little is known regarding the accuracy, quality, and viewer engagement of video-based online education. OBJECTIVE: To assess the accuracy, quality, viewer engagement, and viewer experience of rosacea videos on social media. METHODS: Reviewers searched "rosacea" and examined videos on YouTube in September 2018. Videos were categorized by source: 1) Healthcare sources: university/professional organizations, industry, and individuals that were healthcare professionals, and 2) Non-healthcare sources: lay media and individuals that were not healthcare professionals. Video accuracy was measured using the Dy et al. Accuracy Scale (DAS) and Accuracy in Digital-health Instrument (ANDI). Video quality was measured using the Global Quality Scale (GQS). Viewer engagement was measured by the engagement ratio (total likes+dislikes+comments/total views). RESULTS: Of the videos analyzed, 71.7% of videos were from non-healthcare sources. Videos produced by healthcare sources (28.3%) were significantly more accurate than those produced by non-healthcare sources, as measured by ANDI (3.57±0.83 versus 2.54±1.07, P=0.001). Videos created by non-healthcare sources received significantly greater engagement than those by healthcare professionals (viewer engagement ratio 0.031±0.044 versus 0.014±0.013, P=0.0159). CONCLUSION: Rosacea videos on social medi produced by non-healthcare sources were less accurate and of lower quality but received greater viewer engagement than those produced by healthcare sources. PMID:33818977 {url} = URL to article

Exp Ther Med. 2021 May;21(5):534. doi: 10.3892/etm.2021.9966. Epub 2021 Mar 23. ABSTRACT Isotretinoin is an oral derivate of vitamin A that has been used since 1982 for the treatment of multiple dermatologic conditions such as severe acne, rosacea, scarring alopecia, ichthyosis or non-melanoma skin cancer prophylaxis. The recommended dose is 0.5-1 mg/kg/day for a period of 4-6 months in sebaceous gland pathologies. There are many adverse effects caused by isotretinoin but by far the most important is the teratogenicity induced by this drug which is estimated to have a 20-35% risk to infants that are exposed to isotretinoin in utero and includes numerous congenital defects such as craniofacial defects, cardiovascular and neurological malformations or thymic disorders. Isotretinoin induces apoptosis and cell cycle arrest in human sebocytes, emphasizing these as processes associated with its teratogenic effect. The aim of this review is to analyze the latest literature data regarding the teratogenic effect of isotretinoin for both fertile females and males and its biological effects underlying the occurrence of congenital malformations under the influence of isotretinoin. PMID:33815607 | PMC:PMC8014951 | DOI:10.3892/etm.2021.9966 {url} = URL to article

Molecules. 2021 Mar 6;26(5):1424. doi: 10.3390/molecules26051424. ABSTRACT Rosacea is a skin inflammatory condition that is accompanied by not only redness and flushing but also unseen symptoms, such as burning, stinging, and itching. TRPV1 expression in UVB-exposed skin can lead to a painful burning sensation. Upregulated TRPV1 expression helps release neuropeptides, including calcitonin gene-related peptide, pituitary adenylate cyclase-activating polypeptide, and vasoactive intestinal peptide, which can activate macrophage and inflammatory molecules. In this study, we found that radiofrequency (RF) irradiation reduced TRPV1 activation and neuropeptide expression in a UVB-exposed in vivo model and UVB- or heat-treated in an in vitro model. RF irradiation attenuated neuropeptide-induced macrophage activation and inflammatory molecule expression. Interestingly, the burning sensation in the skin of UVB-exposed mice and patients with rosacea was significantly decreased by RF irradiation. These results can provide experimental and molecular evidence on the effective use of RF irradiation for the burning sensation in patients with rosacea. PMID:33800730 | DOI:10.3390/molecules26051424 {url} = URL to article

Microorganisms. 2021 Mar 18;9(3):628. doi: 10.3390/microorganisms9030628. ABSTRACT Cutibacterium acnes is the most abundant bacterium living in human, healthy and sebum-rich skin sites, such as the face and the back. This bacterium is adapted to this specific environment and therefore could have a major role in local skin homeostasis. To assess the role of this bacterium in healthy skin, this review focused on (i) the abundance of C. acnes in the skin microbiome of healthy skin and skin disorders, (ii) its major contributions to human skin health, and (iii) skin commensals used as probiotics to alleviate skin disorders. The loss of C. acnes relative abundance and/or clonal diversity is frequently associated with skin disorders such as acne, atopic dermatitis, rosacea, and psoriasis. C. acnes, and the diversity of its clonal population, contributes actively to the normal biophysiological skin functions through, for example, lipid modulation, niche competition and oxidative stress mitigation. Compared to gut probiotics, limited dermatological studies have investigated skin probiotics with skin commensal strains, highlighting their unexplored potential. PMID:33803499 | DOI:10.3390/microorganisms9030628 {url} = URL to article

