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  1. Related ArticlesUse of beta-blockers for rosacea-associated facial erythema and flushing: a systematic review and update on proposed mode of action. J Am Acad Dermatol. 2020 Apr 29;: Authors: Logger JGM, Olydam JI, Driessen RJB Abstract BACKGROUND: Flushing and erythema are frequent skin symptoms in rosacea. As their adequate treatment remains a clinical challenge, new treatment options are explored, such as oral β-blockers. OBJECTIVE: To evaluate the efficacy of oral β-blockers for rosacea-associated facial flushing and erythema. METHODS: PubMed, EMBASE, Web of Science, and Cochrane Library were systematically searched, including studies providing original data on the efficacy of oral β-blockers in rosacea patients with facial flushing and/or persistent erythema. Risk of bias was assessed using the Cochrane Risk of Bias tool, Newcastle-Ottawa scale, and Quality in Prognosis Studies tool. RESULTS: Nine studies evaluating the use of carvedilol, propranolol, nadolol, and β-blockers in general were included. Articles studying carvedilol and propranolol showed a large reduction of erythema and flushing during treatment with a rapid onset of symptom control. Bradycardia and hypotension were the most commonly described adverse events. LIMITATIONS: Most studies had a retrospective design with a small sample size, and outcome measurement was often subjective. CONCLUSION: Oral β-blockers could be an effective treatment option for rosacea patients with facial erythema and flushing that does not respond to conventional therapy. Larger prospective trials with objective outcome assessment are needed to validate the promising results of these studies. PMID: 32360760 [PubMed - as supplied by publisher] {url} = URL to article
  2. Related ArticlesAssociation between Rosacea and Cardiometabolic Disease: A Systematic Review and Meta-Analysis. J Am Acad Dermatol. 2020 Apr 28;: Authors: Chen Q, Shi X, Tang Y, Wang B, Xie HF, Shi W, Li J Abstract BACKGROUND: Rosacea is recognized as a chronic inflammatory cutaneous disorder associated with multiple systemic illnesses. However, the association between rosacea and cardiometabolic disease (CMD) remains controversial. OBJECTIVE: To evaluate the association between rosacea and CMD by a systematic review and meta-analysis. METHODS: A comprehensive search of studies published before Oct 16, 2019 was performed in databases of PUBMED, EMBASE, Cochrane Library and Web of Science. The pooled risk ratios (RRs) or standardized mean differences (SMDs) were calculated. RESULTS: Thirteen studies were included, representing 50,442 patients with rosacea. Rosacea cases had higher prevalence of dyslipidemia, higher prevalence of hypertension, higher total cholesterol (TC), higher low-density lipoprotein (LDL), higher triglycerides (TG), higher systolic blood pressure, higher diastolic blood pressure and higher fasting blood glucose (FBG). Rosacea was not associated with ischemic heart disease (IHD), stroke, diabetes and high-density lipoprotein (HDL). LIMITATIONS: No subgroup analysis could be performed according to the subtypes and severity of rosacea. CONCLUSION: Rosacea showed a correlation with hypertension and dyslipidemia, but not with IHD, stroke, nor diabetes. We advocate screening for CMD indicators among rosacea patients, which may be helpful for diagnosis and appropriate treatment at an early stage of disease. PMID: 32360724 [PubMed - as supplied by publisher] {url} = URL to article
  3. Related Articles Improved telangiectasia and reduced recurrence rate of rosacea after treatment with 540 nm-wavelength intense pulsed light: A prospective randomized controlled trial with a 2-year follow-up. Exp Ther Med. 2020 Jun;19(6):3543-3550 Authors: Luo Y, Luan XL, Zhang JH, Wu LX, Zhou N Abstract The aim of the present study was to evaluate the clinical efficacy and safety of 540 nm-wavelength intense pulsed light (IPL) for the treatment of telangiectasia in late-stage rosacea. Between July 2013 and January 2016, patients with rosacea who tested positive for Demodex folliculorum were recruited. Patients received anti-mite therapy and were then randomly apportioned to receive either three 540 nm-IPL treatments at 4-week intervals (IPL group), or no treatment (control group). Telangiectasia was assessed by the same clinician at baseline and at follow-up intervals over 2 years, where ≥90% clearance of telangiectasia was considered to indicate effective treatment. The rates of effective treatment, improvement (≥30% clearance) and recurrence (original or neo-location) were compared in both groups. After 33 patients were lost during