rss

Characteristics of subjective recognition and computer-aided image analysis of facial erythematous skin diseases: A cornerstone of automated diagnosis. Br J Dermatol. 2013 Dec 6; Authors: Choi JW, Kim BR, Lee HS, Youn SW Abstract BACKGROUND: Rosacea and seborrheic dermatitis are common diseases that cause facial erythema. They share common features and are frequently misdiagnosed. OBJECTIVE: To extract characteristic features of rosacea and seborrheic dermatitis through computer-aided image analysis (CAIA) and compare them with subjectively recognized features. Using these findings, we aimed for constructing a decision tree for differential diagnosis. METHODS: In total, 34 clinical photos of facial erythema were included: 12 were diagnosed as erythrotelangiectatic rosacea (ETR), 12 as papulopustular rosacea (PPR), and 10 as seborrheic dermatitis (SEB). Five blinded dermatologists provided their impressions of each photo. The mean, standard deviation, and T-zone to U-zone (T/U) ratios of the erythema parameter a* (a* of the L*a*b* color space) were calculated for each photo using CAIA. These CAIA parameters were compared between impression groups. The most closely related CAIA parameter for each disease was established using the receiver operating characteristic (ROC) curve analysis. A decision tree which predicts the diagnosis from given CAIA parameters was constructed. RESULTS: All PPR diagnosed photos generated impressions of PPR. However, approximately 30% of the ETR diagnosed photos generated misimpressions of SEB and vice versa. PPR was characterized by a large standard deviation of erythema of the cheek, ETR was characterized by a large mean erythema of the U-zone, and SEB was characterized by a large T/U ratio of mean erythema. Among the additional fifteen cases, the decision tree predicted the original diagnosis in fourteen cases, but mis-predicted as SEB in one case of ETR. CONCLUSIONS: The CAIA result of facial erythema is well correlated with the actual clinical diagnosis. The accuracy of differential diagnosis using decision tree with CAIA parameters is as good as that of global examination impressions of dermatologists. This article is protected by copyright. All rights reserved. PMID: 24354615 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24354615?dopt=Abstract = URL to article

The role of zinc in rosacea and acne: further reflections. Int J Dermatol. 2014 Jan;53(1):128-9 Authors: Gessert CE, Bamford JT, Haller IV, Johnson BP PMID: 24350860 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24350860?dopt=Abstract = URL to article

Effects of a facial cream containing the minor alkaloid anatabine on improving the appearance of the skin in mild to moderate rosacea: an open-label case series study. Case Rep Dermatol. 2013;5(3):347-56 Authors: Lanier RK, Cohen AE, Weinkle SH Abstract BACKGROUND: Current medical and scientific research indicates that rosacea, a chronic and often debilitating skin condition that primarily affects the central face, may be caused by an overactive or excessive inflammatory immune response. Regardless of etiology, the accompanying redness and inflammation is unsightly and difficult for the patient. Anatabine is an alkaloid from the plant family Solanaceae that has been shown in several preclinical studies to modulate proinflammatory signaling pathways. OBJECTIVE: A cream containing anatabine was developed and evaluated in an open-label case series study for safety and effects on the appearance of the skin in 10 patients with mild to moderate rosacea. METHODS: Patients applied the cream to the face twice daily for a period of 30 days. Patients and the study physician completed safety and efficacy assessments at study end. RESULTS: Results showed that 50% of the patients self-reported improvement in the appearance of their skin, and the physician noted improvement in 70% of the patients. Photographs taken before and after 30 days of cream use provide visual evidence of the improvement in several patients. There were no complications or adverse events reported by any of the patients in the study, indicating that the anatabine cream was safe and very well tolerated. CONCLUSION: The results of this open-label case series show that a facial cream containing anatabine can improve the appearance of the skin in patients with mild to moderate rosacea and suggest that a double-blind, vehicle-controlled trial in a larger number of subjects is warranted. PMID: 24348385 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/24348385?dopt=Abstract = URL to article

