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J Clin Aesthet Dermatol. 2023 Aug;16(8):34-40. ABSTRACT OBJECTIVE: A new formulation of benzoyl peroxide (E-BPO cream, 5%) entraps benzoyl peroxide (BPO) in silica microcapsules. This study assesses the efficacy, safety, and tolerability of E-BPO cream, 5%, in rosacea in two Phase III clinical trials. METHODS: In two 12-week, randomized, double-blind, vehicle cream-controlled Phase III trials, 733 subjects at least 18 years old with moderate to severe rosacea were randomized (2:1) to once-daily E-BPO cream, 5%, or vehicle. RESULTS: In Study 1, the proportion of subjects achieving IGA clear/almost clear at Week 12 was 43.5 percent for E-BPO cream, 5%, and 16.1 percent for vehicle. In Study 2, the respective values were 50.1 percent and 25.9 percent. In Study 1, the decrease in lesion count from baseline to Week 12 was -17.4 for E-BPO cream, 5%, versus -9.5 for vehicle. In Study 2, the respective values were -20.3 and -13.3 (all P<0.001). The difference was also significant at Week 2. There were no treatment-related serious adverse events; 1.4 percent of subjects (1.8% E-BPO cream, 5%, 0.4% vehicle) discontinued due to adverse events. Assessed local tolerability was found to be similar among subjects in both E-BPO and vehicle. E-BPO was not compared with unencapsulated BPO. CONCLUSION: E-BPO is an effective and well tolerated treatment for rosacea. Clinicaltrials.gov Identifiers: NCT03564119, NCT03448939. PMID:37636253 | PMC:PMC10452484 {url} = URL to article

J Am Acad Dermatol. 2023 Aug 26:S0190-9622(23)02634-8. doi: 10.1016/j.jaad.2023.08.055. Online ahead of print. NO ABSTRACT PMID:37640245 | DOI:10.1016/j.jaad.2023.08.055 {url} = URL to article

Biomedicines. 2023 Jul 31;11(8):2153. doi: 10.3390/biomedicines11082153. ABSTRACT Rosacea is a chronic inflammatory skin disease characterized by recurrent erythema, flushing, telangiectasia, papules, pustules, and phymatous changes in the central area of the face. Patients with this condition often experience a significant negative impact on their quality of life, self-esteem, and overall well-being. Despite its prevalence, the pathogenesis of rosacea is not yet fully understood. Recent research advances are reshaping our understanding of the underlying mechanisms of rosacea, and treatment options based on the pathophysiological perspective hold promise to improve patient outcomes and reduce incidence. In this comprehensive review, we investigate the pathogenesis of rosacea in depth, with a focus on emerging and novel mechanisms, and provide an up-to-date overview of therapeutic strategies that target the diverse pathogenic mechanisms of rosacea. Lastly, we discuss potential future research directions aimed at enhancing our understanding of the condition and developing effective treatments. PMID:37626650 | PMC:PMC10452301 | DOI:10.3390/biomedicines11082153 {url} = URL to article

Antioxidants (Basel). 2023 Jul 27;12(8):1503. doi: 10.3390/antiox12081503. ABSTRACT Skin conditions are a significant cause of fatal and nonfatal disease burdens globally, ranging from mild irritations to debilitating diseases. Oxidative stress, which is an imbalance between reactive oxygen species and the cells' ability to repair damage, is implicated in various skin diseases. Antioxidants have been studied for their potential benefits in dermatologic health, but the evidence is limited and conflicting. Herein, we conducted a systematic review of controlled trials, meta-analyses, and Cochrane review articles to evaluate the current evidence on the utility of antioxidant supplementation for adjunct prevention and treatment of skin disease and to provide a comprehensive assessment of their role in promoting dermatologic health. The Cochrane Library, PubMed, EMBASE, and Epistemonikos databases were queried. Eligibility criteria included (1) primary focus on nanoparticle utility for skin cancer; (2) includes measurable outcomes data with robust comparators; (3) includes a number of human subjects or cell-line types, where applicable; (4) English language; and (5) archived as full-text journal articles. A total of 55 articles met the eligibility criteria for the present review. Qualitative analysis revealed that topical and oral antioxidant supplementation has demonstrated preliminary efficacy in reducing sunburns, depigmentation, and photoaging. Dietary exogenous antioxidants (namely vitamins A, C, and E) have shown chemopreventive effects against skin cancer. Antioxidant supplementation has also shown efficacy in treating non-cancer dermatoses, including rosacea, psoriasis, atopic dermatitis, and acne vulgaris. While further studies are needed to validate these findings on a larger scale, antioxidant supplementation holds promise for improving skin health and preventing skin diseases. PMID:37627498 | PMC:PMC10451863 | DOI:10.3390/antiox12081503 {url} = URL to article

