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  1. [Acne rosacea-a pedigree with ten cases]. Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2019 Jul 10;36(7):747 Authors: Xia R, Cao L, Fang L, Xiong H, Yang L PMID: 31302927 [PubMed - in process] {url} = URL to article
  2. Treatment of Rhinophyma With Surgical Excision and Amniotic Membrane. J Craniofac Surg. 2019 Jul;30(5):1563-1564 Authors: Yoo JJ, Thaller SR Abstract Rhinophyma is a phenotypic subtype of rosacea affecting the nose. It is characterized by phymatous changes, skin thickening/fibrosis, glandular hyperplasia, and chronic inflammation. Treatment of severe rhinophyma is predominantly surgical excision with closure by secondary intention. Amniotic membrane has been used to promote wound healing, fibrosis, and inflammation. In this case study, the authors present a 63-year-old male with longstanding rhinophyma treated with surgical excision with intraoperative placement of amniotic membrane. PMID: 31299768 [PubMed - in process] {url} = URL to article
  3. Acne and rosacea: What's new for treatment? Dermatol Ther. 2019 Jul 11;:e13020 Authors: Dursun R, Daye M, Durmaz K Abstract Acne and rosacea are two well-known chronic skin diseases in dermatology. There are many known therapeutic options of both diseases, but new treatment agents and therapeutic advances come to the agenda day by day. We would like to summarize new treatment advances for acne and rosacea diseases. This article is protected by copyright. All rights reserved. PMID: 31294907 [PubMed - as supplied by publisher] {url} = URL to article
  4. Difference in Vasoconstrictors: Oxymetazoline vs Brimonidine. J Dermatolog Treat. 2019 Jul 11;:1-23 Authors: Okwundu N, Cline A, Feldman SR Abstract OBJECTIVE: Topical oxymetazoline and brimonidine are the only medications approved for treating persistent facial erythema of rosacea. This review aims to investigate the efficacy, safety, pharmacodynamics, and pharmacokinetic properties of oxymetazoline and brimonidine. METHOD AND MATERIALS: Phase II and phase III clinical studies evaluating oxymetazoline and brimonidine were assessed to compare their efficacy and safety. RESULTS: In their respective phase III trials, both oxymetazoline and brimonidine met the primary efficacy outcome of having at least a 2-grade decrease from baseline on both the Clinician Erythema Assessment and the Subject Self-Assessment Scales compared to the vehicle control. Treatment related adverse events of oxymetazoline and brimonidine are most often mild and localized. CONCLUSION: Topical oxymetazoline and brimonidine are effective for the management of persistent facial erythema associated with rosacea with a few mild and localized adverse effects. Further long term research is imperative to further understand their long term effects. PMID: 31294643 [PubMed - as supplied by publisher] {url} = URL to article
  5. Related Articles Case of lupus miliaris disseminatus faciei associated with marked formation of cysts, successfully treated with intralesional injections of triamcinolone acetonide. J Dermatol. 2017 Jul;44(7):e164-e165 Authors: Shimizu A, Funasaka Y, Ueno T, Kanzaki A, Saeki H PMID: 28342206 [PubMed - indexed for MEDLINE] {url} = URL to article
  6. Related Articles Nicotinic acid suppresses sebaceous lipogenesis of human sebocytes via activating hydroxycarboxylic acid receptor 2 (HCA2 ). J Cell Mol Med. 2019 Jul 05;: Authors: Markovics A, Tóth KF, Sós KE, Magi J, Gyöngyösi A, Benyó Z, Zouboulis CC, Bíró T, Oláh A Abstract Nicotinic acid (NA) activates hydroxycarboxylic acid receptor 2 (HCA2 ), and it is widely used in treating dyslipidaemias. Since its side effects include skin dryness, whereas its deficiency can be accompanied by dyssebacia, characterized by sebaceous gland enlargement, we asked if HCA2 is expressed on human sebocytes, and if NA influences sebocyte functions. By using human immortalized SZ95 sebocytes, we found that non-cytotoxic (≤100 μmol/L; MTT-assay) concentrations of NA had no effect on the homeostatic sebaceous lipogenesis (SLG; Nile Red), but normalized excessive, acne-mimicking SLG induced by several lipogenic agents (arachidonic acid, anandamide, linoleic acid + testosterone; Nile Red; 48-hr treatments). Moreover, it exerted significant anti-proliferative actions (CyQUANT-assay), and increased [Ca2+ ]IC (Fluo-4 AM-based Ca2+ -measurement). Although NA did not prevent the lipopolysaccharide-induced pro-inflammatory response (up-regulation [Q-PCR] and release [ELISA] of several pro-inflammatory cytokines) of the sebocytes, collectively, these data support the concept that NA may be effective in suppressing sebum production in vivo. While exploring the mechanism of the sebostatic actions, we found that sebocytes express HCA2 (Q-PCR, immunofluorescent labelling), siRNA-mediated silencing of which prevented the NA-induced Ca2+ -signal and the lipostatic action. Collectively, our data introduce NA, and HCA2 activators in general, as novel, potent and most likely safe sebostatic agents, with possible anti-acne potential. PMID: 31273921 [PubMed - as supplied by publisher] {url} = URL to article
  7. New evidence but still unmet medical needs in rosacea treatment. Br J Dermatol. 2019 Jul;181(1):11-12 Authors: Le Cleach L, Cribier B PMID: 31259410 [PubMed - in process] {url} = URL to article
  8. Related Articles Safety and Effectiveness of Microfocused Ultrasound for Treating Erythematotelangiectatic Rosacea J Drugs Dermatol. 2019 Jun 01;18(6):522 Authors: Schlessinger J, Lupin M, McDaniel D, George R Abstract Background: Anecdotal reports indicate the use of microfocused ultrasound with visualization (MFU-V) improves facial redness. Objective: The purpose of this pilot study was to assess the safety and effectiveness of MFU-V for improving the signs and symptoms of erythematotelangiectatic rosacea. Methods & Materials: Healthy adults with a clinical diagnosis of erythematotelangiectatic rosacea were enrolled (N=91). Eligible subjects had baseline Clinician Erythema Assessment (CEA) scores ≥3 and Patient Self-Assessment (PSA) of erythema scores ≥2. Subjects were randomized to receive one or two low-density MFU-V treatments or one or two high-density MFU-V treatments. Subjects were evaluated at 90, 180, and 365 days after treatment. The primary effectiveness endpoint was treatment success, defined as a 1-point change in CEA scores at 90 days post-treatment. Results: Across groups, 75 to 91.3% of subjects achieved treatment success at 90 days post-treatment. Notable adverse events include bruising (44%), tenderness/soreness (43%), and redness (35%). Treatment results were sustained, lasting up to 1 year. Subject satisfaction was high based on self-assessment questionnaires. Conclusion: The results of this study demonstrated that a single, high-density MFU-V treatment may be effective for treating erythematotelangiectatic rosacea. Based on these results, a large, randomized controlled study of single, high-density MFU-V treatment for erythematotelangiectatic rosacea is warranted. J Drugs Dermatol. 2019;18(6):522-531. PMID: 31251544 [PubMed - as supplied by publisher] {url} = URL to article
  9. Related Articles The Use of Oral Antibiotics in the Management of Rosacea J Drugs Dermatol. 2019 Jun 01;18(6):506 Authors: Nagler AR, Del Rosso J Abstract Rosacea is common inflammatory facial dermatosis. Rosacea has variable manifestations including facial flushing, central facial erythema, telangiectasias, and papulopustular lesions. Treatment of rosacea is challenging given the varied manifestations and incompletely understood etiology, but the treatment of papulopustular presentations often relies on oral antibiotics. Tetracyclines, specifically doxycycline, are the most commonly prescribed antibiotics for rosacea. Other antibiotics that can be used include macrolides, commonly azithromycin, and rarely, metronidazole. This paper will review the evidence for the use of antibiotics in the treatment of rosacea. J Drugs Dermatol. 2019;18(6):506-513. PMID: 31251542 [PubMed - as supplied by publisher] {url} = URL to article
  10. Related Articles What Is PFE? It May Just Be Time You Found Out.... J Drugs Dermatol. 2019 Jun 01;18(6):503 Authors: Del Rosso JQ Abstract With all the literature and research we have on acne and rosacea, there are still many unanswered questions. Over time, as we uncover more information on both preexisting and newly recognized pathophysiologic pathways, modes of drug action, alternative therapies, caveats related to basic skin care, and the potential roles for physical modalities, we often find that specific information that we thought was fact, is later altered, expanded, or corrected. What is interesting, and sometimes perplexing to me personally, is how difficult it is for the clinical dermatology community at large to incorporate well-published concepts into everyday clinical practice. PMID: 31251541 [PubMed - as supplied by publisher] {url} = URL to article
