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J Cutan Med Surg. 2023 Oct 29:12034754231204295. doi: 10.1177/12034754231204295. Online ahead of print. ABSTRACT Psychodermatology pertains to the relationship between the skin and brain. This review aims to summarize the evidence of the mind body connection in four psychophysiological conditions: rosacea, atopic dermatitis (AD), acne vulgaris (AV), and psoriasis. A literature search was conducted using several English language databases. All four conditions share similar psychiatric co-morbidities, including but not limited to anxiety, depression, and suicidality. In rosacea, the upregulation of transient receptor potential vanilloid type 1, Toll like receptor 2, and Th17 cells releases downstream products that are simultaneously implicated in mood disorders. Stress exacerbates AV through the hypothalamic-pituitary-adrenal (HPA) system, which alters functioning of sebocytes and Cutibacterium acnes. In AD and psoriasis, the HPA axis influences Th1, Th2, Th22, and Th1, Th17 immune mediated responses, respectively. This leads to the secretion of pro-inflammatory cytokines which are also involved in the pathogenesis of anxiety and depression. Neurotransmitters implicated in mental illness, such as gamma-aminobutyric acid and serotonin, may also play a role in the development of AD and psoriasis. The management of cutaneous disease may mitigate psychological distress, and future research may show the corollary to also be true. PMID:37898903 | DOI:10.1177/12034754231204295 {url} = URL to article

Photodermatol Photoimmunol Photomed. 2023 Oct 29. doi: 10.1111/phpp.12922. Online ahead of print. ABSTRACT BACKGROUND: Differences in clinical efficacy based on the fluence of fractional picosecond laser treatment for acne scars are unknown. OBJECTIVE: To compare the efficacy and safety of low-fluence versus high-fluence fractional picosecond Nd:YAG 1064-nm laser treatment in acne scar patients. METHODS: In this 12-week, investigator-blinded, randomized, split-face study, 25 patients with moderate-to-severe acne scars received three sessions of high-fluence laser treatment (1.0 J/cm2 ) on one side of their face and low-fluence (0.3 J/cm2 ) on the other side every 4 weeks. Patients were assessed using acne scar counts, the scar global assessment (SGA), and the ECCA scar grading scale every 4 weeks. The histological analysis compared the acne scars obtained before and 4 weeks after treatment. RESULTS: At their last visit, 88.00% and 92.00% of the subjects achieved > 30% reduction in scar counts on the low- and high-fluence sides, respectively, without a significant difference between the two sides. On both sides, the scar counts, SGA, and ECCA score significantly improved 4 weeks after the last treatment. Although the high-fluence side showed a greater reduction in scar counts (-66.73%) than the low-fluence side (-62.13%), the two sides had no significant difference in the grading scores. The high-fluence side showed significantly more severe pain and higher side-effect scores immediately and 4 weeks after treatment. Histological analysis revealed a significantly increased collagen, elastin, and vimentin expression after treatment on the low-fluence side. CONCLUSIONS: The low-fluence setting demonstrated comparable efficacy and superior safety in treating acne scars compared with the high-fluence setting. PMID:37898983 | DOI:10.1111/phpp.12922 {url} = URL to article

Nutrients. 2023 Oct 17;15(20):4405. doi: 10.3390/nu15204405. ABSTRACT As the relationship between exposome factors and inflammatory skin diseases is gaining increasing attention, the objective of this study was to investigate dietary patterns among acne and rosacea patients and to establish the disease risk attributable to nutrition. In this cross-sectional, controlled study, patients' dietary habits were assessed via subjective ratings of beneficial and trigger foods, followed by standardized food frequency surveys (FFS). Scores for disease-specific risk stratification based on dietary habits were proposed. Clinical assessments, dermatologic examinations, and laboratory analyses were performed. A total of 296 patients (acne group (AG) n = 120, control group (ACG) n = 32; rosacea group (RG) n = 105, control group (RCG) n = 39) were included. The significant impact of diet on disease severity was self-reported by 80.8% of the AG and 70.5% of the RG. Leading dietary triggers were found in both groups, while beneficial food items were identified more clearly by the AG. FFS revealed significant dietary differences between the AG, RG, and control groups. Disease-specific scores showed greater precision for acne (odds ratio 14.5 AG, 5.5 RG). The AG had higher insulin-like growth factor (IGF)-1 levels correlating with dairy intake (p = 0.006). Overall, this study underlines the influence of diet on acne and rosacea, providing valuable disease-specific scores for dietary risk stratification. Consuming vegetables, legumes, oily fish, olive oil, and nuts, and limiting meat, cheese, and alcohol appear to be beneficial for both acne and rosacea. Future studies can build on these data to further improve preventive and therapeutic strategies. PMID:37892480 | DOI:10.3390/nu15204405 {url} = URL to article

