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  1. Anti-Inflammatory Activity of Tetracyclines. Dermatol Clin. 2007 Apr;25(2):133-135 Authors: Webster G, Del Rosso JQ Tetracyclines are known to exhibit multiple significant anti-inflammatory actions. This article describes the mechanisms of this anti-inflammatory activity, such as inhibition of chemotaxis, granuloma formation, and protease. The article also discusses the effectiveness of tetracyclines in treating such diseases as acne vulgaris, rosacea, bullous dermatoses, granulomatous disease, and livedo vasculitis. PMID: 17430750 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  2. Objective Evaluation of the Effect of Intense Pulsed Light on Rosacea and Solar Lentigines by Spectrophotometric Analysis of Skin Color. Dermatol Surg. 2007 Apr;33(4):449-454 Authors: Kawana S, Ochiai H, Tachihara R BACKGROUND To date, intense pulsed light (IPL) has been applied to various skin diseases, but there have been few objective evaluations of its efficacy. OBJECTIVE The aim of this study was to perform objective evaluations of the effect of the IPL system on rosacea and solar lentigines. METHODS Twelve patients with rosacea were treated with IPL at the wavelength of 550 to 670 nm, three times every 4 weeks, and the skin color was determined with L(*)a(*)b(*) color space using a spectrophotometer. In addition, 18 patients with solar lentigines were treated once, and the lightness L(*) was determined. RESULTS In all of 6 erythematotelangiectatic rosacea patients and in 5 of 6 papulopustular rosacea patients, each of the L(*)a(*)b(*) values of the posttreated lesions approached those of normal skin areas (efficacy rate, 91.6%). The mean level of the L(*)a(*)b(*) values improved significantly after treatment and particularly in the erythematotelangiectatic rosacea patients. In 12 of 18 patients with solar lentigines, the lightness L(*) was elevated after treatment (efficacy rate, 66.6%). CONCLUSION As demonstrated by spectrophotometric analysis of skin color, IPL at the wavelength of 550 to 670 nm is effective for rosacea and solar lentigines, particularly most useful for erythematotelangiectatic rosacea. PMID: 17430379 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  3. Related Articles [Oxytetracycline--mechanism of action and application in skin diseases] Wiad Lek. 2006;59(11-12):829-33 Authors: Olszewska M Oxytetracycline is a bacteriostatic antibiotic. Newly discovered, additional mechanisms of action include antioxidant, antiinflammatory and immynosupresive activity of oxytetracycline and other tetracyclines. These activities were the basis for developing therapy regimens with oxytetracycline in subantimicrobial doses. Due to its significant efficacy, limited adverse effects and low therapy costs, oxytetracycline at the dose of 500 mg per day is presently considered as therapy of choice in papulopustulous acne. Rosacea and perioral dermatitis are other indications. Topical oxytetracycline shows significant efficacy in primary and secondary skin infections with inflammatory reaction. PMID: 17427500 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  4. Related Articles Rosacea and the pilosebaceous follicle. Cutis. 2004 Sep;74(3 Suppl):9-12, 32-4 Authors: Powell FC The pathophysiology of rosacea remains unknown. A leading theory suggests a vascular basis; however, clinical observations and histopathologic studies suggest that inflammation of the pilosebaceous follicle may be central to the pathogenesis of rosacea. Demodex folliculorum is a frequently seen commensal in the follicles of facial skin. According to evidence from biopsies of the skin surface, individuals with rosacea have a higher density of this parasite. This increased mite density may play a role in the pathophysiology of rosacea by triggering inflammatory or specific immune reactions, mechanically blocking the follicles, or acting as a vector for bacteria. Ongoing research has shown that bacteria from patients with rosacea may behave differently at the higher skin temperature that may be present in patients with rosacea. Another group has isolated bacteria from the Demodex mites; these bacteria may play a pathogenic role in papulopustular rosacea by facilitating follicular-based inflammatory changes. PMID: 15499752 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  5. Related Articles Rosacea as an inflammatory disorder: a unifying theory? Cutis. 