rss

Related Articles Objective severity does not capture the impact of rosacea, acne scarring and photoaging in patients seeking laser therapy. J Eur Acad Dermatol Venereol. 2016 Sep 18; Authors: Thomas CL, Kim B, Lam J, Richards S, See A, Kalouche S, Paver RD, Fernández Peñas P Abstract BACKGROUND: Measures of quality of life (QOL) and patient satisfaction are of great importance in dermatology, as both impact upon treatment adherence and health outcomes. Patients' assessment of QOL often differs from their doctors' predictions and their assessments of skin disease severity do not correlate with patients' own perceptions. The development of laser technology has facilitated successful treatment of many skin conditions, but studies on patient satisfaction are lacking. OBJECTIVES: Our aim was to determine the extent of discordance between patient and dermatologist-assessed disease severity and assess the impact of acne scarring, rosacea and photoaging on QOL. Our secondary aim was to assess patient satisfaction with laser therapy. METHODS: A prospective study of patients undergoing laser treatment for acne scarring, rosacea and photoaging was conducted over 1 year at the Skin & Cancer Foundation Australia. Subjective disease severity was determined using a visual analogue scale (VAS). Two dermatologists determined objective severity using validated grading scales to score photographs. QOL impact was measured by Skindex-16, satisfaction was measured using an amended Comprehensive Satisfaction Questionnaire (PSQ-18). RESULTS: A total of 147 individuals sought laser therapy for acne scarring, rosacea and photoaging. Dermatologists' subjective disease severity correlated weakly with patient-reported severity. All conditions negatively impacted upon QOL. Patients with rosacea had the most symptomatic impact; acne scarring was associated with the greatest self-esteem and social functioning issues; photoaging patients were the least affected. There were significant correlations between subjective severity assessment and Skindex-16 scores. There was notable discordance between dermatologist's skin severity assessment and patient's self-reported QOL impact. CONCLUSION: Skin conditions can have a profound impact on patient QOL, which is affected by patients' perception of disease severity and not fully appreciated by dermatologists' own severity assessments. Laser therapy is associated with high patient satisfaction. PMID: 27640402 [PubMed - as supplied by publisher] {url} = URL to article

Filling in Pediatric Acne Practice Gaps: A Prospective Multicenter Study of Case-Based Education. J Adolesc Health. 2016 Sep 13; Authors: Feldstein S, Afshar M, Krakowski AC, Eichenfield LF Abstract PURPOSE: Studies have documented practice gaps in acne management between pediatricians and dermatologists. Evidence-based recommendations for acne management were published by the American Acne and Rosacea Society and the American Academy of Pediatrics in 2013. We assess the impact of a case-based learning intervention on pediatrician knowledge and treatment of acne in accordance with published recommendations. METHODS: Participants were recruited at four conferences for pediatric providers. Knowledge of the recommendations and confidence in utilizing them was assessed. Five case-based questions were presented, with providers choosing acne treatments before, immediately after, and 3 months after a case-based educational presentation. Answer selections consistent with the recommendations were scored as correct, and all responses were evaluated for patterns of medication selection. RESULTS: A total of 150 individuals participated, most with over 10 years experience. Knowledge of the recommendations and confidence in prescribing acne therapy was poor. The average preintervention management selections were 70% correct, increasing significantly to 86% 3 months after intervention (p < .01). The most significant improvements were demonstrated in provider's ability to choose regimens for moderate acne consistent with published recommendations, and in recommendation-consistent usage of retinoids and benzoyl peroxide (p < .05). Persisting practice gaps included a reluctance to use topical retinoids in preadolescents and lack of initiating oral combination therapies in patients with severe acne. CONCLUSIONS: A case-based educational intervention significantly increased providers choosing acne treatments in accordance with evidence-based recommendations in an examination setting. Limitations of the study include an inability to assess actual provider prescribing behavior through this methodology. PMID: 27638004 [PubMed - as supplied by publisher] {url} = URL to article