Related ArticlesConsensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 1: a status report on the disease state, general measures, and adjunctive skin care. Cutis. 2013 Nov;92(5):234-40 Authors: Del Rosso JQ, Thiboutot D, Gallo R, Webster G, Tanghetti E, Eichenfield L, Stein-Gold L, Berson D, Zaenglein A Abstract Rosacea is a common clinical diagnosis that encompasses a variety of presentations, predominantly involving the centrofacial skin. Reported to present most commonly in adults of Northern European heritage with fair skin, rosacea can affect males and females of all ethnicities and skin types. Pathophysiologic mechanisms that appear to correlate with the manifestation of rosacea have been the focus of multiple research studies, with outcomes providing a better understanding of why some individuals are affected and how their visible signs and symptoms develop. A better appreciation of the pathophysiologic mechanisms and inflammatory pathways of rosacea has allowed therapeutic strategies to be optimally incorporated. Part 1 of this 5-part series discusses the rosacea disease state with an emphasis on clinical correlation, reviews adjunctive skin care for cutaneous rosacea, and provides management caveats. PMID: 24343208 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24343208?dopt=Abstract = URL to article

Related ArticlesFocal Limbal Stem Cell Deficiency in Turner Syndrome: Report of Two Patients and Review of the Literature. Cornea. 2013 Dec 13; Authors: Strungaru MH, Mah D, Chan CC Abstract PURPOSE:: The aim of this study was to report the presence of focal limbal stem cell deficiency (LSCD) in 2 cases of Turner syndrome. METHODS:: This is a case review. RESULTS:: A 25-year-old woman with a history of Turner syndrome diagnosed at 15 years of age was referred for "advanced chronic bilateral phlyctenular disease." The patient's visual acuity at presentation was 20/25-2 in the right eye and 20/30-2 in the left eye. Slit-lamp examination of both eyes showed inferior conjunctivalization of the corneal epithelium consistent with LSCD. The patient was started on topical cyclosporine 0.05%. A 23-year-old woman with the Turner syndrome was referred for rosacea keratitis. An ocular assessment revealed the visual acuity at presentation to be 20/25 in the right eye and 20/30 in the left eye. Slit-lamp examination of both eyes showed significant conjunctivalization with epithelial scarring and opacity. The patient was started on erythromycin ointment before bedtime, artificial tears, and warm compresses. CONCLUSIONS:: This study reports the first cases in the literature describing the coexistence of LSCD and Turner syndrome. Management of any ocular surface inflammation is important to prevent the progression of LSCD. PMID: 24342891 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24342891?dopt=Abstract = URL to article

Related Articles"Downward steps technique" with CO2 ultrapulsed laser for the treatment of rhinophyma: our protocol. Acta Chir Plast. 2013;55(1):16-8 Authors: Corradino B, Di Lorenzo S, Moschella F Abstract BACKGROUND: The rhinophyma is an important soft-tissue hypertrophy of the nose. In literature a wide range of surgical approaches to rhinophyma has been described such as dermoabrasion, scalpel shave, cryosurgery, electrocautery, near total excision with skin grafting, and laser excision. PATIENTS AND METHODS: The authors describe their experience with CO(2) ultrapulsed laser in 14 elderly male patients, using their personal approach, the Downward steps technique. With this technique they removed the pathological hypertrophic tissue using a progressive reduction of the laser power during the treatment. They obtained good results from morphological and aesthetic point of view, in a single laser session. CONCLUSIONS: Major complications such as hypertrophic scars, infections, hyperpigmentation were not observed. PMID: 24188317 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/24188317?dopt=Abstract = URL to article

Related Articles[Dry eye]. Ophthalmologe. 2013 Jun;110(6):498-9 Authors: Cursiefen C PMID: 23783991 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/23783991?dopt=Abstract = URL to article

Related ArticlesComparative effectiveness of nonpurpuragenic 595-nm pulsed dye laser and microsecond 1064-nm neodymium:yttrium-aluminum-garnet laser for treatment of diffuse facial erythema: A double-blind randomized controlled trial. J Am Acad Dermatol. 2013 Sep;69(3):438-43 Authors: Alam M, Voravutinon N, Warycha M, Whiting D, Nodzenski M, Yoo S, West DP, Veledar E, Poon E Abstract BACKGROUND: Facial erythema is a common symptom that responds to vascular laser treatment, but there are few comparative studies. OBJECTIVE: We sought to compare the effectiveness of microsecond 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser with nonpurpuragenic 595-nm pulsed dye laser (PDL) for diffuse facial erythema. METHODS: This was a split-face, double-blind randomized controlled trial. Bilateral cheeks received 4 treatments each at one month intervals with PDL or Nd:YAG. Spectrophotometer measurements, digital photographs, pain scores, and patient preferences were recorded. RESULTS: Sixteen patients enrolled and 2 dropped out. Fourteen patients, all skin types I to III, 57% women, mean age 42 years, completed the study and were analyzed. Spectrophotometer readings changed after both PDL (8.9%) and Nd:YAG (2.5%), but varied by treatment type, with PDL reducing facial redness 6.4% more from baseline than Nd:YAG (P = .0199; 95% confidence interval -11.6 to -1.2). Pain varied (P = .0028), with Nd:YAG associated with less pain, at 3.07, than PDL at 3.87. Subjects rated redness as improved by 52% as a result of PDL, and 34% as a result of Nd:YAG (P = .031; 95% confidence interval -34.6 to -1.94). No serious adverse events were observed. LIMITATIONS: Lasers settings are not standardized across devices. CONCLUSION: Facial erythema is safely and effectively treated with PDL and Nd:YAG. Nonpupuragenic PDL may be more effective for lighter-skinned patients, but microsecond Nd:YAG may be less painful. PMID: 23688651 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/23688651?dopt=Abstract = URL to article