2004 Jan;73(1 Suppl):5-8 Authors: Millikan LE Rosacea is increasingly being viewed as an immune-based disorder. Various immune factors, such as eicosanoids, proinflammatory cytokines, and polymorphonuclear leukocytes, appear to be involved in the vascular, inflammatory, and proliferative subtypes of this disorder. Many pharmacologic agents that effectively treat the symptoms of rosacea show anti-inflammatory and/or immunomodulating effects, providing further evidence that rosacea is an inflammatory disorder. PMID: 14959939 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  6. Related Articles Excision of rhinophyma with a laser scanner handpiece--a modified technique. Rhinology. 2002 Jun;40(2):83-7 Authors: Skoulakis CE, Papadakis CE, Papadakis DG, Bizakis JG, Kyrmizakis DE, Helidonis ES Rhinophyma is a slowly progressive, benign dermatological disorder of the tip of the nose. The most widely accepted theory is that rhinophyma is the end stage result of chronic acne rosacea. The primary reason for excision of rhinophyma is cosmetic deformity. However, nasal obstruction may present, as rhinophyma may obstruct nasal vestibules. Surgery is the treatment of choice for rhinophyma. Medical therapy has not given satisfactory results. The surgical treatment modalities are divided into two main groups. The first is complete excision, with primary closure for small lesions, or skin grafting for large lesions. The second group includes incomplete excision followed by re-epithelialization from the remaining glandular epithelium. The carbon dioxide (CO2) laser has been advocated for excision of rhinophyma. Newer instrumentation, such as Swiftlase and SurgiTouch (ESC Sharplan) or Ultrapulse (Coherent) is more effective in vaporization and carbonization resulting in better hemostasis (Ries and Speyer, 1996). In this report, 7 patients with rhinophyma treated with the Swiftlase are reviewed. The surgical technique, the complications and the follow-up are discussed. PMID: 12091999 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  7. Related Articles Stinging and rosacea. Acta Derm Venereol. 1999 Nov;79(6):460-1 Authors: Lonne-Rahm SB, Fischer T, Berg M A total of 32 rosacea patients (25 with the papulopustular type of rosacea and 7 with the erythematotelangiectatic type) and 32 healthy persons were single-blind tested with a solution of 5% lactic acid and pure water applied to their cheeks. Twenty-four patients and 6 controls reacted positively as "stingers" (p<0.001) in this objective test of sensitive skin. All 7 of the patients with erythematotelangiectatic rosacea, but only 17/25 with the papulopustular type, were stingers (n.s.). The reason why some patients react with subjective symptoms, such as itching, burning, stinging, prickling or tingling, is unclear. The findings in this study are not surprising, but do support the theory that impairment due to different stimuli, most likely because of vascular sensitivity, is a central mechanism in the aetiology of rosacea. The correlation between sensitive vessels and sensitive skin has, however, not yet been determined. PMID: 10598761 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  8. Related Articles [Neighboring forms of allergy.] J Fr Ophtalmol. 2007 Mar;30(3):306-13 Authors: Baudouin C Chronic allergic conjunctivitis constitutes a complex ocular surface disease involving many mechanisms, extending well beyond the simple field of mast cells and IgE. Lacrimal film, the eyelids, the environment, especially iatrogenic in origin, closely interact with each other and involve many cell systems such as goblet cells, eosinophils, and lymphocytes. It is therefore imperative to reach a better understanding of the mechanisms associated and eliminate confounding pathologies that may mimic allergic conjunctivitis. Dry eye syndrome or rosacea may be very close to chronic allergic diseases, and long-term use of preservative-containing eyedrops may result in inflammatory reactions that may be very difficult to discriminate from a primarily allergic disease. PMID: 17417159 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  9. Related Articles [The vicious circle in dry eye syndrome: a mechanistic approach.] J Fr Ophtalmol. 2007 Mar;30(3):239-46 Authors: Baudouin C The mechanistic view of dry eye disease aims at completing the classic etiological approach that classifies the disease as parallel ocular surface disorders leading to lacrimal film impairment and dry eye. This approach proposes two levels of ocular surface impairment (with standard etiologies, previously validated in the NEI/Industry workshop), which may not be independent diseases but rather risk factors and/or ways to enter a self-stimulated biological process involving the ocular surface. All external disorders proposed in this model, although unlikely to be fully exhaustive, are classical mechanisms considered to be causes of tear film impairment and ocular surface damage, by tear instability and evaporation, tear hyposecretion, or both. These mechanisms, sometimes alone - when severe