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Res Sq. 2023 Dec 4:rs.3.rs-3647800. doi: 10.21203/rs.3.rs-3647800/v1. Preprint. ABSTRACT Dysregulation of the immune system in individuals with Down syndrome is thought to play a major role in the pathophysiology of many clinical presentations. This natural history of disease study took a comprehensive evaluation of the prevalence of different immune related diagnoses in a cohort of 1299 patients with Down syndrome compared to a 2605 control cohort of patients without Down syndrome at Mount Sinai Health System in NY, NY over the past 18 years. We conducted a stepwise analysis of the odds of receiving a diagnosis at the Chapter, Sub-chapter and Diagnosis level of the ICD-CM-10 code system. Individuals in our Down syndrome cohort had higher odds of a diagnosis with inflammatory and autoimmune presentations such as Alopecia areata (OR 6.06, p = 0.01), Other sepsis (OR 4.79, p < 0.001, Purpura and Other hemorrhagic conditions (OR 2.31, p < 0.001), and Rosacea (OR 3.11, p < 0.001). They also presented with lower odds of a diagnosis of Herpesviral infection (OR 0.42, p = 0.01), and Viral warts (OR 0.51, p = 0.04). We posit that dysregulation of the immune system in individuals with Down syndrome has impact on infectious diseases, including lowering the incidence of viral disease, and increasing its severity. Our data also suggests inflammation and autoimmune mediated diseases, in particular of the skin, is exacerbated in individuals with Down syndrome. Finally, there may be a need for greater clinical attention to non-emergent conditions within the Down syndrome patient population as those can also greatly affect quality of life. PMID:38106041 | PMC:PMC10723534 | DOI:10.21203/rs.3.rs-3647800/v1 {url} = URL to article

An Bras Dermatol. 2023 Dec 14:S0365-0596(23)00254-4. doi: 10.1016/j.abd.2022.09.016. Online ahead of print. NO ABSTRACT PMID:38102048 | DOI:10.1016/j.abd.2022.09.016 {url} = URL to article

J Invest Dermatol. 2023 Dec 14:S0022-202X(23)03055-5. doi: 10.1016/j.jid.2023.11.002. Online ahead of print. NO ABSTRACT PMID:38099889 | DOI:10.1016/j.jid.2023.11.002 {url} = URL to article Full Text

Clin Exp Dermatol. 2023 Dec 12:llad442. doi: 10.1093/ced/llad442. Online ahead of print. NO ABSTRACT PMID:38085069 | DOI:10.1093/ced/llad442 {url} = URL to article

Dermatol Surg. 2023 Dec 12. doi: 10.1097/DSS.0000000000004057. Online ahead of print. ABSTRACT BACKGROUND: Patients frequently seek laser treatment for vascular conditions. More recently, a novel 532 and 1,064 nm laser was developed to offer greater flexibility. OBJECTIVE: A prospective clinical trial evaluated the safety and efficacy of a novel, variable-sequenced, long-pulsed, 532 and 1,064 nm laser with cryogen spray cooling (DermaV, Lutronic, South Korea). MATERIALS AND METHODS: Subjects with vascular conditions were enrolled for laser treatments. Clinical evaluations and optical coherence tomography (OCT) imaging were performed. RESULTS: Thirteen subjects were enrolled. The mean age was 51.3 years, and 92.3% were women. Fitzpatrick skin types I-IV were included. Treatment indications included broken blood vessels, rosacea, port-wine birthmark, and spider angioma. For physician investigator grading, all subjects were graded as improved at both 30-day and 90-day follow-up. Blinded photographic review by 3 independent, blinded physicians had a mean of 89.7% of cases selected correctly with at least 2 of 3 in agreement for 100.0% of cases. Optical coherence tomography imaging showed significant reductions in vessel density ( p = .018) and diameter ( p = .003) of the superficial vascular plexus. No serious adverse events occurred. CONCLUSION: A novel, variable-sequenced, long-pulsed, 532 and 1,064 nm laser with cryogen spray cooling can safely and effectively improve vascular conditions and lesions as determined by both clinical and OCT evaluation. PMID:38085090 | DOI:10.1097/DSS.0000000000004057 {url} = URL to article