Skin Res Technol. 2023 Aug;29(8):e13427. doi: 10.1111/srt.13427. ABSTRACT INTRODUCTION: The Flash-lamp pulsed dye laser (FPDL) is nowadays considered the most precise laser currently on the market for treating superficial vascular lesions. In this study, we gathered data from 10 years of experience regarding dye laser treatment of patients presenting vascular malformations such as telangiectasia, rhinophyma, port-wine stain, cherry and spider angioma and vascular tumours. METHODS: Subjects were enrolled from 2013 to 2023 based on the vascular anomalies they presented. They underwent different treatment sessions with the FPDL device. RESULTS: The age-range distribution by vascular anomaly confirmed that haemangiomas are typical in children while rhinophyma is a condition very common in older adults. A difference in sex distribution showed that pathologies such as telangiectasias typically affect women whereas rhinophyma is more frequent in men. Most of the treatments interested the face area but no permanent side effects were registered. CONCLUSIONS: Our 10 years of experience with FPDL demonstrated good results in a wide range of applications for the treatment of different vascular anomalies. The absence of long-term side effects and bearable pain during the treatment makes it a valuable solution for the resolution of benign tumours also in very young patients. PMID:37632184 | PMC:PMC10397371 | DOI:10.1111/srt.13427 {url} = URL to article

Cutis. 2023 Jul;112(1):5-6. doi: 10.12788/cutis.0802. NO ABSTRACT PMID:37611294 | DOI:10.12788/cutis.0802 {url} = URL to article

Fundam Clin Pharmacol. 2023 Aug 23. doi: 10.1111/fcp.12944. Online ahead of print. ABSTRACT BACKGROUND: Although brimonidine is currently used in the clinical treatment of glaucoma and rosacea, research of the deep sedative effect on animals after systemic administration is reported firstly and has shown promising results. METHODS: The median effective dose (ED50 ), the median lethal dose (LD50 ), and the therapeutic index of brimonidine for deep sedation and formalin stimulation assay were determined by various animal experiments. The effect of synergistic anesthesia in rabbits with brimonidine and chloral hydrate was preliminarily evaluated. RESULTS: The ED50 of brimonidine for highly effective sedation by intraperitoneal injection in rats was calculated to be 2.05 mg kg-1 with a 95% confidence interval (CI) of 1.87 to 2.25 mg kg-1 . The ED50 of brimonidine for deep sedation by intravenous and intrarectal injection in rabbits was calculated to be 0.087 mg kg-1 with a 95% CI of 0.084 to 0.091 mg kg-1 and 1.65 mg kg-1 with a 95% CI of 1.43 to 1.91 mg kg-1 , respectively. The LD50 of intraperitoneal brimonidine injection in rats was calculated to be 468 mg kg-1 with a 95% CI of 441 to 497 mg kg-1 and a therapeutic index of 228. Brimonidine has a certain analgesic and heart rate lowering effects. CONCLUSION: The results confirmed that brimonidine has deep sedation and analgesic effects after systemic administration and has high safety. It can be used in combination with other types of sedative drugs to achieve better effects. PMID:37612481 | DOI:10.1111/fcp.12944 {url} = URL to article