Painful Rosacea as a Warning Sign of Intracranial Metastasis of Squamous Cell Carcinoma. Headache. 2016 Sep 16; Authors: Rizzi M, Penner F, Messina G, Castelli N, Franzini A, Capella GL PMID: 27633162 [PubMed - as supplied by publisher] {url} = URL to article

Ivermectin 1% Cream (Soolantra) for Inflammatory Lesions of Rosacea. Am Fam Physician. 2016 Sep 15;94(6):512-513 Authors: Gazewood JD, Johnson K PMID: 27637130 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles A Tailored Approach to the Treatment of a Patient with a Severe Dynamic Manifestation of Rosacea: A Case Report. Drugs R D. 2016 Sep 13; Authors: Schaller M, Gonser L Abstract Rosacea is a chronic inflammatory disease that can manifest as a spectrum of symptoms including erythema, inflammatory lesions, edema, and telangiectasia. Treatment decisions need to be adapted to reflect the nature and severity of the different symptoms present. In this report, we discuss the case of a female patient diagnosed with severe, inflamed papulopustular rosacea (PPR) presenting with a large number of inflammatory lesions and severe background erythema. This patient responded well to a treatment regimen consisting of a short course of antibiotics in combination with a corticosteroid, followed by monotherapy with isotretinoin to reduce the inflammation. Brimonidine gel, used as needed, was then added to isotretinoin to target the remaining background erythema. This case of severe PPR required a combinatorial treatment regimen to effectively target all symptoms present. The patient continued to apply topical metronidazole throughout the different treatment regimens prescribed over the course of almost 1 year. Use of topical metronidazole helped to repair and protect the skin barrier, which minimized the occurrence of dermatological adverse events when topical treatments were used. We conclude that in patients with severe disease and an important inflammatory component, a rapid response can be obtained with a multimodal, tailored approach that also includes treatment to repair and protect the skin barrier. PMID: 27623792 [PubMed - as supplied by publisher] {url} = URL to article

Most people with psoriasis or rosacea are not being treated: a large population study. Dermatol Online J. 2016;22(7) Authors: Wehausen B, Hill DE, Feldman SR Abstract When left untreated, psoriasis and rosacea can have long-term health and psychosocial implications. The purpose of this study was to estimate the percentage of Americans with psoriasis or rosacea who are not being treated. Patient data from a large claims-based database were analyzed to identify the number of patients who are treated for psoriasis or rosacea. The numbers of patients treated were compared to the estimated prevalences of these diseases in the general population, identified from previously published sources. Of the 18,632,362 patients in the database, 140,439 (0.75%) were seen for psoriasis and 165,130 (0.89%) were seen for rosacea. Based on published sources, 3.2% of Americans have psoriasis and about 5.0% have rosacea. We therefore estimated that 77% of people with psoriasis and 82% of people with rosacea are untreated. Greater awareness, resources, and community outreach projects are potential tools that could eliminate this disparity and increase the quality of life for patients with these diseases. PMID: 27617716 [PubMed - as supplied by publisher] {url} = URL to article

Treatment of rosacea with topical ivermectin cream: a series of 34 cases. Dermatol Online J. 2016;22(8) Authors: Mendieta Eckert M, Landa Gundin N Abstract Rosacea is a highly prevalent, chronic inflammatory disease. The use of topical ivermectin cream has recently been described in the treatment of rosacea in three clinical trials. We report our experience in a series of 34 patients treated with topical ivermectin cream. The results are a reflection of the reality of clinical practice and the perception of patients of the treatment. We also evaluate the efficacy in cases of mild rosacea and erythematotelangiectatic rosacea which have not been studied in trials. PMID: 27617938 [PubMed - as supplied by publisher] {url} = URL to article

