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Link between rosacea and glioma in nationwide cohort. Lancet Oncol. 2016 Feb 4; Authors: Bagcchi S PMID: 26853822 [PubMed - as supplied by publisher] {url} = URL to article

A Randomized-Controlled Trial of Oral Low-Dose Isotretinoin for Difficult-To-Treat Papulopustular Rosacea. J Invest Dermatol. 2016 Feb 5; Authors: Sbidian E, Vicaut É, Chidiack H, Anselin E, Cribier B, Dréno B, Chosidow O Abstract Rosacea is a chronic inflammatory facial skin disease with psychosocial impact. Oral cyclines are recommended for moderate-to-severe papulopustular rosacea. Oral isotretinoin was found valuable for difficult-to-treat cases in several reports. This multicenter, double-blind, randomized-placebo-controlled trial compared oral isotretinoin (0.25 mg/kg/day) to placebo (2:1 ratio) for difficult-to-treat papulopustular rosacea. Included patients had at least 8 papulopustular lesions. The primary endpoint after the 4-month-treatment period was the response rate: at least 90% reduction of the number of papules/pustules compared to baseline. Secondary outcomes included measures on quality of life (Skindex score). Between February 2007 and August 2009, 156 patients were randomized to receive either isotretinoin (n=108) or placebo (n=48). In the intention-to-treat population, 57.4% of isotretinoin recipients reached the primary endpoint, compared to 10.4% of those taking the placebo (absolute difference, 47 percentage points; 95% confidence interval (CI), 34.3-59.7; P<0.0001). To consider therapy successful, 2.1 (95% CI 1.7-2.9) patients had to be treated. Skindex scores had improved significantly more for isotretinoin- than placebo-treated patients. Rosacea relapsed in 27 (58.3%) out of 51 patients who accepted 4 months of continued follow-up, with a median of 15 weeks to recurrence. The percentages of patients in each arm who stopped their treatment because of adverse event(s) did not differ. Low-dose isotretinoin was an effective therapeutic option for difficult-to-treat papulopustular rosacea. Further studies should investigate the value of a minimal effective isotretinoin dose to maintain these remissions. PMID: 26854486 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesComparison of single-spot technique and RGB imaging for erythema index estimation. Physiol Meas. 2016 Feb 5;37(3):333-346 Authors: Saknite I, Zavorins A, Jakovels D, Spigulis J, Kisis J Abstract A commercially available point measurement device, the Mexameter(®), and an experimental RGB imaging prototype device were used for erythema index estimation of 50 rosacea patients by analysing the level of skin redness on the forehead, both cheeks and both sides of a nose. Results are compared with Clinician's Erythema Assessment (CEA) values given by two dermatologists. The Mexameter uses 568 nm and 660 nm LEDs and a photodetector for estimation of erythema index, while the used prototype device acquired RGB images at 460 nm, 530 nm and 665 nm LED illumination. Several erythema index estimation algorithms were compared to determine which one gives the best contrast between increased erythema and normal skin. The erythema index estimations and CEA values correlated much better for the RGB imaging data than for those obtained by the conventional Mexameter technique that is widely used by dermatologists and in clinical trials. In result, we propose an erythema index estimation approach that represents increased erythema with higher accuracy than other available methods. PMID: 26849449 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesClustering of autoimmune diseases in patients with rosacea. J Am Acad Dermatol. 