follow-up, the IPL and control groups were comprised of 107 and 120 patients for the final analysis, respectively. The rates of effective treatment and total efficacy in the IPL group (66.36 and 95.33%, respectively) were found to be significantly higher compared with those of the control group (0 and 30.83%, respectively). By contrast, the rates of recurrence were found to be lower in the IPL group (8.41%) compared with the control group (48.33%). Redness-to-blisters associated with IPL treatment (9.7% of analyzed patients) subsided within one week and hyperpigmentation (1.9%) within 3 months. To conclude, treatment with 540 nm-IPL improved facial telangiectasia in late-stage rosacea that remained after sequential anti-mite therapy and effectively reduced the recurrence of rosacea. The present study was registered into the Chinese Clinical Trial Registry under the title 'Sequential therapy for mites folliculitis' (Trial registration number: ChiCTR-IPR-15006451; approved May 27, 2015). PMID: 32346416 [PubMed] {url} = URL to article
  4. Related Articles Dupilumab for the Treatment of Atopic Dermatitis in an Austrian Cohort-Real-Life Data Shows Rosacea-Like Folliculitis. J Clin Med. 2020 Apr 24;9(4): Authors: Quint T, Brunner PM, Sinz C, Steiner I, Ristl R, Vigl K, Kimeswenger S, Neubauer K, Pirkhammer D, Zikeli M, Hoetzenecker W, Reider N, Bangert C Abstract Dupilumab is the first biological treatment approved for moderate-to-severe atopic dermatitis (AD). Efficacy and safety have been demonstrated in clinical trials, but real-life data is still limited. The objective of this study was to retrospectively evaluate Dupilumab treatment in AD patients in a real-life clinical setting. Effectiveness and safety outcomes were collected at baseline and after 2, 6, 10, 24, 39, and 52 weeks by using clinical scores for disease activity, as well as serological markers. Ninety-four patients from five dermatological hospitals were included. After 24 weeks of treatment, the median Investigator Global Assessment (IGA) and Eczema Area and Severity Index (EASI) showed a significant reduction compared to baseline (3.9 ± 0.7 vs. 1.4 ± 0.8 and 26.5 ± 12.5 vs. 6.4 ± 6.5). Interestingly, we observed rosacea-like folliculitis as an unexpected side effect in 6.4% of patients. Dupilumab proves to be an effective and well-tolerated treatment under real-life conditions. The occurrence of rosacea-like folliculitis warrants further mechanistic investigation. PMID: 32344789 [PubMed] {url} = URL to article Wikipedia notes about this treatment, "As of 2019 it costs about US$46,000 per year." "In conclusion, dupilumab is a safe and effective treatment option for patients with moderate-to-severe atopic dermatitis and in specific subsets of patients with asthma." Hum Vaccin Immunother. 2019; 15(9): 2129–2139. A review of dupilumab in the treatment of atopic diseases Quinn Thibodeaux, Mary Patricia Smith, Karen Ly, Kristen Beck, Wilson Liao, and Tina Bhutani
  5. Related Articles Effects of skin care habits on the development of rosacea: A multi-center retrospective case-control survey in Chinese population. PLoS One. 2020;15(4):e0231078 Authors: Huang YX, Li J, Zhao ZX, Zheng BL, Deng YX, Shi W, Steinhoff M, Xie HF Abstract BACKGROUND: Certain cosmetic habits may trigger or aggravate rosacea, while there is little published epidemiologic evidence to support this point. PURPOSE: To examine if daily skin care habits have an effect on the development of rosacea in Chinese population. METHODS: A multi-center retrospective case-control survey of 1,245 rosacea cases and 1,538 skin-healthy controls was conducted in China. Participants completed the questionnaire comprised of demographic characteristics, socioeconomic data and daily skin care habits. Data were collected retrospectively and analyzed using the chi-square test and t-test. Multivariate logistic regression analyses were used to predict rosacea. RESULTS: The multivariate logistic regression analysis highlighted some results: Dry, oily or mixed skin (OR = 6.3-6.9, P< .001), the usage of foaming cleanser (OR = 1.45, 95%CI 1.115-1.886, P = .01), make up more than 6 times a week (OR = 2.839, 95%CI 1.962-4.108, P< .001), using facial mask more than 4 times a week (OR = 2.56-3.069, P< .001), facial treatments at beauty salon more than once a week (OR = 4.946, 95%CI 2.005-12.198, P = .0018) and using beauty salon products (OR = 2.334, 95%CI 1.435-3.976, P = .0018) are positively correlated with the development of rosacea. Using of moisturizing products (OR = 0.602, 95%CI 0.386-0.983, P = .035) and sunscreen cream (OR = 0.303-0.507, P< .001 or P = .0167 for different frequency) presented