medRxiv. 2023 Dec 4:2023.11.28.23299152. doi: 10.1101/2023.11.28.23299152. Preprint. ABSTRACT Acne vulgaris, rosacea, and hidradenitis suppurativa are enduring inflammatory skin conditions that frequently manifest with akin clinical attributes, posing a considerable challenge for their distinctive diagnosis. While these conditions do exhibit certain resemblances, they also demonstrate distinct underlying pathophysiological mechanisms and treatment modalities. Delving into both the molecular parallels and disparities among these three disorders can yield invaluable insights for refined diagnostics, effective management, and targeted therapeutic interventions. In this report, we present a comparative analysis of transcriptomic data across these three diseases, elucidating differentially expressed genes and enriched pathways specific to each ailment, as well as those shared among them. We also identified high dose dietary zinc as a potential therapeutic agent and validated its efficacy in an acne mouse model. PMID:38076983 | PMC:PMC10705630 | DOI:10.1101/2023.11.28.23299152 {url} = URL to article

J Eur Acad Dermatol Venereol. 2023 Dec 11. doi: 10.1111/jdv.19732. Online ahead of print. ABSTRACT Rosacea is a chronic and psychologically ladened disease affecting 1%-3% of people worldwide. The identification and validation of biomarkers in rosacea patients has the potential to improve disease progression, support diagnosis, provide objective measures for clinical trials and aid in management. The objective of this review is to systematically identify all rosacea biomarkers, categorize them by type and identify trends to improve disease expression. Eligibility criteria for this review (PROSPERO CRD42023397510) include randomized controlled trials, case-control studies, cohort studies and other observational studies. No restrictions were placed on patient demographics (age, sex, ethnicity) or language of publication until February 2023. Quality of studies was assessed using the National Institute of Health quality assessment tool. The literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A total of 805 unique articles were screened based on the applied inclusion and exclusion criteria. After the articles were screened based on title/abstract and full-text, a total of 38 studies were included, reporting on a total of 119 unique biomarkers. The results of this review and current rosacea pathogenic mechanisms provide the greatest support for the innate cathelicidin and inflammasome, Th 1 and Th 17 pathways. The most commonly reported biomarkers include IL-1β, TNF-α, IL-37, IFN-γ and MMP-9. Biomarkers identified in this study support current theories of rosacea pathogenesis and provide direction for research to further our knowledge. However, more research is needed to identify biomarkers panels that can provide diagnostic utility. This may be difficult due to the heterogeneity of the disease and potential differences between rosacea subtypes. PMID:38078369 | DOI:10.1111/jdv.19732 {url} = URL to article

Acta Derm Venereol. 2023 Dec 11;103:adv18392. doi: 10.2340/actadv.v103.18392. ABSTRACT Metformin is a widely used drug for treatment of diabetes mellitus, due to its safety and efficacy. In addition to its role as an antidiabetic drug, numerous beneficial effects of metformin have enabled its use in various diseases. Considering the anti-androgenic, anti-angiogenic, anti-fibrotic and antioxidant properties of metformin, it may have the potential to improve chronic inflammatory skin diseases. However, further evidence is needed to confirm the efficacy of metformin in dermatological conditions, This review focuses on exploring the therapeutic targets of metformin in acne vulgaris, hidradenitis suppurativa and rosacea, by studying their pathogeneses. PMID:38078688 | DOI:10.2340/actadv.v103.18392 {url} = URL to article

Acta Derm Venereol. 2023 Dec 7;103:adv18462. doi: 10.2340/actadv.v103.18462. NO ABSTRACT PMID:38059580 | PMC:PMC10719862 | DOI:10.2340/actadv.v103.18462 {url} = URL to article

Clin Exp Dermatol. 2023 Dec 7:llad418. doi: 10.1093/ced/llad418. Online ahead of print. NO ABSTRACT PMID:38059897 | DOI:10.1093/ced/llad418 {url} = URL to article

