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Related Articles Evaluation of a novel very high sun-protection-factor moisturizer in adults with rosacea-prone sensitive skin. Clin Cosmet Investig Dermatol. 2017;10:211-219 Authors: Grivet-Seyve M, Santoro F, Lachmann N Abstract BACKGROUND/OBJECTIVE: Rosacea-prone sensitive skin requires high sun-protection factor (SPF) moisturizers. This study evaluated Daylong Extreme SPF 50+ lotion, a novel cream containing five ultraviolet filters, two emollients, and three skin conditioners. SUBJECTS AND METHODS: This was an open-label, single-center study. On day 1, before treatment, subjects answered a questionnaire on their skin conditions and sunscreen habits, and both subjects and dermatologist evaluated skin status. Subjects applied the product once daily in the morning to the face for 21 days, and after approximately 3-5 minutes they assessed tolerability and short-term cosmetic acceptability in a questionnaire and daily diary. On day 22, the dermatologist and subjects evaluated skin status for long-term tolerance and cosmetic acceptability. RESULTS: The study enrolled 44 individuals (mean age 58.8 years, 91% female). At baseline, most subjects (39 of 44) showed erythema, and ~30% showed dryness and scaling. Dermatologists noted four cases of pustules and one case of papules. After 21 days' treatment with the product, the dermatologist reported significantly less erythema, dryness and scaling, three cases of pustules and two cases of papules. At baseline, ~75% of subjects noted a feeling of dryness, >50% reported tension, and nearly 25% reported tickling. After using the product for 21 days, subjects reported significantly less tension, dryness, and tickling. Some subjects noted itching and burning before and after using the product. One subject noted papules during treatment. Most subjects said that the product was pleasant, did not irritate the skin or cause stinging/burning, was easy to apply, quickly absorbed, and nongreasy, improved skin moisturization, helped prevent sun-provoked facial redness, did not worsen rosacea, and was easily incorporated into their skincare regimen. Half would switch to the product, and 80% of subjects would buy and recommend the product. CONCLUSION: The product was well tolerated in rosacea-prone subjects, producing objective and subjective improvements in skin status and symptoms. PMID: 28652793 [PubMed - in process] {url} = URL to article

Related Articles Dual anti-inflammatory and antiparasitic action of topical ivermectin 1% in papulopustular rosacea. J Eur Acad Dermatol Venereol. 2017 Jun 27;: Authors: Schaller M, Gonser L, Belge K, Braunsdorf C, Nordin R, Scheu A, Borelli C Abstract BACKGROUND: Recently, therapy of rosacea with inflammatory lesions (papulopustular) has improved substantially with the approval of topical ivermectin 1% cream. It is assumed to have a dual mode of action with anti-inflammatory capacities and anti-parasitic effect against Demodex, which however has not yet been demonstrated in vivo. AIM: To find scientific rationale for the dual anti-inflammatory and anti-parasitic mode of action of topical ivermectin 1% cream in patients with rosacea. METHODS: A monocentric pilot study was performed including 20 Caucasian patients with moderate to severe rosacea, as assessed by investigator global assessment (IGA score ≥ 3) and a demodex density ≥ 15/cm(2) . Patients were treated with topical ivermectin 1% cream once daily (Soolantra(®) ) for ≥12 weeks. The density of Demodex mites was assessed with skin surface biopsies. Expression of inflammatory and immune markers were evaluated with RT-PCR and by immunofluorescence staining. RESULTS: The mean density of mites was significantly decreased at week 6 and week 12 (p<0.001). The gene expression levels of IL-8, LL-37, HBD3, TLR4 and TNF-α were downregulated at both time points. Reductions in gene expression were significant for LL-37, HBD3 and TNF-α at both follow up time points and at week 12 for TLR4 (all p<0.05). Reduced LL-37 (p<0.05) and IL-8 expression was confirmed on the protein level by immunofluorescence staining. All patients improved clinically and 16 out of 20 patients reached therapeutic success defined as IGA score ≤ 1. CONCLUSION: Topical ivermectin 1% cream acts by a dual, anti-inflammatory and anti-parasitic mode of action against rosacea by killing Demodex spp. in vivo, in addition to significantly improving clinical signs and symptoms in the skin. This article is protected by copyright. All rights reserved. PMID: 28653460 [PubMed - as supplied by publisher] {url} = URL to article