or becoming chronic or repeatedly present on the ocular surface and when two or more are present - may cause the patient to enter the self-stimulated loop. Tear film instability/imbalance can be considered as the key point of dry eye disease. It will cause local or diffuse hyperosmolarity of the tear film and therefore of superficial epithelial cells of the cornea and/or conjunctiva, stimulating epithelial cells and resident inflammatory cells. Cell damage in the cornea and conjunctiva, by means of apoptosis and direct mechanical and/or osmotic stress, will stimulate the reflex neurosensory arc, in turn stimulating lacrimal gland and neurogenic inflammation, with inflammatory cytokine release, MMP activation, and inflammatory involvement of the conjunctival epithelium. Goblet cell loss is thus directly related to chronic inflammation and surface cell apoptosis subsequent to cell hyperosmolarity and chronic damage, resulting in further tear film instability/imbalance. On the other hand, bacterial changes and an imbalance resulting from specific diseases or from tear film abnormalities may trigger release of endotoxins, lipopolysaccharides, and/or lipase activation, causing eyelid inflammation, meibomian gland dysfunction, and lipidic changes, directly influencing tear film stability and favoring tear evaporation. The lipidic hypothesis therefore participates in the vicious circle as a parallel, independent, or complementary loop. This mechanistic approach proposes a synthetic combination of mechanisms previously validated independently, with two levels of ocular surface impairment, a first level including many possible acute or chronic causes that favor or trigger the imbalance and can be reversible if correctly and specifically managed when possible, and the further involvement of a series of biological cascades centered by tear film imbalance and inflammatory stimulation, finally acting as an independent vicious circle, however the patient entered the loop. Clinically, this approach may explain examples of dry eye syndrome occuring after ocular surgery, contact lens wear, chronic allergy or systemic or topical drugs, and the long-lasting effect even though all causal factors have been removed or have disappeared. This model should be considered as a basis for further reflection on biological mechanisms that could be even more complex but individually constitute potential leads for targeting therapeutic strategies to allow patients to leave the loop even though the triggering factors are still present or can only be attenuated, such as in Sjögren syndrome or ocular rosacea. It also should be considered a complement to more classic etiological and severity classifications aimed at understanding and classifying the large number of diseases that may cause dry eye disease and better assessing the major impairment it causes on the patient's quality of life. PMID: 17417148 [PubMed - in process] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  10. Related Articles Gel vehicles are not inherently more irritating than creams. J Drugs Dermatol. 2006 Mar;5(3):269-72 Authors: Kirkland CR, Yelverton CB, Fleischer AB, Camacho FT, Feldman SR BACKGROUND: It has been thought that topical gels are inherently more irritating than topical creams. Nevertheless, the irritancies of topical products are potentially quite variable, and a priori assumptions about relative irritancy of gels versus creams may not be accurate. PURPOSE: To determine whether a metronidazole gel formulation is more or less irritating to the skin compared to metronidazole creams. METHODS: A total of 32 normal, healthy volunteers were tested using irritancy patches with 0.75% metronidazole gel and cream, 1% metronidazole cream, and petrolatum (used as the "negative control"). Blinded observers evaluated the application sites for signs of irritancy. A numerical score was assigned to these irritancy patch sites each day for 21 days, or until significant irritation developed, and cumulative irritancy scores were calculated for the study period. A mixed model of variance analysis was performed. RESULTS: After 21 days of evaluation, analysis of the mean cumulative irritancy scores for each of the agents used showed there to be no statistical difference in irritancy potential between the metronidazole gel and the metronidazole creams. However, the 1% metronidazole cream was significantly more irritating than petrolatum. CONCLUSION: There was no significant difference in the cumulative irritancy potential of cream and gel preparations of metronidazole. The irritancy of topical formulations for treating rosacea should be considered on a case by case basis. PMID: 16573261 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  11. Related Articles The use of topical azelaic acid for common skin disorders other than inflammatory rosacea. Cutis. 