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Primary Cutaneous Spindle Cell B-Cell Lymphoma of Follicle Origin Mimicking Acne Rosacea. Am J Dermatopathol. 2014 Sep 16; Authors: Garrido MC, Rios JJ, Riveiro-Falkenbach E, Escamez PJ, Ronco MA, Rodríguez-Peralto JL Abstract : Primary cutaneous spindle cell lymphoma is a unique morphologic variant of cutaneous B-cell follicle center lymphoma characterized by a prominent population of spindle-shaped, medium, and large B lymphocytes with a poorly formed storiform pattern.We report a case of a 35-year-old woman who presented with a well-defined erythematous plaque with 2 nodular, nontender nonscaling nonulcerated lesions on her right cheek mimicking acne rosacea. Microscopic examination revealed a tumor mainly centered in the reticular dermis and mostly composed of spindle-shaped large B lymphocytes exhibiting bizarre shapes with "boomerang-like" or "spermatozoa-like" appearance. The immunohistochemical staining demonstrated neoplastic lymphocytes positive for CD20, CD79α, and BCL-6, and negative for CD3, CD43, CD10, BCL-2, and MUM-1. These results supported the diagnosis of a follicle center B-cell lymphoma with spindle cells.Although this rare variant of primary cutaneous B-cell lymphoma is not included in the recent WHO-EORTC classification, the rarity of this tumor and its unique morphologic appearance frequently leads to misdiagnosis and delays its treatment. PMID: 25229568 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/25229568?dopt=Abstract = URL to article

Superiority of ivermectin 1% cream over metronidazole 0.75% cream in treating inflammatory lesions of rosacea: a randomized, investigator-blinded trial. Br J Dermatol. 2014 Sep 16; Authors: Taieb A, Ortonne JP, Ruzicka T, Roszkiewicz J, Berth-Jones J, Peirone MH, Jacovella J, The ivermectin Phase III study group Abstract BACKGROUND: Few therapeutic alternatives currently exist in the treatment of papulopustular rosacea (PPR). OBJECTIVES: Demonstrate superiority of once-daily ivermectin 1% cream (IVM 1%) vs. twice-daily metronidazole 0.75% cream regarding percent reduction of inflammatory lesions in subjects with moderate to severe PPR. METHODS: In this Phase 3, investigator-blinded, randomized, parallel group study, subjects received IVM 1% once daily, or metronidazole 0.75% twice daily over 16 weeks. Efficacy assessments were inflammatory lesion counts and Investigator's Global Assessment (IGA). Safety assessments included incidence of adverse events (AEs) and local tolerance parameters. Subjects evaluated their disease following a 5-grade scale and completed questionnaires. RESULTS: A total of 962 subjects were randomized to receive IVM 1% (n=478) or metronidazole 0.75% (n=484). At week 16, IVM 1% was significantly superior to metronidazole 0.75% in terms of reduction from baseline in inflammatory lesions (83.0% vs. 73.7%; p<.001), observed as early as week 3 (last observation carried forward - LOCF). IGA results (subjects "clear" or "almost clear") also favoured IVM 1%: 84.9% vs. 75.4%, respectively (p<.001). Incidence of AEs was comparable between groups and local tolerability was better for IVM 1%. More subjects receiving ivermectin rated their global improvement as "excellent" or "good." CONCLUSIONS: Ivermectin 1% cream was significantly superior to metronidazole 0.75% cream and achieved high patient satisfaction. This article is protected by copyright. All rights reserved. PMID: 25228137 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/25228137?dopt=Abstract = URL to article

Conjunctival Pigmentation Following Minocycline Therapy. Ophthal Plast Reconstr Surg. 2014 Sep 15; Authors: Khan TT, Reddy UP Abstract Minocycline is a tetracycline antibiotic commonly used to treat acne and rosacea. Although pigmentation of the skin, nails, teeth, oral mucosa, and sclera is a well-recognized adverse outcome associated with minocycline, ocular pigmentation may be missed on routine examination. The authors present a case of a 43-year-old Caucasian woman who demonstrated bilateral pigmented palpebral conjunctival cysts after 12 months of minocycline therapy for cystic acne. To date, only 5 cases of minocycline-induced conjunctival pigmentation have been reported. After drug discontinuation, the patient's examination remained stable and no new ocular lesions were noted. PMID: 25226094 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/25226094?dopt=Abstract = URL to article