Dermoscopy in General Dermatology: A Practical Overview. Dermatol Ther (Heidelb). 2016 Sep 9; Authors: Errichetti E, Stinco G Abstract Over the last few years, dermoscopy has been shown to be a useful tool in assisting the noninvasive diagnosis of various general dermatological disorders. In this article, we sought to provide an up-to-date practical overview on the use of dermoscopy in general dermatology by analysing the dermoscopic differential diagnosis of relatively common dermatological disorders grouped according to their clinical presentation, i.e. dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides and subacute cutaneous lupus erythematosus), papulosquamous/papulokeratotic dermatoses (lichen planus, pityriasis rosea, papulosquamous sarcoidosis, guttate psoriasis, pityriasis lichenoides chronica, classical pityriasis rubra pilaris, porokeratosis, lymphomatoid papulosis, papulosquamous chronic GVHD, parakeratosis variegata, Grover disease, Darier disease and BRAF-inhibitor-induced acantholytic dyskeratosis), facial inflammatory skin diseases (rosacea, seborrheic dermatitis, discoid lupus erythematosus, sarcoidosis, cutaneous leishmaniasis, lupus vulgaris, granuloma faciale and demodicidosis), acquired keratodermas (chronic hand eczema, palmar psoriasis, keratoderma due to mycosis fungoides, keratoderma resulting from pityriasis rubra pilaris, tinea manuum, palmar lichen planus and aquagenic palmar keratoderma), sclero-atrophic dermatoses (necrobiosis lipoidica, morphea and cutaneous lichen sclerosus), hypopigmented macular diseases (extragenital guttate lichen sclerosus, achromic pityriasis versicolor, guttate vitiligo, idiopathic guttate hypomelanosis, progressive macular hypomelanosis and postinflammatory hypopigmentations), hyperpigmented maculopapular diseases (pityriasis versicolor, lichen planus pigmentosus, Gougerot-Carteaud syndrome, Dowling-Degos disease, erythema ab igne, macular amyloidosis, lichen amyloidosus, friction melanosis, terra firma-forme dermatosis, urticaria pigmentosa and telangiectasia macularis eruptiva perstans), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), erythrodermas (due to psoriasis, atopic dermatitis, mycosis fungoides, pityriasis rubra pilaris and scabies), noninfectious balanitis (Zoon's plasma cell balanitis, psoriatic balanitis, seborrheic dermatitis and non-specific balanitis) and erythroplasia of Queyrat, inflammatory cicatricial alopecias (scalp discoid lupus erythematosus, lichen planopilaris, frontal fibrosing alopecia and folliculitis decalvans), nonscarring alopecias (alopecia areata, trichotillomania, androgenetic alopecia and telogen effluvium) and scaling disorders of the scalp (tinea capitis, scalp psoriasis, seborrheic dermatitis and pityriasis amiantacea). PMID: 27613297 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Minocycline-induced pigmentation of the skin and nails. Postgrad Med J. 2015 Nov;91(1081):662 Authors: Ali FR, Yiu ZZ, Ogden S PMID: 26500011 [PubMed - indexed for MEDLINE] {url} = URL to article

