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Related Articles Useful Dermoscopic Findings for Differentiating Rosacea from Seborrheic Dermatitis. Indian J Dermatol. 2020 Jul-Aug;65(4):316-318 Authors: Kang IH, Seo JK, Shin MK PMID: 32831379 [PubMed - as supplied by publisher] {url} = URL to article Partical Text "In conclusion, dermoscopic examination can be useful in the diagnosis of patients with facial inflammatory diseases, especially in patients with rosacea and seborrheic dermatitis, which are common in clinical practice."

Related ArticlesRhinophyma Successfully Treated with Ultra Plus CO2 Laser: Report of a Case and Literature Review. Indian Dermatol Online J. 2020 Jul-Aug;11(4):619-622 Authors: Sakhiya J, Sakhiya D, Sakhiya M, Daruwala F Abstract Rhinophyma (Greek "nose growth") benign skin deformity characterized by tumorous growth leading to a large, bulbous, and erythematous appearing nose. It is a rare subtype of phymatous rosacea. The exact pathogenesis is still not known. It can lead to considerable cosmetic impairment with psychosocial implications and poses a risk of developing an occult malignancy. Early diagnosis and treatment is imperative to avoid these complications. Herein, we report a case of a 47-year-old man presenting with rhinophyma who was treated with ultra plus CO2 laser. PMID: 32832456 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Clinical and non-invasive instrumental evaluation of the efficacy of a non-steroid anti-inflammatory 8-beta Glycyrrhetinic Acid cream for the treatment of erythema in rosacea. Dermatol Ther. 2020 Aug 24;:e14224 Authors: Cameli N, Mariano M, Zanniello R, Berardesca E Abstract BACKGROUND: Rosacea is a very common chronic facial dermatosis characterized by a multiphase evolution. Inflammation is an important compound in rosacea, due to inflammatory reactions to cutaneous microorganisms such as Demodex Follicolorum but also to ultraviolet damage that generates reactive oxygen species. OBJECTIVE: To evaluate the efficacy and tolerability of a non-steroid anti-inflammatory 18-beta Glycyrrhetinic Acid cream for the treatment of mild rosacea by means of non-invasive methods. METHODS: A total of 24 subjects suffering from erythemato-telangiectatic or mild papulo-pustular rosacea were recruited to enter the trial. 12 patient applied an anti-inflammatory cream with 18-beta Glycyrrhetinic acid twice daily for 20 days, 12 patient recruited as control, applied the same formulation without 18-beta Glycyrrhetinic acid. RESULTS: After 10 days treatment, in the patient sample who applied the 18-beta Glycyrrhetinic acid cream a significant reduction of erythema was recorded, the mean change from baseline showed an increase in hydration level of the skin surface but it was not statistically significant. CONCLUSIONS: The use of 18-beta Glycyrrhetinic Acid cream can be helpful in managing symptoms and condition of rosacea skin, especially in the management of erythema. This article is protected by copyright. All rights reserved. PMID: 32833275 [PubMed - as supplied by publisher] {url} = URL to article "Enoxolone (INN, BAN; also known as glycyrrhetinic acid or glycyrrhetic acid) is a pentacyclic triterpenoid derivative of the beta-amyrin type obtained from the hydrolysis of glycyrrhizic acid, which was obtained from the herb liquorice." Wikipedia

Related Articles Risk Factors for Frontal Fibrosing Alopecia: a case-control study in a multiracial population. J Am Acad Dermatol. 2020 Aug 21;: Authors: Ramos PM, Anzai A, Duque-Estrada B, Farias DC, Melo DF, Mulinari-Brenner F, Pinto GM, Abraham LS, Nogueira Santos LD, Pirmez R, Miot HA Abstract BACKGROUND: Frontal fibrosing alopecia (FFA) is a chronic cicatricial alopecia with unknown etiology and a worldwide rising incidence. OBJECTIVE: The objective of this study was to evaluate the association of FFA with demographic and exposition factors in a Brazilian multiracial population. METHODS: A multicenter case-control study was conducted in 11 referral centers throughout Brazil. The study was a case-control study that prospectively recruited 902 participants (451 FFA and 451 sex-matched controls). Study participants completed a thorough questionnaire comprising variables grouped as baseline demographic, environmental exposition, diet, hormonal, allergies, and hair and skin care. RESULTS: When adjusted by sex, age, menopause and skin color, FFA was associated with hair straightening with formalin (OR 3.19), use of ordinary (non-dermatologic) facial soap (OR 2.09) and facial moisturizer (OR 1.99), thyroid disorders (OR 1.69), and rosacea (OR 2.08). Smokers (OR 0.33) and users of anti-residue / clarifying shampoo (OR 0.35), presented a negative association with FFA. There was no association with the use of sunscreen. LIMITATIONS: Recall bias. CONCLUSION: The association with moisturizers, odinary facial soap, and hair straightening with formalin and the negative association with anti-residue / clarifying shampoo reinforce the possibility of an exogenous particle triggering FFA. PMID: 32835739 [PubMed - as supplied by publisher] {url} = URL to article More information on Frontal fibrosing alopecia

