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Related Articles Identification of novel candidate genes in rosacea by bioinformatic methods. Cytokine. 2021 Jan 30;141:155444 Authors: Sun Y, Chen LH, Lu YS, Chu HT, Wu Y, Gao XH, Chen HD Abstract BACKGROUND: Rosacea is a chronic inflammatory skin disease whose psychological consequences severely affect patient's quality of life. OBJECTIVE: To identify candidate genes of rosacea for potential development of new target therapies. METHODS: Gene Expression Omnibus datasets were retrieved to obtain differentially expressed genes (DEGs) between rosacea patients and healthy controls. Gene ontology (GO) analyses were used to identify functions of candidate genes. Related signaling pathways of DEGs were analyzed using Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene set enrichment analysis. Protein-protein interaction (PPI) networks were applied using search tools for the retrieval of interacting genes/proteins and modulations involving PPI networks were evaluated with use of the MCODE app. RESULTS: Samples from 19 rosacea patients and 10 healthy controls of dataset GSE65914 were enrolled. A total of 215 DEGs, 115 GO terms and 6 KEGG pathways were identified. A total of 182 nodes and 456 edges were enriched in PPI networks. Maximal clusters showed 15 central nodes and 96 edges. The toll-like receptor (TLR) signaling pathway was the most significant pathway detected and 5 DEGs were identified as candidate genes which included TLR2, C-C motif chemokine (CCL) 5, C-X-C motif chemokine ligand (CXCL) 9, CXCL10 and CXCL11. The results were verified in rosacea patients with use of real-time polymerase chain reaction and immunohistochemistry. Cell-type enrichment analysis revealed 8 lymphocytes that were enriched in rosacea patients. CONCLUSIONS: The results suggest that both innate and adaptive immune responses were involved in the etiology of rosacea. Five DEGs in the TLR signaling pathway may serve as potential therapeutic target genes. PMID: 33529888 [PubMed - as supplied by publisher] {url} = URL to article More on the Genetic Theory on Rosacea

Related Articles Dermatological effects of Curcuma species: a systematic review. Clin Exp Dermatol. 2021 Jan 31;: Authors: Barbalho SM, de Sousa Gonzaga HF, de Souza GA, de Alvares Goulart R, de Sousa Gonzaga ML, de Alvares Rezende B Abstract Curcuma and its derivatives are associated with anti-inflammatory and antioxidant activities in the skin. They can exhibit beneficial effects in wound-healing, prevention of chronic ultraviolet B damages, and may prevent facial redness such as rosacea and flushing. This review aimed to provide an up-to-date and rigorous synthesis of studies that demonstrated the clinical efficacy of curcuminoids in the skin. We evaluated studies published in the MEDLINE-PubMed/PMC (National Library of Medicine) following the PRISMA guidelines for this review. This search included papers published in the last ten years in controlled clinical trials, double-blind and randomized controlled studies, and case studies. The search resulted in twelve studies published in the last ten years. Curcuma species (C. longa and C. aeruginosa) and curcumin were found to produce different dermatological effects. They may influence antioxidant and anti-inflammatory processes in the production of hyaluronan, the increase in the skin's moisture, and the reduction of axillary hair growth. Curcuma also can reduce thickness, pruritus, erythema, burn, and pain in psoriasis, and can improve radio-dermatitis lesions. Our review results show that Curcuma species may play a role in skin health management and may exhibit different dermatological effects, being a new therapeutic arsenal for Dermatology professionals. Nevertheless, more clinical trials should be conducted with humans to establish the best way of delivering and dosages that would be beneficial for different dermatological conditions. PMID: 33522006 [PubMed - as supplied by publisher] {url} = URL to article Find Curcuma on Amazon