Related ArticlesSarcoid-like lesions in paracoccidioidomycosis: immunological factors. An Bras Dermatol. 2013 Jan-Feb;88(1):113-6 Authors: Medeiros VL, Arruda L Abstract The clinical presentation of paracoccidioidomycosis is spectral. Spontaneous cure, state of latency or active disease with different levels of severity can occur after the hematogenous dissemination. The morphology and number of skin lesions will depend on the interaction of host immunity, which is specific and individual, and fungus virulence. Some individuals have natural good immunity, which added to the low virulence of the fungus maintain the presence of well-marked granulomas with no microorganism and negative serology for a long time, making the diagnosis a challenge. Factors inherent to the fungus, however, may modulate the immune response and modify the clinical picture over the time. We present a sarcoidosis-like clinical presentation and discuss the immunological factors involved. PMID: 23539015 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/23539015?dopt=Abstract = URL to article

Cutaneous indurated plaque on the abdomen associated with diabetes mellitus. Aust Fam Physician. 2013 Dec;42(12):876-7 Authors: Salazar-Nievas M, Crespo-Lora V, Rubio-López J, Arias-Santiago S Abstract Case study A woman, 74 years of age, presented to the emergency department with a lesion on the lower abdominal wall that had started a month earlier and was not associated with any other symptoms. Her family physician had treated it with emollient creams. Relevant past medical history included congestive heart failure, hypertension, hypertensive heart disease, pulmonary hypertension, mitral regurgitation, chronic atrial fibrillation, rosacea and diabetes mellitus that was being treated with oral hypoglycaemics (metformin). Physical examination revealed an area of skin on the lower abdominal wall that was ill-defined and indurated, with whitish papules and a 'cobblestone' appearance (Figure 1). PMID: 24324990 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24324990?dopt=Abstract = URL to article

Rosacea associated with etanercept. Joint Bone Spine. 2013 Dec 6; Authors: Yazici A, Akturk AS, Cefle A, Bayramgurler D, Yildiz KD PMID: 24321438 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24321438?dopt=Abstract = URL to article

Cutaneous angiosarcoma clinically presenting as progressive solid facial edema in a 43-year-old male. Dermatol Online J. 2013;19(11):20409 Authors: Choi WT, Stetsenko GY, Zhang J, Olerud JE, Argenyi ZB, George E Abstract Cutaneous angiosarcoma of the head and neck is a rare, highly malignant neoplasm; prognosis is heavily influenced by tumor size, resectability, and stage at initial diagnosis. Most patients present with one to several erythematous to violaceous patches, plaques, or nodules. However, the clinical presentation is highly variable and leads to delayed diagnosis. We report cutaneous angiosarcoma in a 43-year-old man who presented with an 11-month history of progressive solid (non-pitting) edema involving his entire face, scalp, eyelids, and neck without characteristic clinical features of cutaneous angiosarcoma. A skin biopsy had shown non-specific findings consistent with solid facial edema or rosacea. Various etiologies were considered but there was no significant improvement after directed medical therapy. Repeat skin biopsies revealed angiosarcoma involving the dermis and sub-cutis. Computed tomography (CT) of the chest showed multiple lung nodules bilaterally and a lytic lesion in the T6 vertebra consistent with metastases. He was treated with single agent chemotherapy (paclitaxel), and had a partial response that restored his ability to open both eyes spontaneously; However, his edema has recently progressed 7 months after diagnosis. This is a rare example of cutaneous angiosarcoma presenting as progressive solid facial edema, which underscores the diverse range of clinical manifestations associated with this neoplasm. PMID: 24314784 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24314784?dopt=Abstract = URL to article