2016 Jan 30; Authors: Egeberg A, Hansen PR, Gislason GH, Thyssen JP Abstract BACKGROUND: Rosacea is a common inflammatory skin condition that shares genetic risk loci with autoimmune diseases such as type 1 diabetes mellitus (T1DM) and celiac disease. A recent genomewide association study identified 90 genetic regions associated with T1DM, celiac disease, multiple sclerosis, and/or rheumatoid arthritis, respectively. However, a possible association with rosacea was not investigated. OBJECTIVE: We evaluated the association between rosacea and T1DM, celiac disease, multiple sclerosis, and rheumatoid arthritis, respectively. METHODS: We performed a population-based case-control study. A total of 6759 patients with rosacea were identified and matched with 33,795 control subjects on age, sex, and calendar time. We used conditional logistic regression to calculate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: After adjustment for smoking and socioeconomic status, patients with rosacea had significantly increased ORs for T1DM (OR 2.59, 95% CI 1.41-4.73), celiac disease (OR 2.03, 95% CI 1.35-3.07), multiple sclerosis (OR 1.65, 95% CI 1.20-2.28), and rheumatoid arthritis (OR 2.14, 95% CI 1.82-2.52). The association was mainly observed in women. LIMITATIONS: We were unable to distinguish between the different subtypes and severities of rosacea. CONCLUSIONS: Rosacea is associated with T1DM, celiac disease, multiple sclerosis, and rheumatoid arthritis, respectively, in women, whereas the association in men only reached statistical significance for rheumatoid arthritis. PMID: 26830864 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesDevelopment and Evaluation of a Rosacea Screening Instrument (Rosascreen). J Cutan Med Surg. 2016 Feb 1; Authors: Tan J, Leyden J, Cribier B, Audibert F, Kerrouche N, Berg M, RISG Committee Abstract BACKGROUND: There are no current instruments to facilitate population screening for rosacea. OBJECTIVE: To develop and evaluate a screening instrument for rosacea applicable for population surveys. METHODS: A rosacea-specific screening instrument (Rosascreen), consisting of a subject-completed questionnaire and screening algorithm, was developed based on current diagnostic criteria for rosacea. Three iterations were pilot tested and refined for clarity and sensitivity in adult outpatients with and without rosacea. RESULTS: Three subject groups were consecutively evaluated with iterations of the questionnaire at each centre (overall N = 121). The final version had a sensitivity of 93% to 100% for key diagnostic criteria, and use of the algorithm had a sensitivity of 100% for detection of rosacea and specificity of 63% to 71%. Most subjects found the questionnaire easy to understand and complete. CONCLUSION: Rosascreen, a subject-completed questionnaire and diagnostic algorithm, is a highly sensitive screening instrument that may facilitate estimation of rosacea prevalence in general populations. PMID: 26834119 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesA review of the quality of life following pulsed dye laser treatment for erythemotelangiectatic rosacea. J Cosmet Laser Ther. 2016 Feb 2;:1-5 Authors: Bonsall A, Rajpara S Abstract Rosacea is a chronic condition, affecting up to 10% of the population. It has a negative impact on patients' quality of life (QOL), leading to loss of self-confidence, emotional distress and withdrawal from normal societal interactions. Erythemotelangiectatic (ET) rosacea is a frequent reason for consultation and difficult to treat, as vascular signs such as flushing, erythema and telangiectasia often persist despite medical therapy. Several studies have demonstrated objective improvements in vascular signs following pulsed dye laser (PDL) treatment, but very few have investigated improvement in QOL. We reviewed the current literature to find evidence for the effect of PDL on QOL in ET rosacea. PMID: 26836241 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesManagement of inflammatory corneal melt leading to central perforation in children: a retrospective study and review of literature. Eye (Lond). 2016 Jan 29; Authors: Medsinge A, Gajdosova E, Moore W, Nischal KK Abstract PurposeTo assess the outcome of early therapeutic penetrating keratoplasty (PKP) for corneal melt leading to perforation in children.MethodsCase notes of all the consecutive patients presenting with acute corneal perforation that underwent urgent therapeutic PKP between 2000 and 2010 to the practice of one of the authors, both NHS at Great Ormond Street Hospital for Children and private, were retrospectively reviewed. Onset of perforation, underlying cause, medical and surgical treatment, pre- and post-operative visual acuity, graft clarity, length of follow-up, and post-operative complications were