J Cosmet Dermatol. 2023 Aug 21. doi: 10.1111/jocd.15962. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory disease usually associated with persistent erythema and periodic flushing. This disease is difficult to treat, and the outcomes are often unsatisfactory and prone to recurrence. In recent years, botulinum toxin has been used as a new treatment for rosacea; however, its efficacy and safety remain under discussion. Although a systematic review of the effectiveness and safety of botulinum toxin has been previously conducted by other researchers, our systematic review and meta-analysis evaluate the efficacy of botulinum toxin from a more comprehensive and detailed perspective to provide evidence for clinicians. METHODS: Any study using botulinum toxin for the treatment of rosacea was considered for the analysis. RESULTS: A total of 22 studies were included, 9 of which were randomized controlled trials involving 720 subjects. After treatment, all studies showed varying degrees of improvement in patient signs and symptoms along with reduced Clinician's Erythema Assessment (CEA) scores. The improvement was maintained for several months, and the adverse effects were mild and self-limiting. CONCLUSION: Botulinum toxin may be an effective treatment for patients with rosacea; however, further clinical evidence is needed to confirm its long-term efficacy and side effects. The study was preregistered with Prospero (CRD42022358911). PMID:37605478 | DOI:10.1111/jocd.15962 {url} = URL to article

J Dermatolog Treat. 2023 Dec;34(1):2244616. doi: 10.1080/09546634.2023.2244616. NO ABSTRACT PMID:37605482 | DOI:10.1080/09546634.2023.2244616 {url} = URL to article

J Eur Acad Dermatol Venereol. 2023 Aug 22. doi: 10.1111/jdv.19449. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a common chronic inflammatory skin condition that is often refractory to treatment, with frequent relapses. Alterations in the skin immunological response and Demodex mite infestation are the primary aetiologic factors targeted for treatment. Transient receptor potential cation channel subfamily V member 1 (TRPV1) is a nociceptive cation channel that plays a role in cutaneous neurogenic pain and can be activated by various rosacea triggers. OBJECTIVES: We investigated the effects of TRPV1 modulation in rosacea, focussing on Demodex mite colonization and cutaneous neurogenic inflammation. METHODS: We examined mRNA expression levels according to Demodex population counts. An in vitro study using capsazepine as a TRPV1 antagonist was performed to assess the influence of TRPV1 in keratinocytes. A rosacea-like mouse model was generated by the injection of the 37-amino acid C-terminal cathelicidin peptide (LL37), and changes in the skin, dorsal root ganglion (DRG) and ears were examined. RESULTS: Increased Demodex mite population counts were associated with increased expression levels of TRPV1, tropomyosin receptor kinase A (TrkA) and nerve growth factor (NGF), and these levels could be reduced by capsazepine treatment in keratinocytes. In an in vivo study, the downstream effects of TRPV1 activation were investigated in the skin, DRG and ears of the rosacea-like mouse model. CONCLUSIONS: The findings of this study are instrumental for understanding the underlying causes of rosacea and could potentially lead to the development of new treatments targeting the NGF-TrkA-TRPV1 pathway. The identification of this pathway as a therapeutic target could represent a major breakthrough for rosacea research, potentially resulting in more effective and targeted rosacea treatments. This study contributes to an improved understanding of rosacea pathophysiology, which may lead to the development of more effective treatments in the future. PMID:37606610 | DOI:10.1111/jdv.19449 {url} = URL to article

JAAD Case Rep. 2023 Jun 15;38:102-104. doi: 10.1016/j.jdcr.2023.06.004. eCollection 2023 Aug. NO ABSTRACT PMID:37600738 | PMC:PMC10433285 | DOI:10.1016/j.jdcr.2023.06.004 {url} = URL to article

Indian J Ophthalmol. 2023 Sep;71(9):3272. doi: 10.4103/0301-4738.383879. ABSTRACT [This corrects the article DOI: 10.4103/IJO.IJO_2983_22]. PMID:37602633 | DOI:10.4103/0301-4738.383879 {url} = URL to article

Br J Dermatol. 2023 Aug 19:ljad277. doi: 10.1093/bjd/ljad277. Online ahead of print. NO ABSTRACT PMID:37596936 | DOI:10.1093/bjd/ljad277 {url} = URL to article

Dermatologie (Heidelb). 2023 Sep;74(9):715-724. doi: 10.1007/s00105-023-05197-4. Epub 2023 Aug 18. ABSTRACT Rosacea is a common chronic inflammatory dermatosis of the face, clinically characterized by erythema, telangiectasia, papules, pustules, and rhinophyma. In January 2022, the updated guideline on rosacea was published. Groundbreaking innovations include the new clinical classification according to phenotypes, extended diagnostic and therapeutic recommendations for ocular rosacea and implications of the gut microbiome on rosacea. Furthermore, the guideline encompasses a new chapter on the psychosocial aspects of rosacea and detailed recommendations for approved and off-label therapies. PMID:37594512 | DOI:10.1007/s00105-023-05197-4 {url} = URL to article