2006 Feb;77(2 Suppl):22-4 Authors: Del Rosso JQ Topical azelaic acid (AzA) is approved for the treatment of acne vulgaris and inflammatory (papulopustular) rosacea. Because of diverse mechanisms of action that correlate with potential therapeutic benefit, AzA has been used to treat several common dermatoses including acne vulgaris, inflammatory rosacea, erythematotelangiectatic rosacea, perioral dermatitis, melasma, and postinflammatory hyperpigmentation. This article reviews the therapeutic use of topical AzA for the treatment of common skin disorders other than the US Food and Drug Administration (FDA)-approved indications of acne vulgaris and inflammatory rosacea. PMID: 16566285 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  12. Related Articles Case studies. Cutis. 2006 Feb;77(2 Suppl):17-21 Authors: Bikowski JB PMID: 16566284 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  13. Related Articles A clinical overview of azelaic acid. Cutis. 2006 Feb;77(2 Suppl):12-6 Authors: Elewski B, Thiboutot D Azelaic acid (AzA) initially was released in a 20% cream formulation, which has been shown to be effective in the treatment of mild to moderate rosacea. Recently, a 15% gel formulation was developed that vastly improved the delivery of AzA and has been proven by multiple studies to be effective in the treatment of rosacea. We present studies that examine both of these formulations, first in comparison with their vehicles and then in contrast with other well-accepted topical treatments of rosacea, such as metronidazole cream and gel. PMID: 16566283 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  14. Related Articles The evolution of azelaic acid. Cutis. 2006 Feb;77(2 Suppl):4-6 Authors: Fleischer AB Azelaic acid (AzA) is a naturally occurring dicarboxylic acid that has a long and complex history in the treatment of skin disorders. We summarize research on AzA from the past 25 years and follow its progress from a treatment of hyperpigmentation to a therapy for acne vulgaris and inflammatory (papulopustular) rosacea. PMID: 16566281 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  15. Related Articles Rosacea. A manageable condition. Mayo Clin Health Lett. 2006 Mar;24(3):7 Authors: PMID: 16566076 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  16. Related Articles Down-regulating causes of fibrosis with tamoxifen: a possible cellular/molecular approach to treat rhinophyma. Ann Plast Surg. 2006 Mar;56(3):301-5 Authors: Payne WG, Ko F, Anspaugh S, Wheeler CK, Wright TE, Robson MC Fibrosis and proliferative scarring are prominent features of the severe forms of rhinophyma. Up-regulation of growth and fibroblast kinetics are hallmarks of fibrosis. Persistent overexpression or dysregulated activation of the fibrogenic isoforms of transforming growth factor beta (TGF-beta) is associated with the increased fibroblast function leading to fibrotic conditions such as rhinophyma. Tamoxifen, a synthetic nonsteroidal antiestrogen, can neutralize or down-regulate TGF-beta. Fibroblast-populated collagen lattices (FPCLs) were constructed from fibroblasts cultured from rhinophyma or normal nasal skin. One-half of each set of FPCLs was treated with Tamoxifen. Lattice contraction was serially measured over 5 days, and the supernatants of the cultures were analyzed for TGF-beta-2 by immunoassay. Tamoxifen significantly decreased fibroblast activity by decreasing contraction of the treated lattices (P < 0.05) and significantly decreased the production/secretion of TGF-beta-2 by rhinophyma fibroblasts (P < 0.001). These results suggest a possible new cellular/molecular approach to the treatment of the fibrotic varieties of rhinophyma. PMID: 16508362 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  17. Related Articles The use of photodynamic therapy in dermatology: results of a consensus conference. J Drugs Dermatol. 2006 Feb;5(2):140-54 Authors: Nestor MS, Gold MH, Kauvar AN, Taub AF, Geronemus RG, Ritvo EC, Goldman MP, Gilbert DJ, Richey DF, Alster TS, Anderson RR, Bank DE, Carruthers A, Carruthers J, Goldberg DJ, Hanke CW, Lowe NJ, Pariser DM, Rigel DS, Robins P, Spencer JM, Zelickson BD Photodynamic therapy (PDT) has significant promise in improving outcomes of patients with a variety of cutaneous conditions. A group of experts met to review the principles, indications, and clinical benefits of PDT with 5-aminolevulinic acid (ALA). They also reviewed PDT with methyl aminolevulinate. The experts established consensus statements for pretreatment, posttreatment, ALA contact time, light sources, and numbers of sessions associated with ALA PDT for actinic keratosis