significantly negative correlations with rosacea. Frequency of cleansing showed a nonlinear association with rosacea: using facial cleansers 1~3 times per week (OR = 0.647, 95%CI 0.429-0.975, P  =  .038) showed beneficial effects while using facial cleanser excessively (twice or more daily) (OR = 2.131, 95%CI 1.394-3.256, P< .001) positively correlated to rosacea strongly. CONCLUSIONS: Excessive use of facial cleanser (twice or more a day) and facial mask (more than 4 times a week), frequent makeup (more than 6 times a week), regular skin care in beauty salon (more than once a week), and using beauty salon products were closely correlated to the development of rosacea in Chinese population. PMID: 32339170 [PubMed - as supplied by publisher] {url} = URL to article
  6. Related Articles Otophyma in a woman: A rare and neglected clinicopathological entity. Australas J Dermatol. 2019 Nov;60(4):e337-e338 Authors: Azizzadeh-Roodpishi S, Ghanadan A, Daneshpazhooh M, Tavakolpour S, Mahmoudi H PMID: 31064030 [PubMed - indexed for MEDLINE] {url} = URL to article
  7. Related Articles Demodex blepharokeratoconjunctivitis affecting young patients: A case series. Indian J Ophthalmol. 2020 May;68(5):745-749 Authors: Patel NV, Mathur U, Gandhi A, Singh M Abstract Purpose: To report clinical characteristics of Demodex blepharokeratoconjunctivitis affecting young patients. Methods: This is a retrospective review of 14 patients with the history of chronic red eyes with corneal involvement. All patients were diagnosed with ocular demodicosis based on the results of eyelash sampling. All patients were treated with 50% tea tree oil lid scrubs and two doses of oral ivermectin (200 mcg/kg). Results: The median age of patients at diagnosis was 27 years (range: 11-39 years). The duration of symptoms ranged from 2 months to 20 years. Rosacea was present in only three patients. Four patients had best corrected visual acuity less than 20/60. Allergic conjunctivitis (n = 7) and viral keratitis (n = 5) were the most common misdiagnosis previously made. Cylindrical dandruff was present in only six patients and eyelashes were clean in rest of them. Inferior vascularization was present in eight eyes, superior in seven eyes, and corneal scars were present in 12 eyes. Four patients had steroid-related complications. All patients, except one responded to tea tree oil treatment and 13 patients were off steroids after 3 weeks of starting the treatment. Conclusion: Demodex infestation of eyelids can lead to chronic blepharokeratoconjunctivitis in healthy pediatric and young adult patients who otherwise have good hygiene, which can often be overlooked or misdiagnosed. Viral keratitis and allergic conjunctivitis are common misdiagnoses and demodicosis can be confirmed by simple epilation. Early diagnosis and treatment can prevent long-term steroid use and its related complications. PMID: 32317439 [PubMed - in process] {url} = URL to article
  8. Related Articles Skin manifestations associated with irritable bowel syndrome. J Eur Acad Dermatol Venereol. 2020 Apr 20;: Authors: Passeron T, Piche T Abstract Irritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and/or discomfort, related to abnormal bowel habits, leading to profound alterations of quality of life. IBS patients are usually classified according to the predominance symptoms associated with abdominal pain; IBS with predominance of diarrhea (IBS-D), constipation (IBS-C) or mixed troubles (IBS-A). Several studies have suggested a higher prevalence of other comorbidities in IBS patients. Asthma, food, pollen and animal allergies, psoriasis and rheumatoid arthritis were found to be associated with IBS. A nationwide epidemiological study reported a slight, although statistically significant, increase of rosacea in patients with IBS. PMID: 32314430 [PubMed - as supplied by publisher] {url} = URL to article
  9. Related Articles Efficacy of Topical Timolol 0.5% in the Treatment of Acne and Rosacea: A Multicentric Study. J Clin Aesthet Dermatol. 