Ann Dermatol Venereol. 2023 Sep;150(3):199-201. doi: 10.1016/j.annder.2023.05.004. Epub 2023 Aug 16. ABSTRACT BACKGROUND: Ocular rosacea is an underdiagnosed form of rosacea that may occur without typical cutaneous signs of rosacea. Manifestations include blepharitis, lid margin telangiectasias, and scleritis. A systematic comparison of treatment options for ocular rosacea in children is lacking. METHODS: A systematic review was conducted according to the PRISMA guidelines on treatment for pediatric ocular rosacea. RESULTS: Eleven articles were included, representing 135 patients with a mean age of 5 years, of whom 69% (n = 75/108) were female. 55% (n = 55/99) exhibited ocular symptoms prior to cutaneous symptoms. Most patients (83%, n = 34/41) experienced a delay in diagnosis (mean 27 months, range 2-120 months). Doxycycline was the most frequently reported treatment (25%, n = 33/135). A complete response was achieved in 33% of patients treated with doxycycline (n = 10/30), while 53% (n = 16/30) achieved a partial response. Erythromycin was used in 20% of cases (n = 26/135), with a complete response in 58% (n = 15/26) and partial response in 42% (n = 11/26). Metronidazole was used in 14% of patients (n = 19/135), with a complete response being reported in 79% (n = 15/19) and partial response in 21% (n = 4/19). CONCLUSION: Systemic antibiotics, led by doxycycline, were the most commonly reported treatment modalities for pediatric ocular rosacea. Increased awareness of ocular rosacea in this population is crucial for earlier diagnosis. PMID:37596128 | DOI:10.1016/j.annder.2023.05.004 {url} = URL to article

J Cutan Med Surg. 2023 Aug 17:12034754231194017. doi: 10.1177/12034754231194017. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory disorder that can adversely affect the patient's quality of life (QOL). However, few studies have examined the association between the psychological burden and willingness to pay (WTP) with rosacea features and severity. OBJECTIVES: The study aimed to determine the overall psychological burden and WTP among Korean rosacea patients and identify factors that may contribute, such as patient demographics, clinical features, and rosacea severity. METHODS: This prospective cross-sectional study recruited Koreans with rosacea. All were asked to complete a questionnaire on their demographics, rosacea-related symptoms, self-rated severity, dermatology life quality index (DLQI), and WTP. The clinical features were assessed by a board-certified dermatologist. The investigator's global assessment and global flushing severity score (GFSS) were used to determine the clinical severity of rosacea. Multiple regression analysis was conducted to identify factors contributing to the psychological burden and WTP. RESULTS: Out of 201 rosacea patients, 147 (73.1%) were female, and 54 (26.9%) males, with a median age of 50.1 years. Their median DLQI score was 8 (interquartile range [IQR]): 4.0-13.0). The median WTP per month for the control of rosacea was $100, with relative WTP (WTP/household income per month x 100) being 3.3%. According to the multiple regression model, phymatous change (β = .153, p = .030), DLQI score (β = .152, P = .045), and GFSS (β = .154, P = .041) contributed most to the WTP. CONCLUSION: Rosacea patients experience substantial psychological and economic burdens. More vigorous treatment should be performed for those with phyma and severe flushing whose QOL is most severely affected. PMID:37587799 | DOI:10.1177/12034754231194017 {url} = URL to article

Dermatol Online J. 2023 Jun 15;29(3). doi: 10.5070/D329361439. NO ABSTRACT PMID:37591279 | DOI:10.5070/D329361439 {url} = URL to article

Clin Dermatol. 2023 Aug 15:S0738-081X(23)00088-3. doi: 10.1016/j.clindermatol.2023.08.009. Online ahead of print. NO ABSTRACT PMID:37591470 | DOI:10.1016/j.clindermatol.2023.08.009 {url} = URL to article

