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Dermatol Ther. 2021 Feb 28:e14920. doi: 10.1111/dth.14920. Online ahead of print. ABSTRACT Inflammatory rosacea is clinically characterized by persistent erythema and inflammatory lesions. Its severity is generally based on clinical observation that may be cumbersome. The aim of this study was to assess if erythema-directed digital photography (EEDP) and colorimeter (COL) correlate and are concordant with clinical evaluation of erythema degree of rosacea under topical treatment. Thirty naïve patients with mild/moderate inflammatory rosacea were instructed to apply ivermectin cream for 8 weeks. Erythema degree was performed at baseline, and at 2, 4, 6 and 8 weeks by clinician erythema assessment based on 5-point severity scale (from 0=no erythema to 4=fiery redness), and by instrumental evaluation by EDDP using the same 5-point scale of clinical assessment and by COL using a 5-point scale (from 0=<1 units=no erythema to 4>12 units=fiery redness). Concordance and correlation analysis were performed using Cohen's Kappa coefficient and Correlation Coefficient test respectively. At baseline a statistically significant concordance/correlation value between EDDP/COL was observed. At 2 weeks, the statistical concordance/correlation value between instrumentals were both increased, along with a slight significant concordance between clinical assessment and erythema-directed digital photography. At 4, 6 and 8 weeks, a statistically significant increase of concordance/correlation value among all the considered parameters from baseline was found. The results of our study showed that at baseline and during the early treatment stage both EDDP and COL were able to appreciate more accurately the erythema grade compared to clinical observation supporting the use of non-invasive techniques for a more objective evaluation of erythema in rosacea. This article is protected by copyright. All rights reserved. PMID:33641260 | DOI:10.1111/dth.14920 {url} = URL to article

Cureus. 2021 Jan 22;13(1):e12850. doi: 10.7759/cureus.12850. ABSTRACT Indeterminate cell histiocytosis (ICH) is a rare proliferative disorder of histiocytes, which display morphologic and immunophenotypic characteristics of both Langerhans cell histiocytosis (LCH) and non-Langerhans cell histiocytosis (NLCH). We describe an unusual clinical presentation of ICH mimicking rosacea and provide a relevant review of the literature. PMID:33628700 | PMC:PMC7897367 | DOI:10.7759/cureus.12850 {url} = URL to article

J Cosmet Dermatol. 2021 Feb 24. doi: 10.1111/jocd.14020. Online ahead of print. ABSTRACT BACKGROUND: Pathophysiology of rosacea is not completely understood and involves a complex interaction among genetics, ultraviolet (UV) light, microorganisms, impaired skin barrier, neuronal and vascular dysfunction, and immune system disruption. AIMS: To describe the etiology of rosacea with an emphasis on the role of UV radiation and exposome, and to review the importance of non-pharmacologic strategies focusing on photoprotection. METHODS: We conducted a narrative review of the literature. We performed literature searches with Pubmed from January 1990 to November 2020 using the keywords "rosacea", "pathogenesis", "ultraviolet radiation", "exposome", "photoprotection", "sunscreens" and "non-pharmacologic agents". The search was limited to English, Spanish and French language articles. RESULTS: Several environmental factors such as UV light, diverse microorganisms, air pollution, tobacco smoking, nutrition and psychological stress showed to trigger or worsen rosacea. UV radiation was reported to induce proinflammatory, proangiogenic and profibrotic responses. We found 6 original articles about the impact of sunscreens on rosacea. The use of sunscreens containing ingredients with emollient, anti-inflammatory and/or vasoregulatory properties was shown to significantly improve symptomatology. CONCLUSION: UV radiation and the exposome play a key role in the development of rosacea. UV light is implicated in all significant aspects of rosacea: skin inflammation, neoangiogenesis, telangiectasia and fibrosis, and may even initiate rosacea. While the use of sunscreens is widely recommended, literature on the impact of photoprotection in rosacea is scarce. Adequately formulated sunscreens could not only provide the required level of photoprotection, but may help to mitigate the barrier dysfunction, neutralize facial redness (tinted sunscreens) and decrease inflammation and vascular dysfunction. PMID:33626227 | DOI:10.1111/jocd.14020 {url} = URL to article