Clinical and Histologic Effects of Fractional Microneedling Radiofrequency Treatment on Rosacea. Dermatol Surg. 2016 Sep 7; Authors: Park SY, Kwon HH, Yoon JY, Min S, Suh DH Abstract BACKGROUND: Fractional microneedling radiofrequency (FMR) is an emerging treatment modality, but its effect on rosacea has not been studied yet. OBJECTIVE: To investigate the potential impact of FMR treatment on clinical improvement and histologic changes in rosacea patients. MATERIALS AND METHODS: A 12-week, prospective, randomized, split-face clinical trial was conducted. Two sessions of FMR were performed on one side of the cheeks with 4-week interval and the other side remained untreated. Erythema index from DermaSpectrometer and a* value from Spectrophotometer CM-2002 were measured at each visit for the objective measurement of erythema. Histologic analysis of skin samples was also carried out. RESULTS: Clinical evaluation and photometric measurement revealed the reduction of redness in the treated side compared with untreated side and baseline. Erythema index decreased 13.6% and a* value decreased 6.8% at Week 12 compared with baseline. Reduced expression of markers related to inflammation, innate immunity, and angiogenesis was observed in immunohistochemical staining of tissue obtained after FMR treatment. CONCLUSION: Fractional microneedling radiofrequency treatment showed modest clinical and histologic improvement of rosacea, and it might be used as an alternative or in combination with other treatment methods. PMID: 27608206 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Efficacy and safety of permethrin 5% topical gel vs. placebo for rosacea: a double-blind randomized controlled clinical trial. J Eur Acad Dermatol Venereol. 2016 Sep 7; Authors: Raoufinejad K, Mansouri P, Rajabi M, Naraghi Z, Jebraeili R Abstract BACKGROUND: Rosacea is a chronic, multifactorial, dermatological condition. Increased density of Demodex folliculorum mites in the skin of rosacea patients suggests a possible role for these mites in the pathophysiology of rosacea. OBJECTIVE: To evaluate the effects of permethrin 5% topical gel vs. placebo on Demodex density (Dd) and clinical presentations of rosacea patients, and also to further refine the quantitative assessment of Dd in the non-invasive standard skin surface biopsy (SSSB). METHODS: Twenty patients with bilateral papulopustular rosacea and ≥5 mites/cm(2) were enrolled in the study. Participants and physicians were blinded to the group assignments. Each patient applied permethrin on one side and placebo on the other side of the face twice daily for 12 weeks. SSSB and photography and Rosacea Clinical Scorecard of the National Rosacea Society were used to assess the patients at the baseline, 2nd, 5th, 8th, and 12th weeks for both sides of the face. Causality and severity of adverse drug reactions (ADRs) were assessed by WHO Scale and Hartwig Scale, respectively. RESULTS: Dd was not significantly different between the two groups at the baseline. In both groups, Dd significantly decreased after 12 weeks compared to the baseline. At the end of the 12th week, the Dd in the permethrin group was significantly lower than the placebo group. Severity of the clinical presentations decreased in both groups at the end of week 12 in comparison to the baseline, particularly in the permethrin group. ADRs were all mild and in most cases unlikely related to permethrin. CONCLUSION: Permethrin 5% gel can significantly reduce the Dd and severity of presentations in rosacea patients and can be a safe and effective option in the management of this chronic disorder. This new SSSB technique offers an easy, quick, inexpensive, and non-invasive sampling method proper for quantitative assessment of Dd. PMID: 27600257 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Association between rosacea and gastrointestinal disorders. Br J Dermatol. 2016 Sep 7; Authors: Alexoudi A, Gatzonis S Abstract We read with great interest the results of a nationwide cohort study published by Egeberg et al.(1) demonstrating that the prevalence of coeliac disease, Crohn disease, ulcerative colitis, irritable bowel syndrome, small intestinal bacterial overgrowth (SIBO) and Helicobacter pylori infection was higher among patients with rosacea when compared with controls. Recently, with regard to the same cohort, the authors indicated that rosacea constitutes an independent risk factor for Parkinson disease (PD).(2) The entire gastrointestinal tract (GIT) is affected in PD and motility disorders are included in the most common nonmotor manifestations in these patients. Additionally, increasing evidence suggests that GIT might be the site of initiation of PD. Persistent gastric or intestinal infection with H. pylori and SIBO deteriorates motor fluctuations. This article is protected by copyright. All rights reserved. PMID: 27603953 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles The Bard's Blunder-Debunking the Myth Around Rhinophyma. JAMA Dermatol. 2016 Apr;152(4):379 Authors: Augustynowicz A, Maranda EL, Zullo J, Cai L, Jimenez J PMID: 27074357 [PubMed - indexed for MEDLINE] {url} = URL to article