The Role of Polyphenols in Rosacea Treatment: A Systematic Review. J Altern Complement Med. 2017 Jun 26;: Authors: Saric S, Clark AK, Sivamani RK, Lio PA, Lev-Tov HA Abstract OBJECTIVES: Various treatment options are available for the management of rosacea symptoms such as facial erythema, telangiectasia, papules and pustules, burning, stinging, and itching. Botanical therapies are commonly used to treat the symptoms. The objective of this review is to evaluate the use of polyphenols in rosacea treatment. DESIGN: PubMed, Embase, Biosis, Web of Knowledge, and Scopus databases were systematically searched for clinical studies evaluating polyphenols in the management of rosacea. RESULTS: Of 814 citations, 6 met the inclusion criteria. The studies evaluated licochalcone (n = 2), silymarin (n = 2), Crysanthellum indicum extract (n = 1), and quassia extract (n = 1). The studies only evaluated topical formations of stated polyphenols. Main results were summarized. CONCLUSIONS: There is evidence that polyphenols may be beneficial for the treatment of rosacea symptoms. Polyphenols appear to be most effective at reducing facial erythema and papule and pustule counts. However, studies included have significant methodological limitations and therefore large-scale, randomized, placebo-controlled trials are warranted to further assess the efficacy and safety of polyphenols in the treatment of rosacea. PMID: 28650692 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Rosacea in black South Africans with skin phototypes V and VI. Clin Exp Dermatol. 2017 Jun 22;: Authors: Dlova NC, Mosam A Abstract Rosacea is a chronic facial dermatosis considered to affect primarily white patients with light phototype skin, and is poorly documented in black patients. The aim of this study was to document the clinical features of rosacea in patients with phototypes V and VI. An 8-year retrospective chart review of patients with a clinical and histological diagnosis of rosacea or acne rosacea was undertaken. Of 6700 patients, 15 (0.2%) had rosacea. All were of African descent with skin phototype V or VI. Mean age was 47 years, and female : male ratio was 14 : 1. Of the 15 patients, 5 (33%) were positive for human immunodeficiency virus; 5 (33%) had used topical steroids to treat the roseacea; 6 (40%) had phototype V and presented with erythema, telangiectasia and erythematous papules, while 9 (60%) had phototype VI skin and presented with skin-coloured papules; and 10 (67%) had histology showing granulomatous rosacea, while 5 (33%) declined a facial skin biopsy. A high index of suspicion is required to diagnose rosacea in black patients as the classic signs of erythema and telangiectasia are difficult to discern. PMID: 28639713 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Rosacea and its association with enteral microbiota in Korean females. Exp Dermatol. 2017 Jun 21;: Authors: Nam JH, Yun Y, Kim HS, Kim HN, Jung HJ, Chang Y, Ryu S, Shin H, Kim HL, Kim WS Abstract BACKGROUND: Rosacea is a chronic inflammatory dermatosis affecting the face and eyes. An association between systemic comorbidities and rosacea has been reported, but the link to enteral microbiota is uncertain. OBJECTIVES: We aimed to investigate the link between rosacea and enteral microbiota. METHODS: A cross-sectional study was performed in a sample of Korean women who participated in a health checkup program at the Kangbuk Samsung Hospital Health Screening Center between 23 June 2014 and 5 September 2014. The gut microbiome was evaluated by 16S rRNA gene and metagenome sequence analyses. RESULTS: A total of 12 rosacea patients and 251 controls were enrolled. We identified links between rosacea and several changes in gut microbiota: reduced abundance of Peptococcaceae family unknown genus, Methanobrevibacter (genus), Slackia (genus), Coprobacillus (genus), Citrobacter (genus), and Desulfovibrio (genus), and increased abundance of Acidaminococcus (genus), Megasphaera (genus), and Lactobacillales order unknown family unknown genus. CONCLUSIONS: A link between rosacea and enteral microbiota was observed in this metagenomic study. A large and elaborate study is needed to confirm these findings and to elucidate the mechanisms involved. This article is protected by copyright. All rights reserved. PMID: 28636759 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Nutrition and skin: Kids are not just little people. Clin Dermatol. 2016 Nov - Dec;34(6):698-709 Authors: McCusker M, Sidbury R Abstract There has been a surge of new data regarding the pathophysiology of skin diseases. We are appreciating the sophisticated interplay among the skin, the immune system, and the environment. More elegant and highly specific medicines have been designed to target certain immune mediators of the adaptive immune system. In parallel fashion, we are learning more about the elegance of the innate immune system and how nutrition as early as the prenatal period can affect the priming of other immune cells. Concerns about the long-term impact of new immune-modulating medicines-especially in the pediatric population-have patients asking their dermatologists for nutritional alternatives to medical therapies. Nutrients and nutritional therapies appear to play a role at different ages for different dermatoses. Probiotics are showing promise as a therapeutic option for patients older than 1 year for atopic dermatitis. Systemic contact allergens appear to be a bigger burden on the adult population with atopic dermatitis. Obesity is a growing concern for both children and adults with psoriasis. Milk and high glycemic foods have a strong impact on the teenage acne population. Vitamins A and D are addressed as piece of the alopecia areata puzzle. Zinc and homeopathy are presented finally as possible treatments to the everlasting wart. PMID: 27968929 [PubMed - indexed for MEDLINE] {url} = URL to article