Xolair (Omalizumab), a brand name medication originally designed to reduce sensitivity to allergens, has been used to treat a variant of rosacea, Rosacea Lymphedema (Morbihan Disease). "Omalizumab is used to treat people with severe, persistent allergic asthma, uncontrollable with oral or injectable corticosteroids." [1] One paper concludes, "The abundance of mast cells, producing vasoactive substances, proteases and cathelicidins, such as Cath-37, may be important in the pathogenesis of rosacea as well as of MS, and studies indicate that the antihistamine ketotifen shows beneficial outcome in the treatment of rosacea. Omalizumab is a humanised monoclonal antibody that binds the circulating IgE antibodies and may stabilise mast cells in the treatment of chronic urti- caria. Typical flushes in MS and rosacea are similar to the temporary erythematous swellings observed in urticaria and angioedema. Accordingly, we hypothesize that omalizumab could stabilize mast cells in MS and reduce the temporary swelling." [2] Reply to this Topic There 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. End Notes [1] Omalizumab, Wikipedia [2] Acta Derm Venereol. 2019 Jun 01;99(7):677-678 Morbihan Syndrome Successfully Treated with Omalizumab. Kafi P, Edén I, Swartling C

Related Articles Morbihan disease: a case report and differentiation from Melkersson-Rosenthal syndrome. Dermatol Online J. 2020 Jun 15;26(6): Authors: Kuraitis D, Coscarart A, Williams L, Wang A Abstract We present a 32-year old woman with a 9-year history of upper facial swelling. A workup by the ophthalmology department led to the diagnosis of Melkersson-Rosenthal syndrome. Re-evaluation in our dermatology clinic confirmed a diagnosis of Morbihan disease. Herein, we review case reports and case series of upper facial swelling in the dermatologic and ophthalmologic literature. Although the two entities share histopathological changes, they tend to have different clinical presentations. Melkersson-Rosenthal syndrome appears to be more likely diagnosed in the ophthalmologic literature when the clinical presentation and histopathology may be more consistent with Morbihan disease. In a patient with upper facial swelling, an absence of orolabial swelling, and lack of facial neuropathy, we argue for a diagnosis of Morbihan disease over Melkersson-Rosenthal syndrome, especially if the patient has a history of rosacea. PMID: 32815689 [PubMed - as supplied by publisher] {url} = URL to article More info on Morbihan Disease

A very severe case of rhinophyma requiring a three-stage reconstruction with a forehead flap. Ann R Coll Surg Engl. 2020 Aug 18;:e1-e4 Authors: Saad M, Matteucci P Abstract Rhinophyma is a skin condition that affects the nose. It is often characterised by a large, red, bulbous nose. It can have a physical, psychological and social impact on the patient. Management options include conservative medical therapy such as retinoids or surgical excision followed by reconstruction as required. The reconstruction options can range from a dermal substitute full-thickness skin graft to local flaps, depending on the wound bed. We present a severe case of rhinophyma that required a complex reconstruction with a three-stage forehead flap because of the mass effect and the wound that resulted from the surgical excision of an extremely large and troublesome rhinophyma. PMID: 32808811 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesManaging Rosacea in the Clinic: From Pathophysiology to Treatment-A Review of the Literature. J Clin Aesthet Dermatol. 2020 Apr;13(4 Suppl):S17-S22 Authors: Johnson SM, Berg A, Barr C Abstract Rosacea is a chronic skin disease characterized by a waxing and waning course. It can encompass different symptoms including erythema, papules/pustules, telangiectasia, and phymata and sometimes secondary manifestations, such as itching, burning, or stinging. This article reviews recent changes in rosacea management. Discussion of relevant medical literature augmented with clinical expertise is also provided. Notably, while patients report that rosacea negatively impacts their emotional and overall well-being, they also tend to have low satisfaction with treatment and are prone to discontinuing therapy and/or using rosacea medications on an intermittent basis, thereby undermining treatment efficacy. Fortunately, the therapeutic armamentarium for rosacea is expanding, and experts now recommend a treatment approach that targets the presenting signs and/or symptoms, with the goal of achieving the greatest possible clearance. More so than in the past, several treatments can be used concurrently to best address the overall presentation of rosacea in an individual patient. PMID: 32802248 [PubMed - as supplied by publisher] {url} = URL to article