Rosacea fulminans or acute rosacea? Report of 5 cases and review of the literature. G Ital Dermatol Venereol. 2016 Oct;151(5):553-7 Authors: Mantovani L, Zauli S, Virgili A, Bettoli V Abstract Rosacea fulminans, previously called pyoderma faciale, is an inflammatory disease considered a dramatic form of rosacea rather than of acne. Typical features are: exclusive facial involvement of young women, sudden onset of large nodules without other signs of acne, remission without scarring or with minimal scars, no recurrences or systemic symptoms. Oral isotretinoin associated with a short course of systemic and topical corticosteroids represent the recommended treatment. Personal observation of 5 cases has induced us to make a review of worldwide literature in order to better define this clinical entity. In our opinion, rosacea fulminans is a valid diagnosis, but clinical criteria should be rigorously respected to fully exclude rosacea conglobata and acne fulminans. PMID: 27595202 [PubMed - in process] {url} = URL to article

Related Articles Development of a core outcome set for clinical trials in rosacea: study protocol for a systematic review of the literature and identification of a core outcome set using a Delphi survey. Trials. 2016;17(1):429 Authors: Iyengar S, Williamson PR, Schmitt J, Johannsen L, Maher IA, Sobanko JF, Cartee TV, Schlessinger D, Poon E, Alam M Abstract BACKGROUND: Rosacea is a chronic inflammatory disorder affecting millions of individuals worldwide. Diagnosis is based on signs and symptoms with management and treatment aimed to suppress inflammatory lesions, erythema, and telangiectasia. While many clinical trials of rosacea exist, the lack of consensus in outcome reporting across all trials poses a concern. Proper evaluation and comparison of treatment modalities is challenging. In order to address the inconsistencies present, this project aims to determine a core set of outcomes which should be evaluated in all clinical trials of rosacea. METHODS/DESIGN: This project will utilize a methodology similar to previous core outcome set research. A long list of outcomes will be extracted over four phases: (1) systematic literature review, (2) patient interviews, (3) other published sources, and (4) stakeholder involvement. Potential outcomes will be examined by the Steering Committee to provide further insight. The Delphi process will then be performed to prioritize and condense the list of outcomes generated. Two homogenous groups of physicians and patients will participate in two consecutive rounds of Delphi surveys. A consensus meeting, composed of physicians, patients, and stakeholders, will be conducted after the Delphi exercise to further select outcomes, taking into account participant scores. By the end of the meeting, members will vote and decide on a final recommended set of core outcomes. For the duration of the study, we will be in collaboration with both the Core Outcome Measures in Effectiveness Trials (COMET) and Cochrane Skin Group - Core Outcome Set Initiative (CSG-COUSIN). DISCUSSION: This study aims to develop a core outcome set to guide assessment in clinical trials of rosacea. The end-goal is to improve the reliability and consistency of outcome reporting, thereby allowing sufficient evaluation of treatment effectiveness and patient satisfaction. PMID: 27580586 [PubMed - in process] {url} = URL to article

Related Articles The Microbiota of the Human Skin. Adv Exp Med Biol. 2016;902:61-81 Authors: Egert M, Simmering R Abstract The aim of this chapter is to sum up important progress in the field of human skin microbiota research that was achieved over the last years.The human skin is one of the largest and most versatile organs of the human body. Owing to its function as a protective interface between the largely sterile interior of the human body and the highly microbially contaminated outer environment, it is densely colonized with a diverse and active microbiota. This skin microbiota is of high importance for human health and well-being. It is implicated in several severe skin diseases and plays a major role in wound infections. Many less severe, but negatively perceived cosmetic skin phenomena are linked with skin microbes, too. In addition, skin microorganisms, in particular on the human hands, are crucial for the field of hygiene research. Notably, apart from being only a potential source of disease and contamination, the skin microbiota also contributes to the protective functions of the human skin in many ways. Finally, the analysis of structure and function of the human skin microbiota is interesting from a basic, evolutionary perspective on human microbe interactions.Key questions in the field of skin microbiota research deal with (a) a deeper understanding of the structure (species inventory) and function (physiology) of the healthy human skin microbiota in space and time, (b) the distinction of resident and transient skin microbiota members, PMID: 27161351 [PubMed - indexed for MEDLINE] {url} = URL to article