recorded.ResultsFour eyes of four consecutive patients (mean age of 9.5 years and median 8.5 years, range 4-17 years) were treated for acquired acute onset corneal perforations. There were three females and one male. Etiologies included herpes simplex keratitis secondary to immune recovery disease post bone marrow transplantation, acanthamoeba keratitis, recessive dystrophic epidermolysis bullosa, and blepharokeratoconjunctivitis with acne rosacea. Pre-operative visual acuity ranged from hand movements to 6/150. All the patients had severe anterior chamber inflammation. All eyes improved in visual acuity ranging from 6/9 to 6/18 with clear grafts at last follow-up. There was no recurrence of melt or perforation. Mean follow-up was 67 months (median 44 months).ConclusionPKP during the acute phase together with aggressive medical therapy and close follow-up may achieve good visual outcomes in children with corneal melt with perforation and should be considered. Waiting may sometimes allow the marked inflammatory response seen in children to cause irreversible structural and/or functional damage.Eye advance online publication, 29 January 2016; doi:10.1038/eye.2015.278. PMID: 26821761 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesRosacea: Diagnosis and management. Nurse Pract. 2016 Jan 27; Authors: Napierkowski DB PMID: 26825576 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesAssociation of Rosacea With Risk for Glioma in a Danish Nationwide Cohort Study. JAMA Dermatol. 2016 Jan 27; Authors: Egeberg A, Hansen PR, Gislason GH, Thyssen JP Abstract Importance: Rosacea, a common facial skin disorder, has a poorly understood pathogenesis in which increased matrix metalloproteinase activity might play an important role. Glioma accounts for 80% of all primary malignant tumors in the central nervous system, and these tumors also show upregulation of certain matrix metalloproteinases. Objective: To investigate the association between rosacea and the risk for glioma. Design, Setting, and Participants: Nationwide cohort study of the Danish population from individual-level linkage of administrative registers. All Danish citizens 18 years or older from January 1, 1997, to December 31, 2011, were eligible for inclusion. A total of 5 484 910 individuals were eligible for analysis; of these, 68 372 had rosacea and 5 416 538 constituted the reference population. Data were analyzed from July 14 to August 10, 2015. Main Outcomes and Measures: The outcome of interest was a diagnosis of glioma. Incidence rates per 10 000 person-years were calculated, and incidence rate ratios adjusted for age, sex, and socioeconomic status were estimated by Poisson regression distribution models. Results: Of the 5 484 910 individuals in the study population, 21 118 individuals developed glioma during the study period, including 20 934 of the 5 416 538 individuals in the reference population (50.4% women; mean [SD] age, 40.8 [19.7] years) and 184 of the 68 372 patients with rosacea (67.3% women; mean [SD] age, 42.2 [16.5] years).The incidence rate (95% CI) of glioma was 3.34 (3.30-3.39) in the reference population and 4.99 (4.32-5.76) in patients with rosacea. The adjusted incidence rate ratio (95% CI) of glioma in patients with rosacea was 1.36 (1.18-1.58) in our primary analysis. When analyses were limited to patients with a primary diagnosis of rosacea by a hospital dermatologist (n = 5964), the adjusted incidence rate ratio was 1.82 (1.16-2.86). Conclusions and Relevance: Rosacea was associated with a significantly increased risk for glioma in a nationwide cohort. This association may be mediated, in part, by mechanisms dependent on matrix metalloproteinases. Increased focus on neurologic symptoms in patients with rosacea may be warranted. PMID: 26818473 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesRosacea patients seeking advice: Qualitative analysis of patients' posts on a rosacea support forum. J Dermatolog Treat. 