Optimizing Management of Otophyma: A Case Series Highlighting the Role of Surgical and Retinoid Therapy. Ear Nose Throat J. 2020 Aug 17;:145561320947619 Authors: Paradiso MM, Kaffenberger BH, Rock AN, Dodson EE Abstract Otophyma is a rare condition that can result in conductive hearing loss. Current otophyma literature does not examine validated treatment outcomes for patients. Utilizing a medical and surgical approach to maintain a patent canal can lead to significant objective improvements. The aim of this case series is to describe a combined successful approach in 3 cases from an academic, multidisciplinary center. The main outcomes analyzed were pre and post air-bone gap audiogram analysis and disimpaction frequency. The results showed that post-management, patient 1 had substantial improvement in hearing, recovering 49 dB in his right ear and 25 dB in his left ear, demonstrating near complete air-bone gap closure. Patient 2 showed a similar dermatologic and functional improvement, although objective audiometric assessment related to otophyma could not be performed due to coexisting chronic otitis media and cholesteatoma. Patient 3, in the 12 months prior to comanagement, had 8 bilateral disimpactions, and following comanagement had 2 disimpactions in 23 months. All 3 patients were pleased with the resultant functional and physical appearance following comanagement. By presenting this approach and objective measures of treatment, we hope to improve future clinical decision-making in a rare condition. PMID: 32804571 [PubMed - as supplied by publisher] {url} = URL to article

In which rosacea patients should Demodex in the eyelashes be investigated? Niger J Clin Pract. 2020 Aug;23(8):1039-1043 Authors: Ogrum A, Alim S Abstract Aim: The aim of this study was to investigate the relationship between the presence of Demodex on the face and within the eyelash follicles in patients with rosacea. Subjects and Methods: This prospective cross-sectional study included 80 participants, 40 patients with rosacea and 40 individuals with no rosacea as controls. The presence of Demodex on the face was assessed by standard superficial skin biopsy. Sixteen eyelashes were epilated from each patient and control. Results: The rate of Demodex infestation and severe infestation on the face in patients with rosacea was significantly higher than the control group. Demodex count within the eyelash follicle was significantly higher in patients with erythematotelangiectatic type rosacea than the control group. There was no increase in blepharitis in rosacea patients but when blepharitis was present, the rate of the presence of Demodex was higher in this group. There was a statistically significant relationship between the presence of Demodex within the eyelashes and itchy eyes in people without blepharitis. Conclusion: When at least one Demodex is found on the face in rosacea patients, the eyelashes should be examined for effective treatment of the mite. Itchy eyes may be an important sign of the presence of Demodex in people without blepharitis. PMID: 32788478 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesEnhanced Pulsed Dye Laser for Facial Rejuvenation. Lasers Surg Med. 2020 Aug 10;: Authors: Victor Ross E, Chodkiewicz H, Javvaji S, Zumwalt J, Kutscher TD, Tran C Abstract BACKGROUND AND OBJECTIVES: To evaluate the efficacy of an enhanced pulsed dye laser (PDL) for treatment of facial-dyschromia. STUDY DESIGN/MATERIALS AND METHODS: Thirteen patients were enrolled in the study. Nine patients were female, four were male, with a mean age of 61 years. All patients presented with either facial telangiectasia, rosacea, pigment, or a combination thereof. At the initial evaluation, test spots were performed to determine the subject's response to selected treatment parameters. In the study, the enhanced 595 nm PDL deployed a spot size range of 5-12 mm with fluences ranging from 8 to 18 J/cm2 . Pulse duration was 10 milliseconds. Enhancements in this device included the option for contact or cryogen spray cooling, increased maximum pulse energy, increased repetition rate, option for addition of radiofrequency (RF), an option for a 15 mm spot size, and longer dye life. The smaller spots were used only for focal low contrast pigmented lesions that persisted after overall facial treatment with the larger spot. Smaller fluences were applied for general rejuvenation with the 12 mm spot (mean ~9 J/cm2 ). Sapphire contact cooling was applied at 10°C. A smaller area of the skin was reserved (typically pre-auricular area) for