  11. Related Articles A comment on Helicobacter pylori and rosacea. G Ital Dermatol Venereol. 2019 Aug;154(4):507-508 Authors: Sacco M PMID: 31251009 [PubMed - in process] {url} = URL to article
  12. Related Articles Contact allergy from fragrances and formaldehyde contributing to papulopustular rosacea. Contact Dermatitis. 2019 Jun 25;: Authors: Darrigade AS, Dendooven E, Aerts O Abstract Allergic contact dermatitis caused by fragrances and formaldehyde is common (1,2), but pustular dermatitis as a manifestation of contact allergy is rare (3). We report a case of therapy-resistant rosacea for which (occupational) contact allergy to fragrances, and to a lesser extent formaldehyde, was identified as an aggravating factor. This article is protected by copyright. All rights reserved. PMID: 31237351 [PubMed - as supplied by publisher] {url} = URL to article
  13. Related Articles Topical probiotics: the unknowns behind their rising popularity. Dermatol Online J. 2019 May 15;25(5): Authors: Lee GR, Maarouf M, Hendricks AJ, Lee DE, Shi VY Abstract OBJECTIVE: Topical probiotics have been used for skin care and treatment since the early 20th century. Over the past decade, there has been a dramatic surge of commercially-available topical probiotic products. We conducted a systematic search of clinical data relating to the use of topical probiotics and identified relevant clinical and regulatory gaps. METHODS: PubMed and Google Scholar searches were conducted for trials and reviews of probiotics. FDA definitions of cosmetics, drugs, and regulation of topical probiotics were reviewed. RESULTS: Topical probiotics have shown efficacy in a number of limited trials, particularly those involving the treatment of acne, atopic dermatitis, and rosacea. However, there is a paucity of literature on the safety profiles, mechanistic action, and therapeutic potential of topical probiotic products. Several regulatory gaps exist, including approval and classification of topical probiotic products by the FDA; currently there are no topical probiotic products the FDA has approved as drugs. CONCLUSION: With increasing popularity among the general public, but insufficient clinical data to demonstrate large-scale effectiveness and a thorough understanding of side effects, there is a need for further mechanistic and clinical investigation, as well as improved regulation and standardization of topical probiotic products. PMID: 31220895 [PubMed - in process] {url} = URL to article
  14. Item 109 – UE 4 Dermatoses faciales : acné, rosacée, dermatite séborrhéique. Ann Dermatol Venereol. 2018 Mar;145 Suppl 1:S7-S16 Authors: CEDEF PMID: 29429583 [PubMed - indexed for MEDLINE] {url} = URL to article
  15. [PATHOGENETIC FEATURES AND METHODS FOR TREATMENT OF VARIOUS FORMS OF ROSACEA]. Georgian Med News. 2019 Apr;(289):116-120 Authors: Tsiskarishvili T, Katsitadze A, Tsiskarishvili NV, Tsiskarishvili NI, Chitanava L Abstract The aim of the work was to study the features of the pathogenesis of various clinical forms of rosacea (the presence of mite Demodex folliculorum, the determination of VEGF, IL-2 IL-6, IL-8) and, based on the obtained results, to ensure adequate methods of therapy. Mite identification was performed by microscopy. The concentration of cytokines in patients with various clinical forms of rosacea (papulopustular form 15 patients, steroid form - 15, erythematous telangiectic form - 10, Ophthalmo Rosacea - 3, rhinophyma - 3) was determined by enzyme immunoassay using appropriate monoclonal antibodies and expressed in samples. Based on the results we obtained in the local treatment of patients with papulopustular rosacea (with a high population density of demodicosis ticks and an increased concentration of IL-8 in the blood), 1% ivermectin cream was applied externally to the skin of the face 1 time per day every day for the entire course of treatment (3-4 months). In patients with erythematous-teloangiectatic form (with a high cytokine VEGF, IL-8), a combined phased use of 1% pimecrolimus cream 14 days and 0.5% bromonidine tartrate gel