Microorganisms. 2023 Oct 19;11(10):2586. doi: 10.3390/microorganisms11102586. ABSTRACT Emerging research underscores the substantial link between gut flora and various inflammatory skin diseases. We hypothesize that there exists a complex gut-skin axis, possibly affecting the progression of conditions such as eczema, acne, psoriasis, and rosacea. However, the precise nature of the causal connection between gut flora and skin diseases remains unestablished. In this study, we started by compiling summary data from genome-wide association studies (GWAS) featuring 211 unique gut microbiota and four types of skin conditions. We scrutinized these data across different taxonomic strata. Subsequently, we leveraged Mendelian randomization (MR) to ascertain if there is a causal link between gut microbiota and these skin conditions. We also performed a bidirectional MR analysis to identify the causality's direction. By utilizing Mendelian randomization, we identified 26 causal connections between the gut microbiome and four recognized inflammatory skin conditions, including 9 positive and 17 negative causal directions. Additional sensitivity analyses of these results revealed no evidence of pleiotropy or heterogeneity. Our MR analysis suggests a causal connection between gut microbiota and skin diseases, potentially providing groundbreaking perspectives for future mechanistic and clinical studies on microbiota-affected skin conditions. PMID:37894244 | DOI:10.3390/microorganisms11102586 {url} = URL to article

Photodermatol Photoimmunol Photomed. 2023 Oct 27. doi: 10.1111/phpp.12921. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic skin disorder characterised by abnormal neurovasculature and inflammation in the central region of the face. The efficacy of pulsed-dye laser and intense pulsed light treatments for rosacea have been demonstrated in several clinical trials. However, there is currently no research on the efficacy of long-pulsed alexandrite laser (LPAL) therapy alone for rosacea-related facial redness and its effect on skin microbiota. AIM: To evaluate the efficacy of LPAL therapy on facial redness in rosacea and assess changes in skin microbiota composition. METHODS: Subjects with rosacea (n=21, mean age: 39.2±11.3 years) were recruited from two medical institutions and received monthly LPAL treatments (Clarity II™, Lutronic Corp.) for 3 months. At each visit, clinical photographs were taken, and erythema was measured using a spectrometer. At the initial and final visits, the Dermatology Life Quality Index (DLQI) and Skin Sensitivity Questionnaire (SSQ) were evaluated. Skin swabs were obtained at the initial and final visit, and facial microbiome composition was analysed using 16s rRNA amplicon sequencing. RESULTS: After three LPAL treatment sessions, the average facial erythema index, measured using Mexameter® decreased significantly from 360.0 ± 96.7 at baseline to 312.0 ± 94.5 at the final visit (p <0.05). The DLQI and SSQ showed significant improvement of symptoms. Skin microbiome diversity and relative abundance were altered significantly, particularly in the genera Clostridium, Lawsonella, Bacteroides, and Lactobacillus. CONCLUSIONS: LPAL therapy alone showed favourable efficacy for the treatment of facial redness in rosacea, with some impacts on the skin microbiota composition. PMID:37890996 | DOI:10.1111/phpp.12921 {url} = URL to article