Related ArticlesAdult with papular eruption on the central aspect of the face. J Am Acad Dermatol. 2014 Aug;71(2):410-2 Authors: Michaels JD, Cook-Norris RH, Lehman JS, Gibson LE PMID: 25037798 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/25037798?dopt=Abstract = URL to article

Related ArticlesReply to "Allergic contact dermatitis to topical brimonidine tartrate gel 0.33% for treatment of rosacea". J Am Acad Dermatol. 2014 Oct;71(4):833-4 Authors: Del Rosso JQ PMID: 25219709 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25219709?dopt=Abstract = URL to article

Related ArticlesAllergic contact dermatitis to topical brimonidine tartrate gel 0.33% for treatment of rosacea. J Am Acad Dermatol. 2014 Oct;71(4):832-3 Authors: Swanson LA, Warshaw EM PMID: 25219708 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25219708?dopt=Abstract = URL to article

Related ArticlesWidespread ulcerated and vegetative plaques with an unusual rhinophymatous nose. JAMA Dermatol. 2014 Jul;150(7):773-4 Authors: Champagne C, Davies E, Grabczynska S PMID: 24869652 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/24869652?dopt=Abstract = URL to article

Rosacea: An Update on Medical Therapies. Skin Therapy Lett. 2014 Jun;19(3):1-4 Authors: Chang BP, Kurian A, Barankin B Abstract Rosacea is a common, chronic cutaneous condition that affects the face. Two topicals and one oral medication are currently approved for the treatment of rosacea, including azelaic acid, metronidazole, and sub-antimicrobial dose of doxycycline. Identification of subtypes can help guide treatment strategies. It is essential for psychosocial implications of rosacea to be considered and conservative management, such as nonpharmacologic routine skin care, must form an important part of the overall care. Recently, new insights into the pathophysiology of rosacea have led to the emergence of etiologically oriented treatments. Ivermectin, an acaricidal agent that has been shown to be effective against rosacea refractory to other therapies, is currently in Phase 3 trials. Brimonidine, which was US FDA approved last year and recently sanctioned by Health Canada, has filled an essential therapeutic void in the targeted treatment of diffuse facial erythema. PMID: 25188361 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/25188361?dopt=Abstract = URL to article

Management of cutaneous rosacea: emphasis on new medical therapies. Expert Opin Pharmacother. 2014 Sep 4;:1-10 Authors: Del Rosso JQ Abstract Introduction: Over the past decade, both basic science and clinical research have provided new information on pathophysiology and therapy that has led to advances in the management of rosacea. As rosacea is a very common facial skin disorder in adults of both genders and essentially all races and ethnicities, these advances can provide therapeutic benefit to many affected individuals around the world. Areas covered: This article provides a collective review of more recent information on the pathophysiology and clinical manifestations of rosacea, and discusses individual medical therapies based on PubMed literature searches on 'rosacea', 'rosacea therapies' and each therapy that are included in this article. The perspectives of the author on management of rosacea are also included. Newer therapies and treatment concepts received greater emphasis. Expert opinion: Management of cutaneous rosacea involves patient education, integration of proper skin care, differentiation of visible manifestations and symptoms, selecting therapies that correlate with the manifestations that are to be treated, setting realistic patient expectations on anticipated degree and time course of response and designing an overall management plan that addresses needs of the individual patient. In many cases, a combination approach is needed, and due to the chronicity of the disease long-term management is often warranted. PMID: 25186025 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/25186025?dopt=Abstract = URL to article

Recent advances in the understanding and management of rosacea. F1000Prime Rep. 2014;6:50 Authors: Wollina U Abstract Rosacea is a chronic relapsing inflammatory facial dermatosis. There are several known triggers but the pathogenesis remains unknown. Recent achievements in understanding this disease point to the importance of skin-environmental interactions. This includes physical and chemical factors, but also microbial factors. The impairment of the skin barrier function and the activation of the innate immune defences are major and connected pathways contributing to an ongoing inflammatory response in the affected skin. This becomes modulated by endogenous factors like neurovascular, drugs, and psychological factors. These factors offer new therapeutic targets for rosacea treatment. There is a broader range of anti-inflammatory compounds available with a favourable safety record. Only recently have persistent erythema and flushing been addressed by new drug formulations. PMID: 25184040 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/25184040?dopt=Abstract = URL to article