was administered once a day - 14 days (with a single course of 1 month). In patients with a steroid form of rosacea with a high concentration of cytokines (IL-2, IL-6, IL-8), 1% pimecrolimus was administered 2 times a day - 1 month, 1% ivermectin 1 time a day - 14 days. During therapy, patients with advanced treatment were divided into 2 groups. Patients of group 1, who received externally 1% ivermectin 1 time per day as the main therapy, in the evening for 16 weeks. Group 2 applied 1% ivermectin and 1% pimercolimus cream for 16 weeks. In group 2 patients showed a significant improvement in a shorter time (4 weeks compared to 8 weeks in 1 group of patients). Taking into account the torpid flow and the difficulty of rosacea therapy, the pathogenetic approach when choosing new external preparations, opens promising directions for further deeper study of the pathophysiological mechanisms underlying the individual clinical forms of dermatosis. At the same time, the efficacy and safety of using ivermectin, pimecrolimus, and brimonidine tartrate in the treatment of various forms of this dermatosis suggests their widespread use in practical dermatology. PMID: 31215891 [PubMed - in process] {url} = URL to article
  16. The many faces of rosacea: liberal diagnostic criteria have ramifications on disease prevalence and accuracy. J Eur Acad Dermatol Venereol. 2019 Jun 14;: Authors: Wienholtz N, Egeberg A, Thyssen JP Abstract We read with great interest the article by Tizek et al., which suggests that certain skin diseases are more common in Germany than previously thought. We were particularly interested in the finding that 25.5% of study participants fulfilled the criteria for rosacea based on dermatologist examination. The authors rightfully suggest that the high rosacea prevalence may be explained by the effect of intense (acute or chronic) ultraviolet exposure and high age of study participants. This article is protected by copyright. All rights reserved. PMID: 31199527 [PubMed - as supplied by publisher] {url} = URL to article
  17. Response to 'Letter to the editor' by Wienholtz et al. entitled 'The many faces of rosacea: liberal diagnostic criteria have ramifications on disease prevalence and accuracy'. J Eur Acad Dermatol Venereol. 2019 Jun 14;: Authors: Tizek L, Schielein MC, Seifert F, Biedermann T, Böhner A, Zink A Abstract We thank Wienholtz et al.1 for their comments on our article entitled 'Skin disease are more common than we think: screening results of an unreferred population at the Munich Oktoberfest'. Rosacea is a common inflammatory skin disease with a widely ranging prevalence in different countries (less than 1% to 22%), but even within Germany (2.3% to 12.3%).There might be several reasons for these different findings: examined study population, primary or secondary data source, or as mentioned by Wienholtz et al., a lacking research-based classification system. This article is protected by copyright. All rights reserved. PMID: 31199525 [PubMed - as supplied by publisher] {url} = URL to article
  18. Related Articles A case series of demodicosis in children. Pediatr Dermatol. 2019 Jun 13;: Authors: Douglas A, Zaenglein AL Abstract Demodex mites are commensal inhabitants of the pilosebaceous unit that are typically absent or at low numbers in childhood. When they are present, they can cause a primary eruption or exacerbate an underlying facial dermatosis. Here we report five cases of demodicosis occurring in childhood, the clinical presentations, and responses to treatment. Papulopustular lesions predominate, prompting the advice "pustules on noses, think demodicosis!" PMID: 31197860 [PubMed - as supplied by publisher] {url} = URL to article
  19. Related Articles Minocycline-Induced Hyperpigmentation. J Am Osteopath Assoc. 2018 Jul 01;118(7):492 Authors: Skorin L, Norberg S PMID: 29946676 [PubMed - indexed for MEDLINE] {url} = URL to article