Clin Cosmet Investig Dermatol. 2023 Oct 17;16:2893-2897. doi: 10.2147/CCID.S429480. eCollection 2023. ABSTRACT BACKGROUND: Cutaneous metastasis is rare in clinical practice, especially that from primary hepatocellular carcinoma (HCC), which is even rarer. CASE PRESENTATION: This report describes a male patient with HCC with cutaneous metastases to the nasal tip. The patient developed a raised nodule at the nasal tip 5 years after surgery for HCC, with surface ulceration and crusting and no obvious symptoms. Abdominal computed tomography (CT) showed an obvious mass in the liver. The skin lesions on the nasal tip were confirmed to be cutaneous metastasis of HCC by histopathological and immunohistochemical examinations. CONCLUSION: The incidence of cutaneous metastasis of HCC is extremely low, and nasal tip cutaneous metastasis of HCC has no specific clinical manifestations; therefore, it needs to be distinguished from rosacea rhinophyma, fungal and atypical mycobacterial infections, tumours of vascular origin, and tumours of skin appendages that occur in the nasal tip and is prone to misdiagnosis and missed diagnosis, thus requiring clinical dermatologists and otolaryngologists to be aware of such metastasis. PMID:37869532 | PMC:PMC10590066 | DOI:10.2147/CCID.S429480 {url} = URL to article

J Cosmet Dermatol. 2023 Oct 21. doi: 10.1111/jocd.16041. Online ahead of print. ABSTRACT OBJECTIVE: This study aims at investigating the difference in facial skin barrier function between rosacea patients and the healthy population of different ages in the Qinghai region and its correlation with age, providing a basis for clinical nursing and treatment. METHODS: The data of 216 rosacea patients were collected, and 211 healthy testers were selected as the control group. The skin barrier characteristics of rosacea patients of different ages were evaluated by comparing transepidermal water loss (TEWL), stratum corneum hydration (SCH), sebum content (SC), and pH values between the two groups. Then, the correlation between skin barrier function and age in rosacea patients and the healthy population was analyzed. RESULTS: In all four age groups, the TEWL of the rosacea group was higher than that of the healthy control group, and the epidermal hydration was lower than the healthy control group. In the population aged over 40, the sebum content in rosacea was lower than that in the healthy control group. In the age group of 40-59, the pH value of the rosacea group was higher than the healthy control group. In both the rosacea and the control groups, TEWL was positively correlated with age, and epidermal hydration was negatively correlated with age. The sebum content in rosacea group was negatively correlated with age (p < 0.05). CONCLUSION: As age increases, the facial epidermal function of both rosacea patients and the healthy population declines. Therefore, with increasing age, attention should be paid to enhance the epidermal function to slow down the skin aging process. PMID:37864385 | DOI:10.1111/jocd.16041 {url} = URL to article

Clin Cosmet Investig Dermatol. 2023 Oct 13;16:2855-2862. doi: 10.2147/CCID.S429099. eCollection 2023. ABSTRACT INTRODUCTION: The pathogenesis of COVID-19 includes systemic immune activation and endothelial dysfunction, which is closely related to the pathogenesis of rosacea. In order to investigate the influence of COVID-19 infection on the condition of rosacea patients, we retrospectively investigated the impact of COVID-19 infection and COVID-19-related masks on rosacea patients. METHODS: We collected the basic information from rosacea patients who had a long-term follow-up at West China Hospital of Sichuan University. Between January 2023 and March 2023, we recruited 87 rosacea patients for this survey. RESULTS: Our results showed that COVID-19 infection could aggravate the condition of rosacea patients, and the change in the symptoms was not related to fever, temperature, antipyretics use, and vaccination. In addition, we observed a significant association between the type of mask worn by rosacea patients and exacerbation, while the duration of mask usage did not exhibit a similar relationship. DISCUSSION: Considering the ongoing global utilization of masks due to the COVID-19 pandemic and the possible recurrence of COVID-19 infection, dermatologists should monitor the condition of rosacea patients infected with COVID-19 and adjust the treatment regimens accordingly. PMID:37854545 | PMC:PMC10581019 | DOI:10.2147/CCID.S429099 {url} = URL to article

