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The association of the sebum excretion rate with melasma, erythematotelangiectatic rosacea, and rhytides. Dermatol Online J. 2015;21(6) Authors: Foolad N, Shi VY, Prakash N, Kamangar F, Sivamani RK Abstract BACKGROUND: Rosacea and melasma are two common skin conditions in dermatology. Both conditions have a predilection for the centrofacial region where the sebaceous gland density is the highest. However it is not known if sebaceous function has an association with these conditions. AIMS AND OBJECTIVES: We aimed to assess the relationship between facial glabellar wrinkle severity and facial sebum excretion rate for individuals with rosacea, melasma, both conditions, and in those with rhytides. Secondly, the purpose of this study was to utilize high resolution 3D facial modeling and measurement technology to obtain information regarding glabellar rhytid count and severity. MATERIALS AND METHODS: A total of 21 subjects participated in the study. Subjects were divided into four groups based on facial features: rosacea-only, melasma-only, rosacea and melasma, rhytides-only. A high resolution facial photograph was taken followed by measurement of facial sebum excretion rate (SER). RESULTS: The SER was found to decline with age and with the presence of melasma. The SER negatively correlated with increasing Wrinkle Severity Rating Scale. Through the use of 3D facial modeling and skin analysis technology, we found a positive correlation between clinically based grading scores and computer generated glabellar rhytid count and severity. CONCLUSION: Continuing research with facial modeling and measurement systems will allow for development of more objective facial assessments. Future studies need to assess the role of technology in stratifying the severity and subtypes of rosacea and melasma. Furthermore, the role of sebaceous regulation may have important implications in photoaging. PMID: 26158356 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/26158356?dopt=Abstract = URL to article

Light-emitting Diodes: A Brief Review and Clinical Experience. J Clin Aesthet Dermatol. 2015 Jun;8(6):36-44 Authors: Opel DR, Hagstrom E, Pace AK, Sisto K, Hirano-Ali SA, Desai S, Swan J Abstract BACKGROUND: In the early 1990s, the biological significance of light-emitting diodes was realized. Since this discovery, various light sources have been investigated for their cutaneous effects. STUDY DESIGN: A Medline search was performed on light-emitting diode lights and their therapeutic effects between 1996 and 2010. Additionally, an open-label, investigator-blinded study was performed using a yellow light-emitting diode device to treat acne, rosacea, photoaging, alopecia areata, and androgenetic alopecia. RESULTS: The authors identified several case-based reports, small case series, and a few randomized controlled trials evaluating the use of four different wavelengths of light-emitting diodes. These devices were classified as red, blue, yellow, or infrared, and covered a wide range of clinical applications. The 21 patients the authors treated had mixed results regarding patient satisfaction and pre- and post-treatment evaluation of improvement in clinical appearance. CONCLUSION: Review of the literature revealed that differing wavelengths of light-emitting diode devices have many beneficial effects, including wound healing, acne treatment, sunburn prevention, phototherapy for facial rhytides, and skin rejuvenation. The authors' clinical experience with a specific yellow light-emitting diode device was mixed, depending on the condition being treated, and was likely influenced by the device parameters. PMID: 26155326 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/26155326?dopt=Abstract = URL to article

Rosacea associated with increased risk of some cancers. Lancet Oncol. 2015 Jul 2; Authors: Bagcchi S PMID: 26143688 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26143688?dopt=Abstract = URL to article

Granulomatous Rosacea and Periorificial Dermatitis: Controversies and Review of Management and Treatment. Dermatol Clin. 2015 Jul;33(3):447-455 Authors: Lee GL, Zirwas MJ Abstract Granulomatous rosacea and periorificial dermatitis are common skin conditions affecting the face. This article examines the historical origin, causes, clinical presentation, and management strategies for these entities. PMID: 26143424 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26143424?dopt=Abstract = URL to article