  20. Related Articles Vascular endothelial growth factor gene polymorphisms in patients with rosacea: A case-control study. J Am Acad Dermatol. 2019 Jun 07;: Authors: Hayran Y, Lay I, Mocan MC, Bozduman T, Ersoy-Evans S Abstract BACKGROUND: Rosacea is a chronic disease that is characterized by facial skin inflammation and vascular abnormality. Vascular endothelial growth factor (VEGF) is a potent mediator of vascular permeability and inflammation that might play a role in the pathogenesis of rosacea. OBJECTIVE: This study aimed to determine the association between VEGF gene polymorphisms and rosacea. METHODS: A case-control study design was used to compare 100 patients with rosacea and 100 age- and gender-matched control subjects in terms of VEGF polymorphisms based on polymerase chain reaction and the serum level of VEGF and VEGF receptors based on enzyme-linked immunosorbent assay. RESULTS: Heterozygous and homozygous +405C/G polymorphism of the VEGF gene was observed to increase the risk of rosacea 1.7-fold (95% confidence interval 1.2-4.2) and 2.3-fold (95% confidence interval 1.2-4.2), respectively. There was a significant positive correlation between the severity of rosacea and +405C/G polymorphism of the VEGF gene in patients with erythematotelangiectatic rosacea. LIMITATIONS: Serum VEGF and VEGF receptor levels were measured in the limited number of patients. CONCLUSION: The present findings indicate that +405C/G polymorphism of the VEGF gene increases the risk of rosacea. PMID: 31182382 [PubMed - as supplied by publisher] {url} = URL to article
  21. Related Articles Rosacea Fulminans: two case reports and review of the literature. J Dermatolog Treat. 2019 Jun 06;:1-11 Authors: Angileri L, Veraldi S, Barbareschi M Abstract Rosacea Fulminans is a rare and severe inflammatory dermatosis which affects predominantly childbearing women. It is characterized by sudden onset and it usually localizes exclusively on the centrofacial areas, presenting with numerous fluctuant inflammatory nodules and papules which may coalesce. Treatment with isotretinoin in combination with topical and systemic corticosteroids is successful. Clearance of lesions may be obtained under systemic treatment with no or minimal scarring outcomes. Due to rare incidence its pathophysiological mechanisms, diagnosis and management remain controversial. We report two cases of Rosacea Fulminans arised in otherwise healthy people and completely healed after treatment. Our aim is to share our experience about this disease in order to increase knowledge about its diagnosis, management and its treatment. We also make a review of the literature of this peculiar dermatosis. PMID: 31169436 [PubMed - as supplied by publisher] {url} = URL to article
  22. Related Articles A randomized phase 3b/4 study to evaluate concomitant use of topical ivermectin 1% cream and doxycycline 40 mg modified-release capsules versus topical ivermectin 1% cream and placebo in the treatment of severe rosacea. J Am Acad Dermatol. 2019 May 28;: Authors: Schaller M, Kemeny L, Havlickova B, Jackson JM, Ambroziak M, Lynde C, Gooderham M, Remenyik E, Del Rosso J, Weglowska J, Chavda R, Kerrouche N, Dirschka T, Johnson S Abstract BACKGROUND: Randomized controlled studies of combination therapies in rosacea are limited. OBJECTIVE: Evaluate efficacy and safety of combining ivermectin 1% cream (IVM) and doxycycline 40 mg modified-release capsules∗ (DMR) versus IVM and placebo (PBO) for treatment of severe rosacea. METHODS: This 12-week, multicenter, randomized, investigator-blinded, parallel-group comparative study randomized adult subjects with severe rosacea (Investigator's Global Assessment [IGA]=4) to either IVM and DMR (combination arm) or IVM and PBO (monotherapy). RESULTS: A total of 273 subjects participated. IVM and DMR displayed superior efficacy in reduction of inflammatory lesions (-80.3% vs. -73.6% for monotherapy, p=0.032) and IGA score (p=0.032). Combination therapy had a faster onset of action as of week 4; it significantly increased the number of subjects achieving IGA 0 (11.9% vs. 5.1%, p=0.043)† and 100% lesion reduction (17.8% vs. 7.2%, p=0.006) at week 12. Both treatments reduced the Clinician's Erythema Assessment score, stinging/burning, flushing episodes, Dermatology Life Quality Index and ocular signs/symptoms, and were well-tolerated. LIMITATIONS: The duration of study prevented evaluation of potential recurrences or further improvements. CONCLUSION: Combining IVM and DMR can produce faster responses, improve response rates, and increase patient satisfaction in severe rosacea. PMID: 31150711 [PubMed - as supplied by publisher] {url} = URL to article