Clin Dermatol. 2023 Sep 14:S0738-081X(23)00081-0. doi: 10.1016/j.clindermatol.2023.08.002. Online ahead of print. ABSTRACT Eyelid dermatitis may present with a variety of clinical findings including erythema, pruritus, and edema, and it has a wide differential. Allergic contact dermatitis due to allergen sources in personal care products, cosmetics, and fragrances is a leading cause of eyelid dermatitis and may be challenging to diagnose by clinical examination alone. Expanded patch testing, in addition to careful inspection of the surrounding skin for additional areas of involvement and clinical clues, remains an important tool in differentiating allergic contact dermatitis from other relevant etiologies of eyelid dermatitis including irritant contact dermatitis, atopic dermatitis, seborrheic dermatitis, and rosacea. We present a practical approach to the management of eyelid dermatitis including the use of a topical anti-inflammatory for long-term control of eyelid findings. Further diagnostic workup may be warranted in patients with refractory eyelid dermatitis. PMID:37574152 | DOI:10.1016/j.clindermatol.2023.08.002 {url} = URL to article

Clin Dermatol. 2023 Aug 11:S0738-081X(23)00083-4. doi: 10.1016/j.clindermatol.2023.08.004. Online ahead of print. ABSTRACT Chronic eyelid and ocular itch affect many patients seeking dermatologic or ophthalmologic care and have a high burden on patient quality of life. Clinicians should consider the broad range of possible diagnoses when approaching the patient with itch of the eyes or eyelids lasting more than 6 weeks. Allergic conjunctivitis and allergic contact dermatitis are the most common causes of chronic itch of the eyes and eyelids, respectively. Other diagnoses to consider include atopic dermatitis, xerosis, neurogenic itch, dry eye syndrome, seborrheic dermatitis, blepharitis, rosacea, lichen simplex chronicus, and papulosquamous disorders. If no organic cause can be elucidated, diagnoses of psychogenic pruritus or chronic pruritus of unknown origin may be considered. Herein, we discuss the possible etiologies of chronic eyelid and ocular itch inclusive of clinical presentation, diagnostic considerations, and current therapies. PMID:37574153 | DOI:10.1016/j.clindermatol.2023.08.004 {url} = URL to article

Dermatol Pract Concept. 2023 Jul 1;13(3). doi: 10.5826/dpc.1303a182. ABSTRACT INTRODUCTION: Few studies have evaluated the histopathological characteristics of clinical rosacea subtypes in detail. OBJECTIVES: To assess rosacea histopathological features in correspondence to clinical subgroups. METHODS: The histopathological findings of 204 rosacea patients were analyzed retrospectively and were compared among clinical subtypes. RESULTS: Thirt-Two Percent of patients were male and 68% were female. Seventy-three patients had erythematotelangiectatic rosacea (ETR) and 110 had papulopustular rosacea (PPR), 12 were ETR + PPR, 4 ocular, 2 phymatous, and 3 had Morbihan's edema. Perivascular and perifollicular lymphohistiocytic infiltration, perifollicular exocytosis, follicular spongiosis, and ectatic vessels were almost found in all subtypes. Solar elastosis was higher in ETR. Spongiosis, exocytosis of inflammatory cells into epidermis, acanthosis, and granulomatous reaction were higher in PPR. Inflammatory cells exocytosis was more in PPR and phymatous. Demodex folliculorum was identified in 27% of ETR, 33.6% of PPR, 50% of phymatous, one ocular patient, and none of Morbihan edema. Demodex brevis were found in 5% of ETR, 3% of PPR, and 50% of phymatous. Demodex brevis not folliculorum was more in phymatous. Spongiosis was the most common finding in ocular rosacea. CONCLUSIONS: Spongiosis, exocytosis of inflammatory cells, and granulomatous reactions were more in PPR. Solar elastosis was more in ETR. Histopathological findings were compatible with clinical subgroups. PMID:37557115 | DOI:10.5826/dpc.1303a182 {url} = URL to article