addition of RF energy just before the pulse (40-70 J/cm3 ) over 100 milliseconds with a 20 milliseconds delay between the end of the RF pulse and beginning of the laser pulse. The minimum fluence that achieved vessel closure/vessel bluing and/or slight immediate pigment darkening was applied based on test spots performed just before treatment to the entire face. Determinations of improvement were made by evaluation of photographs with standard settings using polarized and nonpolarized images. Up to three treatments were performed approximately 1 month apart with follow-up visits 1 and 3 months after the final treatment. RESULTS: Evaluation by a panel of blind observers determined a mean clearance of at least 50% in all lesions, while 77% of lesions had 50-75% clearance, and 23% of lesions had 76-100% clearance. Pain was approximately 4/10. Subjective lesion improvement and satisfaction rates were 3 out of 4 and 3.6 out 4, respectively. CONCLUSION: An enhanced PDL is effective in one pass treatments for facial rejuvenation with considerably less operative time than previous commercially available systems. A second pass applied to focal challenging lesions results in even more improvement, in a single treatment session. Lasers Surg. Med. © 2020 Wiley Periodicals LLC. PMID: 32779273 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles[Strawberry and raspberry anaphylaxis]. Rev Med Liege. 2020 Jul;75(7-8):494-496 Authors: Collins A, Derkenne B, Giebels K, Carvelli T Abstract Strawberry IgE-mediated hypersensitivity is often reported rarely confirmed. Only a few cases are described in medical literature, unlike other fruits of the rosacea family. Strawberry is rich in histamine. It can cause histamine release syndrome, especially when eaten in large quantities. However IgE-mediated hypersensitivity exists. We reported the case of a 9-year-old boy with a history of strawberry and raspberry anaphylaxis. PMID: 32779896 [PubMed - in process] {url} = URL to article

Related ArticlesRetrospective analysis of 19 papulopustular rosacea cases treated with oral minocycline and supramolecular salicylic acid 30% chemical peels. Exp Ther Med. 2020 Aug;20(2):1048-1052 Authors: Wang L, Li XH, Wen X, Li XX, Du D, Li Y, Jiang X Abstract Papulopustular rosacea (PPR) is characterized by central facial erythema and transient papules and/or pustules, with or without telangiectases. The treatment of PPR is challenging due to the unclear and complex pathogenesis. In the present retrospective study, patients with PPR treated with oral minocycline and supramolecular salicylic acid (SSA) 30% chemical peels enrolled between June 2018 and June 2019 were evaluated. All patients were treated with 50 mg minocycline twice a day and SSA 30% twice a month. A total of 19 patients were enrolled and all received the therapy for 12 weeks. A significant reduction of rosacea severity was observed by Investigator Severity Assessment (ISA) after treatment; the mean score reduced from 3.32±0.6 at baseline to 0.89±0.7 (P<0.01) at 12 weeks. After 12 weeks, all patients achieved at least a 'moderate response' and 17 patients (89.47%) obtained 'excellent improvement' in the Investigator Global Assessment of efficacy. No obvious adverse reactions were observed during each patient's visit. In conclusion, the combination treatment of minocycline and SSA 30% was an effective therapy for PPR. The limitation of the present study was that it was a retrospective analysis; more high-quality, prospective, blinded, controlled clinical trials are required to evaluate the efficacy based on the current study. PMID: 32765658 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesA predictive model for differential diagnosis between rosacea and sensitive skin: a cross-sectional study. Chin Med J (Engl). 2020 Aug 05;: Authors: Wang XY, Liu YY, Liu YX, Ma WW, Zhang JW, Liu ZJ, Liu J, Zhou BR, Xu Y PMID: 32769497 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesRosacea and the gastrointestinal system. Australas J Dermatol. 2020 Aug 06;: Authors: Searle T, Ali FR, Carolides S, Al-Niaimi F Abstract Rosacea is a common skin condition characterised by erythema, papules and pustules. Increasing evidence suggests that the gut-skin axis is implicated in the pathogenesis of rosacea. Sufficient evidence exists to support the notion that the gut microbiome plays a role in the inflammatory cutaneous response and there appear to be associations with small intestinal bacterial overgrowth and Helicobacter pylori infection. A dysbiotic microbiome and an innate immune system dysregulation contribute to the pathophysiology of rosacea, and further exploration of their roles is warranted. Greater understanding of this condition and the effect of the gut-skin axis could allow for more efficacious and timely treatment. This article reviews our current