Dermatology. 2023 Oct 17. doi: 10.1159/000534245. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory dermatological condition in humans, and its pathogenesis remains unclear. However, the development of rosacea is suspected to be related to Demodex, a microscopic commensal organism that resides in or near hair follicles and sebaceous glands. Although Demodex is known to be a host-specific, obligate commensal organism, it is currently difficult to be cultured in vitro to parasitize and infect other animal hosts. Therefore, direct evidence for a pathogenic role of Demodex in rosacea is currently lacking. SUMMARY: As circumstantial evidence, non-invasive skin-detecting techniques have shown abnormally elevated numbers of Demodex in rosacea patients. Increased cytokine levels such as IL-10, IL-8, and IL-12p70 have been observed in human sebocytes following Demodex challenge, and acaricides have been found to be effective in rosacea therapy, all point to a close relationship between Demodex and rosacea. Based on these findings, we conducted a comprehensive literature review to summarize the current state of knowledge, research insights, and clinical treatment recommendations for Demodex-associated rosacea, with the ultimate goal of improving patient outcomes. KEY MESSAGES: Rosacea appears to have a close bond with Demodex. Recent studies have implicated that Demodex mites are involved in the development of rosacea. Based on a comprehensive review of the current literature, we have cited substantial evidence supporting this relationship, proposed a possible vicious cycle between Demodex and rosacea, and illustrated the changes in immune responses during this process. In addition, we recommend that patients with both rosacea and Demodex infection be treated early with a combination of topical ivermectin and topical Th1 inhibitors to improve treatment outcomes. PMID:37848012 | DOI:10.1159/000534245 {url} = URL to article

Invest Ophthalmol Vis Sci. 2023 Oct 3;64(13):22. doi: 10.1167/iovs.64.13.22. ABSTRACT PURPOSE: To investigate oxidative stress markers in tears and serum of patients with ocular rosacea and to examine their association with both ocular surface parameters and cutaneous rosacea subtypes. METHODS: This prospective study includes rosacea patients with ocular involvement and healthy controls. We performed ophthalmological examination of all participants and collected tear breakup time (TBUT), Schirmer, Meibomian gland dysfunction (MGD) and Ocular Surface Disease Index (OSDI) scores. We quantified the total antioxidant status (TAS), total oxidant status (TOS), and arylesterase (ARE) levels from tear and serum samples, and calculated the oxidative stress index (OSI). We also classified patients into phymatous, erythematotelangiectatic, papulopustular subtypes. RESULTS: We included 90 ocular rosacea patients and 30 healthy controls. Oxidative stress (TOS, OSI) levels were significantly higher (P < 0.01) and antioxidant levels (TAS, ARE) were significantly lower (P < 0.01) in both tear and serum samples of ocular rosacea patients as compared to controls. We found a significant positive correlation between the tear and serum values regarding oxidative stress parameters (P < 0.05). Besides, OSI was negatively correlated with TBUT and positively correlated with MGD score (meiboscore) and OSDI (P < 0.05). The Schirmer score was not correlated with OSI. No difference was found between the cutaneous subtypes with respect to TAS, TOS, ARE, and OSI results. CONCLUSIONS: In this study, we identified oxidative stress markers in the serum and tears of ocular rosacea patients and showed their correlation with clinical signs of MGD, suggesting that oxidative stress contributes to ocular rosacea pathogenesis and that oxidative stress could be an indicator of MGD severity. PMID:37843493 | PMC:PMC10584021 | DOI:10.1167/iovs.64.13.22 {url} = URL to article

Int J Dermatol. 2023 Oct 12. doi: 10.1111/ijd.16881. Online ahead of print. NO ABSTRACT PMID:37828794 | DOI:10.1111/ijd.16881 {url} = URL to article