Periorbital (eyelid) dermatides. Clin Dermatol. 2014 Jan-Feb;32(1):131-40 Authors: Wolf R, Orion E, Tüzün Y Abstract Physicians in various specialties-and dermatologists in particular-frequently encounter various forms of inflammation of the eyelids and of the anterior surface of the eye. Distinguishing the cause of itchy, painful, red, edematous eyelids is often difficult. Because the uppermost layer of the eyelids is part of the skin that wraps the entire body, almost every skin disease in the textbook can affect the periorbital area as well. In this contribution, we focused on the most common such disorders that require special consideration, as a result of their special appearance, their challenging diagnosis, or the nature of their treatment. We reviewed the key features of several common dermatides that affect the eyelids, such as atopic dermatitis, seborrheic dermatitis, allergic contact dermatitis, airborne contact dermatitis, rosacea, psoriasis, and others. We focused on the special clinical features, causes, and treatments specific to the delicate skin of the eyelids. Because structures of the eye itself (ie, the conjunctiva, the cornea, the lens, and the retina) may be involved in some of the discussed periorbital skin diseases, we found it useful to add a brief summary of the eyelid complications of those diseases. We then briefly reviewed some acute sight-threatening and even life-threatening infections of the eyelids, although dermatologists are not likely to be the primary care physicians responsible for treating them. PMID: 24314387 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24314387?dopt=Abstract = URL to article

Perioral dermatitis. Clin Dermatol. 2014 Jan-Feb;32(1):125-30 Authors: LipozenÄić J, Hadžavdić SL Abstract Perioral dermatitis is a relatively common inflammatory facial skin disorder that predominantly affects women. It is rarely diagnosed in children. A typical perioral dermatitis presentation involves the eruption of papules and pustules that may recur over weeks to months, occasionally with fine scales. The differential diagnosis includes seborrheic dermatitis, systemic lupus erythematosus, acne vulgaris, lupus miliaris disseminatus faciei, polymorphous light eruption, steroid-induced rosacea, granulomatous perioral dermatitis, contact dermatitis (allergic and irritant), and even basal cell carcinoma. The histopathology is similar to that of rosacea, with a perivascular and perifollicular lymphohistiocytic infiltrate and sebaceous hyperplasia. The etiology of perioral dermatitis is unknown, but the uncritical use of topical corticosteroids often precedes skin lesions. Physical sunscreens with high sun protection factors may cause perioral dermatitis in children. PMID: 24314386 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24314386?dopt=Abstract = URL to article

Rosacea and rhinophyma. Clin Dermatol. 2014 Jan-Feb;32(1):35-46 Authors: Tüzün Y, Wolf R, Kutlubay Z, KarakuÅŸ O, Engin B Abstract Rosacea is a common and chronic inflammatory cutaneous disease with unknown etiology. The pathophysiology of rosacea is still poorly understood. Epidemiological studies indicate a genetic component, but a rosacea gene has not been detected yet. Recent molecular studies propose that an altered innate immune response is involved in the pathogenesis of the rosacea disease. Signs of rosacea are indicated by the presence of characteristic facial or ocular inflammation involving both the vascular and tissue stroma. A wide range of drug options is available for the treatment of rosacea, including several topical ones (metronidazole, antibiotics, azelaic acid, benzoyl peroxide, sulfacetamide/sulfur, retinoids) and oral ones (mainly tetracyclines, metronidazole, macrolides, isotretinoin). This review highlights the recent clinical and pathophysiological developments concerning rosacea. PMID: 24314376 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24314376?dopt=Abstract = URL to article

Acneiform eruptions. Clin Dermatol. 2014 Jan-Feb;32(1):24-34 Authors: Dessinioti C, Antoniou C, Katsambas A Abstract Is it acne or is it not? When this question arises, we can presume that we have crossed the boundaries of "acneiform eruptions" of the face. Although acne may be considered a condition fairly easy to diagnose, it is not rare for the practicing dermatologist or the general physician to wonder when faced with an acneiform eruption before establishing a diagnosis. In this review, we address facial acneiform eruptions in children and in adults, including perioral dermatitis, granulomatous periorificial dermatitis, nevus comedonicus, acne cosmetica, rosacea, demodicosis, folliculitis, acneiform presentation of cutaneous lymphomas, and drug-induced [epidermal growth factor receptor (EGFR) inhibitors, steroids, etc] acneiform eruptions, along with their diagnosis and therapeutic approaches. The major distinguishing factor in acneiform eruptions is that, in contrast to acne, there are no comedones (whiteheads or blackheads). PMID: 24314375 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24314375?dopt=Abstract = URL to article