Related Articles Multidisciplinary Consideration of Potential Pathophysiologic Mechanisms of Paradoxical Erythema with Topical Brimonidine Therapy. Adv Ther. 2016 Aug 25; Authors: Docherty JR, Steinhoff M, Lorton D, Detmar M, Schäfer G, Holmes A, Di Nardo A Abstract Rosacea is a chronic inflammatory disease with transient and non-transient redness as key characteristics. Brimonidine is a selective α2-adrenergic receptor (AR) agonist approved for persistent facial erythema of rosacea based on significant efficacy and good safety data. The majority of patients treated with brimonidine report a benefit; however, there have been sporadic reports of worsening erythema after the initial response. A group of dermatologists, receptor physiology, and neuroimmunology scientists met to explore potential mechanisms contributing to side effects as well as differences in efficacy. We propose the following could contribute to erythema after application: (1) local inflammation and perivascular inflammatory cells with abnormally functioning ARs may lead to vasodilatation; (2) abnormal saturation and cells expressing different AR subtypes with varying ligand affinity; (3) barrier dysfunction and increased skin concentrations of brimonidine with increased actions at endothelial and presynaptic receptors, resulting in increased vasodilation; and (4) genetic predisposition and receptor polymorphism(s) leading to different smooth muscle responses. Approximately 80% of patients treated with brimonidine experience a significant improvement without erythema worsening as an adverse event. Attention to optimizing skin barrier function, setting patient expectations, and strategies to minimize potential problems may possibly reduce further the number of patients who experience side effects. FUNDING: Galderma International S.A.S., Paris, France. PMID: 27562835 [PubMed - as supplied by publisher] {url} = URL to article

The role of small intestinal bacterial overgrowth in rosacea: A 3-year follow-up. J Am Acad Dermatol. 2016 Sep;75(3):e113-5 Authors: Drago F, De Col E, Agnoletti AF, Schiavetti I, Savarino V, Rebora A, Paolino S, Cozzani E, Parodi A PMID: 27543234 [PubMed - in process] {url} = URL to article

Facial Dermatitis and Rosacea. Semin Cutan Med Surg. 2016 Jun;35(6S):S107-S109 Authors: Fowler JF Abstract Rosacea is a chronic skin disorder associated with flushing, erythema, dryness, burning and stinging, and inflammatory papules and pustules. New treatments available or in development target the inflammatory and erythematous components of the disease. These agents include the selective α2 receptor agonist brimonidine, the topical agents ivermectin cream 1% and azelaic acid foam 15%, and use of tetracyclinetype antibiotics, which affect the cathelicidin pathway. Semin Cutan Med Surg 35(supp6):S107-S109. PMID: 27537212 [PubMed - as supplied by publisher] {url} = URL to article

Enlarged facial pores: an update on treatments. Cutis. 2016 Jul;98(1):33-36 Authors: Dong J, Lanoue J, Goldenberg G Abstract Enlarged facial pores remain a common dermatologic and cosmetic concern from acne and rosacea, among other conditions, that is difficult to treat due to the multifactorial nature of their pathogenesis and negative impact on patients' quality of life. Enlarged facial pores are primarily treated through addressing associative factors, such as increased sebum production and cutaneous aging. We review the current treatment modalities for enlarged or dense facial pores, including topical retinoids, chemical peels, oral antiandrogens, and lasers and devices, with a focus on newer therapies. PMID: 27529707 [PubMed - as supplied by publisher] {url} = URL to article