Front Immunol. 2023 Sep 27;14:1231848. doi: 10.3389/fimmu.2023.1231848. eCollection 2023. ABSTRACT BACKGROUND: Observational studies have shown that gut microbiota is closely associated with inflammatory dermatoses such as psoriasis, rosacea, and atopic dermatitis (AD). However, the causal relationship between gut microbiota and inflammatory dermatosis remains unclear. METHODS: Based on Maximum Likelihood (ML), MR-Egger regression, Inverse Variance Weighted (IVW), MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO), Weighted Mode, and Weighted Median Estimator (WME) methods, we performed a bidirectional two-sample Mendelian randomization (MR) analysis to explore the causal relationship between gut microbiota and inflammatory dermatosis. The genome-wide association study (GWAS) summary data of gut microbiota came from the MiBioGen consortium, while the GWAS summary data of inflammatory dermatosis (including psoriasis, AD, rosacea, vitiligo, acne, and eczema) came from the FinnGen consortium and IEU Open GWAS project. Cochran's IVW Q test tested the heterogeneity among instrumental variables (IVs). The horizontal pleiotropy was tested by MR-Egger regression intercept analysis and MR-PRESSO analysis. RESULTS: Eventually, the results indicated that 5, 16, 17, 11, 15, and 12 gut microbiota had significant causal effects on psoriasis, rosacea, AD, vitiligo, acne, and eczema, respectively, including 42 protective and 34 risk causal relationships. Especially, Lactobacilli and Bifidobacteria at the Family and Genus Level, as common probiotics, were identified as protective factors for the corresponding inflammatory dermatoses. The results of reverse MR analysis suggested a bidirectional causal effect between AD and genus Eubacterium brachy group, vitiligo and genus Ruminococcaceae UCG004. The causal relationship between gut microbiota and psoriasis, rosacea, acne, and eczema is unidirectional. There was no significant heterogeneity among these IVs. In conclusion, this bidirectional two-sample MR study identified 76 causal relationships between the gut microbiome and six inflammatory dermatoses, which may be helpful for the clinical prevention and treatment of inflammatory dermatoses. PMID:37828993 | PMC:PMC10565349 | DOI:10.3389/fimmu.2023.1231848 {url} = URL to article

JAAD Int. 2023 Jul 30;13:172-178. doi: 10.1016/j.jdin.2023.07.012. eCollection 2023 Dec. ABSTRACT BACKGROUND: Many patients with rosacea join online support groups to gather and disseminate information about disease management and provide emotional support for others. OBJECTIVE: To better understand rosacea patient's primary concerns for the disease as well as their disease search patterns online. METHODS: Overall, 207,038 posts by 41,400 users were collected from June 1, 2017, to June 1, 2022, in a popular online forum. We applied Latent Dirichlet Allocation (LDA), an unsupervised machine learning model, to organize the posts into topics. Keywords for each topic supplied by LDA were used to manually assign topic and category labels. RESULTS: Twenty-three significant topics of conversation were identified and organized into 4 major categories, including Management (50.33%), Clinical Presentation (24.14%), Emotion (21.97%), and Information Appraisal (3.57%). LIMITATIONS: Although we analyzed the largest forum on the internet for rosacea, generalizability is limited given the presence of other smaller forums and the skewed demographics of forum users. CONCLUSION: Social media forums play an important role for disease discussion and emotional venting. Although rosacea management was the most frequently discussed topic, emotional posting was a significantly prevalent occurrence. PMID:37823041 | PMC:PMC10562143 | DOI:10.1016/j.jdin.2023.07.012 {url} = URL to article

Eur J Dermatol. 2023 Aug 1;33(4):419-425. doi: 10.1684/ejd.2023.4534. ABSTRACT BACKGROUND: Therapeutic make-up has previously been proven to be efficacious in improving the quality of life of patients with facial dermatoses, but its efficacy has only been assessed in the short term (less than one month). OBJECTIVES: This study aimed to determine whether the effect of therapeutic make-up on patients' quality of life persists in the longer term, i.e., after one year. MATERIALS & METHODS: This study included 53 patients who benefited from a therapeutic make-up consultation in the context of various facial dermatoses (pigmentation disorders, scars, acne, rosacea, eczema, adverse events of chemotherapy, etc.). Patients were asked to complete a quality-of-life questionnaire to obtain the Skindex score at baseline, and one month (M1) and one year (M12) after the first consultation. The difference in scores between baseline and M12 was calculated and Student's t-test was used to assess the significance of the values. RESULTS: Our results showed a significant difference (p<0.001) with an improvement in quality-of-life score by more than 10% between baseline and M12, for all the dimensions of the score (Emotion, Symptoms and Functioning). Based on the subgroup analysis, this score particularly improved for patients suffering with acne or rosacea (p=0.009) and scars (p=0.43), as well as for younger patients (<30 years old) (p=0.009). CONCLUSION: This is the first study to demonstrate a persistent long-term effect of therapeutic make-up on the quality of life of patients with facial dermatoses. PMID:37823493 | DOI:10.1684/ejd.2023.4534 {url} = URL to article