Augmented supraorbital skin sympathetic nerve activity responses to symptom trigger events in rosacea patients. J Neurophysiol. 2015 Jul 1;:jn.00458.2015 Authors: Metzler-Wilson K, Toma K, Sammons DL, Mann S, Jurovcik AJ, Demidova O, Wilson TE Abstract Facial flushing in rosacea is often induced by trigger events. However, trigger causation mechanisms are currently unclear. This study tested the central hypothesis that rosacea causes sympathetic and axon reflex mediated alterations resulting in trigger-induced symptomatology. Twenty rosacea patients and age/sex-matched controls participated in one or a combination of symptom triggering stressors. Protocol 1: Forehead skin sympathetic nerve activity (SSNA; supraorbital microneurography) was measured during sympathoexcitatory mental (2 min serial subtraction of novel numbers) and physical (2 min isometric handgrip) stress. Protocol 2: Forehead skin blood flow (laser-Doppler flowmetry) and transepithelial water loss/sweat rate (capacitance hygrometry) were measured during sympathoexcitatory heat stress (whole-body heating via perfusing 50°C water through a tube-lined suit). Protocol 3: Cheek, forehead, forearm, and palm skin blood flow were measured during non-painful local heating to induce axon reflex vasodilation. Heart rate and mean arterial pressure (MAP) were recorded via finger photoplethysmography to calculate cutaneous vascular conductance (CVC; flux*100/MAP). Higher patient transepithelial water loss was observed (rosacea=0.20±0.02 vs. control=0.10±0.01 mg/cm2/min, p<0.05). Heart rate and MAP changes were not different between groups during sympathoexcitatory stressors or local heating. SSNA during early mental (32±9 and 9±4% increase) and physical (25±4 and 5±1% increase, for rosacea and controls, respectively) stress was augmented in rosacea (both p<0.05). Heat stress induced more rapid sweating and cutaneous vasodilation onset in rosacea compared to controls. No axon reflex vasodilation differences were observed between groups. These data indicate that rosacea affects SSNA, and that hyper-responsiveness to trigger events appears to have a sympathetic component. PMID: 26133800 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26133800?dopt=Abstract = URL to article

Related ArticlesIdiopathic Facial Aseptic Granuloma: A Rare, Benign Pediatric Dermatological Lesion. Otolaryngol Head Neck Surg. 2015 Jun 30; Authors: Shams A, Stevens JR, Bowe SN PMID: 26129738 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26129738?dopt=Abstract = URL to article

Related ArticlesClinical evaluation of 30 patients with localized nasal rosacea. J Dermatol. 2015 Jul 1; Authors: Lee WJ, Lee YJ, Won CH, Chang SE, Choi JH, Lee MW Abstract The clinical features of localized nasal rosacea have not been described in detail. This study was designed to analyze the subtypes and severity of localized nasal rosacea. Our present study included 30 patients with localized nasal rosacea. The erythematotelangiectatic subtype (13/30, 43.3%) was the most common type, followed by the phymatous subtype (9/30, 30%). The duration of rosacea was shorter and the severity of localized nasal rosacea was lower in the erythematotelangiectatic subtype cases compared with the patients with mixed or phymatous subtypes. Almost all of the papulopustular eruptions or phymatous lesions were associated with erythematotelangiectatic lesions. These findings suggest that the erythematotelangiectatic subtype may be considered the initial phase of localized nasal rosacea. PMID: 26126724 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26126724?dopt=Abstract = URL to article