2016 Mar;27(2):99-102 Authors: Alinia H, Moradi Tuchayi S, Farhangian ME, Huang KE, Taylor SL, Kuo S, Richardson I, Feldman SR Abstract BACKGROUND: Social media have become outlets for patients to voice opinions and ask questions. Since suffering from rosacea is an isolating experience and the disease is poorly understood, patients use social media to expand their knowledge about the condition. OBJECTIVE: To understand rosacea patients' online health information seeking habits to obtain a better insight of their educational needs. METHODS: Ten percent of posts in online rosacea forum composed of 3350 members and 27 051 posts, discussing patient viewpoints and concern, selected by stratified random sampling. Three hundred and nine queries were directly categorized to patients "seeking advice" by two investigators and qualitatively analyzed. RESULTS: Patients primarily sought advice about treatments (n = 155, 50.1%), triggers (n = 53, 17.1%), diet (n = 48, 15.5%), skin care (n = 37, 11.9%) and special presentations of the disease (n = 22, 7.1%). Questions frequently pertained to adverse effects, efficacy and target of therapy (78, 49, 30 posts, respectively). CONCLUSION: Proactively providing reliable resources and comprehensive explanations on treatments, triggers, diet and skin care could be helpful in reducing patients' confusion about rosacea and enhancing rosacea patient-physician relationships. PMID: 26815357 [PubMed - in process] {url} = URL to article

Related ArticlesDrugs for rosacea. Med Lett Drugs Ther. 2016 Feb 1;58(1487):16-17 Authors: PMID: 26812123 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesSensitive skin. J Eur Acad Dermatol Venereol. 2016 Feb;30 Suppl 1:2-8 Authors: Misery L, Loser K, Ständer S Abstract Sensitive skin is a clinical condition defined by the self-reported facial presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus. Sensitive skin may occur in individuals with normal skin, with skin barrier disturbance, or as a part of the symptoms associated with facial dermatoses such as rosacea, atopic dermatitis and psoriasis. Although experimental studies are still pending, the symptoms of sensitive skin suggest the involvement of cutaneous nerve fibres and neuronal, as well as epidermal, thermochannels. Many individuals with sensitive skin report worsening symptoms due to environmental factors. It is thought that this might be attributed to the thermochannel TRPV1, as it typically responds to exogenous, endogenous, physical and chemical stimuli. Barrier disruptions and immune mechanisms may also be involved. This review summarizes current knowledge on the epidemiology, potential mechanisms, clinics and therapy of sensitive skin. PMID: 26805416 [PubMed - in process] {url} = URL to article

Related ArticlesSkin compatibility and efficacy of a cosmetic skin care regimen with licochalcone A and 4-t-butylcyclohexanol in patients with rosacea subtype I. J Eur Acad Dermatol Venereol. 2016 Feb;30 Suppl 1:21-7 Authors: Schoelermann AM, Weber TM, Arrowitz C, Rizer RL, Qian K, Babcock M Abstract BACKGROUND: Patients with rosacea often show facial sensitivity to cosmetics or skin care products that can influence the severity of symptoms and exacerbate erythema and inflammation. Nevertheless, special skin care is necessary to address cosmetic concerns and reduce the potential side-effects of topical or oral treatment of the disease. Appropriate skin care should comprise gentle cleansing, effective moisturization, soothing actives, UV protection and concealing pigments to help neutralize the appearance of redness. OBJECTIVE: To determine the compatibility and efficacy of a skin care regimen (consisting of a cleanser, a day care with SPF25 and a night care) containing licochalcone A (Lic A), an anti-irritant from the licorice plant Glycyrrhiza inflata, and 4-t-butylcyclohexanol (SymSitive(®) ), a substance which acts as a sensitivity regulator, in female subjects with clinically determined subtype I rosacea. METHODS: Thirty-two test subjects with mild to moderate rosacea used the skin care regimen daily for 8 weeks. Clinical assessment of erythema, subjective irritation and clinical photography were performed at baseline and after 4 and 8 weeks. Additionally, a quality-of-life questionnaire was filled out by the test subjects at baseline and week 8. The subjects completed a self-assessment questionnaire on product properties after 4 and 8 weeks of product use. RESULTS: Clinical assessments and subject response confirmed very