J Clin Med. 2021 Mar 22;10(6):1311. doi: 10.3390/jcm10061311. ABSTRACT The temporal relationships between inflammatory bowel disease (IBD)-associated cutaneous manifestations and IBD remain uncertain, with existing evidence mostly from separate cross-sectional studies. We sought to determine the risks of IBD-related dermatologic diseases before and after the diagnosis of IBD. We identified 2847 cases of IBD and 14,235 matched controls from the Taiwan National Health Insurance Research Database between 2003 and 2014. The risks of cutaneous manifestations before and after the diagnosis of IBD were estimated with multivariable-adjusted analyses. At diagnosis, IBD was associated with atopic dermatitis (odds ratio (OR) = 1.61; 95% confidence interval (CI), 1.14-2.28), erythema nodosum (OR = 7.44; 95%CI, 3.75-14.77), aphthous stomatitis (OR = 2.01; 95%CI, 1.72-2.35), polyarteritis nodosa (OR = 5.67; 95%CI, 2.69-11.98), rosacea (OR = 1.67, 95%CI = 1.19-2.35), and cutaneous T cell lymphoma (OR = 21.27; 95%CI, 2.37-191.00). IBD was associated with the subsequent development of pyoderma gangrenosum (hazard ratio (HR) = 17.79; 95%CI, 6.35-49.86), erythema nodosum (HR = 6.54; 95%CI, 2.83-15.13), polyarteritis nodosa (HR = 2.69; 95%CI, 1.05-6.90), hidradenitis suppurativa (HR = 2.48; 95%CI, 1.03-5.97), psoriasis (HR = 2.19; 95%CI, 1.27-3.79), rosacea (HR = 1.92; 95%CI, 1.39-2.65), and aphthous stomatitis (HR = 1.45; 95%CI, 1.22-1.72). This study clarified the associations and temporal relationships between cutaneous manifestations and IBD, highlighting the need for interdisciplinary care in the patient with specific dermatologic diseases presenting with abdominal symptoms, or the IBD patients with cutaneous lesions. PMID:33810197 | DOI:10.3390/jcm10061311 {url} = URL to article

Orbit. 2021 Mar 31:1-6. doi: 10.1080/01676830.2021.1905668. Online ahead of print. ABSTRACT Purpose: Rosacea is a common cause of ocular surface disease. Specific immunologic features have been implicated in its pathogenesis, including toll-like receptors, mitogen-associated kinase, and nuclear factor kappa-B. Myeolid differentiation factor 88 (MYD88) has been associated with these elements, suggesting a role for this protein in rosacea. This study was designed to compare the expression of MYD88 in the eyelids of patients with and without this disease.Methods: Western blotting for MYD88 was performed in 14 control patients and 15 patients with rosacea. Bands were quantified and normalized to actin. Immunohistochemical staining for MYD88 was performed in a different cohort of 12 patients with rosacea and 12 controls, and positively-staining cells were counted across five consecutive 40x fields. Statistical analyses compared the differences between the two groups via a dedicated software package.Results: On western blotting, the mean ratios of MYD88 to actin were 13.8 (standard deviation = 14.1) and 44.3 (standard deviation = 39.6) in control and rosacea patients, respectively (p = .002). On immunohistochemistry, the mean numbers of positively-staining cells were 12.1/40x field (standard deviation = 9.61/40x field) and 27.4/40x (standard deviation = 18.7/40x field) in control and rosacea patients, respectively (p = .0438).Conclusions: MYD88 is enriched in eyelid specimens of rosacea. This finding further implicates the innate immune system in the pathogenesis of rosacea, and is consistent with previous reports regarding the role of this protein in ocular surface disease and the previously-implicated cellular features of the disease. Inhibition of MYD88 may be a successful treatment strategy to manage rosacea. PMID:33789561 | DOI:10.1080/01676830.2021.1905668 {url} = URL to article

Br J Ophthalmol. 2021 Mar 31:bjophthalmol-2020-318420. doi: 10.1136/bjophthalmol-2020-318420. Online ahead of print. ABSTRACT BACKGROUND: Chalazia are common inflammatory eyelid lesions, but their epidemiology remains understudied. This retrospective case-control study examined the prevalence, risk factors and geographic distribution of chalazia in a large veteran population. METHODS: Data on all individuals seen at a Veterans Affairs (VA) clinic between October 2010 and October 2015 were extracted from the VA health database. Subjects were grouped based on International Classification of Diseases, Ninth Revision (ICD-9) code for chalazion. Univariable logistic regression modelling was used to identify clinical and demographic factors associated with chalazion presence, followed by multivariable modelling to examine which factors predicted risk concomitantly. All cases were mapped across the continental US using geographic information systems modelling to examine how prevalence rates varied geographically. RESULTS: Overall, 208 720 of 3 453 944 (6.04%) subjects were diagnosed with chalazion during the study period. Prevalence was highest in coastal regions. The mean age of the population was 69.32±13.9 years and most patients were male (93.47%), white (77.13%) and non-Hispanic (93.72%). Factors associated with chalazion risk included smoking (OR=1.12, p<0.0005), conditions of the tear film (blepharitis (OR=4.84, p<0.0005), conjunctivitis (OR=2.78, p<0.0005), dry eye (OR=3.0, p<0.0005)), conditions affecting periocular skin (eyelid dermatitis (OR=2.95, p<0.0005), rosacea (OR=2.50, p<0.0005)), allergic conditions (history of allergies (OR=1.56, p<0.0005)) and systemic disorders (gastritis (OR=1.54, p<0.0005), irritable bowel syndrome (OR=1.45, p<0.0005), depression (OR=1.35, p<0.0005), anxiety (OR=1.31, p<0.0005)). These factors remained associated with chalazion risk when examined concomitantly. CONCLUSION: Periocular skin, eyelid margin and tear film abnormalities were most strongly associated with risk for chalazion. The impact of environmental conditions on risk for chalazion represents an area in need of further study. PMID:33789846 | DOI:10.1136/bjophthalmol-2020-318420 {url} = URL to article