Related ArticlesOcular surface disease associated with immune checkpoint inhibitor therapy. Ocul Surf. 2021 Feb 18;: Authors: Park RB, Jain S, Han H, Park J Abstract Immune-related adverse events (irAEs) is a term used to describe the various toxicities associated with immune checkpoint inhibitor (ICI) use. As this class of cancer immunotherapy grows, the diversity of documented irAEs also continues to expand. Ocular toxicities secondary to ICI use are relatively rare, occurring in an estimated 1% of patients, with dry eye and uveitis as the most frequently reported ocular side effects. This article specifically investigates the relationship between ocular surface disease and ICI therapy through a review of the existing literature. Dry eye disease (DED), conjunctivitis, and keratitis were the most commonly reported irAEs affecting the ocular surface across the 29 studies reviewed. Keratoplasty graft rejection was also described in two case reports. Our review of eight clinical trials found the incidence of DED, the most common ocular surface irAE, to range from 1 to 4%. Nearly all cases of ocular surface irAEs were graded as mild or moderate in severity and were often self-limited or controlled with conservative treatment. Duration of checkpoint inhibitor use prior to onset of ocular surface side effects varied widely, ranging from days to months. Ocular surface toxicities associated with checkpoint immunotherapy appear to be under-reported and under-investigated. Further work remains to be done to investigate the full breadth of ocular surface pathologies and the molecular mechanisms by which these toxicities occur. PMID: 33610743 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesScale and Pustule on Dermoscopy of Rosacea: A Diagnostic Clue for Demodex Species. Dermatol Pract Concept. 2021 Jan;11(1):e2021139 Authors: Serarslan G, Makbule Kaya Ö, Dirican E Abstract Background: Demodex mites are highly found in the skin of patients with rosacea. The diagnosis of Demodex can be made by standardized skin surface biopsy. Dermoscopy is a tool used in the noninvasive diagnosis of various dermatological diseases. Objectives: To determine whether dermoscopic features of demodicosis are associated with the result of standardized skin surface biopsy in patients with rosacea and to compare dermoscopic features of rosacea in Demodex-positive and negative samples and Demodex type. Methods: A total of 30 patients (7 male, 23 female) were included in the study. Dermoscopic examination was performed on both the clinically most severely affected areas and adjacent healthy skin. The skin surface biopsy sample was taken from the same place from where the dermoscopic image was taken. Results: A total of 83 (lesion n = 60, non-lesion n = 23) areas were evaluated. Demodex was detected in 60.2% (n = 50) of the samples. Half of these samples revealed only Demodex folliculorum, and the remaining half revealed D folliculorum and Demodex brevis. Of the Demodex-positive samples, 88% had Demodex tails (P =0.001) and 68% Demodex follicular openings (P = 0.002) on dermoscopy. In D folliculorum+D brevis-positive samples, the rate of scale and pustule was higher than D folliculorum-positive samples (P = 0.017 and P = 0032, respectively). Conclusions: The sensitivity and specificity of Demodex tail are higher than Demodex follicular opening and scale and pustule detection with dermoscopy and may indicate the coexistence of both D folliculorum and D brevis. PMID: 33614217 [PubMed] {url} = URL to article