Related ArticlesIs the effect of smoking on rosacea still somewhat of a mystery? Cutan Ocul Toxicol. 2015 Jun 30;:1-5 Authors: Kucukunal A, Altunay I, Arici JE, Cerman AA Abstract CONTEXT: Rosacea is an inflammatory skin disease with a chronic course. In the past, the association between rosacea and smoking was examined only in a few studies. OBJECTIVE: The objective of this study is to investigate the prevalence and the influence of smoking in rosacea patients. MATERIALS AND METHODS: This prospective cross-sectional study includes 200 rosacea patients and 200 age- and gender-matched rosacea-free controls. Using National Rosacea Society Expert Committee classification, we divided patients into three subgroups as having erythematotelangiectatic (ETR), papulopustular (PPR), and phymatous rosacea (PhR). Demographic data, risk factors, and smoking habits were recorded. RESULTS: In multivariate analysis, the prevalence of smoking was significantly higher (66%) among patients compared with controls. ETR subtype (43.5%) was found to be significantly higher among active smokers (p < 0.001). Considering the risk factors, caffeine intake and alcohol consumption could not be evaluated because of their never or rarely intake. Whereas rates of photosensitive skin type and positive family history were significantly prominent in ETR patients (p < 0.001). While PhR was mostly detected in men who are very old, a significant tendency was found to develop ETR in women. CONCLUSION: While a significantly increased risk of developing rosacea among smokers was observed in this study, ETR seems to be the disease of active smokers. Further studies are required for better understanding of the association between rosacea and smoking. PMID: 26122087 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26122087?dopt=Abstract = URL to article

Related ArticlesSevere Granulomatous Rosacea in a Boy Successfully Treated with Topical Azelaic Acid. Indian J Dermatol. 2015 May-Jun;60(3):323 Authors: Mitoma C, Takahara M, Furue M PMID: 26120187 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/26120187?dopt=Abstract = URL to article

Related ArticlesThe Role of Topical Brimonidine Tartrate Gel as a Novel Therapeutic Option for Persistent Facial Erythema Associated with Rosacea. Dermatol Ther (Heidelb). 2015 Jun 26; Authors: Johnson AW, Johnson SM Abstract Rosacea is a chronic inflammatory skin condition that commonly presents with persistent facial erythema with or without the coincident presence of flushing, telangiectasias, inflammatory papules or pustules, phymatous changes, or ocular involvement. Patients often present with a constellation of various signs and symptoms of the disease, and an individualized treatment plan should be tailored to a patient's unique clinical presentation. Previously available medications for rosacea have all targeted the inflammatory erythematous papules and pustules frequently associated with the disease, leaving a therapeutic gap for the common manifestation of persistent facial erythema. Brimonidine tartrate 0.33% gel was approved by the US Food and Drug Administration in August 2013 as the first medication available for the topical treatment of persistent facial erythema associated with rosacea. Brimonidine gel is a highly selective α2-adrenergic receptor agonist with potent vasoconstrictive effects, which leads to significant reduction of persistent facial erythema in the majority of patients when applied once daily. Based on large-scale clinical trials and post-marketing reports, brimonidine gel has maintained a good safety profile with a minority of patients experiencing adverse effects from its use, most of which are cutaneous in nature, mild-to-moderate in degree, occur early after initiation of treatment, often resolve spontaneously with continued use, and generally resolve after discontinuation of use. Among the reported adverse effects, two distinct manifestations of worsened erythema have been described. Brimonidine gel can be integrated into a treatment regimen along with concomitant therapies for facial papules and pustules with no increased risk of adverse events with combination therapy. Education about optimal application methods, setting reasonable expectations for treatment, and minimizing inflammation are important factors for the successful use of brimonidine gel as part of a patient's overall rosacea treatment regimen. PMID: 26112098 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26112098?dopt=Abstract = URL to article