Ann Dermatol. 2023 Nov;35(Suppl 2):S314-S316. doi: 10.5021/ad.22.131. ABSTRACT Lowe syndrome (LS), also known as oculocerebrorenal syndrome, is an X-linked multisystemic disorder caused by mutations in OCRL1, which encodes a member of the inositol-5-phosphatase family. As implied by its name, congenital cataracts, defects in the central nervous system, and renal manifestations are the main symptoms. Early hidradenitis suppurativa (HS) occurrence in Dent disease 2 (DD2), which is a mild variant of LS and shares the OCRL1 gene mutation, has been reported, although not in LS patients. Here, we report a case of HS in a 17-year-old boy with genetically confirmed LS, which suggests that defects in the OCRL1 gene may contribute to HS pathogenesis. PMID:38061729 | DOI:10.5021/ad.22.131 {url} = URL to article

An Bras Dermatol. 2023 Dec 6:S0365-0596(23)00246-5. doi: 10.1016/j.abd.2023.01.008. Online ahead of print. ABSTRACT BACKGROUND: The development of rosacea is suggested to be closely associated with lipid metabolism, inflammation, and anxiety/depression. Gamma linolenic acid (GLA) is a key factor participating in lipid metabolism, which is also confirmed to regulate the inflammatory response. However, the associations of serum GLA levels with rosacea severity and psychological status still remain unclear. OBJECTIVE AND LIMITATIONS OF THE STUDY: The present study aimed to investigate the associations of gamma linolenic acid (GLA), a key factor participating in lipid metabolism and the inflammatory response, with rosacea severity and psychological status. The present study still had some limitations. First, this study is a cross-sectional study and does not provide longitudinal evidence about the relationship between GLA and rosacea; Second, the cohort in this study is also relatively small, and a larger cohort is needed in further investigation to reveal the potential role of lipid metabolism in the pathogenesis of rosacea. METHODS: A total of 62 rosacea patients were consecutively recruited. Patient's Self-Assessment (PSA) scale and Clinician Erythema Assessment (CEA) as well as 7-item Generalized Anxiety Disorder (GAD-7) and 9-item Patient Health Questionnaire (PHQ-9) were conducted to evaluate the degree of erythema severity and anxiety/depression, respectively. Serum GLA levels were determined by gas chromatography mass. RESULTS: Lower levels of serum GLA in rosacea patients were observed (p<0.001), and subgroup analysis revealed that patients with higher-level GLA had lower scores of PSA, CEA, GAD-7 and PHQ-9. Moreover, Spearman correlation analysis uncovered that serum GLA levels were negatively associated with PSA, CEA, GAD-7 as well and PHQ-9 scores, respectively. Linear regression model found that serum GLA levels at baseline were a predictive factor for prognosis of clinical outcomes after 1-month conventional treatment. CONCLUSION: The present study indicates that lower levels of serum GLA in rosacea patients are negatively associated with the degree of erythema and anxiety/depression status. PMID:38061964 | DOI:10.1016/j.abd.2023.01.008 {url} = URL to article

J Korean Med Sci. 2023 Dec 4;38(47):e402. doi: 10.3346/jkms.2023.38.e402. ABSTRACT BACKGROUND: Rosacea is a common inflammatory skin disease with multiple etiologies. Proton pump inhibitors (PPIs) and histamine-2 receptor antagonists (H2RA) are acid suppressive drugs widely used for gastrointestinal (GI) diseases, and long-term use has been reported to be associated with dysbiosis which is a potential risk for development of rosacea. This study aimed to study the association between rosacea and acid suppressants in the Korean national cohort. METHODS: We used Korean National Health Insurance Service-National Sample Cohort data of 749,166 patients with upper GI diseases between 2001 and 2013. Duration of acid suppressants was compared between patients with and without rosacea together with other sociodemographic characteristics and hazard ratios were estimated. RESULTS: Longer use of acid suppressants was significantly associated with increased risk of rosacea. After adjustment for possible confounders, increased cumulative defined daily dose was significantly associated with risk of rosacea (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.20-2.00; P = 0.001). Other factors significantly associated with risk of rosacea include residing in the rural area (OR, 2.58; 95% CI, 2.18-3.06; P < 0.001), greater Charlson Comorbidity Index score (OR, 1.45; 95% CI, 1.15-1.83; P = 0.002), and comorbidities (malignancy, thyroid disease, and depression). CONCLUSION: Results from our study indicate that H2RA or PPI is associated with the occurrence of rosacea among patients with GI diseases in the Korean population. The risk was increased in dose-dependent manner, even after adjusting for confounding variables. Clinicians should be aware of risks associated with prolonged use of acid suppressive drugs. PMID:38050914 | PMC:PMC10695752 | DOI:10.3346/jkms.2023.38.e402 {url} = URL to article