  23. Data augmentation in dermatology image recognition using machine learning. Skin Res Technol. 2019 May 29;: Authors: Aggarwal SLP Abstract BACKGROUND: Each year in the United States, over 80 million people are affected by acne, atopic dermatitis, rosacea, psoriasis, and impetigo. Artificial intelligence and machine learning could prove to be a good tool for assisting in the diagnosis of dermatological conditions. The objective of this study was to evaluate the use of data augmentation in machine learning image recognition of five dermatological disease manifestations-acne, atopic dermatitis, impetigo, psoriasis, and rosacea. MATERIALS AND METHODS: Open-source dermatological images were gathered and used to retrain TensorFlow Inception version-3. Retraining was done twice-once with and once without data augmentation. Both models were tested with the same images, and R software was used to perform statistical analysis. RESULTS: The average of each of the statistical measures (sensitivity, specificity, PPV, NPN, MCC, and F1 Score) increased when data augmentation was added to the model. In particular, the average Matthews correlation coefficient increased by 7.7%. Each of the five dermatological manifestations had an increase in area under the curve (AUC) after data augmentation with the average increase in AUC of 0.132 and a standard deviation of 0.033. Atopic dermatitis had the highest increase in AUC of 0.18. With data augmentation, the lowest AUC was 0.87 for psoriasis and the highest was 0.97 for acne, indicating that the model performs well. CONCLUSION: With a deep learning-based approach, it is possible to differentiate dermatological images with appreciable MCC, F1 score, and AUC. Further, data augmentation can be used to increase the model's accuracy by a significant amount. PMID: 31140653 [PubMed - as supplied by publisher] {url} = URL to article
  24. Related Articles Facial Neutrophilic Dermatosis Mimicking Iododerma and Associated With Inflammatory Bowel Disease. JAMA Dermatol. 2018 05 01;154(5):619-621 Authors: Matthews NH, Wong V, Robinson-Bostom L, Lajevardi N PMID: 29516091 [PubMed - indexed for MEDLINE] {url} = URL to article
  25. Related Articles Thalidomide ameliorates rosacea-like skin inflammation and suppresses NF-κB activation in keratinocytes. Biomed Pharmacother. 2019 May 24;116:109011 Authors: Chen M, Xie H, Chen Z, Xu S, Wang B, Peng Q, Sha K, Xiao W, Liu T, Zhang Y, Li J, Deng Z Abstract BACKGROUND: Rosacea is a chronic inflammatory skin disorder of uncertain etiology. Evidence suggests the underlying pathogenesis is modulated by abnormal inflammatory and vascular responses. Thalidomide is a synthetic derivative acid with anti-inflammatory and anti-angiogenic properties. However, its effects on rosacea remain unknown. OBJECTIVES: To investigate the effects of thalidomide on the lesional alterations and molecular mechanisms in rosacea. METHODS: Mice were intradermally injected with LL37 to induce rosacea-like features and intraperitoneally administered with thalidomide. The severity of skin inflammation was evaluated. The mRNA levels of cytokines and chemokines associated with rosacea were assessed by qPCR. The number of CD4 positive infiltrated T helper cells and CD31 positive microvessels, and related-genes were measured by immunofluorescence, qPCR and ELISA. Moreover, the effect of thalidomide on inhibiting NF-κB activation was determined by immunofluorescence and western blot. RESULTS: Our results showed that thalidomide significantly alleviated erythema and reduced inflammatory cell infiltration in dermis of LL37-induced rosacea-like mice. The production of cytokines and chemokines induced by LL37 was decreased by thalidomide in mice skin and HaCaT keratinocytes. Particularly, we showed thalidomide reduced CD4+ T helper cell infiltration and downregulated Th1- and Th17-polarizing genes. In addition, thalidomide treatment lowered the microvessel density and vascular endothelial growth factor (VEGF) expression. We further demonstrated that thalidomide suppressed NF-κB activation in LL37-treated skin and in TNF-α-stimulated HaCaT keratinocytes in vitro. CONCLUSIONS: Our findings suggest thalidomide attenuates the inflammation and represses NF-κB activation in skin, which leads to assumptions that thalidomide may be a new therapeutic agent for rosacea. PMID: 31132668 [PubMed - as supplied by publisher] {url} = URL to article
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