Related Articles Interactions between immune system and the microbiome of skin, blood and gut in pathogenesis of rosacea. Acta Microbiol Immunol Hung. 2021 Jan 29;: Authors: Joura MI, Brunner A, Nemes-Nikodém É, Sárdy M, Ostorházi E Abstract The increasingly wide use of next-generation sequencing technologies has revolutionised our knowledge of microbial environments associated with human skin, gastrointestinal tract and blood. The collective set of microorganisms influences metabolic processes, affects immune responses, and so directly or indirectly modulates disease. Rosacea is a skin condition of abnormal inflammation and vascular dysfunction, and its progression is affected by Demodex mites on the skin surface. When looking into the effects influencing development of rosacea, it is not only the skin microbiome change that needs to be considered. Changes in the intestinal microbiome and their circulating metabolites, as well as changes in the blood microbiome also affect the progression of rosacea. Recent research has confirmed the increased presence of bacterial genera like Acidaminococcus and Megasphera in the intestinal microbiome and Rheinheimera and Sphingobium in the blood microbiome of rosacea patients. In this review we discuss our current knowledge of the interactions between the immune system and the skin, gut and blood microbiome, with particular attention to rosacea diagnostic opportunities. PMID: 33522984 [PubMed - as supplied by publisher] {url} = URL to article Microorganisms of the Human Microbiome in Rosacea

Cytokine. 2021 Jan 30;141:155444. doi: 10.1016/j.cyto.2021.155444. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin disease whose psychological consequences severely affect patient's quality of life. OBJECTIVE: To identify candidate genes of rosacea for potential development of new target therapies. METHODS: Gene Expression Omnibus datasets were retrieved to obtain differentially expressed genes (DEGs) between rosacea patients and healthy controls. Gene ontology (GO) analyses were used to identify functions of candidate genes. Related signaling pathways of DEGs were analyzed using Kyoto Encyclopedia of Genes and Genomes (KEGG) and gene set enrichment analysis. Protein-protein interaction (PPI) networks were applied using search tools for the retrieval of interacting genes/proteins and modulations involving PPI networks were evaluated with use of the MCODE app. RESULTS: Samples from 19 rosacea patients and 10 healthy controls of dataset GSE65914 were enrolled. A total of 215 DEGs, 115 GO terms and 6 KEGG pathways were identified. A total of 182 nodes and 456 edges were enriched in PPI networks. Maximal clusters showed 15 central nodes and 96 edges. The toll-like receptor (TLR) signaling pathway was the most significant pathway detected and 5 DEGs were identified as candidate genes which included TLR2, C-C motif chemokine (CCL) 5, C-X-C motif chemokine ligand (CXCL) 9, CXCL10 and CXCL11. The results were verified in rosacea patients with use of real-time polymerase chain reaction and immunohistochemistry. Cell-type enrichment analysis revealed 8 lymphocytes that were enriched in rosacea patients. CONCLUSIONS: The results suggest that both innate and adaptive immune responses were involved in the etiology of rosacea. Five DEGs in the TLR signaling pathway may serve as potential therapeutic target genes. PMID:33529888 | DOI:10.1016/j.cyto.2021.155444 {url} = URL to article

Acta Microbiol Immunol Hung. 2021 Jan 29. doi: 10.1556/030.2021.01366. Online ahead of print. ABSTRACT The increasingly wide use of next-generation sequencing technologies has revolutionised our knowledge of microbial environments associated with human skin, gastrointestinal tract and blood. The collective set of microorganisms influences metabolic processes, affects immune responses, and so directly or indirectly modulates disease. Rosacea is a skin condition of abnormal inflammation and vascular dysfunction, and its progression is affected by Demodex mites on the skin surface. When looking into the effects influencing development of rosacea, it is not only the skin microbiome change that needs to be considered. Changes in the intestinal microbiome and their circulating metabolites, as well as changes in the blood microbiome also affect the progression of rosacea. Recent research has confirmed the increased presence of bacterial genera like Acidaminococcus and Megasphera in the intestinal microbiome and Rheinheimera and Sphingobium in the blood microbiome of rosacea patients. In this review we discuss our current knowledge of the interactions between the immune system and the skin, gut and blood microbiome, with particular attention to rosacea diagnostic opportunities. PMID:33522984 | DOI:10.1556/030.2021.01366 {url} = URL to article