Related ArticlesRandomised controlled trial of topical kanuka honey for the treatment of rosacea. BMJ Open. 2015;5(6):e007651 Authors: Braithwaite I, Hunt A, Riley J, Fingleton J, Kocks J, Corin A, Helm C, Sheahan D, Tofield C, Montgomery B, Holliday M, Weatherall M, Beasley R Abstract OBJECTIVE: To investigate the efficacy of topical 90% medical-grade kanuka honey and 10% glycerine (Honevo) as a treatment for rosacea. DESIGN: Randomised controlled trial with blinded assessment of primary outcome variable. SETTING: Outpatient primary healthcare population from 5 New Zealand sites. PARTICIPANTS: 138 adults aged ≥16, with a diagnosis of rosacea, and a baseline blinded Investigator Global Assessment of Rosacea Severity Score (IGA-RSS) of ≥2. 69 participants were randomised to each treatment arm. 1 participant was excluded from the Honevo group, and 7 and 15 participants withdrew from the Honevo and control groups, respectively. INTERVENTIONS: Participants were randomly allocated 1:1 to Honevo or control cream (Cetomacrogol), applied twice daily for 8 weeks. MAIN OUTCOME MEASURES: The primary outcome measure was the proportion of participants who had a ≥2 improvement in the 7-point IGA-RSS at week 8 compared to baseline. Secondary outcomes included change in IGA-RSS and subject-rated visual analogue score of change in severity (VAS-CS) on a 100 mm scale (0 mm 'much worse', 100 mm 'much improved') at weeks 2 and 8. RESULTS: 24/68 (34.3%) in the Honevo group and 12/69 (17.4%) in the control group had a ≥2 improvement in IGA-RSS at week 8 compared to baseline (relative risk 2.03; 95% CI 1.11 to 3.72, p=0.020). The change in IGA-RSS for Honevo compared to control at week 2 minus baseline was -1 (Hodges-Lehman estimate, 95% CI -1 to 0, p=0.03), and at week 8 minus baseline was -1 (Hodges-Lehman estimate, 95% CI -1 to 0, p=0.005). The VAS-CS at week 2 was 9.1 (95% CI 3.5 to 14.7), p=0.002, and at week 8 was 12.3 (95% CI 5.7 to 18.9)¸ p<0.001 for Honevo compared to control. CONCLUSIONS: Honevo is an effective treatment for rosacea. TRIAL REGISTRATION NUMBER: This trial was registered in the Australian and New Zealand Clinical Trials Registry ACTRN12614000004662. PMID: 26109117 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/26109117?dopt=Abstract = URL to article

Personal history of rosacea and risk of incident cancer among women in the US. Br J Cancer. 2015 Jun 23; Authors: Li WQ, Zhang M, Danby FW, Han J, Qureshi AA Abstract BACKGROUND: Rosacea is an inflammatory skin disease. We examined the association between personal history of rosacea and risk of incident cancers. METHODS: A total of 75 088 whites were included from the Nurses' Health Study II (1991-2011). Information on clinician-diagnosed rosacea and diagnosis year was collected in 2005. All cancers other than basal cell carcinoma (BCC) were confirmed. RESULTS: During 1 447 205 person-years, we identified 5194 cases with internal malignancies and 5788 with skin cancers. We did not observe significant associations between personal history of rosacea and internal malignancies, except for thyroid cancer (hazard ratio (HR)=1.59, 95% confidence interval (CI)=1.07-2.36). Among skin cancers, personal history of rosacea was associated with an elevated risk of BCC (HR=1.50, 95% CI=1.35-1.67). CONCLUSIONS: We suggest possible associations between personal history of rosacea and an increased risk of thyroid cancer and BCC. Further studies are warranted to replicate our findings and to explore the underlying mechanisms.British Journal of Cancer advance online publication 23 June 2015; doi:10.1038/bjc.2015.217 www.bjcancer.com. PMID: 26103573 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26103573?dopt=Abstract = URL to article