good tolerability of the regimen, a statistically significant improvement in clinical grading for erythema and tactile roughness at weeks 4 and 8 and on telangiectasia at week 8 when compared to baseline scores. A statistically significant improvement in facial redness (a*) values, based on the L*a*b* colorimetric system, was determined at week 4 and 8 in comparison to baseline. No difference in corneometric measurement was detected at week 4 and 8 compared to baseline. CONCLUSION: The skin care regimen was found to be highly compatible with the sensitive facial skin of patients with rosacea subtype I and effective in improving signs of rosacea. Therefore, the daily use of skin care products containing LicA and SymSitive(®) in patients with rosacea improves the overall skin appearance and the quality of life of these patients. PMID: 26805419 [PubMed - in process] {url} = URL to article

Related ArticlesIs optical coherence tomography an effective device for evaluation of tear film meniscus in patients with acne rosacea? Eye (Lond). 2016 Jan 15; Authors: Eroglu FC, Karalezli A, Dursun R Abstract PurposeTo investigate the tear meniscus using Fourier-domain optical coherence tomography (FD-OCT) in patients with acne rosacea and to determine the relationship between tear film break-up tests (TBUT), Schirmer test and FD-OCT values and to compare them with that of healthy controls.MethodsOne hundred and four patients with acne rosacea and 104 body mass index age-sex-matched healthy subjects were enrolled in this prospective case-control study. Tear meniscus height (TMH), tear meniscus depth (TMD), and tear meniscus cross-sectional area (TMA) were measured using FD-OCT (RTVue-100); TBUT, Schirmer test and dry eye questionnaire (OSDI) were evaluated. Correlation was assessed using Spearman's correlation coefficient.ResultsMean TMH, TMD, TMA, TBUT, and Schirmer test values of acne rosacea patients were significantly lower than and OSDI score significantly higher than those of controls. Tear mensicus values were significantly correlated with OSDI scores, TBUT, and Schirmer test results. The intraobserver intraclass correlation coefficient (ICC) for tear parameters ranged from 0.90 to 0.96 and interobserver ICC ranged from 0.92 to 0.94, which revealed high reproducibility for all measurements parameters both acne rosacea and control subjects. Accuracy of dry eye diagnosis by FD-OCT was 60.4% for TMH, 58.7% for TMD, and 64.8% for TMA.ConclusionTear meniscus measurement with FD-OCT could provide acceptable specificity and sensitivity in diagnosis of dry eye in acne rosacea patients.Eye advance online publication, 15 January 2016; doi:10.1038/eye.2015.277. PMID: 26768918 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesOrphan diseases of the nose and paranasal sinuses: Pathogenesis - clinic - therapy. GMS Curr Top Otorhinolaryngol Head Neck Surg. 2015;14:Doc04 Authors: Laudien M Abstract Rare rhinological diseases are a diagnostic challenge. Sometimes it takes months or even years from the primary manifestation of the disease until the definitive diagnosis is establibshed. During these times the disease proceeds in an uncontrolled or insufficiently treated way. (Irreversible) damage results and sometimes life-threatening situations occur. The unexpected course of a (misdiagnosed) disease should lead to further diagnostic reflections and steps in order to detect also rare diseases as early as possible. The present paper discusses granulomatous diseases of the nose and paranasal sinuses caused by mycobacteria, treponema, Klebsiella, fungi, and protozoa as well as vasculitis, sarcoidosis, rosacea, cocaine-induced midline destruction, nasal extranodal NK/T cell lymphoma, and cholesterol granuloma. Furthermore, diseases with disorders of the mucociliary clearance such as primary ciliary dyskinesia and cystic fibrosis are presented, taking into consideration the current literature. PMID: 26770278 [PubMed] {url} = URL to article