Asymmetric connectivity of spawning aggregations of a commercially important marine fish using a multidisciplinary approach. PeerJ. 2014;2:e511 Authors: Munguia-Vega A, Jackson A, Marinone SG, Erisman B, Moreno-Baez M, Girón-Nava A, Pfister T, Aburto-Oropeza O, Torre J Abstract Understanding patterns of larval dispersal is key in determining whether no-take marine reserves are self-sustaining, what will be protected inside reserves and where the benefits of reserves will be observed. We followed a multidisciplinary approach that merged detailed descriptions of fishing zones and spawning time at 17 sites distributed in the Midriff Island region of the Gulf of California with a biophysical oceanographic model that simulated larval transport at Pelagic Larval Duration (PLD) 14, 21 and 28 days for the most common and targeted predatory reef fish, (leopard grouper Mycteroperca rosacea). We tested the hypothesis that source-sink larval metapopulation dynamics describing the direction and frequency of larval dispersal according to an oceanographic model can help to explain empirical genetic data. We described modeled metapopulation dynamics using graph theory and employed empirical sequence data from a subset of 11 sites at two mitochondrial genes to verify the model predictions based on patterns of genetic diversity within sites and genetic structure between sites. We employed a population graph describing a network of genetic relationships among sites and contrasted it against modeled networks. While our results failed to explain genetic diversity within sites, they confirmed that ocean models summarized via graph and adjacency distances over modeled networks can explain seemingly chaotic patterns of genetic structure between sites. Empirical and modeled networks showed significant similarities in the clustering coefficients of each site and adjacency matrices between sites. Most of the connectivity patterns observed towards downstream sites (Sonora coast) were strictly asymmetric, while those between upstream sites (Baja and the Midriffs) were symmetric. The best-supported gene flow model and analyses of modularity of the modeled networks confirmed a pulse of larvae from the Baja Peninsula, across the Midriff Island region and towards the Sonoran coastline that acts like a larval sink, in agreement with the cyclonic gyre (anti-clockwise) present at the peak of spawning (May-June). Our approach provided a mechanistic explanation of the location of fishing zones: most of the largest areas where fishing takes place seem to be sustained simultaneously by high levels of local retention, contribution of larvae from upstream sites and oceanographic patterns that concentrate larval density from all over the region. The general asymmetry in marine connectivity observed highlights that benefits from reserves are biased towards particular directions, that no-take areas need to be located upstream of targeted fishing zones, and that some fishing localities might not directly benefit from avoiding fishing within reserves located adjacent to their communities. We discuss the implications of marine connectivity for the current network of marine protected areas and no-take zones, and identify ways of improving it. PMID: 25165626 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/25165626?dopt=Abstract = URL to article

Rosacea: New and Emerging Treatments. Drugs. 2014 Aug 26; Authors: Moustafa FA, Sandoval LF, Feldman SR Abstract Rosacea is a chronic inflammatory skin condition that negatively impacts patients' quality of life. We sought to review important aspects of the pathogenesis of rosacea and the role of new treatment options in its management. New, emerging treatments show promise; however, quality randomized controlled trials for many of these drugs are lacking. Brimonidine tartrate is an effective newly approved treatment for erythematotelangiectatic rosacea. Topical oxymetazoline has potential for the treatment of erythematotelangiectatic rosacea, with efficacy described in case reports and randomized controlled trials currently underway. Both oral and topical ivermectin have been studied for the treatment of papulopustular rosacea, both showing benefit; however, only topical ivermectin 1 % cream has been studied in randomized controlled trials. As our understanding of the etiology of rosacea continues to evolve, so will our options for therapeutic interventions. Further studies need to be performed to assess the long-term safety and efficacy of these treatments. PMID: 25154627 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/25154627?dopt=Abstract = URL to article

[Rosacea - dermocosmetic management: skin-care and corrective make-up]. Ann Dermatol Venereol. 2014 Sep;141 Suppl 2:S179-83 Authors: Deshayes P Abstract Rosacea is a common disorder of facial skin. The main symptoms are facial flushing and redness, then persistent redness and pimple-like bumps. The use of gentle cleansing routine and products developed especially for rosacea minimizes skin irritation. Wearing sun protection and limitating sun exposure is highly recommended. Because of its chronic evolution, clinical symptoms such as red-faced effects can substantially impact the quality of life of patients. Corrective make-up can be used to conceal those symptoms, hence improving the quality of life of patients without aggrieving lesions. PMID: 25151935 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25151935?dopt=Abstract = URL to article