Related ArticlesNoninflammatory comedones have greater diversity in microbiome and are more prone to biofilm formation than inflammatory lesions of acne vulgaris. Int J Dermatol. 2020 Dec 08;: Authors: Loss M, Thompson KG, Agostinho-Hunt A, James GA, Mongodin EF, Rosenthal I, Cheng N, Leung S, Chien AL, Kang S Abstract BACKGROUND: The ability of Cutibacterium acnes strains to form biofilms has been correlated with their virulence. OBJECTIVE: This study examined biofilm and skin microbiota in acne patients in order to understand their role in the development of acne lesions. METHODS: Thin sections of punch biopsy specimens of (i) uninflamed comedones, (ii) inflammatory lesions, and (iii) uninvolved adjacent skin of acne patients were examined. Epiflourescence and confocal laser scanning microscopy were used for biofilm detection, and pyrosequencing with taxonomic classification of 16s rRNA gene amplicons was used for microbiota analysis. RESULTS: Of the 39 skin specimens from patients with mild-moderate acne (n = 13) that were studied, nine (23%) contained biofilm. Among these specimens, biofilm was most frequently detected in comedones (55.6%) and less frequently in inflammatory papules (22.2%) and uninvolved skin (22.2%). Comedones demonstrated the highest mean alpha diversity of all the lesion subtypes. The relative abundance of Staphylococcus was significantly higher in comedones (11.400% ± 12.242%) compared to uninvolved skin (0.073% ± 0.185%, P = 0.024). CONCLUSIONS: The microenvironment of the comedone differs from that of inflammatory lesions and unaffected skin. The increased frequency of biofilm in comedones may account for the lack of host inflammatory response to these lesions. PMID: 33615460 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesVarious skin manifestations related to inflammatory bowel disease: A nationwide cross-sectional study on the Korean population. J Dermatol. 2021 Feb 19;: Authors: Jo UH, Lee JY, Lee H, Kim DY, Kang S, Koh SJ, Park H Abstract Inflammatory bowel disease (IBD) presents with various extraintestinal manifestations. As part of them, various skin diseases are suggested to be related to IBD. We aimed to identify the epidemiology and risk of developing skin manifestations in patients with IBD. We used Korean insurance claims data and selected patients with IBD and age/sex-matched non-IBD subjects between 2013 and 2017 using the diagnosis code and prescription records of IBD-specific medications. The prevalence and risk of concurrent skin diseases were estimated. We identified 64 837 patients with IBD. Reactive skin eruptions including pyoderma gangrenosum and erythema nodosum were associated with IBD with highest odds ratios among three categories of reactive, inflammatory, and autoimmune skin diseases. Inflammatory skin diseases including rosacea, psoriasis, atopic dermatitis, hidradenitis suppurativa, and acne conglobata were significantly associated with IBD, but the association was less marked compared to reactive skin eruptions. The patients with IBD also had a higher risk of autoimmune skin diseases including vitiligo and alopecia areata than non-IBD subjects. We determined that IBD was related to various skin diseases including reactive, inflammatory, and autoimmune skin diseases. Considering these relationships can allow better management of patients with IBD and comorbid skin diseases. PMID: 33608949 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesRosacea with persistent facial erythema and high Demodex density effectively treated with topical ivermectin alone or combined with oral carvedilol. Dermatol Ther. 2021 Feb 18;:e14899 Authors: Huang HP, Hsu CK, Lee JY Abstract Topical ivermectin is effective in treating papulopustular rosacea, but its effect on persistent facial erythema of rosacea with high Demodex densities has not been well documented. We retrospectively reviewed 39 rosacea patients with persistent facial erythema and high Demodex densities. Clinician's erythema assessment (CEA) and Demodex density were evaluated before and after topical ivermectin alone or combined with oral carvedilol. Three patients (all with papulopustular rosacea, in ivermectin group) dropped out due to early ivermectin-induced local flare of rosacea. In the remaining patients (ivermectin group n=14; ivermectin-carvedilol group n=22), the CEA grade and Demodex density were significantly reduced, both p<0.01. There was no statistically significant difference between the two groups in CEA before and after treatment (p=0.07 and p=0.23, respectively), and in Demodex density (p=0.82 and 0.10, respectively). Both regimens markedly improved the persistent facial erythema with response being excellent in 26 of 36 patients (72%), good in 2, fair in 4 and none in 4. There was a correlation between the reduction of CEA and Demodex density after treatment (rho=0.50, p=0.002). The results showed that topical ivermectin was effective in reducing persistent facial erythema of rosacea with Demodex overgrowth. This article is protected by copyright. All rights reserved. PMID: 33605018 [PubMed - as supplied by publisher] {url} = URL to article

Public Interest in Dermatologic Symptoms, Conditions, Treatments, and Procedures during the COVID-19 Pandemic: Insights from Google Trends. Dermatol Ther. 2021 Feb 17;: Authors: Esen-Salman K, Akın-Çakıcı Ö, KardeŞ S, Salman A Abstract BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic had substantial effect both on daily life and medical practice. Internet data have been used to analyze the trends in public interest in various medical conditions and treatments. OBJECTIVES: To analyze the public interest in dermatologic symptoms, conditions, treatments, and procedures during the COVID-19 pandemic. METHODS: Google Trends was queried for a total of 120 dermatological search queries. Three periods of 2020 ((March 15-May 9), (May 10-July 4), and (July 5-October 31)) were compared to the previous four years (2016-2019). RESULTS: A significantly decreased interest in skin cancers and certain dermatologic conditions (e.g. pityriasis rosea, scabies) was observed throughout the study period. Whereas a significant increase of interest in dry skin, hair shedding, oily hair, atopic dermatitis, and hand eczema was detected during the study. An initial decrease in interest was followed by a significant increase for acne, comedones, melasma, rosacea, botox, dermaroller, and peeling. CONCLUSION: The study demonstrated a significant impact of the COVID-19 pandemic on the public interest in dermatology. The present results would help to create healthcare policies and information sources, which can meet the public demand. The reasons for the observed trends and their effect on patient outcomes might be of interest for future studies. This article is protected by copyright. All rights reserved. PMID: 33595849 [PubMed - as supplied by publisher] {url} = URL to article Coronavirus and Rosacea

Expert Opin Emerg Drugs. 2021 Feb 18:1-11. doi: 10.1080/14728214.2021.1887138. Online ahead of print. ABSTRACT Introduction: Rosacea is a common, chronic and relapsing inflammatory skin disease of the centrofacial area. Despite advancing knowledge on its pathogenesis, diagnosis, and treatment, some major unknowns still remain, including systematic evidence-based guidelines useful both for clinical assessment and therapeutic management. Topical treatment is regarded as a first-line option for mild to moderate rosacea and includes traditional and new FDA-approved prescription drugs, as well as off-label alternative topical agents. Areas covered: Since improved awareness of rosacea pathogenetic mechanisms has led to the development of new potential therapeutic agents, a search was performed on the ClinicalTrial.gov registry. The results identified several investigational topical drugs able to target one or more of the pathogenetic factors of rosacea. Expert opinion: The main unmet needs in the topical treatment of rosacea remain the management of vasomotor flushes and telangiectasias, as well as of troublesome symptoms such as burning and/or stinging. No single agent effective on all rosacea phenotypes is available so far, and preventive treatments capable of halting disease progression have not been identified yet. Finally, data on long-term efficacy and tolerability are still incomplete, especially for drugs more recently introduced in the market. PMID:33596752 | DOI:10.1080/14728214.2021.1887138 {url} = URL to article