Related Articles Rosacea, Germs, and Bowels: A Review on Gastrointestinal Comorbidities and Gut-Skin Axis of Rosacea. Adv Ther. 2021 Jan 28;: Authors: Wang FY, Chi CC Abstract Rosacea is a chronic inflammatory disease with complicated pathophysiology that involves genetic and environmental elements and dysregulation of innate and adaptive immunity, neurovascular responses, microbiome colonization or infection, resulting in recurrent inflammation. Rosacea has been reported associated with various gastrointestinal diseases including inflammatory bowel disease, celiac disease, irritable bowel syndrome, gastroesophageal reflux disease, Helicobacter pylori (HP) infection, and small intestine bacterial overgrowth (SIBO). The link may involve common predisposing genetic, microbiota, and immunological factors, comprising the theory of the gut-skin axis. Although the evidence is still controversial, interestingly, medications for eradicating SIBO and HP provided an effective and prolonged therapeutic response in rosacea, and conventional therapy for which is usually disappointing because of frequent relapses. In this article, we review the current evidence and discuss probable mechanisms of the association between rosacea and gastrointestinal comorbidities. PMID: 33507499 [PubMed - as supplied by publisher] Full text {url} = URL to article Do You Have a Gut Feeling About Your Rosacea?

Related Articles Topical corticosteroid withdrawal ("steroid addiction"): An update of a systematic review. J Dermatolog Treat. 2021 Jan 26;:1-24 Authors: Hwang J, Lio PA Abstract BACKGROUND: Topical corticosteroid withdrawal is an entity associated with chronic steroid use and misuse that has not been fully described. OBJECTIVE: To further characterize this entity, elucidate relevant clinical features, and investigate possible treatments we provided an update to a systematic review done in 2015. METHODS: We searched Ovid Medline, Pubmed, and Cochrane library for terms related to topical corticosteroid withdrawal from April 2014 to September 2020. RESULTS: This entity usually occurs after prolonged use of moderate- to high-intensity topical steroid usage usually on the face. It is most common in women and many patients present due to improper use such as for cosmetic reasons. Symptoms include erythema, itchiness, and burning; secondary lesions are commonly scales. LIMITATIONS: Due to paucity of available study, we elected to include all articles found which led to limitations being lack of heterogeneity, diversity of outcome measures reported, and higher risk of bias in some included studies. CONCLUSION: Topical corticosteroid withdrawal should be suspected in patients presenting with prolonged usage, erythema, and burning or itch. Patient education and follow up is important to address improper usage. Future studies should focus on comparison group studies to investigate treatment and risk factors. PMID: 33499686 [PubMed - as supplied by publisher] {url} = URL to article More Information on this Subject

Adv Ther. 2021 Jan 28. doi: 10.1007/s12325-021-01624-x. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory disease with complicated pathophysiology that involves genetic and environmental elements and dysregulation of innate and adaptive immunity, neurovascular responses, microbiome colonization or infection, resulting in recurrent inflammation. Rosacea has been reported associated with various gastrointestinal diseases including inflammatory bowel disease, celiac disease, irritable bowel syndrome, gastroesophageal reflux disease, Helicobacter pylori (HP) infection, and small intestine bacterial overgrowth (SIBO). The link may involve common predisposing genetic, microbiota, and immunological factors, comprising the theory of the gut-skin axis. Although the evidence is still controversial, interestingly, medications for eradicating SIBO and HP provided an effective and prolonged therapeutic response in rosacea, and conventional therapy for which is usually disappointing because of frequent relapses. In this article, we review the current evidence and discuss probable mechanisms of the association between rosacea and gastrointestinal comorbidities. PMID:33507499 | DOI:10.1007/s12325-021-01624-x {url} = URL to article

Related ArticlesContact dermatitis from an azelaic acid-containing gel. Contact Dermatitis. 2021 Jan 26;: Authors: Buonomo M, Ruggiero JL, Warshaw E PMID: 33496982 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesThe association between vitamin deficiency and otolaryngologic diseases: A therapeutic target. Med Hypotheses. 2020 Feb;135:109448 Authors: Huang Y, Liu A, Liu L, Wang B, Liang G Abstract Vitamins are indispensable nutrients for metabolism. Adequate vitamin intake plays vital role in physiological processes including embryonic development, cellular and immunity proliferation and differentiation, DNA synthesis and oxidative response. In contrast, insufficient vitamin levels usually lead to a large number of clinical manifestations including xerophthalmia, nyctalopia, hyperpigmentation, vitiligo, jaundice, megaloblastic anemia, glossitis, scurvy, stroke, cancer, coronary heart disease, Alzheimer's disease, multiple sclerosis and Parkinson's disease. In recent years, more and more researches have focused on the relationship between vitamin family and otorhinolaryngologic diseases. This review will summarize the current knowledge of vitamin family and vitamin-mediated regulating role in those related otorhinolaryngologic diseases. PMID: 31733530 [PubMed - indexed for MEDLINE] {url} = URL to article