Related ArticlesClinical manifestation and associated factors of seborrheic dermatitis in Korea. Eur J Dermatol. 2016 Jan 14; Authors: Park SY, Kwon HH, Min S, Yoon JY, Suh DH Abstract Systematic investigations of clinical manifestation and factors associated with the severity of seborrheic dermatitis (SD) have rarely been reported in Asia We investigated the clinical manifestation and associated factors of SD. Patients were asked to fill a self-questionnaire including symptom severity and aggravating factors. We evaluated objective severity and involved sites of SD. Patients were categorized into 3 groups; young age group (age <30), middle age group (30≤ age <60), and old age group (age ≥60) and we compared clinical features among them. RESULTS: Among 253 patients included, scalp was the most frequently involved site and the most frequently reported aggravating factor was psychological stress. Different age groups have distinct clinical features and severity. Severity of SD decreased with age and patients in the old age group had less frequent involvement of the lower face. Risk factors of scalp involvement were male gender, disease duration ≥7 years and a history of acne. We investigated associated factors of SD and observed different clinical features between the age groups. We suggest that the adult form of SD can be categorized into 3 groups; young age SD, middle age SD and old age SD. PMID: 26771150 [PubMed - as supplied by publisher] {url} = URL to article

Rosacea or photodamaged skin? Use of brimonidine gel in differentiating erythema in the two conditions. Australas J Dermatol. 2016 Jan 13; Authors: Oon HH, Lim ZV Abstract In this case report, we detail the response of a 37-year-old Caucasian man with an overlap of erythematotelangiectatic rosacea and telangiectatic photoaging to brimonidine tartrate gel. With the application of brimonidine only on half of his face, skin analysis images, clinician's and patient's assessment showed that there was significant improvement in the erythema. This case has lent insight into how brimonidine can be used to assess the extent of photoaging by eliminating the erythema of rosacea to some degree. We propose that it can be used as a non-invasive test to differentiate between the two conditions, sparing patients from skin biopsies and molecular analysis. PMID: 26763464 [PubMed - as supplied by publisher] {url} = URL to article

Status report from the American Acne & Rosacea Society on medical management of acne in adult women, part 3: oral therapies. Cutis. 2015 Dec;96(6):376-382 Authors: Del Rosso JQ, Harper JC, Graber EM, Thiboutot D, Silverberg NB, Eichenfield LF Abstract Parts 1 and 2 of this 3-part series provided an overview of the epidemiology, visible patterns, and important considerations for clinical and laboratory evaluation of acne vulgaris (AV) in adult women and reviewed the role of proper skin care and topical therapies in this patient population. In Part 3, oral therapies including combination oral contraceptives, spironolactone, antibiotics, and isotretinoin are discussed along with important considerations that clinicians should keep in mind when selecting oral agents for management of AV in adult women. PMID: 26761932 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesLinear extensions of hypopigmentation as a side effect of topical corticosteroid application. Int J Dermatol. 2016 Jan 12; Authors: Kwon HH, Suh DH PMID: 26756396 [PubMed - as supplied by publisher] {url} = URL to article

The role of altered cutaneous immune responses in the induction and persistence of rosacea. J Dermatol Sci. 2015 Dec 19; Authors: Margalit A, Kowalczyk MJ, Żaba R, Kavanagh K Abstract Rosacea is a chronic inflammatory skin condition that predominantly affects the skin of the face and the eyes. Several factors are associated with the onset and persistence of the condition, including an altered immune response in the skin and elevated levels of Demodex mites. Alterations in the immune response include elevated levels of LL-37 in rosacea skin, increased expression of TLR-2 and increased amounts of vitamin D3 in epidermal tissue. The combined effect of these changes may make the skin more sensitive to external and internal stimuli. External stimuli that may trigger or sustain rosacea inflammation include exposure to ultraviolet light, while internal factors may include the presence of elevated numbers of Demodex mites. These mites may directly stimulate an immune response or release bacteria within the pilosebaceous unit that act as a trigger for inflammation. This review will highlight the changes that occur in the immune response of the skin and describe how Demodex mites and associated bacteria may activate this response and lead to the characteristics of rosacea. PMID: 26747056 [PubMed - as supplied by publisher] {url} = URL to article