[Role of laser in the treatment of rosacea]. Ann Dermatol Venereol. 2014 Sep;141 Suppl 2:S175-8 Authors: Mazer JM Abstract The role of vascular lasers in the treatment of rosacea is important. Despite the relative low number of studies using an excellent methodology, one can consider that it is un-discussable. Two lasers are mainly used: pulsed dye lasers and KTP lasers. But the main discussion is the choice of the principle of treatment, related to the pulse duration, photocoagulation or selective photothermolysis. Photothermolysis is more effective, mainly on thintelangiectasias and diffuse erythrosis, but it induces purpura, and certain patients do not agree with those side effects. Nd-Yag lasers must be carefully used, because they can induce facial atrophic scars. They are rarely effective, with long lasting results, on flushes, but they improve the quality of life of patients. Their main limit is the logical lack of efficacy on the inflammatory lesions, even if patients often notice an improvement of the disease. Recurrences are common after several years of follow up. PMID: 25151934 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25151934?dopt=Abstract = URL to article

[Erythema of rosacea: a new and effective treatment]. Ann Dermatol Venereol. 2014 Sep;141 Suppl 2:S169-74 Authors: Hougeir FG Abstract Until recently, our rosacea patients have had to suffer of their erythema with limited effective treatments. Mirvaso(®) (Brimonidine tartrate 0.5%, Brimonidine 3mg/g) is a new medication, indicated for the treatment of the erythema of rosacea. The phase III pivotal and long term studies showing the efficacy and tolerability of Mirvaso(®) are summarized. PMID: 25151933 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25151933?dopt=Abstract = URL to article

[impact of erythrosis in patients suffering from rosacea]. Ann Dermatol Venereol. 2014 Sep;141 Suppl 2:S165-8 Authors: Misery L Abstract In rosacea, transient or permanent erythrosis is a common symptom. It is related to vasodilatation, under the control of the nervous System. It can therefore be increased by stress. The impact of rosacea, especially when there is an erythrosis, is not negligible. There is an impact on quality of life, sometimes severe, and psychological and social consequences. Ereutophobia is common. Stigma is common, even more so as facial redness and other signs of rosacea evoke wrongly alcoholism. PMID: 25151932 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25151932?dopt=Abstract = URL to article

[Physiopathology of rosacea]. Ann Dermatol Venereol. 2014 Sep;141 Suppl 2:S158-64 Authors: Cribier B Abstract For a long time rosacea was thought to be mainly a vascular disorder. In the past ten years many other concepts have emerged, such as the neurovascular aspects and involvement of innate immunity. There is obviously a genetic part in rosacea, as it is much more common in people with fair skin, blue eyes and Celtic ascendance. The same persons are submitted to continental weather, with major temperature seasonal variations. Erythema and telangiectasia result from dilated superficial capillaries that have bizarre shapes, and induce constant edema of the dermis. This might be a favouring factor for Demodex colonization, which plays a major role in rosacea. Inflammation is always present, even in erythematotelangiectatic subtypes. It involves innate immunity, in response to environmental factors, like Demodex and its own biotope, resulting in overproduction of LL37, a pro-inflammatory peptide able to induce skin inflammation in an animal model, trough activation of inflammatory cells. Tool like receptors are involved in the activation of innate immunity. Demodex is the cause of ganulomas seen in papulopustular rosacea, but it is also always present in the erythematotelangiectatic subtypoe. Colonization by Demodex is nevertheless not decreased with conventional treatments of rosacea, like tetracyclins and metronizaole. This might be due to induction of inflamation by bacteria hosted by Demodex, like Bacillus oleronius, and dozens of bacteria that are being investigated. Finaly, rhinophyma is linked to both vascular changes and activation of fibrosis, involving TGF beta. PMID: 25151931 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25151931?dopt=Abstract = URL to article

