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  1. Related Articles The curious case of Patient K. Med J Aust. 2018 12 10;209(11):501-502 Authors: Elisha R PMID: 30521445 [PubMed - indexed for MEDLINE] {url} = URL to article
  2. Dermatologic Problems Commonly Seen by the Allergist/Immunologist. J Allergy Clin Immunol Pract. 2019 Jul 25;: Authors: Cohen L, Seminario-Vidal L, Lockey RF Abstract Allergists/immunologists see a variety of skin disorders, some of which have a known immunologic basis while others do not. We review the prevalence, etiology, clinical presentation and effective and low-cost care of common dermatologic conditions seen in outpatient practices. Conditions discussed include pityriasis alba, seborrheic dermatitis, rosacea, acne, tinea infections, intertrigo, lichen planus, tinea versicolor, lichen simplex chronicus, scabies, pityriasis rosea, keratosis pilaris and seborrheic keratosis. An understanding of frequently encountered cutaneous diseases and their therapies will help provide immediate access to treatment and improve the experience for both the affected patient and the clinician. PMID: 31351991 [PubMed - as supplied by publisher] {url} = URL to article
  3. A new superficial needle-scraping method for assessing Demodex density in papulopustular rosacea. J Cosmet Dermatol. 2019 Jul 25;: Authors: Huang HP, Hsu CK, Lee JY Abstract BACKGROUND: Standardized skin surface biopsy (SSSB) is often performed to determine the density of Demodex mites in facial papulopustular eruptions. AIM: We aimed to test the applicability of a new, "superficial needle-scraping" (SNS) method for assessing Demodex density in papulopustular rosacea (PPR). PATIENTS AND METHODS: Using SNS method, we measured the Demodex density in patients with PPR, also enrolling the patients with acne vulgaris as controls. SNS was performed by gently scraping off 5 small pustules with the convex surface of the tip of an 18# needle for examination. For comparison, SSSB was also performed in patients with PPR. Demodex density was expressed as "mites per 5 pustules" for SNS and as "mites per cm2 " for SSSB. RESULTS: A total of 40 patients with PPR and 35 patients with acne vulgaris were recruited. There were no statistically significant differences in age or sex between the PPR and acne groups. The Demodex density was 5.6 ± 4.2 in the PPR group versus 0.3 ± 1.0 in the acne group (P < .001). The cutoff of "≥3 Demodex mites per 5 pustules" gave a sensitivity of 78% and a specificity of 97%, and the area under the receiver operating characteristic curve was 0.89. Moreover, SNS and SSSB gave mutually concordant results (positive or negative) in half of the patients. CONCLUSION: Our study suggests that SNS is a simple and convenient method for assessing Demodex density of pustules in PPR and can be a useful alternative or addition to SSSB for evaluation of Demodex-associated facial papulopustular eruptions. PMID: 31343825 [PubMed - as supplied by publisher] {url} = URL to article
  4. Dermatoses in parkinsonism: the importance of multidisciplinary follow-up. Rev Assoc Med Bras (1992). 2019 Jul 22;65(6):791-795 Authors: Antunes I, Purim KSM, Grande LL, Alberton NC, Navarro TFR, Winckler TCD Abstract Parkinsonism is characterized by bradykinesia with rigidity and/or resting tremor, in addition to non-motor symptoms, which include dermatological manifestations. The objective of this study is to evaluate the main dermatoses in patients with parkinsonism found at the Philanthropic Association of Curitiba - PR. A cross-sectional descriptive study was carried out with the application of a questionnaire and dermatological evaluation of the patients. The sample consisted of 386 patients and was composed mainly by men (55.4%), between 60-74 years old (51.6%), with complete primary education (45.3%), disease diagnosis time between 5-10 years (35%) and in use of medication (96.6%). The most prevalent dermatoses were pigmented nevus (36.3%), warts (25.1%), actinic keratosis (22%), seborrheic keratosis (21.5%), seborrheic dermatitis (20.5%), and rosacea (19.2%). Among the 13 cases (3.4%) of malignant cutaneous neoplasms confirmed by biopsy, 2 were melanomas. Regarding patients' sex, there was a higher prevalence of inflammatory dermatoses (OR 1.64, 95% CI 1.08-2.51, p = 0.025) and benign cutaneous neoplasms (OR 1.77, 95% CI 1.16-2.69, p = 0.01) in men. As to age, patients aged between 60-74 years had more pre-malignant skin lesions (OR 2.60, 95% CI 1.05-6.44, p <0.001) and seborrheic keratosis (OR 2.52, 95% CI 1.02-6.25, p = 0.001) and, in those older than 75 years, actinic keratosis was more frequent (OR 5.43, 95% CI 2.17-13.6, p <0.001). The results of the study show that it is fundamental to dermatologically evaluate and monitor these patients, aiming at diagnosis and early treatment of lesions, especially of skin cancer. PMID: 31340306 [PubMed - in process] {url} = URL to article