Dermatol Ther (Heidelb). 2023 Oct 12. doi: 10.1007/s13555-023-01048-1. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory disease with a multifactorial pathogenesis. The wide spectrum of clinical phenotypes, including erythema, telangiectasia, inflammatory papules and pustules, and phyma, demand an individualized approach to treatment. This narrative review offers an updated reference for rosacea management by covering the latest developments in both topical and systemic treatments, including data from newly approved therapies, updates to current treatment modalities and ongoing clinical trials. Although use of benzoyl peroxide as a treatment for rosacea has typically been limited due to irritation, the improved tolerability due to microencapsulation of benzoyl peroxide 5% cream provides a new therapeutic option for patients with rosacea. Minocycline foam and topical ivermectin cream add to our armamentarium of treatment options, particularly for inflammatory papules and pustules. Sarecycline has a narrower spectrum of antibacterial activity, which might reduce the development of antibiotic resistance and disruption of the microbiome compared to other oral antibiotics. Brimonidine gel and oxymetazoline cream provide topical options for redness and flushing. There is emerging evidence about the role of hydroxychloroquine and intradermal botulinum toxin A, which may improve rosacea through their effects on mast cells. The clinical trials pipeline includes agents with a variety of mechanisms, including mast cell stabilization, antimicrobial, anti-inflammatory, and vasoconstrictive effects. However, the clinical pipeline for rosacea appears limited, and there remain important unmet needs for patients with more recalcitrant rosacea or phymatous disease. In addition, there is a need for comparative effectiveness studies to identify the highest value treatment approaches for patients with rosacea. PMID:37824060 | DOI:10.1007/s13555-023-01048-1 {url} = URL to article

J Dtsch Dermatol Ges. 2023 Oct 9. doi: 10.1111/ddg.15193. Online ahead of print. NO ABSTRACT PMID:37814397 | DOI:10.1111/ddg.15193 {url} = URL to article

Contrast Media Mol Imaging. 2023 Sep 27;2023:9842640. doi: 10.1155/2023/9842640. eCollection 2023. ABSTRACT [This retracts the article DOI: 10.1155/2022/9437697.]. PMID:37810501 | PMC:PMC10551483 | DOI:10.1155/2023/9842640 {url} = URL to article

J Eur Acad Dermatol Venereol. 2023 Oct;37 Suppl 7:17-24. doi: 10.1111/jdv.18916. ABSTRACT BACKGROUND: The journey of patients with skin diseases through healthcare has been scarcely investigated. OBJECTIVE: To analyse the journey of people with skin diseases in the different healthcare environment in Europe. METHODS: This multinational, cross-sectional, European study was conducted on a representative sample of the adult general population of 27 European countries. The prevalence of the most frequent skin diseases was determined. Information was collected on the patient journey from the first medical consultation to the diagnosis, and the reasons for not consulting a healthcare professional. RESULTS: On a total of 44,689 individuals, 30.3% reported to have consulted a dermatologist during the previous 2 years. Participants consulted mainly for mole control or skin cancer screening (22.3%), followed by chronic skin diseases (16.2%). The diagnoses of acne, atopic dermatitis, psoriasis and rosacea were made most frequently by a dermatologist, while fungal skin infections were diagnosed more often by a general practitioner (GP), and sexually transmitted diseases (STD) by other specialists. The diagnosis was not always definitive at the first consultation, in particular for STD. The percentage of people who did not consult a healthcare professional for their skin disease was particularly high for acne (36.4%), alopecia (44.7%) and fungal infection (30.0%). Moreover, 17.7% of respondents with psoriasis did not consult. A high percentage of participants with alopecia thought that the disease was not worrying, while patients with psoriasis often answered that they were able to manage the disease since they had already consulted a doctor. Many patients with acne (41.1%) and fungal infection (48.2%) thought that they were able to handle the disease by themselves. CONCLUSION: The analysis of the self-reported medical journey of patients with common skin diseases may allow to understand the unmet needs of patients, thus improving outcomes and reducing expenses. PMID:37806003 | DOI:10.1111/jdv.18916 {url} = URL to article