J Invest Dermatol. 2021 Feb 15:S0022-202X(21)00119-6. doi: 10.1016/j.jid.2021.02.002. Online ahead of print. ABSTRACT BACKGROUND: The pathogenesis of rosacea is incompletely understood. Signaling neuropeptides including pituitary adenylate cyclase-activating polypeptide (PACAP), a regulator of vasodilation and edema, are upregulated in rosacea skin. Here, we evaluated PACAP38-induced rosacea features and examined whether a 5-HT1B/1D receptor agonist could reduce these features. METHODS: A total of 35 patients with erythematotelangiectatic rosacea received an intravenous infusion of 10 pmol/kg/min of PACAP38 followed by an intravenous infusion of 4 mg sumatriptan or placebo (saline) on two study days in a double-blind, randomized, placebo-controlled and crossover trial. RESULTS: PACAP38 increased facial skin blood flow by 90%, dilated the superficial temporal artery by 56%, and induced prolonged flushing and facial edema. Compared with placebo, sumatriptan reduced PACAP38-induced facial skin blood flow for 50 mins (p = 0.023), constricted the superficial temporal artery for 80 mins (p = 0.010) and reduced duration of flushing (p = 0.001) and facial edema (p < 0.001). CONCLUSIONS: We established a clinical experimental model of rosacea features and showed that sumatriptan was able to attenuate PACAP38-induced rosacea flushing and edema. Findings support a key role of PACAP38 in rosacea flushing pathogenesis. It remains unknown whether PACAP38 inhibition can improve rosacea. PMID:33600826 | DOI:10.1016/j.jid.2021.02.002 {url} = URL to article

Related ArticlesEvaluation of epicardial fat thickness and the ankle brachial index in patients with rosacea: A case-control study. J Cosmet Dermatol. 2021 Feb 12;: Authors: Aksu Çerman A, Er Kara A, Aktaş Karabay E, Kaya HE, Kıvanç Altunay İ Abstract BACKGROUND: Recent data suggest that rosacea is related to cardiovascular diseases (CVD) due to its inflammatory nature and immune dysregulation. AIM: The aim of this study was to evaluate the values of epicardial fat thickness (EFT) and the ankle-brachial index (ABI) in patients with rosacea, as indicators of subclinical atherosclerosis and CVD risk. METHODS: This prospective case-control study was carried out on 62 participants, including 31 rosacea patients and 31 controls. The values of EFT and ABI were measured in all subjects. RESULTS: The mean thickness of EFT was statistically higher in rosacea patients (0.54 ± 0.12 mm) than in the controls (0.39 ± 0.05 mm) (P < 0.01). ABI was not significantly different between the subjects with rosacea and the comparison group (1.02 ± 0.1 vs. 0.98 ± 0.07; P = 0.131). A total of 29% of the rosacea patients had mitral valve insufficiency (MVI), while 3.2% of the control group had MVI (P = 0.006). A mild degree of tricuspid valve insufficiency (TVI) was present in 45.2% of the rosacea patients, while 19.4% of the controls had TVI (P = 0.03). CONCLUSION: Rosacea may be associated with subclinical cardiac dysfunction. EFT measurements in rosacea patients can provide early detection of possible subclinical cardiovascular diseases, which can be life extending in rosacea. However, further studies with larger sample sizes are required to confirm the present findings. PMID: 33576108 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesLupus miliaris disseminatus faciei with complete response to isotretinoin. Dermatol Online J. 2021 Jan 15;27(1): Authors: Rogel-Vence M, Carmona-Rodríguez M, Herrera-Montoro V, González-Ruiz L, Cortina-de la Calle MP, Sánchez-Caminero MP Abstract Lupus miliaris disseminatus faciei is an uncommon type of granulomatous rosacea characterized by a papular eruption in the central regions of the face. A 43-year-old woman presented with an asymptomatic papular eruption on the face that had developed over a period of five months. Physical examination revealed multiple, small, reddish-brown papules, distributed symmetrically on the central area of the face. A biopsy was taken, showing dermal epithelioid cell granulomas with central necrosis and surrounding lymphocytic infiltrate with multinucleate giant cells. No foreign bodies were found in granulomas and no mycobacterial or fungal components were detected. On the basis of these findings, the diagnosis of lupus miliaris disseminatus faciei was made. The patient was given oral isotretinoin 20mg/day with initial slow response. After 6 months' treatment the lesions completely disappeared. Many authors consider this entity to be a variant of granulomatous rosacea. It is a chronic condition that primarily affects young adults. Treatment is usually unsatisfactory. Therapies with corticosterois, tetracyclines, retinoids, clofazimine or topical tacrolimus have been described but there is a lack of controlled studies and convincing results. Our success with a 6-month course of low dose isotretinoin suggests consideration of a longer trial prior to abandoning this as treatment. PMID: 33560791 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Oily sensitive skin: A review of management options. J Cosmet Dermatol. 2020 May;19(5):1016-1020 Authors: Hong JY, Park SJ, Seo SJ, Park KY Abstract BACKGROUND: Due to the ever-increasing demands for the personalized care, people seek for the tailored management according to the accurate identification of their skin type. The Baumann Skin Type Indicator, which was proposed by Leslie Baumann, is composed of four parameters: oily or dry, resistant or sensitive, pigmented or nonpigmented, and wrinkled or tight. Among these, oily sensitive skin experiences significant discomfort and resists ordinary treatment. AIMS: In this article, we will review the clinical manifestations, underlying pathogenesis and recommendations on treatment options that may be utilized to help patients with oily sensitive skin. PATIENTS/METHODS: Literature search was conducted using PubMed. The literature concerning Baumann Skin Type Indicator and oily sensitive skin type were considered. RESULTS: Oily sensitive (OS)-type skin is a complex of oily and sensitive skin that causes significant discomfort and undergoes stubborn resistance to treatments. Sebum dysfunction and hypersensitivity may play a key role in the development of sensitive skin. Considering the pathogenesis of OS-type skin, treatment should focus on both seborrhea and hypersensitivity. CONCLUSION: Clinicians can effectively treat the oily sensitive skin by understanding underlying pathogenesis of it. Further investigations are necessary to reach a consensus on the basic pathophysiology and optimal management guidelines for oily sensitive skin. PMID: 32112510 [PubMed - indexed for MEDLINE] {url} = URL to article More information on Sensitive Skin Dermatol Clin. 2008 Jul;26(3):359-73, vi. doi: 10.1016/j.det.2008.03.007. Understanding and treating various skin types: the Baumann Skin Type Indicator Leslie Baumann Baumann Skin Types Bingo Card image courtesy of Wikimedia Commons Baumann Skin Types, Wikipedia