Pediatric rosacea. Cutis. 2016 Jul;98(1):49-53 Authors: Kellen R, Silverberg NB Abstract Because rosacea is uncommon in the pediatric population, care must be taken to exclude other papulopustular disorders. Children can present with vascular, papulopustular, and/or ocular findings. Importantly, ocular symptoms can appear before the cutaneous symptoms of rosacea, leading to misdiagnosis. Rosacea is a clinical diagnosis, but histopathologic examination typically reveals dilated vessels, perivascular lymphohistiocytic infiltrates in the upper dermis, elastosis, and disorganization of the upper dermal connective tissue. Treatment involves avoiding known triggers and utilizing topical and/or systemic therapies. Although treatment can control flares, pediatric rosacea often persists into adulthood. PMID: 27529708 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Clinical assessment of rosacea severity: oriental score vs. quantitative assessment method with imaging and biomedical tools. Skin Res Technol. 2016 Aug 12; Authors: Kim J, Ahn JW, Ha S, Kwon SH, Lee O, Oh C Abstract BACKGROUND: Rosacea is a common chronic inflammatory disorder affecting facial skin. Currently, no accurate and objective method is available for assessing the severity of rosacea. Most studies use the National Rosacea Society Standard (NRSS) grading method, which lacks objectivity and yields varying results. METHODS: Eighteen patients with rosacea were included. Clinical severity was assessed on the basis of the NRSS grade, Investigators' Global Assessment, Patients' Global Assessment, and Dermatology Quality of Life Index. A skin color analysis system was used to measure the facial area showing erythema, and biophysical parameters of facial skin (transepidermal water loss and skin surface hydration) were examined. To find statistical significant in classification severity of the rosacea, statistical analysis was performed with all parameters. RESULTS: A significant correlation (P < 0.05) was found between the NRSS grade, facial area showing erythema, and biophysical parameters. The latter two factors differed significantly among patients with rosacea of different levels of severity (mild, moderate, severe; P < 0.05). CONCLUSION: Color imaging systems can be useful and reliable for evaluating the severity of rosacea, in addition to biophysical parameter assessment. The combination of these two analytical methods enabled objective and quantitative evaluation of the severity of rosacea. PMID: 27514310 [PubMed - as supplied by publisher] {url} = URL to article

Related Articles Four Diseases, Two Associations, One Patient: A Case of Frontal Fibrosing Alopecia, Lichen Planus Pigmentosus, Acne Rosacea, and Morbihan Disease. Skinmed. 2016;14(3):225-8 Authors: Walker JL, Robinson-Bostom L, Landow S Abstract A 77-year-old woman born in the Dominican Republic presented with fullness of the glabella and medial eyebrows for 1 year followed by alopecia of the lateral eyebrows and frontal hairline. She stated that although she had a high hairline at baseline, it had receded in the past year. She had also noted central scalp hair thinning that started 6 years earlier. She denied all styling practices that used traction or chemical processes, although she admitted to hair dye and blow dryer use. She reported "acne" in the central face for decades and darkening of the skin on the lateral face for several years. Her medical history included hypertension, hyperlipidemia, hypothyroidism, benign paroxysmal positional vertigo, and treated breast ductal hyperplasia. Her medications were metoprolol, amlodipine, aspirin, levothyroxine, omeprazole, pravastatin, and meclizine; she denied starting any new medications within the past 2 years. Her family history was notable for androgenic pattern alopecia in a brother and a high hairline in her father. Review of systems was negative except for knee arthralgias and seasonal allergic rhinitis. PMID: 27502265 [PubMed - in process] {url} = URL to article