Wounds. 2023 Nov;35(11):E391-E393. doi: 10.25270/wnds/23064. ABSTRACT BACKGROUND: Rosacea is a significant problem, affecting 5.5% of the world population. Currently used treatment techniques such as transfer flaps and implants are insufficient to meet the needs of many patients, which suggests that alternative approaches are needed. CASE REPORT: This report describes a case of rosacea complicated by giant rhinophyma treated with excision and closure by secondary intention and growth factor application. The patient was admitted to the Department of Dermatology at The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China, in July 2021, and underwent excision of the external nasal redundancy under general anesthesia. The postoperative wound was left open. The patient's wounds healed completely 2 months after surgery, and there was no recurrence at 6-month follow-up. The wounds recovered well, with only slight scarring. CONCLUSION: The positive outcomes for this patient suggest that wound excision and closure by secondary intention and growth factor application may be beneficial for patients with rosacea complicated by giant rhinophyma. PMID:38048616 | DOI:10.25270/wnds/23064 {url} = URL to article

J Am Acad Dermatol. 2023 Dec 2:S0190-9622(23)03266-8. doi: 10.1016/j.jaad.2023.11.050. Online ahead of print. NO ABSTRACT PMID:38049068 | DOI:10.1016/j.jaad.2023.11.050 {url} = URL to article

Cont Lens Anterior Eye. 2023 Dec 3:102099. doi: 10.1016/j.clae.2023.102099. Online ahead of print. ABSTRACT PURPOSE: Ocular demodicosis can cause debilitating ocular surface disease. As ivermectin is effective at reducing Demodex proliferation in rosacea, this study investigated the efficacy of topical ivermectin 1.0% cream in treating ocular demodicosis. METHODS: This retrospective single-centre clinical practice chart analysis involved the off-label treatment of patients who had ocular demodicosis with topical ivermectin 1.0 % cream (Soolantra, Galderma Ltd, UK) applied nightly to the lid margins of both eyes for 3 months. Ocular surface health was assessed at baseline when the treatment was prescribed and followed up at 3 and 12 months after baseline. Slit lamp biomicroscopy was used to take digital images of the upper eyelid lashes. Manual image analysis with ImageJ was conducted by a masked assessor to quantify signs of ocular demodicosis including the number of lashes with collarettes, with visible Demodex tails and with follicle pouting. RESULTS: Data from a total of 75 patients with ocular demodicosis were analysed for this study (mean age 66.6 ± 13.9 years, 44 female). The numbers of lashes with collarettes (Median [Interquartile range]: 8 [4-13] at baseline to 0 [0-2] at the final visit, p < 0.001) and lashes with follicle pouting (3 [1-5] at baseline to 0 [0-1.8] at the final visit, p < 0.001) decreased with treatment. Any sign of lashes with visible tails was eliminated by the final visit (p < 0.007). Fluorescein staining severity score also improved, particularly from baseline (1 [0-2]) to the second visit (0 [0-1], p < 0.001). CONCLUSIONS: The findings of this study show evidence for the efficacy of a 3-month course of topical ivermectin 1.0% cream in treating ocular demodicosis as indicated by reduction in collarettes, follicle pouting and visible Demodex tails. More research is warranted to improve the diagnosis, management and monitoring of this condition which is often overlooked or misdiagnosed. PMID:38049351 | DOI:10.1016/j.clae.2023.102099 {url} = URL to article