Related Articles Rate of Adverse Events and Healthcare Costs Associated with the Topical Treatment of Rosacea. Am Health Drug Benefits. 2017 May;10(3):113-119 Authors: Williamson T, Kamalakar R, Ogbonnaya A, Zagadailov EA, Eaddy M, Kreilick C Abstract BACKGROUND: Rosacea is a condition more common in women than in men, and in people aged ≥30 years than in younger patients. Adverse events associated with the use of topical medications for rosacea may lead to a lack of treatment adherence. Previous studies have reported low treatment adherence rates among patients with rosacea. OBJECTIVE: To describe the rate of treatment discontinuation resulting from adverse events and the associated healthcare costs among patients with rosacea who are receiving a topical medication. METHODS: We conducted a retrospective cohort study of patients diagnosed with rosacea based on International Classification of Diseases, Ninth Revision, Clinical Modification code 695.3 who were newly initiating topical treatment with metronidazole, azelaic acid, sodium sulfacetamide/sulfur, or benzoyl peroxide between January 1, 2009, and September 30, 2013. Patients were identified from the MarketScan Commercial Claims and Encounters database and the Medicare Supplemental database and had to be aged ≥30 years, have continuous coverage with medical and pharmacy benefits ≥12 months before treatment and ≥3 months after treatment inititation, and have no evidence of oral antibiotic use or ocular rosacea during the study period. The 3-month period immediately after the index date (ie, first topical rosacea treatment) was defined as the postindex period and was used to evaluate the outcome measures, which included the rate of adverse events, treatment patterns, and healthcare costs. RESULTS: The final cohort included 49,351 patients, with a mean age of 54 years, and 74.5% of the patients were female. Metronidazole was the most common (72.7%) treatment, followed by azelaic acid (21.7%), sodium sulfacetamide/sulfur (3.4%), and benzoyl peroxide (2.2%). A total of 6270 (12.7%) patients had a coded adverse event, of whom 199 (3.2%) continued treatment despite the adverse event, 466 (7.4%) switched to another treatment within 8.8 days, and 5605 (89.4%) discontinued therapy within 31.1 days. Patients with adverse events incurred, on average, a cost of $325 (medical, $143; pharmacy, $182) in rosacea-related costs; patients without adverse events incurred, on average, a cost of $172 (medical, $14; pharmacy, $157) in rosacea-related costs. CONCLUSIONS: The majority of adverse events associated with current topical drugs for rosacea resulted in treatment switch or discontinuation. Drugs with a different mechanism of action or new formulations of existing drugs may provide additional treatment options for patients and may lead to improved adherence and better symptom control. PMID: 28626508 [PubMed] {url} = URL to article