[signs and symptoms of rosacea]. Ann Dermatol Venereol. 2014 Sep;141 Suppl 2:S151-7 Authors: Schmutz JL Abstract Rosacea is a chronic inflammatory dermatosis characterized by outbreaks of exacerbation and remission. The diagnosis of rosacea based on specific clinical criteria, mainly centrofacial erythema occurring between 30 and 50 years. The disease predominates in women, in light phototype, especially from Northern Europe. Several classifications of the disease exist. In France, Edouard Grosshans described four stages. Stage I is that of flushing, stage II is that of erythrocouperosis, stage III papules and pustules and stage IV rhinophyma. German schools described only 3 stages, like experts from the National Rosacea Society (NRS), who described four subtypes: The patient can enter the disease at any stage. Clinical aspects of rosacea Stage I (flushes) sometimes starts very early at the age of 20 years by the occurrence of paroxysmal facial erythema that might be associated with conjunctival hyperemia. Flushes occur after meals, sudden change in temperature or absorption of alcohol or hot drinks. Stage II or erythrocouperosis comprises permanent facial erythema with telangiectasia. Stage III is the most characteric of the disease. On the erythematous background patient develop outbreak of papules and pustules. Stage IV is mainly observed in males and is characterized mainly by rhinophyma. There is no consensus regarding the description of the other variants. NRS describe a particular subtype, granulomatous or lupoid rosacea, characterized by yellowish or brownish papules of the cheeks and peri-orificial areas. Ocular rosacea is common and should be systematically looked for in all patients with rosacea. Steroid rosacea is a complication of topical corticosteroids use on the face. Fulminant rosacea occurs abruptly in young women, who develop papules, pustules and deep purulent sinuses. Treatment includes the combination of systemic corticosteroids and isotretinoin. Rosacea is also possible in children. Clinical knowledge of rosacea and its clinical forms is essential for appropriate treatment, that can change the patients'life. PMID: 25151930 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25151930?dopt=Abstract = URL to article

Comparative Efficacy of Intense Pulsed Light for Different Erythema Associated with Rosacea. J Cosmet Laser Ther. 2014 Aug 25;:1-18 Authors: Liu J, Liu J, Ren Y, Li B, Lu S Abstract Abstract Objective: To compare the efficacy of IPL (540-950nm) in treating different erythema associated with rosacea. Methods: Thirty-two patients with erythematotelangiectatic rosacea (ETR, n=16) and papulopustular rosacea (PPR, n=16) were recruited. Three treatments of IPL (540-950nm) were administered on the face at 3-weeks intervals. Clinical improvement in erythema was independently assessed by two dermatologists using a quartile grading scale [0, ≤25% improvement (poor); 1, 26-50% improvement (fair); 2, 51-75% improvement (good); 3, 76-100% improvement (excellent)]. Patient satisfaction was evaluated using a 10-point visual analogue scale (VAS: 0, lowest; 10, highest). Results: Thirty patients were in this study. All patients showed improvement in erythema after three sessions of IPL (540-950nm) treatment. Based on physician assessment the overall clinical improvement in PPR group was significantly higher (mean±SD: PPR group 2.167±0.748 vs. ETR group 1.400±0.541; P=0.003) and patient satisfaction was also higher in PPR group (mean±SD; PPR group 6.867±1.457 vs.ETR group 5.600±1.502; P=0.026). The proportion of patients showing >75% clinical improvement among PPR group was also higher than that among ETR group (5/15 and 0/15 respectively, P =0.021). Side-effects were minimal and transient (erythema and/or oedema) for patients. Conclusions: IPL(540-950nm) is a safe and effective treatment of rosacea-associated erythema, especially for perilesional erythema. PMID: 25151911 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/25151911?dopt=Abstract = URL to article

Related ArticlesSelf regressing skin-colored papules with acneiform scarring over the face. Dermatol Online J. 2014;20(8) Authors: Mandal RK, Sarkar AD, Ghosh SK Abstract Lupus miliaris disseminata faciei is a chronic inflammatory dermatosis of unknown etiology, which mostly involves the face in young adults. Earlier attempts had been made to relate it to tuberculosis, rosacea, and sarcoidosis without any strong evidence. For the past few years it has been considered as a distinct entity by various authors and was given a new nomenclature, "facial idiopathic granulomas with regressive evolution" (FIGURE). We also support this new nomenclature and present a young man with facial idiopathic granulomas and scarring consistent with this diagnosis. PMID: 25148286 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/25148286?dopt=Abstract = URL to article

Related ArticlesMinocycline-induced hyperpigmentation. J Community Hosp Intern Med Perspect. 2014;4 Authors: Fiscus V, Hankinson A, Alweis R Abstract A 62-year-old male with a long history of rosacea, which was well controlled on minocycline, presented to his primary care physician for routine examination. Physical examination was noted for non-palpable, non-pruritic blue patches of hyperpigmentation on the medial aspects of his lower extremities bilaterally. Recognition and management of the findings are discussed. PMID: 25147636 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/25147636?dopt=Abstract = URL to article