Related ArticlesExperience in managing glaucoma filtration surgery complications with oral doxycycline: A case series. Eur J Ophthalmol. 2021 Feb 07;:1120672121992953 Authors: Yong GY, Mohamed-Noor J, Ong PY, Suliman NB, Lim CW, Zahari M Abstract PURPOSE: To report the clinical profile and effectiveness of oral doxycycline as a non-invasive treatment for glaucoma filtering surgery complications. METHOD: Prospective case series. RESULTS: Doxycycline is widely used in treating corneal melts, ocular surface diseases, meibomian gland disease, recurrent epithelial cell erosion, rosacea, and keratitis sicca. This prospective case series highlights the successful treatment of five patients with leaking blebs and conjunctiva erosion from glaucoma filtration surgery with the use of oral doxycycline. There was no adverse event reported in our cases. CONCLUSIONS: This study suggests that oral doxycycline may be a feasible non-surgical treatment modality due to its ability to inhibit collagenolysis, restore the Meibomian gland function, thereby stopping breakdown and promote conjunctival tissue healing. PMID: 33550831 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesCellulose Nanocrystals for Skin Barrier Protection by Preparing a Versatile Foundation Liquid. ACS Omega. 2021 Feb 02;6(4):2906-2915 Authors: Tang J, He H, Wan R, Yang Q, Luo H, Li L, Xiong L Abstract Most of the foundation liquids in the market need makeup removers for cleaning, while the excessive use of makeup removers might lead to skin barrier damage, which would further lead to many kinds of dermatosis, such as skin sensitivity, facial telangiectasia, rosacea, acne, as well as various cosmetic contact dermatitis. Inspired by the protective effect of fiber-rich diet on the intestinal mucosal mechanical barrier, a novel hemp/cellulose nanocrystals (CNCs)-based foundation liquid featuring easy-wiping property has been constructed, which will effectively solve the post-makeup skin cleaning problems. In this experiment, the formula of the foundation liquid can be obtained through hemp/CNCs instead of mineral oil and titanium oxide, which are considered to have undesirable local tolerance, sensitizing potential, and are environmental pollutants, to create a moisture barrier. Industrial hemp is a hot issue in cosmetic research, and a great quantity of discarded industrial hemp stalk is available to be used to produce hemp/CNCs through grinding and acidification. The graft technique is adapted to obtain hemp/CNCs-g-polylactic acid (PLA). By replacing the hydroxyl group on the side of hemp/CNCs, hemp/CNCs-g-PLA reduces the intermolecular hydrogen bonding, resulting in a higher dispersion in the oil phase. The hemp/CNCs-g-PLA has excellent performance in terms of biological compatibility, water resistance, and non-penetration into the skin. With basic features of a foundation liquid to alleviate discoloration, age spots, and skin roughness, the foundation liquid based on hemp/CNCs-g-PLA provides a novel characteristic of easy-wiping, which helps to avoid the damage to the skin barrier caused by excessive cleansing. PMID: 33553909 [PubMed] {url} = URL to article