Related ArticlesInterventions for rosacea: abridged updated Cochrane systematic review including GRADE assessments. Br J Dermatol. 2015 Jun 22; Authors: van Zuuren EJ, Fedorowicz Z Abstract Rosacea is a common chronic facial dermatosis. This update of our Cochrane review on interventions for rosacea summarises the evidence, including GRADE assessments, of the effects of the currently available treatments. Searches included: Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, MEDLINE, EMBASE, Science Citation Index, and ongoing trials registries (July 2014). One hundred six randomised controlled trials (RCT's) with 13,631participants were included, a more than 80% increase since the last update in 2011. Pooling of data was feasible for a few outcomes; for topical metronidazole and azelaic acid and both appeared to be more effective than placebo (moderate and high quality evidence respectively). Topical ivermectin was more effective than placebo based on two studies (high quality evidence), and slightly more effective than metronidazole in one study. Brimonidine was more effective than vehicle in reducing erythema in rosacea (high quality evidence). Cyclosporine ophthalmic emulsion was effective for ocular rosacea (low quality evidence). For oral treatments there was moderate quality evidence for the effectiveness of tetracycline based on two old studies, and high quality evidence for doxycycline 40 mg compared to placebo according to physician assessments. One study at high risk of bias demonstrated equivalent effectiveness for azithromycin and doxycycline 100 mg. Minocycline 45 mg may be effective for papulopustular rosacea (low quality evidence). Low-dose isotretinoin appeared to be slightly more effective than doxycycline 50-100 mg (high quality evidence). Laser and light-based therapies for erythema in rosacea were effective (low quality evidence). Further RCT's are required for ocular rosacea. This article is protected by copyright. All rights reserved. PMID: 26099423 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26099423?dopt=Abstract = URL to article

Related ArticlesDo tutorials on application method enhance adapalene-benzoyl peroxide combination gel tolerability in the treatment of acne? J Dermatol. 2015 Jun 20; Authors: Kwon HH, Park SY, Yoon JY, Min S, Suh DH Abstract Fixed-dose combination adapalene 0.1% and benzoyl peroxide 2.5% gel (A-BPO) has rarely been studied for Asian acne patients, while they have complained of local irritations more often when applying individual components. In this study, we compared A-BPO gel with benzoyl peroxide (BPO) in terms of efficacy and tolerability in Korean patients first, and assessed the clinical benefit of a dermatological tutorial on application technique in reducing irritations for A-BPO. This study was conducted as a single-blind controlled split-face trial for a 12-week period. Each half facial side of 85 patients was randomly assigned to either A-BPO or BPO. Success rate, lesion counts and safety profiles were evaluated (analysis I). During initial assignment, all patients were further randomized to either dermatological tutorial (DT) or non-tutorial (NT) subgroups depending on the presence of dermatologists' tutorials for application methods to their A-BPO sides. Clinical data of the A-BPO side was compared between two subgroups (analysis II). As a result, A-BPO gel outperformed BPO, demonstrating better efficacy in success rates and lesion counts as early as 1 week. However, A-BPO proved significantly less tolerable compared with both BPO and previous A-BPO data from Caucasians. Bioengineering measurements further confirmed clinical data (analysis I). The DT subgroup achieved much better tolerability with comparable therapeutic efficacies compared with the NT subgroup (analysis II). In conclusion, A-BPO demonstrated higher efficacies in acne compared with BPO in Korean patients, while skin irritation levels were notable concurrently. Dermatologists' education for application methods would significantly decrease these side-effects, maintaining superior efficacy levels. PMID: 26096777 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26096777?dopt=Abstract = URL to article

Severe Tacrolimus-Induced Granulomatous Rosacea Recalcitrant to Oral Tetracyclines. J Drugs Dermatol. 2015 Jun 1;14(6):628-630 Authors: Hu L, Alexander C, Velez NF, Yang C, Canales AL, Liu S, Vleugels RA Abstract Topical tacrolimus has been observed to induce granulomatous rosacea (GR) in prior case reports and series. In most cases, patients recover fully after withdrawing tacrolimus and initiating doxycycline or minocycline. Herein, we describe a case of severe GR, which required further therapy. Clinicians should be aware of this rare complication because of the frequent use of topical tacrolimus. <br /><br /> <em>J Drugs Dermatol. 2015;14(6):628-630.</em>. PMID: 26091390 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26091390?dopt=Abstract = URL to article