J Am Acad Dermatol. 2023 Oct 5:S0190-9622(23)02899-2. doi: 10.1016/j.jaad.2023.10.003. Online ahead of print. NO ABSTRACT PMID:37804934 | DOI:10.1016/j.jaad.2023.10.003 {url} = URL to article

J Drugs Dermatol. 2023 Oct 1;22(10):1063-1064. ABSTRACT Rosacea has variable clinical presentation consisting of four overlapping phenotypes: erythematotelangiectatic, papulopustular, phymatous, and ocular.1 Rosacea's pathogenesis involves increased cutaneous density of Demodex folliculorum mites, which drive inflammation through activation of Toll-like receptor-2.1,2 Thus, topical ivermectin (IVM) 1.0% cream's anti-inflammatory and acaricidal activity provides an effective and targeted treatment for moderate-to-severe rosacea. However, literature assessing IVM is limited to efficacy in treating the papulopustular presentation, limiting generalizability.1,3,4 Although our primary endpoint was to assess patient adherence, the objective of this secondary analysis was to assess IVM efficacy in rosacea, regardless of clinical presentation. PMID:37801528 {url} = URL to article

Cureus. 2023 Sep 1;15(9):e44549. doi: 10.7759/cureus.44549. eCollection 2023 Sep. ABSTRACT Gluten sensitivity is defined as a chronic intolerance to gluten ingestion in genetically predisposed individuals. The etiology is thought to be immune-mediated and has a variable dermatologic presentation. Celiac disease (CD) is one of the most common forms of gluten intolerance and encompasses a wide range of extra-intestinal pathology, including cutaneous, endocrine, nervous, and hematologic systems. Psoriasis, another long-term inflammatory skin condition, has been linked to significant symptomatic improvement with a gluten-free diet (GFD). Palmoplantar pustulosis (PP), a variant of psoriasis, and aphthous stomatitis, which causes recurrent oral ulcers, have also exhibited beneficial results after the dietary elimination of gluten. In addition to this, dermatitis herpetiformis (DH), another immune-mediated skin disorder, is genetically similar to CD and has, therefore, shown tremendous improvement with a GFD. Another highly prevalent long-term skin condition called atopic dermatitis (AD), however, has revealed inconsistent results with gluten elimination and would require further research in the future to yield concrete results. Hereditary angioedema (HA) has shown an association with gluten intolerance in some patients who had symptomatic benefits with a GFD. Similarly, vitiligo and linear IgA bullous dermatosis have also shown some clinical evidence of reversal with a GFD. On the contrary, rosacea enhances the risk of developing CD. This narrative review emphasizes the potential impact of gluten intolerance on different cutaneous conditions and the potential therapeutic effect of a GFD on various symptomatic manifestations. There is a need for additional clinical and observational trials to further expand on the underlying pathophysiology and provide conclusive and comprehensive recommendations for possible dietary interventions. PMID:37790051 | PMC:PMC10544948 | DOI:10.7759/cureus.44549 {url} = URL to article