The efficacy of intense pulsed light for treating erythematotelangiectatic rosacea is related to severity and age. Ann Dermatol. 2014 Aug;26(4):491-5 Authors: Lim HS, Lee SC, Won YH, Lee JB Abstract BACKGROUND: Rosacea is a chronic cutaneous disease. Therapeutic modalities should be chosen based on the identified sub-types and clinical features in each patient. Vascular lasers, including intense pulsed light (IPL), are reportedly safe and effective in treating erythematotelangiectatic rosacea (ETR). OBJECTIVE: In this study, we assess the comparative efficacy of IPL related to several factors including clinical severity and the age of patients with ETR. METHODS: Patients with ETR were classified into two groups according to the National Rosacea Society Severity Guideline. Severity score and erythema index (EI) were measured using a clinical scorecard and mexameter. For additional evaluation of therapeutic efficacy, investigator and patient global assessments (IGA, PGA) were checked. Efficacy of IPL was analyzed according to severity score, EI, IGA, and PGA related to sex, age, lactic acid stinging test, and severity. RESULTS: Analyses of the efficacy of IPL according to severity score, EI, IGA, and PGA based on sex, age, lactic acid stinging test, and severity revealed significant differences with age and severity only. CONCLUSION: This study supports the efficacy of IPL treatment for patients with ETR. IPL may be more effective in patients with more severe ETR and in younger patients with ETR. PMID: 25143679 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/25143679?dopt=Abstract = URL to article

Non-Obligatory Role of Prostaglandin D2 Receptor Subtype 1 in Rosacea: Laropripant in Comparison to a Placebo Did Not Alleviate the symptoms of Erythematoelangiectaic Rosacea. J Clin Pharmacol. 2014 Aug 20; Authors: Krishna R, Guo Y, Schulz V, Cord-Cruz E, Smith S, Hair S, Nahm WK, Draelos ZD Abstract Erythematotelangiectatic rosacea shares facial flushing features with those seen after niacin. This study was performed to test the hypothesis whether prostaglandin D2 (PGD2) receptor subtype 1 antagonist (MK-0524) will improve the symptoms of rosacea. The purpose of this study was to evaluate the effect of MK-0524 100 mg administered once daily for 4 weeks on the signs and symptoms of erythematotelangiectatic rosacea. Subjects received MK-0524 100 mg once-daily (n = 30) or placebo (n = 30) for 4 weeks. The primary pharmacodynamics endpoint was change in Clinician's Erythema Assessment (CEA) score from Baseline to Week 4. The Patient Self-Assessment (PSA) was a secondary endpoint. MK-0524 was generally well tolerated in this study For the primary endpoint of change in CEA score from Baseline to Week 4, the least-squares mean of change from Baseline to Visit 4/Week 4 was -3.7 and -3.4 for placebo and MK 0524 (100 mg), respectively. The least-squares mean difference (placebo minus MK-0524) with 90% confidence interval of change in CEA score from Baseline to Visit 4/Week 4 was estimated as -0.3 (-1.6, 1.0). For the secondary endpoints, the least-squares mean difference (placebo minus MK-0524) with 90% confidence interval of change from Baseline to Visit 4/Week 4 was estimated as -0.7 (-7.7, 6.4) for PSA total score, -4.5 (-14.2, 5.3) for PSA emotion score, -1.3 (-7.8, 5.3) for PSA symptoms score, and 3.6 (-4.3, 11.4) for PSA functioning score. MK-0524 administered once daily for 4 weeks was generally well tolerated in this population of subjects with rosacea. However, there were no clinically meaningful changes in the primary endpoint of CEA given that the response to MK-0524 could not be differentiated from that to placebo. There was also no clinically meaningful change in the secondary endpoint, PSA. A DP1 antagonist is not likely to be effective in rosacea. PMID: 25142778 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/25142778?dopt=Abstract = URL to article

Related ArticlesThe role of zinc in acne and prevention of resistance: have we missed the "base" effect? Int J Dermatol. 2014 Jan;53(1):125-7 Authors: Sardana K, Chugh S, Garg VK PMID: 24350859 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/24350859?dopt=Abstract = URL to article

Related ArticlesDrug samples in dermatology: out of the closet, into the dustbin. JAMA Dermatol. 2014 May;150(5):483-5 Authors: Katz KA, Reid EE, Chren MM PMID: 24740350 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/24740350?dopt=Abstract = URL to article