Related Articles Inhibition of Hippo Signaling Improves Skin Lesions in a Rosacea-Like Mouse Model. Int J Mol Sci. 2021 Jan 19;22(2): Authors: Lee J, Jung Y, Jeong SW, Jeong GH, Moon GT, Kim M Abstract The Hippo signaling pathway plays a key role in regulating organ size and tissue homeostasis. Hippo and two of its main effectors, yes-associated protein (YAP) and WWTR1 (WW domain-containing transcription regulator 1, commonly listed as TAZ), play critical roles in angiogenesis. This study investigated the role of the Hippo signaling pathway in the pathogenesis of rosacea. We performed immunohistochemical analyses to compare the expression levels of YAP and TAZ between rosacea skin and normal skin in humans. Furthermore, we used a rosacea-like BALB/c mouse model induced by LL-37 injections to determine the roles of YAP and TAZ in rosacea in vivo. We found that the expression levels of YAP and TAZ were upregulated in patients with rosacea. In the rosacea-like mouse model, we observed that the clinical features of rosacea, including telangiectasia and erythema, improved after the injection of a YAP/TAZ inhibitor. Additionally, treatment with a YAP/TAZ inhibitor reduced the expression levels of YAP and TAZ and diminished vascular endothelial growth factor (VEGF) immunoreactivity in the rosacea-like mouse model. Our findings suggest that YAP/TAZ inhibitors can attenuate angiogenesis associated with the pathogenesis of rosacea and that both YAP and TAZ are potential therapeutic targets for patients with rosacea. PMID: 33477764 [PubMed - in process] {url} = URL to article More on Angiogenesis & Rosacea

Related Articles Rose Flowers-A Delicate Perfume or a Natural Healer? Biomolecules. 2021 Jan 19;11(1): Authors: Mileva M, Ilieva Y, Jovtchev G, Gateva S, Zaharieva MM, Georgieva A, Dimitrova L, Dobreva A, Angelova T, Vilhelmova-Ilieva N, Valcheva V, Najdenski H Abstract Plants from the Rosacea family are rich in natural molecules with beneficial biological properties, and they are widely appreciated and used in the food industry, perfumery, and cosmetics. In this review, we are considering Rosa damascena Mill., Rosa alba L., Rosa centifolia L., and Rosa gallica L. as raw materials important for producing commercial products, analyzing and comparing the main biological activities of their essential oils, hydrolates, and extracts. A literature search was performed to find materials describing (i) botanical characteristics; (ii) the phytochemical profile; and (iii) biological properties of the essential oil sand extracts of these so called "old roses" that are cultivated in Bulgaria, Turkey, India, and the Middle East. The information used is from databases PubMed, Science Direct, and Google Scholar. Roses have beneficial healing properties due to their richness of beneficial components, the secondary metabolites as flavonoids (e.g., flavones, flavonols, anthocyanins), fragrant components (essential oils, e.g., monoterpenes, sesquiterpenes), and hydrolysable and condensed tannins. Rose essential oils and extracts with their therapeutic properties-as respiratory antiseptics, anti-inflammatories, mucolytics, expectorants, decongestants, and antioxidants-are able to act as symptomatic prophylactics and drugs, and in this way alleviate dramatic sufferings during severe diseases. PMID: 33478154 [PubMed - in process] {url} = URL to article Rose Petals for Rosacea Effective Treatment in Three Volunteers