Patient Prefer Adherence. 2023 Sep 27;17:2395-2400. doi: 10.2147/PPA.S431955. eCollection 2023. ABSTRACT OBJECTIVE: To retrospectively analyze the factors influencing the treatment of rosacea patients with regular follow-up by self-management support in the new media chronic disease management model, to explore the effect of self-management support and to provide an objective basis for clinical application. METHODS: Female patients with rosacea who were regularly followed up for more than 6 months at the rosacea follow-up clinic of the Department of Dermatology, West China Hospital, Sichuan University, from March 2022 to June 2023, with erythema and capillary dilation as the main clinical phenotype, met the rosacea diagnostic criteria of the American Rosacea Expert Committee 2017 edition, and received medications recommended by the Chinese Rosacea Treatment Guidelines (2021 edition). A total of 125 patients were treated with combined photobiomodulation therapy (PBMT), and the patients were divided into a standardized group (CEA<1, IGA<1) and a non-standardized group (CEA≥1, IGA≥1) based on significant rosacea efficacy (CEA<1, IGA<1) within 6 months. The age, gender, education level, duration of rosacea, treatment regimen, education intensity, CEA, and IGA baseline data were compared between the two groups, and logistic regression analysis was performed to analyze the factors influencing the significant efficacy of rosacea. RESULTS: There was a significant difference in the mean length of education between the two groups (P<0.05), and the differences between the rest of the baseline information of the two groups were not statistically significant (P>0.05). Logistic regression analysis showed that the variable that significantly influenced the efficacy of treatment was the mean length of education (≥130.5 min/month), and the intensity of education was significantly associated with the efficacy of treatment. CONCLUSION: Self-management support in the new media chronic disease management model has a positive impact on the treatment of rosacea patients. PMID:37790861 | PMC:PMC10544126 | DOI:10.2147/PPA.S431955 {url} = URL to article

Arch Dermatol Res. 2023 Oct 4. doi: 10.1007/s00403-023-02725-z. Online ahead of print. ABSTRACT Microencapsulation has received extensive attention because of its various applications. Since its inception in the 1940s, this technology has been used across several areas, including the chemical, food, and pharmaceutical industries. Over-the-counter skin products often contain ingredients that readily and unevenly degrade upon contact with the skin. Enclosing these substances within a silica shell can enhance their stability and better regulate their delivery onto and into the skin. Silica microencapsulation uses silica as the matrix material into which ingredients can be embedded to form microcapsules. The FDA recognizes amorphous silica as a safe inorganic excipient and recently approved two new topical therapies for the treatment of rosacea and acne. The first approved formulation uses a novel silica-based controlled vehicle delivery technology to improve the stability of two active ingredients that are normally not able to be used in the same formulation due to potential instability and drug degradation. The formulation contains 3.0% benzoyl peroxide (BPO) and 0.1% tretinoin topical cream to treat acne vulgaris in adults and pediatric patients. The second formulation contains silica microencapsulated 5.0% BPO topical cream to treat inflammatory rosacea lesions in adults. Both formulations use the same amorphous silica sol-gel microencapsulation technology to improve formulation stability and skin compatibility parameters. PMID:37792034 | DOI:10.1007/s00403-023-02725-z {url} = URL to article

Acta Derm Venereol. 2023 Oct 3;103:adv10331. doi: 10.2340/actadv.v103.10331. ABSTRACT In the rosacea an unstable skin microbiota is significant for disease progression. However, data on the influence on the skin microbiota of treatment with systemic antibiotics are limited. This single-arm trial recruited patients with rosacea. Oral minocycline 50 mg was administered twice daily for 6 weeks. The lesions on the cheek and nose were sampled for 16S rRNA amplicon sequencing and metagenomic sequencing at baseline, 3 weeks and 6 weeks of treatment. Physiological parameters were detected using non-invasive instruments. After treatment, distribution of the Investigator Global Assessment scores changed significantly. For the skin microbiota, a notable increase in α-diversity and a shift of structure were observed after treatment. Treatment was accompanied by a reduction in the relative abundance of Cutibacterium and Staphylococcus, indicating negative correlations with increased bacterial metabolic pathways, such as butyrate synthesis and L-tryptophan degradation. The increased butyrate and tryptophan metabolites would be conducive to inhibiting skin inflammation and promoting skin barrier repair. In addition, the abundance of skin bacterial genes related to tetracycline resistance and multidrug resistance increased notably after antibiotic treatment. PMID:37787419 | PMC:PMC10561103 | DOI:10.2340/actadv.v103.10331 {url} = URL to article

Dermatitis. 2023 Oct 3. doi: 10.1089/derm.2023.0106. Online ahead of print. NO ABSTRACT PMID:37788393 | DOI:10.1089/derm.2023.0106 {url} = URL to article