  5. Related Articles StatPearls Book. 2019 01 Authors: Abstract Rhinophyma is a disfiguring nasal deformity due to the proliferation of sebaceous glands and underlying connective tissue. The name itself is broken down into "rhis," derived from Greek meaning nose, and "phyma," also Greek, for skin tumor. While rhinophyma is the most common subtype of these tumor-like swellings, other sites include the following[1]: Mentophyma (chin). Metophyma (forehead). Gnatophyma (chin). Otophyma (ears). Bleharophyma (eyelids). Acne rosacea is the precursor condition to later development of rhinophyma and was linked to this disease as the ultimate expression of rosacea in 1846 by Ferdinando Hebra Von (1816-1880). [2] Historically, the condition has been known to exist as seen in a 15th Century painting by Domenico Ghirlandaio (1490), "An Old Man and His Grandson," which shows a man with a large rhinophyma (See Figure). This disfiguring disorder is essential to treat, as patients are subject to psychological distress and respiratory issues when alar thickening can obstruct the external nasal valves. An additional social challenge is a commonly presumed link to excessive alcohol use. The direct causal relationship between rhinophyma and alcohol has not been substantiated and has promoted a social stigma, as colloquial names for this condition include "whiskey nose" and "gin blossom." [3] [4]"Potato nose" is another common lay description of this type of nose. Hollywood has used rhinophyma to indicate distasteful or villainous characters: in "Snow White and the Seven Dwarfs" (1937), the villain Queen was given a rhinophyma, besides deep rhytids and periorbital swelling. PMID: 31335093 {url} = URL to article
  6. Patient-focused Solutions in Rosacea Management: Treatment Challenges in Special Patient Groups J Drugs Dermatol. 2019 Jul 01;18(7):608-612 Authors: Cices A, Alexis AF Abstract Rosacea is among the most common facial skin conditions diagnosed by dermatologists. Typical clinical features include erythema, flushing, telangiectasia, papules, and pustules distributed on the central face. While the prevalence of rosacea is highest among white populations of Northern European descent, recent reports have found that rosacea frequently occurs in people from a broad range of racial/ethnic backgrounds and skin types. When rosacea presents in darker skin types, the diagnosis is often more challenging due to masking of features by increased epidermal melanin. As such, under-diagnosis and underreporting may contribute to misconceptions about the prevalence of rosacea in populations with skin of color. Recognizing the unique presentations and complications associated with darker skin types is necessary to reduce the disparities in rosacea treatment, especially as the American population continues to become increasingly heterogeneous. Although rosacea is most common in middle-aged females, patients of other demographics may have more negative impacts on quality of life due to their disease. In this article, we review rosacea management with a focus on special patient groups: people with skin of color, and less common forms of rosacea, in order to diminish the physical and psychosocial burden of rosacea in all patient groups. Due to the variability inherent to rosacea, we advocate for an individualized, patient-centered approach to disease management. PMID: 31329380 [PubMed - as supplied by publisher] {url} = URL to article
  7. Related Articles Severe Type of Minocycline-Induced Hyperpigmentation Mimicking Peripheral Arterial Occlusive Disease in a Bullous Pemphigoid Patient. Antibiotics (Basel). 2019 Jul 16;8(3): Authors: Wu MY, Hou YT, Yiang GT, Tsai AP, Lin CH Abstract Minocycline is a tetracycline group antibiotic that is known to cause significant antibacterial and anti-inflammatory effects. Minocycline has been widely used to treat systemic infection, acne, dermatitis, and rosacea. However, various dose-related side effects of hyperpigmentation in whole body tissues have been reported. Three main types of minocycline-induced hyperpigmentation have been identified. In rare severe hyperpigmentation cases, drug-induced hyperpigmentation can mimic local cellulitis or peripheral arterial occlusive disease (PAOD). These processes require different therapeutic strategies. Therefore, early diagnosis is extremely important for physicians to determine the etiology of the hyperpigmentation, and subsequently discontinue the minocycline if indicated. We describe a rare case presenting a severe form of type III minocycline-induced hyperpigmentation mimicking peripheral arterial occlusive disease in a bullous pemphigoid patient. PMID: 31315305 [PubMed] {url} = URL to article
  8. [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
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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
  21. 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
  22. [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
  23. 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
  24. 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
  25. 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
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