Dapsone Gel in the Treatment of Papulopustular Rosacea: A Double-Blind Randomized Clinical Trial. J Drugs Dermatol. 2015 Jun 1;14(6):602-606 Authors: Faghihi G, Khosravani P, Nilforoushzadeh MA, Hosseini SM, Assaf F, Zeinali N, Smiley A Abstract BACKGROUND: We aimed to evaluate the effects of 5% dapsone gel compared with 0.75% metronidazole gel in the treatment of papulopustular rosacea.<BR /> METHODS: In a double-blind randomized clinical trial, 56 adult patients with papulopustular rosacea were enrolled. The severity of disorder was determined by the patient according to visual analogue score (VAS). Investigator's global assessment (IGA) scores and number of inflammatory lesions were recorded. 5% dapsone gel was administered for group D and 0.75% metronidazole gel was administered for group M. Systemic doxycycline was administered for all patients. Follow-up assessments were done at 4, 8, and 12 weeks. Changes in VAS, IGA scores and number of lesions were evaluated. Intention to treat analysis was carried out using SPSS version 17 (Chicago, IL).<BR /> RESULTS: There was no significant difference in sex and age distribution between the two groups. Mean (SD) IGA score before and after intervention in group D was 3.9 (0.9) and 3.3 (0.9), respectively (<EM>P</EM>&lt;0.0001). Mean (SD) IGA score before and after intervention in group M was 4.2 (1.2) and 3.6 (1.3), respectively (<EM>P</EM>&lt;0.0001). Mean (SD) number of lesions before and after intervention in group D was 15 (7.4) and 11.1 (6), respectively (<EM>P</EM>&lt;0.0001). Mean (SD) number of lesions before and after intervention in group M was 17.6 (7.7) and 12.5 (7.4), respectively (<EM>P</EM>&lt;0.0001). Mean (SD) VAS score before and after intervention in group D was 6.6 (1.8) and 5.7 (1.9), respectively (<EM>P</EM>&lt;0.0001). Mean (SD) VAS score before and after intervention in group M was 6.9 (2.0) and 5.3 (2.1), respectively (<EM>P</EM>&lt;0.0001). Mean IGA score, mean number of lesions and mean VAS score were not significantly different between the two groups, whether before, during or after intervention.<BR /> CONCLUSION: Dapsone gel was as effective as metronidazole gel in the treatment of papulopustular rosacea.<BR /><BR /> <EM>J Drugs Dermatol</EM>. 2015;14(6):602-606. PMID: 26091386 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26091386?dopt=Abstract = URL to article

Treatment of Rosacea: Expert Insight on Trends and Best Practice. J Drugs Dermatol. 2015 Jun 1;14(6):546-547 Authors: Stein Gold L PMID: 26091377 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26091377?dopt=Abstract = URL to article

Management of Acne &amp; Rosacea: Working Toward the Same Goals…Facing New Challenges. J Drugs Dermatol. 2015 Jun 1;14(6):543 Authors: Del Rosso JQ PMID: 26091375 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26091375?dopt=Abstract = URL to article

Related Articles[NEW OPPORTUNITIES OF IPL-THERAPY IN COMPLEX TREATMENT OF THE ROSACEA VASCULAR FORMS]. Georgian Med News. 2015 Jun;(243):62-6 Authors: Svyatenko T, Starostina O Abstract From the numerous reasons of emergence of an eritema, face skin teleangiektaziya, the particular interest in practice of dermatovenereologists, cosmetologists represents such widespread disease, as a rosacea. Despite well described clinical stages of a disease and the fulfilled protocols of treatment, early manifestations of this pathology very often remain not distinguished. It promotes progressing of a disease and transition to heavier clinical forms. Pathogenesis the rosacea is considered as angioneurosis vessels of the person with prevalence of venous insufficiency. Prevalence of a rosacea among patients who address to dermatologists, to cosmetologists, causes need for development of correct protocols of prevention and treatment of these states with use of modern knowledge and equipment. Data of own supervision of authors in the period of 2014-2015 for 26 patients at the age of 23-49 years with a vascular form of a rosacea whom complex therapy joined an IPL technique are provided in article. Considering the available own experience of use of IPL systems, authors came to a conclusion that the technique conforms to all safety requirements and increases efficiency of treatment of a vascular form of a rosacea. PMID: 26087733 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/26087733?dopt=Abstract = URL to article