2020 Mar;13(3):22-27 Authors: Al Mokadem SM, Ibrahim AM, El Sayed AM Abstract BACKGROUND: Acne and rosacea are common chronic inflammatory skin diseases associated with psychosocial impairment, anxiety, depression, and impaired overall quality of life. Timolol maleate is a potent nonselective β-blocker that causes a combination of vasoconstriction and inhibition of inflammatory mediators. OBJECTIVES: We assessed the clinical efficacy and safety of topical timolol maleate 0.5% for the treatment of acne and rosacea. METHODS: A total of 116 patients (58 patients with rosacea and 58 patients with acne) were treated with topical timolol maleate 0.5% every night before bedtime for eight weeks. RESULTS: The severity of both acne and rosacea decreased relative to baseline; however, the improvement in rosacea was not statistically significant. CONCLUSION: In our study, topical timolol maleate 0.5% demonstrated effectiveness in the treatment of acne, especially in noninflammatory lesions, but seems to be more effective in erythematotelangiectatic rosacea than papulopustular rosacea lesions, with insignificant side effects. The addition of topical timolol to the standard treatment protocol for acne and rosacea is expected to be beneficial, especially by way of improving comedones of acne and resistant inflammatory erythema of both acne and rosacea. PMID: 32308793 [PubMed] {url} = URL to article For more information
  10. Related Articles Crusted demodicosis in an immunocompetent patient. Cutis. 2019 Oct;104(4):E9-E11 Authors: Bisbee E, Rudnick E, Loyd A PMID: 31774896 [PubMed - indexed for MEDLINE] {url} = URL to article
  11. Related Articles StatPearls Book. 2020 01 Authors: Abstract Malar rash, also named a butterfly rash, is a common facial presentation of multiple disorders.[1] characterized by an erythematous flat or raised rash across the bridge of the nose and cheeks, which usually spares nasolabial folds. It may be transient or progress to involve other areas of facial skin.[2] This is mainly seen in patients with systemic lupus erythematosus. As per the American College of Rheumatology, Malar rash is one of the criteria for systemic lupus erythematosus (SLE); it may also be present with other types of lupus including discoid lupus and subacute cutaneous lupus.[2] Differential diagnoses for malar rash are as follows: systemic lupus erythematosus, cellulitis, rosacea, erysipelas, dermatomyositis, and pellagra. Treatment starts with sun protection, including appropriate clothing, sunscreens, and behavior change and management of the underlying disease. PMID: 32310441 {url} = URL to article
  12. Related Articles Use of Permethrin in the Treatment of Rosacea Fulminans During Pregnancy: One Case Report. Dermatol Ther. 2020 Apr 19;: Authors: María GC, Esther GS, Ángel AG, Valtueña J, Dani RS, Pilar ML Abstract INTRODUCTION: Rosacea fulminans (RF) is a rare dermatological condition which occurs exclusively in women and it is characterized by a sudden onset of painful papules, pustules, cysts and nodules on the face. CASE REPORT: A 28-year-old woman was referred to our clinic due to a painful facial eruption within the 13th week of her second pregnancy. After physical examination, the diagnosis of RF during pregnancy was established. Several treatments were used: mupirocin ointment, topical zinc oxide, topical erythromycin, oral erythromycin, metronidazole gel, oral metronidazole, oral amoxiciline and oral prednisone. Finally, the patient was started on 5% permethrin cream with complete clearing of the lesions. DISCUSSION: Nowadays a wide range of treatments for rosacea are available: topical metronidazole, oral metronidazole, topical ivermectin, oral tetracyclines, oral isotretinoin, systemic steroids, photodynamic therapy or pulsed dye laser. However, in pregnant patients the treatment alternatives are limited. CONCLUSION: We consider that 5% permethrin cream could be an effective, cheap and safe treatment not only in regular patients with rosacea but also in pregnant women, representing an important alternative in the context of pregnancy when therapeutic options are limited. To our knowledge this is the first case of rosacea treated with 5% permethrin cream in monotherapy during pregnancy. This article is protected by copyright. All rights reserved. PMID: 32306498 [PubMed - as supplied by publisher] {url} = URL to article
  13. Related Articles Demodex: A skin resident in Man and his best friend. J Eur Acad Dermatol Venereol. 2020 Apr 15;: Authors: Foley R, Kelly P, Gatault S, Powell F Abstract Demodex mites are microscopic arachnids found in the normal skin of many mammals. In humans, it is well established that Demodex mite density is higher in patients with the skin condition rosacea, and treatment with acaricidal agents is effective in resolving symptoms. However, pathophysiology of rosacea is complex and multifactorial. In dogs, demodicosis is a significant veterinary issue, particularly the generalised form of the disease which can be fatal if untreated. In each species, clinical and molecular studies have shown that the host's immunological interactions with Demodex mites are an important, but not fully understood, aspect of how Demodex can live in the skin either as a harmless commensal organism or as a pathogenic agent. This review outlines the role of Demodex mites in humans and dogs, considering morphology, prevalence, symptoms, diagnosis, histology treatment, and pathogenesis. PMID: 32294279 [PubMed - as supplied by publisher] {url} = URL to article