Related Articles Paeoniflorin inhibits the macrophage-related rosacea-like inflammatory reaction through the suppressor of cytokine signaling 3-apoptosis signal-regulating kinase 1-p38 pathway. Medicine (Baltimore). 2021 Jan 22;100(3):e23986 Authors: Liu Z, Zhang J, Jiang P, Yin Z, Liu Y, Liu Y, Wang X, Hu L, Xu Y, Liu W Abstract ABSTRACT: Rosacea is a facial chronic inflammatory skin disease with immune and vascular system dysfunction. Paeoniflorin (PF) is a traditional Chinese medicine with anti-inflammatory properties. However, its effects on rosacea remain unknown. Here, we investigated the mechanisms through which PF inhibits the macrophage-related rosacea-like inflammatory response. Immunohistochemical methods were used to detect differences in the inflammatory response and degree of macrophage infiltration in granulomatous rosacea lesions and their peripheral areas. Cell Counting Kit-8 was used to determine the cytotoxicity of PF towards RAW 264.7 cells. Reverse transcription-quantitative polymerase chain reaction and western blotting were used to measure the influence of PF on mRNA and protein expression levels of suppressor of cytokine signaling 3 (SOCS3), apoptosis signal-regulating kinase 1 (ASK1)-p38, Toll-like receptor 2, and cathelicidin antimicrobial peptide ( or LL37) in the lipopolysaccharide (LPS)-induced macrophage-related rosacea-like inflammatory response of RAW 264.7 cells. Inflammatory cell infiltration was more pronounced in granulomatous rosacea lesions than in peripheral areas. LL37 expression increased significantly, and the infiltration of a large number of CD68+ macrophages was observed in the lesions. PF promoted SOCS3 expression in RAW 264.7 cells and inhibited the LPS-induced increase in toll-like receptor 2 and LL37 expression through the ASK1-p38 cascade, thereby alleviating the macrophage-related rosacea-like inflammatory response. These changes could be abrogated by SOCS3 siRNA in vitro.In conclusion, the pathogenesis of rosacea involves abnormal macrophage infiltration within the lesions. PF inhibits the macrophage-related rosacea-like inflammatory response through the SOCS3-ASK1-p38 pathway, demonstrating its potential application as a novel drug for rosacea therapy. PMID: 33545988 [PubMed - as supplied by publisher] {url} = URL to article Read the next post (scroll below) See the pretty flowers. More information on Cathelicidin Peptide LL-37 and Vitamin D3 What are cytokine?

Related Articles Topical Timolol 0.5% Gel-Forming Solution for Erythema in Rosacea: A Quantitative, Split-Face, Randomized, and Rater-Masked Pilot Clinical Trial. J Am Acad Dermatol. 2021 Feb 03;: Authors: Tsai J, Chien AL, Kim N, Rachidi S, Connolly BM, Lim H, Alessi César SS, Kang S, Garza LA PMID: 33548303 [PubMed - as supplied by publisher] {url} = URL to article For more information on topical timolol and rosacea

Related ArticlesImplementing the Association Between Rosacea, Hypertension, and Dyslipidemia in Clinical Practice. J Am Acad Dermatol. 2021 Feb 02;: Authors: Pona A, Labbe J, Afriyie F, Jiwani R, Powell JR PMID: 33545221 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesEffects of Intense Pulsed Light on Tear Film TGF-β and Microbiome in Ocular Rosacea with Dry Eye. Clin Ophthalmol. 2021;15:323-330 Authors: Sagaser S, Butterfield R, Kosiorek H, Kusne Y, Maldonado J, Fautsch MP, Patel D, Shen JF Abstract Purpose: To assess tear film transforming growth factor-beta (TGF-β) and ocular microbiome changes after intense pulsed light with meibomian gland expression (IPL-MGX) vs only MGX in treating ocular rosacea with dry eye symptoms. Methods: Twenty patients were randomly assigned to IPL-MGX or MGX. Patients were examined, treated, and administered the ocular surface disease index (OSDI) survey every 4-6 weeks for four total treatments. Tear film and conjunctival samples were collected at first and last visits, and analyzed for TGF-β concentration and 16s rRNA amplicon sequencing of ocular microbiome. Wilcoxon Rank Sum and Sign-Rank were used to examine changes from baseline. Results: OSDI revealed significantly greater improvement in symptoms after IPL-MGX (p=0.030) compared to MGX. There was no significant difference in mean TGF-β1, 2, or 3 concentration after IPL-MGX (p=0.385, 0.709, 0.948, respectively). Quantities of Clostridium, Klebsiella, Brevibacterium, Lactobacillus, Neisseria, Streptococcus, Corynebacterium, Butyricicoccus, and Actinomyces were significantly reduced from baseline in both groups but without a significant difference between the two treatment groups. Conclusion: IPL-MGX improved dry eye symptoms more than MGX alone. IPL treatment offered no additional benefit to MGX in decreasing virulent bacteria present on the ocular surface and did not influence TGF-β levels in tears. Prospective studies on IPL-MGX with larger sample sizes are needed to further investigate cytokines and IPL in patients suffering from ocular rosacea with dry eye symptoms. ClinicalTrialsgov Identifier: NCT03194698. PMID: 33536740 [PubMed] {url} = URL to article