The practical usefulness of dermoscopy in general dermatology. G Ital Dermatol Venereol. 2015 Jun 18; Authors: Errichetti E, Stinco G Abstract Beside to traditional use, dermoscopy is more and more used in the assessment of other "general" dermatologic conditions, namely scalp and hair disorders (trichoscopy), nails abnormalities (onychoscopy), skin infections and infestations (entomodermoscopy), and cutaneous inflammatory diseases (inflammoscopy). Among the list of new applications of dermoscopy, the study of inflammatory dermatoses is probably the most promising topic in terms of development and usefulness, considering the large number of such disorders and the frequent problems in their differential diagnosis which the dermatologist encounters in own daily clinical practice. In this paper, we report selected relatively common clinical differential diagnosis issues concerning inflammatory dermatoses (and some clinically related noninflammatory conditions), analysing them by a dermoscopic point of view in order to assist their noninvasive resolution according to the available literature data and our personal experience, including papulosquamous dermatoses (guttate psoriasis, classic pityriasis lichenoides chronica, pityriasis rosea, lichen planus, lymphomatoid papulosis, pityriasis rubra pilaris, papulosquamous sarcoidosis, disseminated forms of porokeratosis and papulosquamous chronic GVHD), dermatoses presenting with erythematous-desquamative patches/plaques (plaque psoriasis, eczematous dermatitis, pityriasis rosea, mycosis fungoides, subacute cutaneous lupus erythematosus), palmar psoriasis vs chronic hand eczema, scalp psoriasis vs seborrheic dermatitis, erythematous-desquamative disorders typically involving the elbows (psoriasis vulgaris, circumscribed juvenile pityriasis rubra pilaris, dermatomyositis/Gottron's sign), itchy papulonodular dermatoses (hypertrophic lichen planus, prurigo nodularis, nodular scabies and acquired perforating dermatosis), common facial inflammatory skin diseases (rosacea, seborrheic dermatitis and demodicidosis), lichen sclerosus vs morphea, urticaria vs urticarial vasculitis and common inflammatory cicatricial alopecia (discoid lupus erythematosus, lichen planopilaris and folliculitis decalvans). PMID: 26086412 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26086412?dopt=Abstract = URL to article

Related ArticlesTreatment of ocular rosacea: comparative study of topical cyclosporine and oral doxycycline. Int J Ophthalmol. 2015;8(3):544-9 Authors: Arman A, Demirseren DD, Takmaz T Abstract AIM: To compare the effectiveness of topical cyclosporine A emulsion with that of oral doxycycline for rosacea associated ocular changes and dry eye complaints. METHODS: One hundred and ten patients with rosacea were screened. Thirty-eight patients having rosacea associated eyelid and ocular surface changes and dry eye complaints were included in the study. Patients were randomly divided into two groups: nineteen patients were given topical cyclosporine twice daily and nineteen patients were given oral doxycycline 100 mg twice daily for the first month and once daily for the following two months. Symptom and sign scores, ocular surface disease index questionnarie and tear function tests were evaluated at baseline and monthly for 3mo. Three months after results were compared with that of baseline. RESULTS: Mean values of symptom, eyelid sign and corneal/conjunctival sign scores of each treatment group at baseline and 3mo after treatments were compared and both drugs were found to be effective on rosacea associated ocular changes (P<0.001). Cyclosporine was more effective in symptomatic relief and in the treatment of eyelid signs (P=0.01). There was statistically significant increase in the mean Schirmer score with anesthesia and tear break up time scores in the cyclosporine treatment group compared to the doxycycline treatment group (P<0.05). CONCLUSION: Cyclosporine as a topical drug can be used in the treatment of rosacea associated ocular complications because it is more effective than doxycycline. In addition ocular rosacea as a chronic disease requires long term treatment and doxycycline has various side effects limiting its long term usage. PMID: 26086005 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/26086005?dopt=Abstract = URL to article