Related Articles Systemic therapy of ocular and cutaneous rosacea in children. J Eur Acad Dermatol Venereol. 2017 Jun 16;: Authors: Gonser LI, Gonser CE, Deuter C, Heister M, Zierhut M, Schaller M Abstract BACKGROUND: In paediatric rosacea, ocular symptoms are often predominant. Literature about systemic therapy of paediatric ocular rosacea is sparse, though. OBJECTIVE: Analysis of children with ocular rosacea treated systemically, particularly addressing remission and recurrence rates. METHODS: Retrospective study reviewing the medical records of children with ocular rosacea treated with systemic antibiotic therapy. Nine out of 19 patients were chosen for detailed analysis. To our knowledge, this is the first study in paediatric ocular rosacea requiring systemic therapy with a larger patient group and a longer follow-up (mean follow-up = 30.2 months). RESULTS: Seventeen patients (89.5%) suffered from blepharitis, 15 patients (78.9%) from conjunctivitis, twelve patients (63.2%) from chalazia/styes and nine female patients (47.4%) from corneal involvement. We used erythromycin (n = 9) or roxithromycin (n = 1) in patients younger than eight years and doxycycline (n = 8) or minocycline (n = 1) in patients older than eight years. Seven out of nine patients treated with erythromycin, one out of eight patients treated with doxycycline and the patient treated with minocycline achieved a complete remission of ocular and cutaneous symptoms. Two out of nine patients treated with erythromycin, seven out of eight patients treated with doxycycline and the patient treated with roxithromycin achieved a partial remission. Relapses occurred in the patient treated with minocycline (cutaneous), two out of eight patients treated with doxycycline (ocular and cutaneous) and one out of nine patients treated with erythromycin (cutaneous). CONCLUSION: To achieve a complete remission of cutaneous and ocular rosacea, a long-term anti-inflammatory treatment of at least six months is necessary. The remission and relapse rates after successful treatment seem to be lower than in adults as all nine patients treated with erythromycin achieved a complete remission and did not show any relapse. This article is protected by copyright. All rights reserved. PMID: 28621909 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Rosacea and demodicidosis associated with gain-of-function mutation in STAT1. J Eur Acad Dermatol Venereol. 2017 Jun 16;: Authors: Second J, Korganow AS, Jannier S, Puel A, Lipsker D Abstract We report a family in which 3 of 5 children as well as the mother, had a gain-of-function (GOF) mutation in the signal transducer and activator of transcription (STAT1) associated with early-onset rosacea and demodicidosis. The proband case (Fig. 1) was a 13-year-old boy of non-consanguineous parents, known for a hypothyroidism, failure to thrive and chronic mucocutaneous candidiasis (CMC) since he was 5-6 years old. On examination, he had medio-facial erythema with telangiectasia, as well as sometimes pruritic papulopustular lesions of the face and neck. This article is protected by copyright. All rights reserved. PMID: 28622416 [PubMed - as supplied by publisher] {url} = URL to article