Related ArticlesSuccessful Treatment of Corticosteroid-Induced Rosacea-Like Dermatitis with Platelet-Rich Plasma Mesotherapy: Report of Seven Cases. Dermatol Ther (Heidelb). 2021 Feb 04;: Authors: Fan X, Yin Y, Dou W, Li T, Xue P, Yang Q, Ma Q Abstract INTRODUCTION: Corticosteroid-induced rosacea-like dermatitis (CIRD) is one of the cutaneous side effects of long and excessive application of topical corticosteroids, resembling rosacea that can present with a series of cutaneous manifestations. Most patients with CIRD undergo a variety of long-term treatments before their symptoms are relieved as there is no accepted standard therapy. We gave each of seven patients two sessions of platelet-rich plasma (PRP) mesotherapy before the routine treatment to restore their skin barrier function, and we were surprised to find that the patients' symptoms and appearance were significantly improved without any further treatments. Here we report this unexpected finding in dealing with CIRD. CASE PRESENTATION: Seven patients, one male and six female, who had history of applying topical corticosteroids on the face for more than 3 months continuously or intermittently for various reasons were diagnosed with CIRD, showing varying degrees of erythema, telangiectasia, and papules, with dry skin, pain, and burning or stinging sensation. We intended to use the restorative effect of PRP to restore the skin barrier function of the patients for further treatment such as tacrolimus ointment, intense pulsed light (IPL), or pulsed dye laser (PDL), so they were treated twice with PRP intradermal injections using a mesogun injector machine. We used the VISIA skin detector to photograph and compare the changes after the treatments. Clinical efficacy was also assessed by the Global Aesthetic Improvement Scale (GAIS). Patients' assessments were recorded using three-point scale questionnaires. After two sessions of PRP treatment, before any further treatment, we were surprised to find that the patients' symptoms had improved significantly, as confirmed by VISIA skin detector and GAIS. All of the patients were satisfied with the outcomes, considering that mesotherapy was not painful and their appearance and symptoms had much improved. CONCLUSIONS: PRP mesotherapy may mitigate sensitivity and inflammation in patients with CIRD by reducing erythema, telangiectasia, and papules. It is worth conducting large randomized controlled trials to verify its safety and efficacy in treating corticosteroid-induced rosacea-like dermatitis and maybe rosacea. PMID: 33539001 [PubMed - as supplied by publisher] {url} = URL to article