  14. Related Articles Measurement of the serum zonulin levels in patients with acne rosacea. J Dermatolog Treat. 2020 Apr 15;:1-13 Authors: Yüksel M, Ülfer G Abstract Objective: Although the etiopathogenesis of acne rosacea has not yet been clearly elucidated, it has been discussed over the years that autoimmunity may play a role. Genetic and environmental factors are known to have combined effects in the background of autoimmunity, but it has recently been emphasized that an impaired intestinal barrier system is also involved in the development of the disease. Zonulin is a protein that reversibly increases intestinal permeability. This study aimed to evaluate the zonulin levels in acne rosacea.Methods: A total of 61 individuals, 30 diagnosed with acne rosacea and 31 healthy controls, were included in this study. There was no difference between the two groups in terms of age, gender, and body mass index. Zonulin was studied using the enzyme-linked immunosorbent assay.Results: The serum zonulin levels were found to be significantly higher in the patient group than in the control group (18.5 ± 2.9 ng/ml and 13.2 ± 2.7 ng/ml, respectively; p < 0.001).Conclusion: This is the first study in the literature to demonstrate that the serum zonulin levels are increased in patients with acne rosacea. PMID: 32293942 [PubMed - as supplied by publisher] {url} = URL to article
  15. Related Articles Relationship between rosacea and sleep. J Dermatol. 2020 Apr 14;: Authors: Wang Z, Xie H, Gong Y, Ouyang Y, Deng F, Tang Y, Li J Abstract Rosacea is a chronic facial skin disease involved in neurovascular dysregulation and neurogenic inflammation. Behavioral factors such as stress, anxiety, depression and sleep were identified to be associated with other inflammatory skin diseases. Few studies have reported sleep status in rosacea. Aiming to investigate the relationship between rosacea and sleep, a case-control survey was conducted, enrolling 608 rosacea patients and 608 sex- and age-matched healthy controls. Sleep quality was assessed through the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Diagnosis and severity grading of rosacea were evaluated under the standard guidelines of the National Rosacea Society. More rosacea patients (52.3%, n = 318) suffered poor sleep quality (PSQI, >5) than the healthy controls (24.0%, n = 146), displaying a much higher PSQI score (rosacea vs control, 6.20 vs 3.95). There was a strong association between sleep quality and rosacea (odds ratio [OR], 3.525; 95% confidence interval [CI], 2.759-4.519). Moreover, the severity of rosacea was also associated with sleep quality (OR, 1.847; 95% CI, 1.332-2.570). Single nucleotide polymorphisms in hydroxytryptamine receptor 2A and adrenoceptor-β1 genes, which are associated with sleep behaviour, were detected and revealed to be associated with rosacea. Furthermore, the LL-37-induced rosacea-like phenotype and sleep-deprivation mice models were applied, revealing that sleep deprivation aggravated the rosacea-like phenotype in mice, with higher expression of matrix metallopeptidase 9, Toll-like receptor 2, cathelicidin antimicrobial peptide and vascular endothelial growth factor. In conclusion, rosacea patients presented poorer sleep quality, as well as a higher propability of genetic background with sleep disturbance. In addition, poor sleep might aggravate rosacea through regulating inflammatory factors, contributing to a vicious cycle in the progression of disease. PMID: 32291809 [PubMed - as supplied by publisher] {url} = URL to article
  16. Related Articles Evaluation of sexual functions in female rosacea patients: a prospective, case-control study. Int J Impot Res. 2020 Apr 14;: Authors: Aktaş Karabay E, Karşıyakalı N, Karabay E Abstract Patients with rosacea have a higher incidence of depression, embarrassment, social phobia, stress, subjective disease perception and decreased quality of life. Sexual dysfunction is one of the main factors contributing to impaired life quality. The aim of this study is to evaluate the presence of sexual dysfunction in women with rosacea. A prospective case-control study was planned to investigate female sexual dysfunction in patients utilizing the Female Sexual Function Index (FSFI). A total of 85 patients with rosacea and 80 healthy control subjects were included in the study. The total FSFI scores were significantly lower in the rosacea group than in the control