Defining treatment success in rosacea as 'clear' may provide multiple patient benefits: Results of a pooled analysis. J Dermatolog Treat. 2017 Jun 15;:1-23 Authors: Webster G, Schaller M, Tan J, Jackson JM, Kerrouche N, Schäfer G Abstract Background Rosacea treatment success is usually defined as a score of 1 ("almost clear") or 0 ("clear") on the 5-point Investigator Global Assessment (IGA) scale. Objective To evaluate whether after successful treatment, "clear" subjects had better outcomes than "almost clear" subjects. Methods A pooled analysis was performed on 1366 rosacea subjects from 4 randomized controlled trials with IGA before and after treatment (ivermectin, metronidazole or vehicle). Assessments included the Dermatology Life Quality Index (DLQI) questionnaire and subject assessment of rosacea improvement. In one trial, patients were followed after the treatment period to measure time to relapse (IGA score ≥ 2). Results At end of treatment, more "clear" than "almost clear" subjects had a clinically meaningful difference in DLQI (59% vs. 44%; P<0.001) and a final DLQI score of 0-1 indicating no effect on quality of life (84% vs. 66%; P<0.001). More "clear" subjects reported an "excellent" improvement in their rosacea (77% vs. 42%; P<0.001). The median time to relapse was more than 8 months for "clear" vs. 3 months for "almost clear" subjects (P<0.0001). Conclusions Achieving an endpoint of "clear" (IGA 0) vs. "almost clear" (IGA 1) is associated with multiple positive patient outcomes including delayed time to relapse. PMID: 28617145 [PubMed - as supplied by publisher] {url} = URL to article

StatPearls Book. 2017 06 Photosensitivity. Abstract Photosensitivity refers to various symptoms, diseases and conditions (photodermatoses) caused or exacerbated by exposure to sunlight. It is classified into the following groups: Primary photodermatoses: Polymorphic light eruption. Juvenile spring eruption. Actinic folliculitis. Actinic prurigo. Solar urticaria. Chronic actinic/photosensitivity dermatitis. Hydroa vacciniforme (associated with Epstein-Barr virus). Exogenous photodermatoses: Drug-induced photosensitivity: common photosensitising drugs are thiazides, tetracyclines, non-steroidal anti-inflammatory drugs (NSAIDs), phenothiazines, voriconazole, quinine, vemurafenib. Photocontact dermatitis: due to phototoxic chemicals such as psoralens in plants, vegetables, fruit; fragrances in cosmetics; sunscreen chemicals; dyes and disinfectants. Pseudoporphyria: induced by drugs and/or renal insufficiency. Photoexacerbated dermatoses: Lupus erythematosus. Dermatomyositis. Darier disease. Rosacea. Pemphigus vulgaris. Pemphigus foliaceus. Atopic dermatitis. Psoriasis. Metabolic photodermatoses (rare): Porphyria cutanea tarda. Erythropoietic protoporphyria. Variegate porphyria. Erythropoietic porphyria (Gunther disease). Genetic photodermatoses (very rare): Xeroderma pigmentosum. Bloom syndrome. Rothmund Thomson syndrome. Cockayne syndrome. PMID: 28613726 {url} = URL to article

Related Articles Topical brimonidine tartrate 0·33% gel effectively reduces the post-treatment erythema of daylight-activated photodynamic therapy. Br J Dermatol. 2016 Jun;174(6):1422-3 Authors: Gerber PA PMID: 26727630 [PubMed - indexed for MEDLINE] {url} = URL to article