Dermatol Pract Concept. 2023 Jul 1;13(3). doi: 10.5826/dpc.1303a168. ABSTRACT INTRODUCTION: Studies have suggested that botulinum toxin A may improve skin quality, and application protocols using hyper-diluted doses of botulinum toxin (microdosing) have been studied as a way to achieve therapeutic goals without fully paralyzing the targeted muscles. OBJECTIVES: To evaluate the effects of a combined protocol utilizing both the standard dosing and the microdosing of AbobotulinumtoxinA for the improvement of skin quality, measured by objective and subjective measurements. METHODS: Thirty patients were treated with botulinum toxin using both the standard technique and the microdosing technique. Objective (Sebumeter®, Mexameter® and digital dermoscopy pictures) and subjective (Global Aesthetic Improvement Scale and a clinical scale for evaluating the quality of facial skin) measurements of the effects in the treated areas were taken to assess the efficacy of the treatment. RESULTS: Digital dermoscopy showed a marked reduction of erythema and telangiectasias. Erythema and telangiectasias improved both on objective and subjective measurements. Skin oleosity, static rhytids, papules and pustules and enlarged pores improved on subjective measurements. Patient satisfaction was high (93%) despite the high rate of adverse events (56%). CONCLUSIONS: The combined application of standard doses and microdoses of AbobotulinumtoxinA is effective in improving the overall quality of facial skin. The effects on erythema and telangiectasias suggest that it is an effective treatment option for patients with erythematotelangiectatic rosacea. When applying microdoses of botulinum toxin in the lower and mid-face, the doses and pattern of injection should be customized for each patient to reduce the occurrence of adverse events. PMID:37557136 | DOI:10.5826/dpc.1303a168 {url} = URL to article

Dermatol Pract Concept. 2023 Jul 1;13(3). doi: 10.5826/dpc.1303a131. ABSTRACT INTRODUCTION: Superficial folliculitis of the scalp (SFS) is a common complaint in clinical practice, and initial presentation may be difficult to differentiate as they may appear very similar to each other. OBJECTIVES: The aim of this thesis is to describe the pathologies that occur clinically as folliculitis of the scalp, identify their causes and characteristics and create a standardized classification. METHODS: This is a retrospective clinical, dermoscopic and histopathological study over 10 years of dermatologic consultations. Only individuals with a confirmed diagnosis of SFS (updated diagnostic criteria or biopsy) were included. RESULTS: In this review, we describe the various clinical features of different causes of SFS in ninety-nine cases and divided into infectious due to fungus, bacteria, or virus and inflammatory conditions such as rosacea, acneiform eruption and Ofuji syndrome. CONCLUSIONS: The clinician must differentiate SFS from other underlying scarring disorders to prevent poorer outcomes. We created an algorithm to help the clinician reach a proper diagnosis. PMID:37557142 | DOI:10.5826/dpc.1303a131 {url} = URL to article

J Drugs Dermatol. 2023 Aug 1;22(8):838-839. doi: 10.36849/jdd.7103. ABSTRACT Improved patient-physician relationships (PPR) are associated with better patient satisfaction and disease outcomes, however, there is limited literature assessing how PPR affects adherence in dermatology. We recruited 30 subjects with a clinical diagnosis of rosacea. Subjects were instructed to use ivermectin 1% cream once daily for 3 months and adherence was measured using the Medication Event Monitoring System cap. The Patient-Doctor Relationship Questionnaire (PDRQ-9), a validated questionnaire assessing patients&rsquo; perceived strength of the relationship with their doctor, was completed. Mean adherence for all subjects over three months of the study was 62%. PDRQ-9 scores positively correlated with adherence rates for 3 months of treatment (r(26)=0.52; P=0.006). The perceived strength of the PPR may have a role in patients&rsquo; adherence to their medications. Improving the PPR, through empathy and effective communication, may facilitate better medication adherence and treatment outcomes.&nbsp;Perche PO, Singh R, Cook MK, et al. The patient-physician relationship and adherence: observations from a clinical study. J Drugs Dermatol. 2023;22(8):838-839. doi:10.36849/JDD.7103. PMID:37556519 | DOI:10.36849/jdd.7103 {url} = URL to article

JAAD Case Rep. 2023 Jun 29;39:14-16. doi: 10.1016/j.jdcr.2023.06.028. eCollection 2023 Sep. NO ABSTRACT PMID:37554359 | PMC:PMC10404599 | DOI:10.1016/j.jdcr.2023.06.028 {url} = URL to article