Effect of IPL in Patients with Meibomian Gland Dysfunction. Klin Monbl Augenheilkd. 2021 Feb 04;: Authors: Schuh A, Muth D, Shajari M, Mayer WJ, Priglinger S, Messmer E Abstract PURPOSE: To evaluate the effect of IPL (intense pulsed light) treatment in patients with meibomian gland dysfunction (MGD). METHODS: Clinical data of 25 patients with MGD who underwent IPL treatment at the department of ophthalmology of Ludwig-Maximilians-University between 2016 and 2018 were analyzed. Demographics, clinical history, examination findings (eyelid vascularization, meibomian gland findings, conjunctival redness, tear film break-up time [TFBUT], corneal staining (Oxford grading scale [OGS]), and subjective patients' findings (including ocular surface disease index [OSDI]) were collected from each visit (D1, D15, D45, D75). RESULTS: All included patients underwent three sessions of IPL treatment in both eyes (D1, D15, D45). There was a significant improvement after IPL treatment (D75) in TFBUT (p < 0.001), corneal staining (OGS) (p < 0.001), conjunctival redness (p < 0.001), lid margin edema (p < 0.001) and redness (p < 0.001), meibum quality (p < 0.001), lid margin telangiectasia (p = 0.005), meibomian gland obstruction (p = 0.001), and OSDI score (p = 0.004). Even after the first IPL session, significant improvements in TFBUT (p < 0.001), corneal staining (OGS p < 0.001), conjunctival redness (p < 0.022), lid margin edema (p < 0.001) and redness (p < 0.016), meibum quality (p = 0.014), and OSDI score (p < 0.013) were noted. There were no relevant negative side effects. Subgroup analysis for age, sex, duration or severity of disease, and associated diagnosis of rosacea showed no significant difference in effectiveness. CONCLUSION: IPL is an effective and safe treatment for patients with MGD, which can be used as a supportive therapeutic option. PMID: 33540463 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles COVID-19 related masks increase severity of both acne (Maskne) and rosacea (Mask rosacea): Multi-center, real-life, telemedical, observational prospective study. Dermatol Ther. 2021 Feb 03;:e14848 Authors: Damiani G, Gironi LC, Grada A, Kridin K, Finelli R, Buja A, Bragazzi NL, Pigatto PD, Savoia P Abstract BACKGROUND: Masks are essential for COVID-19 prevention, but recently they were suggested to modify cutaneous facial microenvironment and trigger facial dermatoses. OBJECTIVE: To evaluate mask- related rosacea and acne (maskne) in untreated patients during lockdown METHODS: In this multi-center, real-life, observational prospective study, we enrolled stable, untreated acne and rosacea patients that wore masks during lockdown at least 6h/day. They underwent two teledermatological consultations, at the baseline and after 6 weeks. Clinical, pharmacological and psychological data were recorded. RESULTS: A total 66 patients, 30 (median age: 34.0 [30.25-29.75] yoa) with acne and 36 patients (median age: 48 [43-54] years) with rosacea, were enrolled in this study. After 6 weeks of mask and quarantine, patients with acne displayed an increased Global Acne Grading Scale (GAGS) score in mask-related areas (P<0.0001). Likewise, after 6 weeks of mask and quarantine, patients with rosacea displayed a worsen in both physican (P<0.0001) and patient (P<0.0001) reported outcomes. Remarkably, patients reported also a statistically significant decrease in their quality of life (P<0.0001). CONCLUSIONS: Masks appear to trigger both acne and rosacea flares. Additional studies are needed to generate evidence and inform clinical decision-making. This article is protected by copyright. All rights reserved. PMID: 33533563 [PubMed - as supplied by publisher] {url} = URL to article Protection of skin barrier for Coronavirus with Personal Protective Equipment

Related Articles Mask-Induced Koebner phenomenon and its clinical phenotypes: a multicenter, real-life study focusing on 873 dermatological consultations during COVID-19 pandemics. Dermatol Ther. 2021 Feb 02;:e14823 Authors: Damiani G, Gironi LC, Kridin K, Pacifico A, Buja A, Bragazzi NL, Spałkowska M, Pigatto PD, Santus P, Young Dermatologists Italian Network, Savoia P Abstract During COVID-19 pandemic, wearing masks for prevention became mandatory but evidence suggest that is also detrimental for skin. Although facial dermatoses due to masks increase in both healthcare workers and general population, a pathogenetic hypothesis remains still elusive. To evaluate the prevalence of dermatological consultations due to Koebner triggered dermatoses In this prospective, multicenter, real life study carried out in Italy from March 11th to December 11th 2020 during COVID-19 pandemics, we evaluated dermatological consultations (in-person and telemedicine) to study the prevalence of Koebner (KB) phenomenon due to masks. We adopted Boyd and Nelder classification for Koebner phenomenon and Bizzozero's for KB intensity. A total of 229/873 (26.2%) dermatological consultations were KB triggered dermatoses and lesions were located in mask-covered ear area (76 [33.2%]), malar area (73 [31.8%]), perioral area (53 [23.1%]) and nose (27 [11.8%]). First KB category grouped 142 patients (psoriasis, vitiligo, maskne and mask rosacea), second one 24 (warts, molluscum contagiosum and impetigo), third one 46 (atopic dermatitis) and fourth one 17 (eczema). Among previously KB negative psoriatic patients that became KB positive, 9/13 (69.2%) had discontinued or modified prescribed anti-psoriatic treatments. Mask-related Koebner phenomenon is an important clinical sign to orient clinician's therapeutic protocols during COVID-19 pandemic, especially in patients with psoriasis. This article is protected by copyright. All rights reserved. PMID: 33527560 [PubMed - as supplied by publisher] {url} = URL to article Protection of skin barrier for Coronavirus with Personal Protective Equipment

Related Articles Reply to: "Implementing the association between rosacea, hypertension, and dyslipidemia in clinical practice". J Am Acad Dermatol. 2021 Jan 30;: Authors: Chen Q, Tang Y, Li J PMID: 33529699 [PubMed - as supplied by publisher] {url} = URL to article Complete List of Systemic Cormorbidities in Rosacea