Related Articles A Diagnostic Approach to Recurrent Orofacial Swelling: A Retrospective Study of 104 Patients. Mayo Clin Proc. 2017 Jun 07;: Authors: Miest RY, Bruce AJ, Comfere NI, Hadjicharalambous E, Endly D, Lohse CM, Rogers RS Abstract OBJECTIVE: To identify patients evaluated in an outpatient setting at our institution with a presentation of recurrent orofacial swelling and to review the spectrum of causes to outline a diagnostic approach. PATIENTS AND METHODS: A retrospective study of 104 patients with more than 1 episode of orofacial swelling lasting for more than 5 days identified through a keyword search of the electronic health record from January 2, 2000, through July 5, 2011. RESULTS: Patients were categorized according to final cause of orofacial swelling: idiopathic orofacial granulomatosis, solid facial edema due to rosacea and acne vulgaris, Crohn disease, contact dermatitis, sarcoidosis, exfoliative cheilitis, lichen planus, actinic cheilitis, cheilitis glandularis, lymphedema, miscellaneous, and multifactorial. Granulomatous inflammation was noted on biopsy in 40 of 85 patients (47%). Oral involvement was associated with Crohn disease (P<.001), and facial and periorbital swelling was associated with solid facial edema in the setting of rosacea and acne vulgaris (P<.001). CONCLUSION: The broad range of diagnoses responsible for recurrent orofacial swelling underscores the diagnostic challenge and importance of a thorough multidisciplinary evaluation to identify underlying causes. PMID: 28601424 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles [Facial manifestations of granulomatous diseases]. Hautarzt. 2017 Jun 07;: Authors: Butsch F Abstract Clinical manifestations of granulomatous diseases are a recurring challenge in everyday dermatological practice. Clinical presentation and histological patterns are variable, depending on the particular disease. Knowledge about the differential diagnosis of granulomatous changes in the face is of decisive importance for making a rational diagnosis and therapy considering the patient's well-being. Therefore, histological and clinical characteristics of important granulomatous diseases that typically manifest on the face are presented here. PMID: 28593339 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Erratum. J Cutan Med Surg. 2017 Jun 01;:1203475417715265 Authors: Abstract Yuka A, Tan J, Baibergenova A, Barankin B, Cochrane CL, Humphrey S, Lynde CW, Marcoux D, Poulin Y, Rivers JK, Sapijaszko M, Sibbald RG, Toole J, Ulmer M, Zip C. Canadian Clinical Practice Guidelines for Rosacea. J Cutan Med Surg. 2016;20(5):432-445. Original DOI: 10.1177/1203475416650427 In the above article, the author affiliation for Ulmer M should have been listed as Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada and Carruthers & Humphrey, Vancouver, BC, Canada. The affiliation for Rivers JK should have been listed as Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada and Pacific DermAesthetics, Vancouver, BC, Canada. PMID: 28593793 [PubMed - as supplied by publisher] {url} = URL to article

Minocycline as an alternative to doxycycline in the treatment of rosacea. Br J Dermatol. 2017 Jun;176(6):1426 Authors: Two AM PMID: 28581215 [PubMed - in process] {url} = URL to article

Misuse of Topical Corticosteroids over Face: A Clinical Study. Indian Dermatol Online J. 2017 May-Jun;8(3):186-191 Authors: Manchanda K, Mohanty S, Rohatgi PC Abstract INTRODUCTION: Topical corticosteroids (TCS) have been widely used in various dermatological diseases. However, because of inadvertent use, TCS misuse has become a common problem faced by dermatologists in various parts of the world. Prolonged use over the face can cause various side effects such as steroid rosacea, acneiform eruptions, and hypertrichosis. AIM: To study the effects of TCS misuse and analyze various factors promoting its use on face. MATERIALS AND METHODS: A total of 100 patients presenting with various facial dermatoses following the misuse of TCS on the face were studied. Detailed history was noted and the various side effects were recorded. RESULTS: Majority of the patients (70%) were females with maximum number of patients belonging to the age group of 11-20 years. Eighty-five percent of the patients were applying TCS for medical conditions, with acne being the most common indication, and the rest were applying as a general face cream. Pruritus and acneiform eruptions were the most common side effects observed and the other reported were erythema, photosensitivity, steroid dependent face, and telangiectasia. CONCLUSION: TCS misuse especially over the face can lead to a multitude of side effects. It is high time to create awareness among the patients as well as doctors regarding the proper usage of this wonder drug. PMID: 28584755 [PubMed - in process] {url} = URL to article