findings and understanding in the skin and gut relationship in rosacea. PMID: 32761824 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesThe High Prevalence of Skin Diseases in Adults Aged 70 and Older. J Am Geriatr Soc. 2020 Aug 04;: Authors: Sinikumpu SP, Jokelainen J, Haarala AK, Keränen MH, Keinänen-Kiukaanniemi S, Huilaja L Abstract BACKGROUND/OBJECTIVES: To determine the prevalence of skin findings and skin diseases in adults aged 70 and older, and to study the association between cutaneous diseases and socioeconomic status (SES), sex, and living status in the older population. DESIGN: Cross-sectional study of Finnish adults aged 70 to 93 as part of the Northern Finland Birth Cohort 1966 Study. SETTINGS: Skin examination data were available for 552 adults. MEASUREMENTS: A whole-body skin examination was performed by dermatologists. The associations between skin diseases and SES, sex, and living status were analyzed. RESULTS: Nearly 80% of the adults had at least one skin disease that required further treatment or follow-up. More than one-third of the study cases (39.1%) had three or more simultaneous skin diseases. Skin diseases were more common in men than in women (P < .001). The most common skin diseases were tinea pedis (48.6%), onychomycosis (29.9%), rosacea (25.6%), actinic keratosis (22.3%), and asteatotic eczema (20.8%). Some association was found between skin diseases and SES and living status. CONCLUSION: A whole-body clinical skin examination is important because it reveals important diagnoses. PMID: 32754902 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesFrequency of different types of facial melanoses referring to the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital in 2019, and assessment of their effect on health-related quality of life. BMC Dermatol. 2020 Aug 03;20(1):4 Authors: Amatya B, Jha AK, Shrestha S Abstract BACKGROUND: Abnormalities of facial pigmentation, or facial melanoses, are a common presenting complaint in Nepal and are the result of a diverse range of conditions. OBJECTIVES: The objective of this study was to determine the frequency, underlying cause and impact on quality of life of facial pigmentary disorders among patients visiting the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital (NMCTH) over the course of one year. METHODS: This was a cross-sectional study conducted at the Department of Dermatology and Venereology, NMCTH. We recruited patients with facial melanoses above 16 years of age who presented to the outpatient department. Clinical and demographic data were collected and all the enrolled participants completed the validated Nepali version of the Dermatology Life Quality Index (DLQI). RESULTS: Between January 5, 2019 to January 4, 2020, a total of 485 patients were recruited in the study. The most common diagnoses were melasma (166 patients) and post acne hyperpigmentation (71 patients). Quality of life impairment was highest in patients having melasma with steroid induced rosacea-like dermatitis (DLQI = 13.54 ± 1.30), while it was lowest in participants with ephelides (2.45 ± 1.23). CONCLUSION: Facial melanoses are a common presenting complaint and lead to substantial impacts on quality of life. Accurate diagnosis and management can prevent or treat many facial melanoses, including those that lead to substantial loss of quality of life, such as melasma with steroid induced rosacea-like dermatitis. Health care systems in low and middle-income countries should dedicate resources to the identification, prevention and treatment of these conditions to improve quality of life. PMID: 32746823 [PubMed - in process] {url} = URL to article

Related ArticlesThe Decrease of Demodex Density After Nd:YAG Laser Application for Facial Telengiactasias: A Case Report. Dermatol Ther. 2020 Jul 30;: Authors: Yalici-Armagan B, Elcin G PMID: 32734702 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesAcute inflammatory Demodex-induced pustulosis in an immunocompetent patient related to topical steroid use. Pediatr Dermatol. 2020 Jul 29;: Authors: Guzman AK, Gittler JK, Amin B, Srikantha R, Balagula Y Abstract Demodex spp. mites are a common colonizer of sebaceous adult skin. Though usually clinically insignificant, demodicosis may be associated with a wide spectrum of skin diseases in immunocompetent hosts, such as erythematotelangiectatic and papulopustular rosacea, Demodex folliculorum, and blepharitis. We present a case of a healthy 9-year-old boy with an exuberant, inflammatory, Demodex-associated pustular eruption of the face, induced by the use of a high-potency topical steroid and successfully treated with oral ivermectin. PMID: 32729151 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesThe versatility of azelaic acid in dermatology. J Dermatolog Treat. 