Int J Dermatol. 2023 Nov 29. doi: 10.1111/ijd.16950. Online ahead of print. NO ABSTRACT PMID:38031285 | DOI:10.1111/ijd.16950 {url} = URL to article

Clin Cosmet Investig Dermatol. 2023 Nov 20;16:3369-3374. doi: 10.2147/CCID.S440138. eCollection 2023. ABSTRACT Granulomatous rosacea (GR) is a rare inflammatory skin disease characterized by persistent, hard, yellow, brown, red, or flesh-colored papules, plaques, or nodules on the face. Limited data are available on patients treated for GR, with only case reports and case series published. Herein, we describe the case of a 53-year-old woman who presented to the hospital with persistent red to brown and pink patches on both cheeks accompanied by a burning sensation for one month. Histopathological examination of a cutaneous biopsy revealed granulomatous inflammation in focal areas. Both acid-fast and Periodic acid-Schiff staining were negative. The patient was diagnosed with GR based on her clinical presentation and laboratory test results. She was treated with abrocitinib, a JAK-1 inhibitor, for 20 weeks. This resulted in substantial improvement in her rash and the associated burning sensation. Subsequent follow-up visits indicated no adverse effects or relapses. Additionally, a literature review was conducted to compare with the current case, which concluded that abrocitinib is a viable treatment option for GR, exhibiting a relatively high safety profile with minimal side effects. PMID:38021428 | PMC:PMC10674708 | DOI:10.2147/CCID.S440138 {url} = URL to article

Clin Cosmet Investig Dermatol. 2023 Nov 18;16:3363-3368. doi: 10.2147/CCID.S441581. eCollection 2023. ABSTRACT An abnormal density of Demodex mites can trigger many skin disorders known as demodicosis. Clinical manifestations of demodicosis may resemble other skin diseases and can coexist with other skin disorders, resulting in underdiagnosis and a more challenging diagnosis. Here, we report three cases of demodicosis in acne vulgaris patients. These case series have discussed their clinical features along with optimal strategies for diagnosis and treatment. PMID:38021431 | PMC:PMC10664713 | DOI:10.2147/CCID.S441581 {url} = URL to article

Postepy Dermatol Alergol. 2023 Oct;40(5):642-646. doi: 10.5114/ada.2023.130523. Epub 2023 Aug 22. ABSTRACT INTRODUCTION: The relationship between rosacea and basal cell carcinoma (BCC) is still not known. Almost all reports questioning the relation between BCC and rosacea are focused on rhinophyma. AIM: To examine the possible connection of BCC and rosacea. MATERIAL AND METHODS: 110 patients with BCC located on the face treated surgically in the Dermatosurgery Unit in 2020-2021 were included in the study. A trained dermatologist assessed the presence or absence of concomitant rosacea and assessed its severity according to the Investigator's Global Assessment (IGA). RESULTS: Fifty-one (46.4%) subjects with BCC and concomitant clinically diagnosed rosacea were found. In our group 35.5% of women had BCC located on the cheeks, while in men most cancers were located on the nose (55%, n = 11), however this difference has not reached statistical significance. CONCLUSIONS: The incidence of rosacea in our population was undoubtedly higher, comparing to the normative population. Both rosacea and BCC share the same risk factors - UV exposure, the potential association should not be neglected. PMID:38028413 | PMC:PMC10646708 | DOI:10.5114/ada.2023.130523 {url} = URL to article