[IMPACT OF OPISTHORCHIS INVASION ON THE COURSE OF A SKIN PROCESS IN PATIENTS WITH ROSACEA]. Med Parazitol (Mosk). 2015 Jul-Sep;(3):36-8 Authors: Aripova ML, Khardikova SA Abstract The authors give the data-and results of their investigations of 47 patents with rosacea concurrent with chronic opisthorchiasis (Group 1) and 40 patients with rosacea without opisthorhiasis (Group 2): It is found that the severer clinical manifestations of rosacea are, the lower the quality of life is in patients. The patients with rosacea concurrent with chronic opisthorchiasis were found to have severe clinical forms. Rosacea diagnostic rating scores was 1.1-fold higher than in the patients without helminthiasis, suggesting a severer course. Quality-of-life dissatisfaction in patients with rosacea concurrent with chronic opisthorchiasis was significantly higher than in those with rosacea only. PMID: 26720969 [PubMed - in process] {url} = URL to article

Related ArticlesFacial Erythema of Rosacea - Aetiology, Different Pathophysiologies and Treatment Options. Acta Derm Venereol. 2015 Dec 30; Authors: Steinhoff M, Schmelz M, Schauber J Abstract Rosacea is a common chronic skin condition that displays a broad diversity of clinical manifestations. Although the pathophysiological mechanisms of the four subtypes are not completely elucidated, the key elements often present are augmented immune responses of the innate and adaptive immune system, and neurovascular dysregulation. The most common primary feature of all cutaneous subtypes of rosacea is transient or persistent facial erythema. Perilesional erythema of papules or pustules is based on the sustained vasodilation and plasma extravasation induced by the inflammatory infiltrates. In contrast, transient erythema has rapid kinetics induced by trigger factors independent of papules or pustules. Amongst the current treatments for facial erythema of rosacea, only the selective α2-adrenergic receptor agonist brimonidine 0.33% topical gel (Mirvaso®) is approved. This review aims to discuss the potential causes, different pathophysiologies and current treatment options to address the unmet medical needs of patients with facial erythema of rosacea. PMID: 26714888 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesRosacea in Patients with Ulcerative Colitis and Crohn's Disease: A Population-based Case-control Study. Inflamm Bowel Dis. 2015 Dec 29; Authors: Spoendlin J, Karatas G, Furlano RI, Jick SS, Meier CR Abstract BACKGROUND: Cutaneous manifestations are common in patients with inflammatory bowel diseases (IBDs) (ulcerative colitis [UC] and Crohn's disease [CD]). Previous case reports described patients with IBD who developed rosacea. IBD and rosacea are inflammatory epithelial diseases, presumably associated with changes in the innate immune system. We explored the association between IBD and incident rosacea. METHODS: We conducted a population-based matched (1:1) case-control analysis on the association between IBD and rosacea, stratified by IBD disease duration and severity. We used data from the UK-based Clinical Practice Research Datalink. Cases had an incident diagnosis of rosacea recorded between 1995 and 2013. RESULTS: Among 80,957 rosacea cases and the same number of controls, a history of UC was associated with an increased risk of rosacea (odds ratio [OR] 1.65, 95% confidence interval [CI], 1.43-1.90), with the highest OR in those with short UC duration (OR 2.85, 95% confidence interval, 1.80-4.50 for patients with <2 years of disease history). A history of CD yielded an overall OR of 1.49 (95% CI, 1.25-1.77), which did not correlate with disease duration. Additional analyses on IBD disease severity yielded evidence for a higher risk of rosacea in those with higher UC and CD activity. CONCLUSIONS: Our findings provide evidence that patients with IBD may be at increased risk of rosacea (higher in UC), particularly during phases of increased IBD-associated gastrointestinal tract inflammation. PMID: 26717319 [PubMed - as supplied by publisher] {url} = URL to article