Related ArticlesReproducing the scalp microbiota community: co-colonization of a 3D reconstructed human epidermis with C. acnes and M. restricta. Int J Cosmet Sci. 2021 Jan 20;: Authors: Meloni M, Balzaretti S, Collard N, Desaint S, Laperdrix C Abstract OBJECTIVE: A 3D reconstructed human epidermis (RHE) model colonized with specific microbial strains was developed to model the complex interactions between strains of the human scalp hair. METHODS: RHE was colonized with Cutibacterium acnes and Malassezia restricta for 72h. The epidermal model was characterized in term of morphology, using immune-labeling targeting biomarkers for barrier structure, proliferation, differentiation and antimicrobial defense. The barrier function was assessed by Trans Epithelial Electrical Resistance (TEER) measurements. In order to study the microorganisms on the epidermal model, viable counts and phenotype ultrastructure analysis were performed by scanning electron microscopy (SEM). RESULTS: The RHE colonized with C. acnes did not lead to severe modifications of the physiological barrier integrity and viability, though it shows aggregates. M. restricta formed large aggregates by a close interaction with the RHE, thus causing both a strong decrease in barrier function and structure degradation and an increased Human Beta Defensin 2 (HBD2) expression. The co-colonized model resulted in barrier depletion, but the overall damage was less severe, respecting the single colonization with M. restricta. The developed 'scalp model' allowed to identify morphological modifications, leading to uncontrolled epidermal renewal and anti-microbial response towards the microbial colonization. CONCLUSION: This study shows a pre-clinical model that recapitulates the interactions that can occur between site specific microbial strains and keratinocytes in dandruff condition. The model can be applied to assess ingredients and products' mechanism of action. PMID: 33469935 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Symptomatic vulvar demodicosis: A case report and review of the literature. J Cutan Pathol. 2020 Nov;47(11):1063-1066 Authors: Hedberg ML, Chibnall RJ, Compton LA Abstract Demodex folliculorum is a mite that commonly inhabits the pilosebaceous units of facial skin, particularly in a perioral and periorbital distribution. While typically an incidental and asymptomatic parasite, Demodex spp. are proposed to contribute to the pathogenesis of facial folliculitis, chronic blepharitis and papulopustular rosacea. Reports of demodicosis in anatomic locations other than the face are exceedingly rare. Here we report a 36-year-old woman with symptomatic Demodex spp. infestation of Fordyce spots of the labia minora. She was referred to dermatology after a 9-month history of tender red bumps on the vulva that would arise and drain over a 24 to 72 hours period, several times per week. Physical examination revealed erythema of the labia minora and introitus with a 4 mm, pink, dome-shaped soft papule on the left labium minus. Wet mount, microbiologic cultures and sexually transmitted infection (STI) screenings were unremarkable. Histopathologic examination revealed a well-circumscribed nodule of suppurative granulomatous inflammation arising in a background of mucosa with Fordyce spots, the majority of which were infiltrated by Demodex spp. Treatment with oral ivermectin and topical metronidazole cream resulted in a symptom-free period of 22 months. This case represents an unusual presentation of symptomatic Demodex infestation. PMID: 33448447 [PubMed - in process] {url} = URL to article More information on oral ivermectin

2021 Jan 16. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. ABSTRACT Rosacea is a common chronic inflammatory disease that presents with recurrent flushing, erythema, telangiectasia, papules, or pustules on nose, chin, cheeks, and forehead. There are four clinical subtypes of rosacea based on the predominant signs and symptoms: erythematotelangiectatic, papulopustular, phymatous, and ocular. The subtypes are not mutually exclusive. Patients can present with features of multiple subtypes, and the predominant features and areas of involvement can change over time. Fifty to seventy-five percent of patients with rosacea have eye involvement with symptoms including dryness, redness, tearing, tingling/burning sensation, foreign-body sensation, light sensitivity, and blurred vision. In addition to the skin and eye symptoms, rosacea can cause anxiety, embarrassment, and depression and can have a significant impact on the quality of life. Although usually limited to the skin, an association of rosacea with systemic comorbidities such as neurologic diseases, inflammatory bowel disease, and cardiovascular diseases has been reported. PMID:32491506 | Bookshelf:NBK557574 {url} = URL to article

Related ArticlesResolution of Refractory Corneal Neovascularization with Subconjunctival Bevacizumab. Case Rep Ophthalmol. 2020 Sep-Dec;11(3):652-657 Authors: Britton AK, Crayford BB Abstract Corneal neovascularization (CNV) has a variety of causes and threatens corneal clarity, thus optimal visual acuity. Conventional medical management includes topical steroids and matrix metalloproteinase inhibitors like doxycycline. Anti-vascular endothelial growth factor (anti-VEGF) agents have demonstrated promise but remain off-label for this indication. However, these agents hold value in cases refractory to first-line medical management. We report the case of a 63-year-old woman who presented with ocular rosacea and CNV affecting vision, on a background of acne rosacea. She was initially treated with fluorometholone and doxycycline, yet continued to deteriorate. Eventually she received two 1.5-mg subconjunctival injections of bevacizumab 2 months apart. CNV completely resolved and results were maintained at 4-year follow-up. This case demonstrates that refractory CNV can be effectively treated with subconjunctival injection of anti-VEGF bevacizumab. The resolution of CNV was also maintained years after injection with minimal adjunctive therapy during this period, and to our knowledge there are no other studies reporting a follow-up period of 4 years after treatment. This is a pertinent case for other clinicians treating patients in a similar situation. PMID: 33442379 [PubMed] {url} = URL to article