group (26.6 vs. 27.6, p < 0.001, respectively). According to the total FSFI scores, 49.4% of the rosacea patients had sexual dysfunction compared with 30.0% of the healthy controls (p = 0.011). The total FSFI scores were negatively correlated with the values of the Dermatologic Life Quality Index (DLQI) (r: -0.251, p = 0.001), disease duration (r: -0.416, p < 0.001), age (r: -0.632, p < 0.001) and body mass index (r: -0.329, p < 0.001). Sexual dysfunction in female rosacea patients was demonstrated in this study. We believe that the recognition of sexual dysfunction in women with rosacea will provide improvements in the life quality of such patients. PMID: 32286521 [PubMed - as supplied by publisher] {url} = URL to article
  17. Related Articles A Corrective Cosmetic Improves the Quality of Life and Skin Quality of Subjects with Facial Blemishes Caused by Skin Disorders. Clin Cosmet Investig Dermatol. 2020;13:253-257 Authors: Andra C, Suwalska A, Dumitrescu AM, Kerob D, Delva C, Hasse-Cieślińska M, Solymosi A, Arenbergerova M Abstract Background: Facial blemishes resulting from skin disorders have a significant effect on the patient's self-esteem and impact quality of life (QOL). Aim: To assess the impact of a corrective cosmetic (CC) on QOL on top of skin quality parameters. Methods: An international observational study was conducted on subjects with visible facial flaws that would benefit from a corrective cosmetic. Investigators collected data regarding demographics, QOL using the Skindex-16 scale, skin dryness and tautness, subject and investigator satisfaction, cosmetic acceptability and tolerance at baseline and after 4 to 6 weeks of daily use. Results: A total of 1840 subjects participated; the mean age was 31.5±11.1 and 95% were women. Acne accounted for 48.9% of skin conditions, followed by melasma (16.7%) and rosacea (15.3%). Of the subjects 81.2% had at least 10% of the face affected and the condition was rated as disfiguring by 45.3% of the subjects; 45.0% and 44.4%, respectively, had neither taut nor dry skin at baseline. Baseline Skindex-16 scores for symptoms, emotions, functioning and overall were 1.4±1.3, 3.5±1.6, 2.4±1.8 and 2.4±1.3, respectively, on a scale from 0 to 6. Compliance was 96.0±10.6%. At the end of the study, Skindex-16 scores had significantly (p<0.0001) improved for all parameters, as did skin dryness and tautness. Subject and investigator satisfaction were high or very high; cosmetic acceptability was high or very high and local tolerance good or very good. Conclusion: The tested corrective cosmetic significantly improved the QOL of subjects with significant facial flaws, skin tautness and dryness, and was well tolerated. PMID: 32280256 [PubMed] {url} = URL to article
  18. Related Articles Comparison of the skin microbiota in acne and rosacea. Exp Dermatol. 2020 Apr 11;: Authors: Thompson KG, Rainer BM, Antonescu C, Florea L, Mongodin EF, Kang S, Chien AL Abstract Acne and rosacea, despite their similar clinical presentations, follow distinct clinical courses, suggesting that fundamental differences exist in their pathophysiology. We performed a case-control study profiling the skin microbiota in rosacea and acne patients compared to matched controls. 19 rosacea and 8 acne patients were matched to controls by age ±5 years, sex, and race. DNA was extracted from facial skin swabs. The V3V4 region of the bacterial 16S rRNA gene was sequenced using Illumina MiSeq and analyzed using QIIME/Metastats 2.0 software. The mean relative abundance of Cutibacterium acnes in rosacea with inflammatory papules and pustules (20.454% ±16.943%) was more similar to that of acne (19.055% ±15.469%) than that of rosacea without inflammatory papules and pustules (30.419% ±21.862%). C. acnes (p=0.048) and Serratia marcescens (p=0.038) were significantly enriched in individuals with rosacea compared to acne. Investigating the differences between the skin microbiota in acne and rosacea can provide important clues toward understanding the disease progression in each condition. PMID: 32278334 [PubMed - as supplied by publisher] {url} = URL to article