Related ArticlesDermatological Adverse Events Associated with Topical Brimonidine Gel 0.33% in Subjects with Erythema of Rosacea: A Retrospective Review of Clinical Studies. J Clin Aesthet Dermatol. 2015 Aug;8(8):29-35 Authors: Holmes AD, Waite KA, Chen MC, Palaniswamy K, Wiser TH, Draelos ZD, Rafal ES, Werschler WP, Harvey AE Abstract BACKGROUND: The topical α2 adrenergic receptor agonist brimonidine gel 0.33% is an effective and safe pharmacological treatment for the facial erythema of rosacea. However, adverse events of worsened redness have occasionally been reported with its use. OBJECTIVE: A detailed analysis of adverse events is needed to accurately define worsening erythema and the adverse-events profile associated with brimonidine gel treatment. METHODS AND MEASUREMENTS: A retrospective review of related dermatological adverse events occurring in subjects enrolled in the two pivotal four-week Phase 3 studies and the 52-week long-term safety study for brimonidine gel was conducted. Measurements included total adverse-event incidences; number of subjects experiencing adverse events; study discontinuation due to adverse events, severity, onset, episodic duration period; and correlation of adverse events to subject disposition, and rosacea profile. RESULTS: Flushing and erythema were the most commonly reported adverse events, occurring in a total of 5.4 percent of subjects in the Phase 3 studies and in 15.4 percent in the long-term study. Most adverse events were mild or moderate in severity, transient, and intermittent. Adverse events occurred early in treatment, and duration was short-lived in the majority of cases. Adverse-event patterns were not remarkably altered with regard to subject disposition in the long-term study. CONCLUSION: Adverse events of worsening redness are not frequent, are transient in nature, and occur early in the course of treatment with brimonidine gel. PMID: 26345379 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/26345379?dopt=Abstract = URL to article

Cross-sectional survey of awareness and behavioral pattern regarding acne and acne scar based on smartphone application. Int J Dermatol. 2015 Sep 4; Authors: Park SY, Park MY, Suh DH, Kwon HH, Min S, Lee SJ, Lee WJ, Lee MW, Ahn HH, Kang H, Lee JB, Ro YS, Ahn KJ, Kim MN, Kim KJ, Kim NI, Korean Society for Acne Research Abstract BACKGROUND: Although acne scar is a permanent sequela that may be induced by improper management of active acne lesion, patient behavior patterns and awareness regarding acne are unclear. The aim of this study was to identify awareness and behavioral patterns concerning acne and acne scar of people having acne and differences between those with and without acne scars. METHODS: The survey was performed via smartphone application for 900 participants in their second to fourth decade having current or previous acne lesions. They were further categorized into two groups based on the presence of acne scar (scar and scarless groups) with no statistical difference in demographic composition. RESULTS: The mean age of all participants was 24.6 ± 5.3. The scar group had a longer disease duration (4.9 years) than those of the scarless group (2.2 years). Participants in the scar group thought that acne scarring affected psychosocial aspects more negatively compared with those in the scarless group. Participants in the scarless group visited dermatology clinics earlier than those in the scar group. In the scar group, 62.1% of participants have never had their acne scars treated medically. Most (88.6%) participants from both groups believed that non-dermatologic treatment caused side effects or aggravated their acne. CONCLUSIONS: Participants with acne scars tended to treat their acne and acne scars improperly, which could negatively affect their daily lives. Acne scars are sequelae of acne and should be regarded as a distinct disease entity, requiring a patient's early visit to dermatologic clinics. PMID: 26340516 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26340516?dopt=Abstract = URL to article