2020 Jul 30;:1-31 Authors: Searle T, Ali FR, Al-Niaimi F Abstract Azelaic acid has numerous pharmacological uses in dermatology. Its anti-inflammatory and anti-oxidant properties are thought to correlate with its efficacy in papulopustular rosacea and acne vulgaris, amongst other cutaneous conditions. We conducted a review of the literature on the use of azelaic acid in dermatology using key terms "acne," "azelaic acid," "dermatology," "melasma," "rosacea," searching databases such as MEDLINE, EMBASE and PubMed. Only articles in English were chosen. The level of evidence was evaluated and selected accordingly listing the studies with the highest level of evidence first using the Oxford Centre of Evidence-Based Medicine 2011 guidance.This review found the strongest evidence supporting the use of azelaic acid in rosacea, followed by its use off-label in melasma followed by acne vulgaris. Weaker evidence is currently available to support the use of azelaic acid in several other conditions such as hidradenitis suppurativa, keratosis pilaris and male androgenic alopecia.Azelaic acid, as a monotherapy or in combination, could be an effective first-line or alternative treatment, which is well-tolerated and safe for a range of dermatological conditions. PMID: 32730109 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesA hypothesis: Role of physical factors in pathophysiology of rhinophyma - Focus on habitual mechanical trauma. Med Hypotheses. 2020 Jul 15;143:110097 Authors: Borzęcki A, Turska M Abstract BACKGROUND: Rhinophyma is a skin disorder which causes nose enlargement and deformation due to proliferation of sebaceous glands and connective tissue. It is not only an aesthetic problem but may also lead to impaired nasal breathing and problems with liquids intake. HYPOTHESIS: Although rhinophyma is considered to be a subtype of rosacea, here we hypothesise whether it is a separate disease with mechanical trauma as a main reason of the disease progress. METHODS: 22 patients with diagnosed rhinophyma were qualified for the study. All patients were physically examined and detailed patients' medical history was obtained. Patients were asked to answer a number of questions regarding their usual skin care, purification procedure as well as handling of the nose and nasal cavity. Results were subjected to statistical analysis. RESULTS: Due to our observations there is a group of patients who have never presented any typical symptoms of rosacea while they are now suffering from rhinophymatous changes. Most of those patients confirmed longlasting mechanical nose cleaning which included any skin lesions removal by squeezing and nose picking which resulted in local skin inflammation, swelling, pain or itching. CONCLUSION: It is suspected that many different factors may induce rhinophyma development. In our opinion, mechanical repetitive trauma is one of the most important. Therefore we encourage physicians to include adequate questions while taking medical history from the patient and implement proper recommendations for nasal care as soon as possible. PMID: 32721796 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesEfficacy of non-ablative fractional 1440-nm laser therapy for treatment of facial acne scars in patients with rosacea: a prospective, interventional study. Lasers Med Sci. 2020 Jul 27;: Authors: Wang B, Deng YX, Yan S, Xie HF, Li J, Jian D Abstract Acne scarring is one of the most common facial skin disorders. The appropriate treatments for acne scars in patients with rosacea have not been studied. This study was designed to evaluate the efficacy and safety of non-ablative fractional 1440-nm laser (1440-nm NAFL) therapy for treatment of atrophic acne scars in patients with rosacea. In this prospective, interventional study, 32 patients with rosacea and acne scars underwent three sessions of 1440-nm NAFL therapy. Therapy efficacy, epidermal barrier function, and side effects were evaluated. Thirty patients completed and the median acne scar scores significantly reduced from 45 (30, 50) to 15 (15, 30) after three treatments (P < 0.001). The improvement score of acne scars was 2.7 ± 0.7; 22 (73.3%) were satisfied or highly satisfied. The rosacea erythema scores changed from 2.1 ± 0.4 to 1.9 ± 0.5 (P = 0.326), and flushing, burning, and stinging were not worse. The oil content after treatments was significantly reduced (P < 0.001), while there was no significant difference in other indicators of skin barrier function. The quality-of-life score decreased from 17.5 ± 3.8 to 14.1 ± 3.0 (P < 0.001). No serious side effects were observed. The 1440-nm NAFL therapy is effective in the treatment of acne scaring in patients with rosacea with little damage to the skin barrier. PMID: 32719961 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesPrimum non nocere; the importance to evaluate the effect of treatment and consider side-effects. Contact Dermatitis. 