Severe erythematotelangiectatic rosacea with cold wave-induced epidermal necrosis treated with carvedilol combined with brimonidine gel. Dermatol Ther. 2017 Jun 06;: Authors: Lee CN, Lee JY PMID: 28585298 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Bacillus cereus strain isolated from Demodex folliculorum in patients with topical steroid-induced rosaceiform facial dermatitis. An Bras Dermatol. 2016 Sep-Oct;91(5):676-678 Authors: Tatu AL, Ionescu MA, Clatici VG, Cristea VC Abstract The aim of the study was to identify Bacillus species from the Demodex folliculorum of patients with topical steroidinduced facial rosaceiform dermatitis. Of the 75 patients examined, 20% had clinical spinulosis, while 18.66% had dermoscopic features of Demodex: follicular plugs and tails. Of the 17.33% positive patients identified upon microscopy for Demodex, samples for bacterial culture were plated on trypticase soy Colombia agar. Identification was performed by microorganisms grown method mass spectrometry. We identified a strain of Bacillus cereus. PMID: 27828651 [PubMed - indexed for MEDLINE] {url} = URL to article

Related Articles Erythromelalgia involving the face. Dermatol Online J. 2017 Apr 15;23(4): Authors: Gilmore RR, Applebaum DS, Parsons JL, Hsu S Abstract Erythromelalgia is a rare disorder characterized by burning pain, erythema, and increased temperature typically involving the distal extremities. Although it can progress to involve the face, erythromelalgia presenting only on the face is particularly rare. This disorder is often misdiagnosed when it presents on the extremities and is even more likely to be misdiagnosed when presenting only on the face, delaying appropriate treatment and causing considerable frustration for the patient. We report a case of a 26-year-old woman with erythromelalgia that involved only the face for a number of years and was treated unsuccessfully as rosacea, seborrheic dermatitis, and contact dermatitis. She subsequently developed involvement of the ears and hands in the more typical distribution of erythromelalgia. We discuss the differential diagnosis of erythromelalgia involving the face and extremities, the proposed pathogenesis and management of the disorder, and the psychological distress this condition can cause. Even when the correct diagnosis of erythromelalgiais made, treatment is difficult, with no single therapy consistently effective. PMID: 28541877 [PubMed - in process] {url} = URL to article The Erythromelalgia Association Erythromelagia (EM)

Related Articles Updating the diagnosis,classification and assessment of rosacea by effacement of subtypes: reply from author. Br J Dermatol. 2017 May 19;: Authors: Tan J Abstract The National Rosacea Society Expert Committee (NRSCOR) 2002 publication indicated that the definition and classification system then proposed was based on scientific knowledge, that it was provisional, and that it would be refined with increasing knowledge.(1) A move from subtyping towards a phenotype approach was proposed by the American Acne and Rosacea Society (AARS)(2) and ROSCO presents the first international effort to advance the diagnosis and classification of rosacea. This article is protected by copyright. All rights reserved. PMID: 28542720 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Rosacea is associated with Helicobacter pylori: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2017 May 23;: Authors: Jørgensen AR, Egeberg A, Gideonsson R, Weinstock LB, Thyssen EP, Thyssen JP Abstract BACKGROUND: Rosacea is a common skin disease characterized by facial erythema, telangiectasia, papules, and pustules. Helicobacter pylori infection has been suggested to play a role in the etiopathogenesis of rosacea. OBJECTIVE: Systematically review and meta-analyse the relationship between rosacea and infection with Helicobacter pylori . METHODS: A literature search was performed using PubMed, EMBASE, and Web of Science. Data extraction and analyses were performed on descriptive data. Study quality was assessed using the Newcastle-Ottawa Scale. Random effects models with DerSimonian-Laird methods were utilized to estimate pooled odds ratios (ORs), with 95% confidence intervals (95% CIs). Heterogeneity of results was assessed using I² statistics. RESULTS: A total of 454 articles were identified and 42 full text articles were chosen for further review. 14 studies were included in the quantitative meta-analysis, comprising a total of 928 rosacea patients and 1,527 controls. The overall association between Helicobacter pylori infection and rosacea was non-significant (OR 1.68, 95% CI 1.00-2.84, p=0.052), but analysis restricted to C-urea-breath test showed a significant association (OR 3.12, 95% CI 1.92-5.07, p<0.0001). Effect of eradication treatment on rosacea symptoms was assessed in seven studies, but without significant effect (RR 1.28, 95% CI 0.98-1.67, p=0.069). CONCLUSION: This meta-analysis found weak associations between rosacea and Helicobacter pylori infection as well as an effect of Helicobacter pylori therapy on rosacea symptoms, albeit that these did not reach statistical significance. Whether a pathogenic link between the two conditions exists, or whether Helicobacter pylori infection represents a proxy for other factors remains unknown. This article is protected by copyright. All rights reserved. PMID: 28543746 [PubMed - as supplied by publisher] {url} = URL to article