Related ArticlesThe association of photo-induced collagen degeneration and the development of telangiectasias in rosacea. J Anat. 2021 Jan 11;: Authors: Thompson KG, Rainer BM, Leung S, Qi J, Kang S, Chien AL Abstract Rosacea is a chronic, often progressive disorder characterized by facial erythema, telangiectasias, papules, pustules, and/or rhinophyma. In this study, we investigated the tissue structure in rosacea compared to controls. We performed a case-control study between five patients with mild-to-moderate erythematotelangiectatic rosacea (ETR) and five matched controls. Facial biopsy samples from rosacea patients and controls were stained with picrosirius red for collagen and CD31 for microvessel identification. Mean collagen content was significantly greater in control samples (19.603% ±8.821%) compared to rosacea samples (16.812% ± 7.787%, p = 0.030). In contrast, mean microvessel density was significantly higher in rosacea patients (4.775 E-5 ± 1.493 E-5 µm-3 ) compared to controls (2.559 E-5 ± 8.732 E-6 µm-3 , p = 0.004). Mean microvessel lumen area was also significantly higher in rosacea patients (491.710 ± 610.188 µm2 ) compared to controls (347.879 ± 539.624 µm2 , p = 0.003). We identified a correlation between decreased collagen content and increased microvessel size and density in rosacea patients that was not observed in controls. These structural changes to the dermal matrix may contribute to the characteristic vessel growth and dilation in rosacea. PMID: 33432575 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesChildhood granulomatous periorificial dermatitis: case report and review of the literature. Dermatol Online J. 2020 Dec 15;26(12): Authors: Fakih A, Makhoul R, Grozdev I Abstract Childhood granulomatous periorificial dermatitis (CGPD), considered a clinical variant of perioral dermatitis, typically affects prepubertal children of African descent. It is a condition of unknown etiology characterized by the presence of a monomorphic yellow-brown papular eruption limited to the perioral, perinasal, and periocular regions that histopathologically shows a granulomatous pattern. This disorder should be differentiated from other conditions as granulomatous rosacea, sarcoidosis, and lupus miliaris disseminatus faciei. We report a case of a 9-year-old boy who presented with flesh-colored perorificial papules on the face, evolving for two months. Upon treatment with topical tacrolimus for follicular eczema, an aggravation of the condition was observed. A skin biopsy confirmed the diagnosis of CGPD. Our patient was successfully treated with a combination of topical metronidazole and topical erythromycin. PMID: 33423420 [PubMed - in process] {url} = URL to article

Related Articles Facial and neck erythema associated with dupilumab treatment: A systematic review. J Am Acad Dermatol. 2021 Jan 08;: Authors: Jo CE, Finstad A, Georgakopoulos JR, Piguet V, Yeung J, Drucker AM Abstract BACKGROUND: Dupilumab-associated facial and/or neck erythema was not reported in phase 3 clinical trials for the treatment of atopic dermatitis, but there have been a number of reports of patients developing this adverse event in clinical practice. OBJECTIVE: To outline all cases of reported dupilumab-associated facial and/or neck erythema to better characterize this adverse event, identify potential etiologies and management strategies. METHODS: A search was conducted on EMBASE and PubMed databases. Two independent reviewers identified relevant studies for inclusion and performed data extraction. RESULTS: A total of 101 patients from 16 studies were reported to have dupilumab-associated facial and/or neck erythema. 52/101 (52%) had baseline atopic dermatitis facial and/or neck involvement and 45/101 (45%) reported different cutaneous symptoms from pre-existing atopic dermatitis, possibly suggesting a different etiology. Suggested etiologies included rosacea, allergic contact dermatitis, and head and neck dermatitis. Most commonly used treatments included topical corticosteroids, topical calcineurin inhibitors, and antifungal agents. In the 57 patients with data on the course of the AE, improvement was seen in 29, clearance in 4, no response in 16, and worsening in 8 patients. 11/101 (11%) discontinued dupilumab due to this adverse event. LIMITATIONS: Limited diagnostic testing, non-standardized data collection and reporting across studies, and reliance on retrospective case reports and case series. CONCLUSION: Some patients on dupilumab develop facial and/or neck erythema which differs from their usual atopic dermatitis symptoms. Prompt identification and empiric treatment may minimize distress and potential discontinuation of dupilumab due to this adverse event. PMID: 33428978 [PubMed - as supplied by publisher] {url} = URL to article More information on dupilumab

