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  1. 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
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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
  15. 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
  16. Related Articles Granulomatous rosacea mimicking eyelid dermatitis. Indian J Dermatol Venereol Leprol. 2005 Sep-Oct;71(5):366-5 Authors: Ajith C, Dogra S, Radotra BD, Handa S PMID: 16394471 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  17. Related Articles Rosacea: a potential complication of expanded flaps. Dermatol Surg. 2006 Jan;32(1):167-8 Authors: Scevola S, Nicoletti G, Faga A PMID: 16393621 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  18. Related Articles Morbidity of over-the-counter topical steroids. J Am Acad Dermatol. 2006 Jan;54(1):182; author reply 182-3 Authors: Tackett BN, Smith MC, Nedorost ST PMID: 16384783 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  19. Related Articles Adverse effects of topical glucocorticosteroids. J Am Acad Dermatol. 2006 Jan;54(1):1-15; quiz 16-8 Authors: Hengge UR, Ruzicka T, Schwartz RA, Cork MJ Topical corticosteroids were introduced into medicine about 50 years ago. They represent a significant milestone in dermatologic therapy. Despite encouragement to report observed adverse drug reactions, the clinical practice of reporting is poor and incomplete. Likewise, adverse effects and safety of topical corticosteroids are neglected in the medical literature. The authors provide an updated review of their adverse-effect profile. Children are more prone to the development of systemic reactions to topically applied medication because of their higher ratio of total body surface area to body weight. Cutaneous adverse effects occur regularly with prolonged treatment and are dependent on the chemical nature of the drug, the vehicle, and the location of its application. The most frequent adverse effects include atrophy, striae, rosacea, perioral dermatitis, acne, and purpura. Those that occur with lower frequency include hypertrichosis, pigmentation alterations, delayed wound healing, and exacerbation of skin infections. Of particular interest is the rate of contact sensitization against corticosteroids, which is considerably higher than generally believed. Systemic reactions such as hyperglycemia, glaucoma, and adrenal insufficiency have also been reported to follow topical application. The authors provide an updated review of local and systemic adverse effects upon administration of topical corticosteroids, including the latest FDA report on the safety of such steroids in children. LEARNING OBJECTIVE: At the completion of this learning activity, participants should be familiar with topical corticosteroids and their proper use. PMID: 16384751 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  20. Related Articles Azithromycin in the treatment of papulopustular rosacea. J Dermatol. 2005 Nov;32(11):926-8 Authors: Dereli T, Inanir I, Kilinç I, Genço√Ñ≈âˆlan G PMID: 16361757 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  21. Related Articles Rosacea, acne rosacea, and actinic telangiectasia: in reply. J Am Acad Dermatol. 2005 Dec;53(6):1103-4 Authors: Odom R, PMID: 16310093 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  22. Related Articles [Periorbital contact eczema] Klin Monatsbl Augenheilkd. 2005 Nov;222(11):853-5 Authors: Worm M, Sterry W Periorbital contact eczema is most commonly the result of an allergic contact dermatitis whereas other eczematous skin diseases like atopic eczema or seborrheic eczema occur less frequently. Also, other diseases like autoimmune disorders or rosacea need to be considered. Allergic contact dermatitis is a T-cell-mediated immunological response towards ubiquitous contact allergens. Activated T-cells migrate through the vessels into the skin and produce several inflammatory mediators. Epicutaneous patch testing is an important tool for the diagnosis of contact allergy whereby the allergens are analysed in terms of their ability to induce eczematous skin reaction. Until now the short-term use of corticosteroids are is employed for the treatment of allergic contact eczema. Modern substances with an optimal therapeutic index should rather be used. PMID: 16308815 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  23. Related Articles Treatment of erythematotelangiectactic rosacea with a KTP YAG laser. J Drugs Dermatol. 2005 Nov-Dec;4(6):760-2 Authors: Miller A The flushing and telangiectasias associated with rosacea are notoriously difficult to treat with standard medications. Newer technologies, namely medical lasers and light sources, have made it possible to control and improve erythematotelangietatic signs of rosacea. The potassium-titanyl-phosphate laser in particular is an efficacious and safe tool for treatment of this disease. PMID: 16302564 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  24. Related Articles Therapeutic response of rosacea to dobesilate. Eur J Med Res. 2005 Oct 18;10(10):454-6 Authors: Cuevas P, Arrazola JM Despite an incomplete understanding of the pathogenesis of rosacea, therapeutic modalities continue to expand. The principal subtype of rosacea includes erythematotelangiestatic rosacea, which is characterized by uncontrolled angiogenesis. Angiogenic growth factors such as fibroblast growth factors (FGF) and vascular endothelial growth factor (VEGF) are currently targets of intense effort to inhibit deregulated blood vessel formation in diseases such as cancer. Here we report a 33-years-old woman with erythematotelangestatic rosacea who responds to a daily treatment of topically applied dobesilate, an inhibitor of FGF, with an improvement in erythema and telangectasia after two weeks. Thus, dobesilate might be useful in the treatment of rosacea and other diseases that depend on pathologic angiogenesis. PMID: 16287608 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
  25. Related Articles Autosomal dominant familial chronic mucocutaneous candidiasis associated with acne rosacea. Ann Acad Med Singapore. 2005 Oct;34(9):571-4 Authors: Ee HL, Tan HH, Ng SK INTRODUCTION: Autosomal dominant chronic mucocutaneous candidiasis (CMC) without endocrinopathy (OMIM 114580) is a well-described entity. The associations recorded with this disorder to date are intercellular adhesion molecule-1 (ICAM-1) deficiency and hyper-immunoglobulin E syndrome. CLINICAL PICTURE: We report a new association in a family (mother and nonidentical twin sons) where acne rosacea is a prominent feature together with CMC. In addition, antibodies to thyroid microsomal and antiparietal cell were also isolated. The autoantibodies might be associated with a current "latent" endocrinopathy in particular autoimmune thyroiditis. TREATMENT: The patient was treated with intermittent pulses of itraconazole for the candidiasis and doxycycline initially before being substituted with isotretinoin 6 months later for the rosacea. OUTCOME: The patient's candidiasis responded well and has been in remission for 3 months while his rosacea continues to improve. PMID: 16284681 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/entrez/query.f...p;dopt=Abstract = URL to article
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