  19. Related Articles Demodex positive discoid lupus erythematosus: Is it a separate entity or an overlap syndrome? Dermatol Ther. 2020 Apr 10;:e13394 Authors: Dursun R, Durmaz K, Oltulu P, Ataseven A Abstract Discoid lupus erythematosus (DLE) is a chronic inflammatory erythematous skin disease that can be triggered by several factors. Rosacea is another skin disease that causes facial redness and tenderness. Demodex mites have been reported in rosacea and DLE patients commonly in the literature. These two diseases can be seen concomitant, mimic each other clinically and share common possible etiologic factors. To assess Demodex mite infestation in both clinical and histopathological findings in DLE patients. We retrospectively evaluated the files of 42 patients with DLE who had been diagnosed DLE based on clinical and histopathological findings between August 2018 and August 2019. Demodex positivity was detected 50% of patients (n = 21). Neutrophile percentages in the dermal and perivascular area were higher in the demodex positive patients (4,43%) than in the Demodex negative patients (2,19%). The intensity of demodex mites correlated positively with dermal neutrophile percentages. ANA was negative in 29 patients (69%) and positive in 13 patients (31%). Anti-dsDNA was negative in serology and follicular plugging was positive in histopathology in all 42 patients (100%). This was a retrospective study. DLE and rosacea share common features in etiopathogenesis and clinical presentation. Inflammation and exacerbations caused by the demodex mites may increase the clinical severity of DLE. Although the position of demodex mites in DLE etiopathogenesis is not known exactly, the presence of high demodex in DLE patients has been determined. Standard skin surface biopsy can be a routine procedure for the evaluation of DLE patients in daily clinical practice. This article is protected by copyright. All rights reserved. PMID: 32275797 [PubMed - as supplied by publisher] {url} = URL to article
  20. Related Articles Granulomatous rosacea-like skin rash: extranodal Rosai-Dorfman disease. Int J Clin Exp Pathol. 2020;13(3):556-558 Authors: Shen HP, Lu ZF, Zhu JW Abstract We report a 38-year-old man who presented with bilateral conjunctival congestion, hoarseness, and progressively growing pruritic, infiltrated skin lesions that had first begun over the face and neck, and later spread to the trunk and the limbs in 4 months. The clinical appearance of the lesions mimics granulomatous rosacea, acne vulgaris, or pityrosporum folliculitis. Histopathologic examination of the lesions from the face and chest both revealed dense dermal nodular lymphohistiocytic infiltrates which were positive for CD68 and S-100, but negative for CD1a. A systemic work-up for him detected no lymphadenopathy or other systemic involvement. A diagnosis of extranodal Rosai-Dorfman disease was made, and the patient received systemic glucocorticoids, with considerable improvement after 4 months of therapy. PMID: 32269695 [PubMed] {url} = URL to article
  21. Related Articles Efficacy of Topical Ivermectin for the Treatment of Cutaneous and Ocular Rosacea. Ocul Immunol Inflamm. 2020 Apr 07;:1-5 Authors: Sobolewska B, Doycheva D, Deuter CM, Schaller M, Zierhut M Abstract Purpose: To investigate the efficacy of once-daily topical treatment of ocular and cutaneous rosacea with ivermectin 1% cream (Soolantra®, Galderma).Methods: Ten patients with rosacea were evaluated in a retrospective monocentric pilot study. Subjective symptoms (measured with the Ocular Surface Disease Index), skin findings, and ocular changes (blepharitis with telangiectasia and meibomian gland dysfunction, conjunctival redness, tear breakup time (TBUT), and fluorescein staining of the cornea) were evaluated. The follow-up was 8 months (range: 5-12 months).Results: The OSDI score decreased in the 8th week of treatment (38.5 ± 21.7, P = .004). After 16 weeks, blepharitis (P = .004), and conjunctival redness (P = .008) had strongly improved, and grade 1 was seen in all patients until the end of follow-up. Fluorescein staining of the cornea (P = .001) and TBUT (P = .016) showed significant improvement until the last follow-up visit. No side effects were observed. Conclusion: Topical ivermectin cream 1% given daily is an effective and safe therapy against rosacea. PMID: 32255398 [PubMed - as supplied by publisher] {url} = URL to article
  22. Anxiety, Depression, and Suicidal Ideation amongst Patients with Facial Dermatoses (Acne, Rosacea, Perioral Dermatitis, and Folliculitis) in Lithuania. Dermatology. 