Related Articles Minocycline foam (Zilxi) for rosacea. Med Lett Drugs Ther. 2020 Nov 16;62(1611):179-180 Authors: PMID: 33429414 [PubMed - as supplied by publisher] {url} = URL to article More information on Zilxi

BMJ Case Rep. 2021 Jan 11;14(1):e239860. doi: 10.1136/bcr-2020-239860. NO ABSTRACT PMID:33431478 | PMC:PMC7802713 | DOI:10.1136/bcr-2020-239860 {url} = URL to article

Dermatol Online J. 2020 Dec 15;26(12):13030/qt9114v42g. ABSTRACT Childhood granulomatous periorificial dermatitis (CGPD), considered a clinical variant of perioral dermatitis, typically affects prepubertal children of African descent. It is a condition of unknown etiology characterized by the presence of a monomorphic yellow-brown papular eruption limited to the perioral, perinasal, and periocular regions that histopathologically shows a granulomatous pattern. This disorder should be differentiated from other conditions as granulomatous rosacea, sarcoidosis, and lupus miliaris disseminatus faciei. We report a case of a 9-year-old boy who presented with flesh-colored perorificial papules on the face, evolving for two months. Upon treatment with topical tacrolimus for follicular eczema, an aggravation of the condition was observed. A skin biopsy confirmed the diagnosis of CGPD. Our patient was successfully treated with a combination of topical metronidazole and topical erythromycin. PMID:33423420 {url} = URL to article

J Am Acad Dermatol. 2021 Jan 8:S0190-9622(21)00079-7. doi: 10.1016/j.jaad.2021.01.012. Online ahead of print. ABSTRACT BACKGROUND: Neither dupilumab-associated facial erythema nor neck erythema was reported in phase 3 clinical trials for the treatment of atopic dermatitis, but there have been a number of reports of patients developing this adverse event in clinical practice. OBJECTIVE: To outline all cases of reported dupilumab-associated facial or neck erythema to better characterize this adverse event, and identify potential etiologies and management strategies. METHODS: A search was conducted on EMBASE and PubMed databases. Two independent reviewers identified relevant studies for inclusion and performed data extraction. RESULTS: A total of 101 patients from 16 studies were reported to have dupilumab-associated facial or neck erythema. A total of 52 of 101 patients (52%) had baseline atopic dermatitis facial or neck involvement and 45 of 101 (45%) reported different cutaneous symptoms from preexisting atopic dermatitis, possibly suggesting a different etiology. Suggested etiologies included rosacea, allergic contact dermatitis, and head and neck dermatitis. Most commonly used treatments included topical corticosteroids, topical calcineurin inhibitors, and antifungal agents. In the 57 patients with data on the course of the adverse events, improvement was observed in 29, clearance in 4, no response in 16, and worsening in 8. A total of 11 of 101 patients (11%) discontinued dupilumab owing to this adverse event. LIMITATIONS: Limited diagnostic testing, nonstandardized data collection and reporting across studies, and reliance on retrospective case reports and case series. CONCLUSION: Some patients receiving dupilumab develop facial or neck erythema that differs from their usual atopic dermatitis symptoms. Prompt identification and empiric treatment may minimize distress and potential discontinuation of dupilumab owing to this adverse event. PMID:33428978 | DOI:10.1016/j.jaad.2021.01.012 {url} = URL to article https://irosacea.org/search/?q=dupilumab&quick=1