2020 Jul 26;: Authors: Sukakul T, Dahlin J, Svedman C PMID: 32713000 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesManagement of severe rhinophyma with electrocautery dermabrasion - A case report. Int J Surg Case Rep. 2020;72:511-514 Authors: Chellappan B, Castro J Abstract INTRODUCTION: Rhinophyma is benign hypertrophic thickening of the skin and edema of the nasal pyramid. The affected tissue enlarges slowly before reaching its permanent size. The lobulated skin surface with hundreds of pores can become cosmetically embarrassing and cause significant psychosocial stress, anxiety, and depression for patients. In addition, extensive alar thickening can obstruct the external nasal valves making treatment necessary to alleviate respiratory issues. No consensus has been reached regarding management of rhinophyma and many surgeons follow the "to each his own technique" mindset. Our objective was to present a case report to support the use of electrocautery and dermabrasion as the mainstay of treatment. PRESENTATION OF CASE: Here we describe the case of a 62-year-old Caucasian male with a long-standing history of acne rosacea who developed severe rhinophyma overtime which lead to nasal obstruction and major cosmetic deformity. Electrocautery and dermabrasion in the operating room were utilized to obtain an outstanding cosmetic result and respiratory function improvement. Loop and Colorado cautery tips were used with cutting current to remove the hypertrophic skin and create a smooth contour. The patient tolerated the procedure well without any complications. The patient's skin was scab-free with normal pigmentation by four weeks post-op. He was satisfied with the cosmetic outcome and reported substantial improvement in his breathing. DISCUSSION: There have been several case reports published which describe using different surgical methods to treat rhinophyma including lasers, electrocautery dermabrasion, surgical blade, cryosurgery, and radio excision. The main limitations of laser therapy are imprecise tissue removal, risk of scarring, dyspigmentation, and bleeding. Other therapies such as surgical excision and skin grafts may require multiple procedures before obtaining a satisfactory cosmetic outcome. CONCLUSION: This case report supports electrocautery dermabrasion as the mainstay of treatment as it is a management technique which allows for smooth contouring, efficient hemostasis, more control in the operating room, and does not require multiple procedures. PMID: 32698277 [PubMed] {url} = URL to article

Related ArticlesImpact of COVID-19 Pandemic on Dermatologists and Dermatology Practice. Indian Dermatol Online J. 2020 May-Jun;11(3):328-332 Authors: Bhat YJ, Aslam A, Hassan I, Dogra S Abstract The COVID-19 pandemic has directly or indirectly affected every human being on this planet. It's impact on the healthcare system has been devastating. The medical fraternity across the world, including India, is facing unprecedented challenges in striving to cope up with this catastrophic outbreak. Like all other specialties, dermatology practice has been profoundly affected by this pandemic. Measures have been taken by dermatologists to control the transmission of the virus, whereas providing health care to patients in the constrained environment. Preventive measures such as social distancing and hand hygienic practices along with patient education is being prioritized. Dermatological conferences and events scheduled across the globe in the first half of year 2020 have been either cancelled or postponed to discourage gatherings. Rationalization of resources and practice of teledermatology are being encouraged in current scenario. Non-urgent visits of the patients are being discouraged and elective dermatology procedures are being postponed. Many national and international dermatology societies have recently proposed recommendations and advisories on usage of biologicals and immunomodulators in present context of COVID-19 pandemic. Urticarial, erythematous, varicelliform, purpuric and livedoid rash as well as aggravation of preexisting dermatological diseases like rosacea, eczema, atopic dermatitis, and neurodermatitis rash have been reported in Covid-19 patients. Self medications and poor compliance of dermatology patients in addition to lack of proper treatment protocols and monitoring are a serious concern in the present scenario. Strategies for future course of action, including the dermatology specific guidelines need to be framed. This issue includes a special symposium on dermatology and COVID-19 having recommendations from special interest groups (SIGs) of Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) Academy on leprosy, dermatosurgery, lasers and dermoscopy. PMID: 32695687 [PubMed] {url} = URL to article