Int J Dermatol. 2023 Nov 28. doi: 10.1111/ijd.16920. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory dermatosis characterized by remissions and flares. Although the rosacea active treatment phase is well established, the long-term maintenance phase is still challenging. OBJECTIVE: To discuss and make recommendations on how to treat patients during the long-term maintenance phase for the main rosacea phenotypes. METHODS: A panel of six board-certified Brazilian dermatologists and one American dermatologist gathered to compose a consensus based upon an initial statement on how to treat rosacea during the long-term maintenance phase based on the methodology Nominal Group Technique. The experts discussed each factor based upon an initial statement on how to treat rosacea patients in the long-term maintenance phase. A sequence of comprehensive narrative reviews was performed; a questionnaire preparation about the definition of the maintenance phase and its management was presented; an interpersonal discussion and ranking of the ideas were conducted. Recommendations were made if the specialists had 75% agreement. RESULTS: The maintenance treatment phase, which starts by achieving IGA 0 or 1 grades at the active phase, should be considered at least during the 9-month period after remission. The recommendations of all treatments target this period. Daily skincare regimen and sunscreen are crucial. Active treatment phase should be recommended if signs or symptoms reappear or worsen. CONCLUSION: Maintenance phase success depends on patient's adherence to daily skin care, appropriate treatments, continued follow-up with dermatologist, and self-assessment to identify new signs and symptoms indicating disease relapse. PMID:38013632 | DOI:10.1111/ijd.16920 {url} = URL to article

Res Sq. 2023 Nov 17:rs.3.rs-3611240. doi: 10.21203/rs.3.rs-3611240/v1. Preprint. ABSTRACT More than 20% of the population across the world is affected by non-communicable inflammatory skin diseases including psoriasis, atopic dermatitis, hidradenitis suppurativa, rosacea, etc. Many of these chronic diseases are painful and debilitating with limited effective therapeutic interventions. However, recent advances in psoriasis treatment have improved the effectiveness and provide better management of the disease. This study aims to identify common regulatory pathways and master regulators that regulate molecular pathogenesis. We designed an integrative systems biology framework to identify the significant regulators across several inflammatory skin diseases. With conventional transcriptome analysis, we identified 55 shared genes, which are enriched in several immune-associated pathways in eight inflammatory skin diseases. Next, we exploited the gene co-expression-, and protein-protein interaction-based networks to identify shared genes and protein components in different diseases with relevant functional implications. Additionally, the network analytics unravels 55 high-value proteins as significant regulators in molecular pathogenesis. We believe that these significant regulators should be explored with critical experimental approaches to identify the putative drug targets for more effective treatments. As an example, we identified IKZF1 as a shared significant master regulator in three inflammatory skin diseases, which can serve as a putative drug target with known disease-derived molecules for developing efficacious combinatorial treatments for hidradenitis suppurativa, atopic dermatitis, and rosacea. The proposed framework is very modular, which can indicate a significant path of molecular mechanism-based drug development from complex transcriptomics data and other multi-omics data. PMID:38014119 | PMC:PMC10680929 | DOI:10.21203/rs.3.rs-3611240/v1 {url} = URL to article

Skin Res Technol. 2023 Nov;29(11):e13525. doi: 10.1111/srt.13525. NO ABSTRACT PMID:38009046 | DOI:10.1111/srt.13525 {url} = URL to article

J Dermatol. 2023 Nov 27. doi: 10.1111/1346-8138.17051. Online ahead of print. ABSTRACT Granulomatous rosacea (GR) is a rare and distinct variant of rosacea. We report three cases of recalcitrant GR successfully treated with pulsed-dye laser (PDL) and provide experimental evidence supporting its potential as a treatment option. PDL treatment demonstrated remarkable efficacy in the three clinical cases, despite their resistance to conventional therapies. Chemokine ligand 9 (CXCL9), a key chemokine involved in inflammation and granuloma formation, was found to be increased in skin sections from all three patients. In vitro experiments using human monocytes and dermal fibroblasts demonstrated that PDL treatment significantly reduced CXCL9 expression in fibroblasts. These findings suggest that PDL may modulate CXCL9 secretion in fibroblasts, potentially limiting the recruitment of immune cells to the lesion. Although further research is needed to fully understand the precise mechanisms underlying the role of CXCL9 in GR, PDL may be a promising therapeutic approach for refractory GR. PMID:38009832 | DOI:10.1111/1346-8138.17051 {url} = URL to article

Clin Exp Dermatol. 2023 Nov 27:llad417. doi: 10.1093/ced/llad417. Online ahead of print. NO ABSTRACT PMID:38011317 | DOI:10.1093/ced/llad417 {url} = URL to article