Related ArticlesAntibiomania: A Rare Case of Metronidazole-Induced Mania. Cureus. 2021 Jan 01;13(1):e12414 Authors: Puri P, Parnami P, Chitkara A, Athwal PSS, Khetrapal S Abstract Metronidazole is a very commonly used drug for the treatment of ailments caused by bacteria and parasites. It can treat a vast array of conditions like rosacea, sexually transmitted diseases (STDs), liver abscess, bedsores, etc. Metronidazole comes with generic side-effects like nausea, vomiting, dizziness, metallic taste, and also rare side-effects like paresthesia, syncope, cerebellar symptoms, psychosis but mania is a rare side-effect. Here, we present a case of metronidazole induced mania in a 50-year-old male with no past medical history who initially presented with a complaint of mild fever, loss of appetite, and fatigue from the past 10-12 days. On further examination and investigations, diagnosis of the amebic liver abscess was made on the basis of USG, serum serology for amebiasis IgG, and a CT scan. Consequently, the patient was started on the drug of choice for amebic liver abscess; IV metronidazole 1.5g/day divided over the day into three doses. Other drugs that were administered were pantoprazole, paracetamol, and ondansetron. On the ninth day of admission, the patient's wife as well as the physician-daughter of the patient reported a change in the behavior of the patient which became a major concern for the family. The patient was restless, energetic, unable to sleep, had racing thoughts, elated mood, petulant, and kept singing loudly in the private patient room. There was no history of any psychiatric illness in the family. Mr. K´s manic symptoms were managed using haloperidol and lorazepam. Upon discontinuing metronidazole, there was a gradual improvement in the manic symptoms, and symptoms improved, haloperidol and lorazepam were able to be tapered down and eventually stopped. Mr. K did not require any use of any selective serotonin reuptake inhibitor (SSRIs), monoamine oxidase inhibitors (MAOIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), or any other atypical psychotropic drug. Manic-psychosis side-effect is a rare entity caused by antibiotics and the symptoms of which would disappear in a few days after stopping the antibiotic. It is also notable that this patient recovered without the use of any psychotropic drugs. Physicians should be aware of the possible neuropsychiatric side-effects of antibiotics which can lead to unnecessary workup. This side-effect did not require the use of any psychotropic drugs in this patient. PMID: 33409111 [PubMed] {url} = URL to article

Related Articles Rhinophyma in women: a case series. Lasers Med Sci. 2021 Jan 07;: Authors: Ismail D, Asfour L, Madan V Abstract Rosacea has an overall female predominance; however, rhinophyma, a feature attributed to advanced rosacea, is exceedingly rare in females. The impact of this condition on quality of life can be profound. Multiple treatment modalities have been described. However fully ablative carbon dioxide (CO2) laser for moderate-severe rhinophyma has been shown to be most effective with good cosmetic outcome and high patient satisfaction. We describe a series of 7 female patients presenting with rhinophyma to a tertiary NHS laser centre and a private dermatology clinic. A retrospective case review of rhinophyma management was performed, assessing presentation, treatments and outcomes. The mean age at presentation was 47 years (27-62 years). Three patients developed rhinophyma before the age of 30 years. One patient had severe, 2 patients had moderate and 4 patients had minor rhinophyma. Four patients underwent fractional CO2 laser treatment with a good cosmetic outcome. Two further patients developed scarring following fully ablative CO2 laser. Long-term low-dose oral isotretinoin was used in 3 patients following laser treatment, to prevent relapse. One patient solely received isotretinoin with a good outcome. In our experience, females suffering with rhinophyma presented for treatment at an early age and stage of severity. Fractional or fully ablative CO2 laser alone or in combination with oral isotretinoin is a very effective treatment modality. PMID: 33411129 [PubMed - as supplied by publisher] {url} = URL to article Reply to this TopicThere is a reply to this topic button somewhere on the device you are reading this post. If you never heard about this topic and you learned about it here first, wouldn't it be a gracious act on your part to show your appreciation for this topic by registering with just your email address and show your appreciation with a post? And if registering is too much to ask, could you post your appreciation for this topic by finding the START NEW TOPIC button in our guest forum where you don't have to register? We know how many have viewed this topic because our forum software shows the number of views. However, most rosaceans don't engage or show their appreciation for our website and the RRDi would simply ask that you show your appreciation, please, simply by a post.