and superficial basal cell carcinoma, photorejuvenation and cosmetic enhancement, acne, sebaceous skin, rosacea, and rhinophyma. They based consensus recommendations on their clinical experience and the medical literature. They also suggested future applications of ALA PDT. Experts concluded that ALA PDT is a safe and effective modality for the treatment of conditions commonly encountered in dermatology. Since downtime is minimal, the technique is suitable for patients of all ages and lifestyles. Appropriate light sources are available in many dermatology offices. The expanding clinical and financial benefits of PDT justify the purchase of an appropriate light source. PMID: 16485882 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  18. Related Articles Photodynamic therapy for the treatment of erythema, papules, pustules, and severe flushing consistent with rosacea. J Drugs Dermatol. 2006 Feb;5(2 Suppl):6-8 Authors: Katz B, Patel V We report a case of a 45-year-old woman who presented with facial erythema, papules, pustules, and severe flushing consistent with rosacea. The patient had failed standard pharmacologic treatments. The patient's flushing was so severe that she had undergone an elective sympathectomy. She received 6 sessions of photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA as Levulan Kerastick, Dusa Pharmaceuticals) given at 2-week intervals. Improvement was evident after the second treatment and was considered "excellent" after the sixth treatment. Improvement continued and no flares were observed 1 month after the final treatment. PMID: 16485874 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  19. Related Articles Laser and light therapies for acne rosacea. J Drugs Dermatol. 2006 Jan;5(1):35-9 Authors: Butterwick KJ, Butterwick LS, Han A Acne rosacea is a multifactorial, somewhat mercurial disorder that can be a challenge to control with standard pharmacologic agents. Laser and light sources have been increasingly utilized, particularly for control of the generalized erythema, flushing, and telangiectasia of rosacea. This paper will review the clinical studies presented in the literature specifically treating patients with rosacea. Long-pulsed dye lasers and intense pulsed light devices can offer patients effective treatment without the purpura of short-pulsed dye lasers. Long-term efficacy has not been studied but maintenance therapy may be necessary to control the vascular manifestations of this disease. PMID: 16468290 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  20. Related Articles Treatment of rosacea with herbal ingredients. J Drugs Dermatol. 2006 Jan;5(1):29-32 Authors: Wu J Since rosacea is a chronic disease and many patients find prescription therapies unsatisfactory, they frequently turn to herbal ingredients for relief of their persistent facial redness. The most useful and frequently used herbal compounds include licorice, feverfew, green tea, oatmeal, lavender, chamomile, tea tree oil, and camphor oil. The utility of most of these herbs is based on their purported anti-inflammatory properties. Some of these herbs have proven effects, many have potential benefits, and some may aggravate rosacea. Due to the fact that many patients fail to inform their physicians about their use of herbal ingredients, dermatologists should be aware of what patients may be using and be able to advise them about the efficacy of these ingredients or the potential for adverse effects. PMID: 16468289 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  21. Related Articles Topical therapies for rosacea. J Drugs Dermatol. 2006 Jan;5(1):23-6 Authors: Nally JB, Berson DS Therapeutic options for rosacea include topical agents, oral therapies, laser and light treatments, and surgical procedures. Topical therapies play a critical role in the treatment of patients with papulopustular rosacea and erythematotelangiectatic rosacea, and have the ability to effectively minimize certain manifestations of the disease, including papules, pustules, and erythema. The 3 primary agents for the topical treatment of rosacea are metronidazole, azelaic acid, and sodium sulfacetamide-sulfur. Each of these therapies is approved for the treatment of rosacea and has been validated by multiple studies. Additional topical therapies including benzoyl peroxide, clindamycin, retinoids, topical steroids, calcineurin inhibitors, and permethrin are not approved for the treatment of rosacea and play variable roles in the management of this condition. PMID: 16468288 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  22. Related Articles Clinical management of chronic disease. J Drugs Dermatol. 