Cutaneous adverse effects during ipilimumab treatment for metastatic melanoma: a prospective study. Eur J Dermatol. 2017 May 19;: Authors: Dika E, Ravaioli GM, Fanti PA, Piraccini BM, Lambertini M, Chessa MA, Baraldi C, Ribero S, Andrea A, Melotti B, Patrizi A Abstract Ipilimumab is an immunomodulatory antibody directed against cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4), which is administered to patients with advanced melanoma, with a proven positive effect on overall survival. The cutaneous adverse effects (AEs) of ipilimumab are relatively frequent, although described as usually mild and rarely life threatening. To describe a three-year experience of a single institute in detecting and managing cutaneous AEs. A cohort of patients (n = 41) treated with ipilimumab (3 mg/kg/three weeks) for metastatic melanoma, from 2013 to 2016, was investigated for adverse cutaneous events. On dermatological evaluation, 34.1% of the patients in our series developed cutaneous AEs: rash (7.3%; n = 3), folliculitis (7.3%; n = 3), mucositis (2.4%; n = 1), rosacea (2.4%; n = 1), eczema (2.4%; n = 1), acneiform eruption (2.4%; n = 1), syringometaplasia mucinosa (2.4%; n = 1), Stevens-Johnson syndrome (2.4%; n = 1), and vitiligo (4.9%; n = 2). These were all Grade 1 and 2 AEs, except for the case of Stevens-Johnson syndrome (Grade 4). On a patient-reported scale, 4.9% (n = 2) and 9.8% (n = 4) of the patients complained of severe xerosis and pruritus, respectively. Ipilimumab was relatively well tolerated in our series, mainly causing mild cutaneous AEs, which, in our experience, responded satisfactorily to conventional therapies. Only in one case the treatment was discontinued, due to Grade 4 side effects. PMID: 28524050 [PubMed - as supplied by publisher] {url} = URL to article

Surgical treatment of rhinophyma: experience from a German cohort of 70 patients. Eur J Dermatol. 2017 May 19;: Authors: Schweinzer K, Kofler L, Spott C, Krug M, Schulz C, Schnabl SM, Breuninger H, Häfner HM, Eberle FC Abstract Rhinophyma is a deforming soft tissue hyperplasia of the nose and surgical removal represents the treatment of choice. Comprehensive data on surgical therapy and the impact of rhinophyma on patient quality of life are lacking. Patients who received surgery for rhinophyma between 2006 and 2015 were retrospectively evaluated for postoperative complications, clinical outcome, recurrence of rhinophyma, and the impact of rhinophyma on daily life. A total of 143 patients were treated with superficial tumour decortication by scalpel under tumescent anaesthesia. Outcomes were determined by clinical review, clinical files, and a patient questionnaire. Of 143 patients, 70 answered the questionnaire and were included in this study with a mean follow-up time of 54 months. Cosmetic results were evaluated as very good or good in 77% of patients. The majority of patients (87%) were very satisfied or satisfied with the postoperative result. Surgical treatment of rhinophyma improved patients' quality of life in 67% of patients. Recurrence of rhinophyma was detected in 38% of patients. Surgery is an effective therapy for rhinophyma with excellent outcome. PMID: 28524054 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Oxymetazoline cream (Rhofade) for rosacea. Med Lett Drugs Ther. 2017 May 22;59(1521):84-86 Authors: PMID: 28520699 [PubMed - in process] {url} = URL to article