Related Articles The efficacy, safety, and tolerability of ivermectin compared with current topical treatments for the inflammatory lesions of rosacea: a network meta-analysis. Springerplus. 2016;5(1):1151 Authors: Siddiqui K, Stein Gold L, Gill J Abstract BACKGROUND: Rosacea is a common chronic skin condition that manifests as recurrent inflammatory lesions. Long-term treatment is required to control symptoms and disease progression, with topical treatments being the first-line choice. Ivermectin 1 % cream is a new once-daily (QD) topical treatment for the inflammatory lesions of rosacea, and it is important to compare the efficacy, safety, and tolerability of ivermectin with other currently available topical treatments. METHODS: A systematic literature review was performed from January 2011 to June 2015, with articles published prior to 2011 retrieved from a Cochrane review on rosacea. Randomized controlled trials of the topical treatment of adult patients with moderate-to-severe papulopustular rosacea were identified from electronic databases and trial registers, and supplemented with data from clinical study reports. Mixed treatment comparisons (MTCs) were conducted to compare different treatments according to Bayesian methodology. RESULTS: 57 studies were identified, with 19 providing data suitable for MTC. Ivermectin 1 % cream QD led to a significantly greater likelihood of success compared with azelaic acid 15 % gel twice-daily (BID) [relative risk (95 % credible interval): 1.25 (1.14-1.37)], and metronidazole 0.75 % cream BID [1.17 (1.08-1.29)] at 12 weeks. Ivermectin 1 % cream QD also demonstrated a significant reduction in inflammatory lesion count compared with azelaic acid 15 % gel BID [-8.04 (-12.69 to -3.43)] and metronidazole 0.75 % cream BID [-9.92 (-13.58 to -6.35)] at 12 weeks. Ivermectin 1 % cream QD led to a significantly lower risk of developing any AE or TRAE compared with azelaic acid 15 % gel BID [0.83 (0.71-0.97) and 0.47 (0.32-0.67), respectively]. CONCLUSIONS: Ivermectin 1 % cream QD appears to be a more effective topical treatment than other current options for the inflammatory lesions of rosacea, with at least an equivalent safety and tolerability profile, and could provide physicians and dermatologists with an alternative first-line treatment option. PMID: 27504249 [PubMed] {url} = URL to article

Rosacea and gastrointestinal disorders - a population-based cohort study. Br J Dermatol. 2016 Aug 8; Authors: Egeberg A, Weinstock LB, Thyssen EP, Gislason GH, Thyssen JP Abstract BACKGROUND: Rosacea is a common inflammatory facial skin condition. Recent genetic and epidemiologic studies have suggested pathogenic links between rosacea and gastrointestinal disorders, but data are limited. OBJECTIVES: The objective was to investigate the association between rosacea and celiac disease (CeD), Crohn's disease (CD), ulcerative colitis (UC), Helicobactor pylori (HP) infection, small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS), respectively. METHODS: We performed a nationwide cohort study. A total of 49,475 patients with rosacea, and 4,312,213 general population controls were identified using nationwide administrative registers. We established the prevalence of the aforementioned disorders, and used Cox regression to obtain hazard ratios (HRs) of the risk of new-onset CeD, CD, UC, HP infection, SIBO, and IBS, respectively, in patients with rosacea. RESULTS: The prevalence of CeD, CD, UC, HP infection, SIBO, and IBS, respectively, was higher among patients with rosacea when compared to the control subjects. Adjusted HRs revealed significant associations between rosacea and CeD (HR 1.46, 1.11-1.93), CD (HR 1.45, 1.19-1.77), UC (HR 1.19, 1.02-1.39), and IBS (HR 1.34, 1.19-1.50) respectively, but not HP infection (HR 1.04, 0.96-1.13) or SIBO (HR 0.71, 0.18-1.86). CONCLUSIONS: Rosacea is associated with certain gastrointestinal diseases, but the possible pathogenic link is unknown. Gastrointestinal complaints in patients with rosacea should warrant clinical suspicion of disease. This article is protected by copyright. All rights reserved. PMID: 27501017 [PubMed - as supplied by publisher] {url} = URL to article