2006 Jan;5(1):7 Authors: Lupo M PMID: 16468285 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  23. Related Articles Laser treatment of vascular lesions. Clin Dermatol. 2006 Jan-Feb;24(1):8-15 Authors: Railan D, Parlette EC, Uebelhoer NS, Rohrer TE Laser treatment of vascular lesions remains one of the more common applications of lasers in dermatology. In fact, lasers have largely become the treatment of choice for vascular birthmarks such as hemangiomas and port-wine stains and the definitive treatment of the telangiectatic form of rosacea. The range of congenital and acquired vascular lesions effectively treated with lasers continues to expand. PMID: 16427501 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  24. Related Articles Tear fluid levels of MMP-8 are elevated in ocular rosacea--treatment effect of oral doxycycline. Graefes Arch Clin Exp Ophthalmol. 2006 Aug;244(8):957-62 Authors: Määttä M, Kari O, Tervahartiala T, Peltonen S, Kari M, Saari M, Sorsa T BACKGROUND: Ocular rosacea (OcR) is a chronic inflammatory disease especially affecting lid margins. Previous studies have shown that it is accompanied by increased levels and activation of tear fluid gelatinases. Matrix metalloproteinase 8 (MMP-8; collagenase 2) levels and activation are commonly elevated in many inflammatory conditions. Therefore we studied here whether MMP-8 concentration and activation in tear fluid are increased also in OcR, and if an oral doxycycline regimen could rectify the situation. METHODS: Tear fluid samples were collected from 22 OcR patients and 22 healthy controls. The OcR patients were then treated with an oral doxycycline regimen for 8 weeks and tear fluid samples collected again after 4 and 8 weeks. Conjunctival brush cytology and patients' subjective symptoms were scored. MMP-8 concentrations in the tear fluid were assessed by immunofluorometric assay and the molecular forms and isoenzyme expression of MMP-8 were studied by Western immunoblotting. RESULTS: The mean MMP-8 concentration was statistically significantly higher in OcR (156.8+/-207.4 mug/ml) than in the normal subjects (53.5+/-66.7 mug/ml) (P=0.036), but decreased to 79.2+/-141.6 mug/l and 53.6+/-75.2 mug/l after 4 and 8 weeks doxycycline treatment, respectively. There was a statistically significant difference between the untreated OcR and the MMP-8 results after 4 or 8 weeks of oral doxycycline (P=0.041 and 0.069, respectively) and the OcR patients experienced statistically significant relief of their subjective symptoms (P=0.0001) after the doxycycline regimen. Both the normal and OcR tear fluid contained the larger, 60-80 kDa highly- glycosylated polymorphonuclear leukocyte-type MMP-8 isoform in Western immunoblotting, but not the 45-55 kDa less glycosylated mesenchymal-type isoform. MMP-8 activation was in practice present only in the OcR samples, and was inhibited by oral doxycycline. CONCLUSIONS: MMP-8 concentration and activation degree in tear fluid are increased in OcR, probably reflecting increased inflammatory activity. Doxycycline effectively reduces these pathologically excessive levels and activation of MMP-8, and relieves patients' subjective symptoms. PMID: 16411105 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  25. Related Articles [staphylococcal endophthalmitis following cataract surgery in a patient with ocular rosacea] J Fr Ophtalmol. 2005 Nov;28(9):981 Authors: Gicquel JJ, Quinton J, Salama B, Pommeraud D, Dighiero P PURPOSE: To report staphylococcal endophthalmitis following cataract surgery in a patient with ocular rosacea. OBSERVATION: A 69-year-old man presented with decreased visual acuity in the right eye, a corneal abscess on the incision and hypopyon 2 weeks after phacoemulsification with intraocular lens placement. The patient was hospitalized. A diagnostic vitreous tap was performed. Antibiotic therapy was initiated both locally (two intravitreal shots + topical administration) and intravenously. RESULTS: Vitreal tap cultures indicated Staphylococcus aureus. The patient's clinical status improved 48 hours after the second intravitreal shot. The same bacterium was cultured from the patient's eyelids and incision abscess. Multilayer amniotic membrane transplantation enabled satisfactory healing of the corneal abscess, which had become perforative. CONCLUSIONS: The source of the S. aureus was the skin lesions on the patient's eyelids. Rosacea is a skin disease that frequently affects the face, nose and eyelids. Although good surgical techniques were performed, with the incision requiring suture, the risk of endophthalmitis after intraocular surgery was increased in the absence of proper preoperative treatment of the dermatological condition. PMID: 16395213 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
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