Erythema in Skin Adjacent to Area of Long-term Brimonidine Treatment for Rosacea: A Novel Adverse Reaction. JAMA Dermatol. 2015 Jun 17; Authors: Gillihan R, Nguyen T, Fischer R, Rajpara A, Aires D PMID: 26083825 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26083825?dopt=Abstract = URL to article

Related Articles[Rosacea fulminans in pregnancy]. Ned Tijdschr Geneeskd. 2015;159(0):A8334 Authors: Haenen CC, Kouwenhoven ST, van Doorn R Abstract We present a 38-year-old woman who suddenly developed erythema with follicular papules and pustules on her face during the second trimester of pregnancy. The diagnosis 'rosacea fulminans' was made. This is an uncommon skin condition that predominantly affects younger women. Treatment with erythromycin was successful. PMID: 26058762 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/26058762?dopt=Abstract = URL to article

Related ArticlesPyridoxine induced rosacea-like dermatitis. Acta Clin Croat. 2015 Mar;54(1):99-102 Authors: Rezaković S, Mokos ZB, Paštar Z Abstract Rosacea is a common chronic inflammatory cutaneous disease of unknown etiology, characterized by remissions and exacerbations, presenting with centrofacial erythema and telangiectasias. It affects mainly adults around the age of 30 years and classically predominates in females. The pathophysiology of rosacea has not yet been fully understood. Risk factors are positive family history, very light skin phototype, sun exposure and consumption of spicy food or alcohol. Recently, there has been some evidence that some drugs or vitamins could be potential factors that can aggravate rosacea or induce rosacea-like symptoms. In this context, we present a 53-year-old female developing rosacea-like dermatitis due to a fixed combination of isoniazid and pyridoxine, which she was receiving along with rifampicin for the treatment of pulmonary tuberculosis. PMID: 26058251 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/26058251?dopt=Abstract = URL to article

Intense pulsed light therapy for the treatment of evaporative dry eye disease. Curr Opin Ophthalmol. 2015 Jul;26(4):314-318 Authors: Vora GK, Gupta PK Abstract PURPOSE OF REVIEW: Evaporative dry eye disease is one of the most common types of dry eye. It is often the result of chronic meibomian gland dysfunction (MGD) and associated ocular rosacea. Evaporative dry eye and MGD significantly reduce patient's quality of life. Traditional treatments, such as artificial tears, warm compresses, and medications, such as topical cyclosporine, azithromycin, and oral doxycycline, provide some relief; however, many patients still suffer from dry eye symptoms. Intense pulsed light (IPL) therapy, which has been used extensively in dermatology to treat chronic skin conditions, is a relatively new treatment in ophthalmology for patients with evaporative dry eye disease. RECENT FINDINGS: There are very few studies published on the use of IPL in patients with dry eye disease. The present review describes the theoretical mechanisms of IPL treatment of MGD and ocular rosacea. Personal clinical experience and recently presented data are reported as well. SUMMARY: IPL therapy has promising results for evaporative dry eye patients. There are statistically significant improvements in clinical exam findings of dry eye disease. More importantly, patients report subjective improvement in their symptoms. More research is needed in this area to help understand the mechanism of dry eye disease and how it can be effectively treated. PMID: 26058031 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/26058031?dopt=Abstract = URL to article