2020 Apr 06;:1-9 Authors: Lukaviciute L, Ganceviciene R, Navickas P, Navickas A, Grigaitiene J, Zouboulis CC Abstract BACKGROUND/OBJECTIVE: Skin diseases, especially those with visible manifestation, are considered to cause a major influence on global mental health. Therefore, we determined the prevalence and severity of anxiety, depression, and suicidal ideation in a large sample of patients with facial dermatoses, namely acne, rosacea, folliculitis, and perioral dermatitis. METHODS: The mental health of patients with facial dermatoses and respective controls was assessed using the Hospital Anxiety and Depression Scale and questions concerning suicidal ideation. RESULTS: The study included 543 patients with facial dermatoses and 497 healthy individuals. Anxiety was present in 37.6% of the patients (14.9% of controls), depression in 21.7% (6.8%), and suicidal thoughts in 9.8% (3.2%) (p < 0.001). Acne patients demonstrated the highest anxiety and depression subscale scores (mean ± standard deviation: 7.1 ± 0.25, 95% confidence interval (CI): 6.58-7.56; controls: 5 ± 0.23, 95% CI: 4.57-5.49). In rosacea 30% of the patients had depression symptoms (adjusted odds ratio (OR): 7.216, 95% CI: 4.122-12.632, p < 0.001), while in folliculitis patients 15.4% (OR: 3.138, 95% CI: 1.241-7.936, p = 0.016) had suicidal thoughts. Patients with anxiety symptoms and suicidal thoughts were on average younger than those without (28.3 ± 0.76 vs. 31.2 ± 0.66 years, p = 0.001 and 25.3 ± 0.98 vs. 30.5 ± 0.55 years, p = 0.007, respectively). CONCLUSION: Acne and rosacea are associated with anxiety, depression, and suicidal ideation in Lithuanian patients. Younger patients are more prone to report such symptoms than older ones. PMID: 32252051 [PubMed - as supplied by publisher] {url} = URL to article
  23. Two is better than one: The combined effects of glycolic acid and salicylic acid on acne-related disorders. J Cosmet Dermatol. 2020 Apr 06;: Authors: Wiegmann D, Haddad L Abstract BACKGROUND: Many companies capitalized on treatable skin conditions by providing expensive prescription medications or high-end over-the-counter cosmetics. However, patients have become more apprehensive toward these medications in lieu of their often-detrimental side effect profile and reactivity with sensitive skin. AIMS: We developed a serum was created to counteract this budding problem. Our goal was to bring an alternative prescription acne medication that was superior in controlling acne when compared to several OTC and prescription-strength medications. We created a new formulary comprising primarily of all natural glycolic acid and salicylic acid. PATIENTS/METHODS: We designed a prospective study to assess the efficacy of our serum composed of glycolic and salicylic acid for patients suffering from mild to moderate inflammatory and cystic acne, rosacea, folliculitis, and keratosis pilaris. Sixty-six patients were selected ranging in age from 17 to 46. They were asked to apply the wake-up serum at night for 2 weeks. At the follow-up appointment, the patients were asked to fill out a questionnaire regarding the changes they have noticed with their skin. RESULTS: Over 90% of the patients reported they had significant overall improvement in acne with decrease in comedonal and cystic acne. 70%-80% of the patients stated decrease in oiliness, even texture, and smoother looking skin. Physical examination findings were consistent with patient-reported assessment. CONCLUSION: A glycolic and salicylic acid combination serum may be considered an alternative treatment method for patients who wish to opt out of the typical prescription medication treatment. PMID: 32250551 [PubMed - as supplied by publisher] {url} = URL to article
  24. Related Articles The role of hypothalamus-pituitary-adrenal (HPA)-like axis in inflammatory pilosebaceous disorders. Dermatol Online J. 2020 Feb 15;26(2): Authors: Saric-Bosanac S, Clark AK, Sivamani RK, Shi VY Abstract Skin is the largest peripheral endocrine organ and functions as a hormone target and endocrine gland. A cutaneous hypothalamus-pituitary-adrenal (HPA)-like axis enables the skin to respond to stress and regulates its steroidogenic activity. The pilosebaceous unit is a site for production and metabolism of a number of steroid hormones, including stress and sex hormones. This is an overview of the important role that the cutaneous HPA-like-axis plays in the pathogenesis and treatment of inflammatory pilosebaceous disorders, including acne, rosacea, seborrheic dermatitis, and hidradenitis suppurativa. PMID: 32239884 [PubMed - as supplied by publisher] {url} = URL to article
  25. Related Articles [Recurrent chalazions in children]. Rev Prat. 2019 Oct;69(8):881-883 Authors: Doan S Abstract Recurrent chalazions in children. Chalazia are caused by an acute inflammation of sebaceous palpebral glands and lead to emergency consultation. Their treatment is most often medical, surgery is reserved for persistant forms. In case of multiple recurrent chalazia in a child, ametropia and ocular rosacea should be ruled out. The latter is a rare but potentially severe disease that can have blinding corneal complications. PMID: 32237654 [PubMed - in process] {url} = URL to article
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