Related ArticlesA controversial proposal: no more antibiotics for acne! Skin Therapy Lett. 2013 Aug;18(5):1-4 Authors: Muhammad M, Rosen T Abstract Administration of antibiotics, often for prolonged periods, has become the de facto standard of care for acne (and rosacea). However, the world is now facing a health crisis relating to widespread antibiotic resistance. The authors provide current evidence to suggest that dermatologists should consider a radical departure from standard operating procedure by severely curtailing, if not outright discontinuing, the routine and regular use of antibiotics for acne. PMID: 24305661 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24305661?dopt=Abstract = URL to article

Related ArticlesHydrophobically modified polymers can minimize skin irritation potential caused by surfactant-based cleansers. J Cosmet Dermatol. 2013 Dec;12(4):314-21 Authors: Draelos Z, Hornby S, Walters RM, Appa Y Abstract INTRODUCTION: The addition of hydrophobically modified polymers (HMPs) to cleansers that contain surfactants can create polymer-surfactant complexes that are less irritating to the skin than commercially available mild cleansers. Our objective was to compare the tolerability and efficacy of a test foaming liquid facial cleanser containing HMPs with a commercial liquid nonfoaming facial cleanser in women with sensitive skin. METHODS: In this randomized, prospective, double-blind, comparative study, women (n = 20 per group) with mild-to-moderate atopic dermatitis (AD), eczema, acne, or rosacea used a test gentle foaming liquid facial cleanser containing HMPs or a commercial gentle liquid nonfoaming facial cleanser daily for 3 weeks. Investigators assessed irritation and skin condition. Study subjects also assessed their skin properties and the performance of each cleanser. RESULTS: Clinicians as well as study subjects consistently rated the test cleanser as effective or slightly more effective at improving symptoms than the commercial cleanser, although no significant differences between groups were observed. At weeks 1 and 3, respectively, more users of the commercial cleanser reported irritation (20% and 10%) than users of the test cleanser (5% and 5%). In addition, subject self-assessments of skin condition and cleansing properties were slightly more improved with the test cleanser than with the commercial cleanser. CONCLUSIONS: Both the test foaming cleanser containing HMPs and the commercial nonfoaming cleanser were effective and well accepted by most women in the study. Improvements were observed by both clinicians and subjects in the group using the test cleanser containing HMPs in all evaluated skin categories. PMID: 24305430 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24305430?dopt=Abstract = URL to article

Severe Demodexfolliculorum-Associated Oculocutaneous Rosacea in a Girl Successfully Treated With Ivermectin. JAMA Dermatol. 2013 Nov 27; Authors: Brown M, Hernández-Martín A, Clement A, Colmenero I, Torrelo A Abstract IMPORTANCE There is a limited therapeutic armamentarium for recalcitrant cases of childhood rosacea. OBSERVATIONS We report the case of a 12-year-old girl who presented with severe ocular and cutaneous rosacea unresponsive to oral doxycycline, oral isotretinoin, and topical tacrolimus. A biopsy specimen showed numerous mites within the folliculosebaceous unit. Treatment with a single dose of oral ivermectin achieved resolution of her symptoms. CONCLUSIONS AND RELEVANCE The causative role of Demodex folliculorum should be considered in immunocompetent children with rosacea or rosacea-like refractory eruptions. In such cases, treatment with ivermectin can be beneficial. PMID: 24284904 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24284904?dopt=Abstract = URL to article

Related ArticlesAntinuclear antibodies in rosacea patients. Postepy Dermatol Alergol. 2013 Feb;30(1):1-5 Authors: Woźniacka A, Salamon M, McCauliffe D, Sysa-Jędrzejowska A Abstract INTRODUCTION: Rosacea is a common inflammatory disorder, characterized by a spectrum of facial manifestations. The clinical similarity to other dermatoses, like lupus erythematosus, might lead to misdiagnosis, particularly in patients with elevated antinuclear antibody titers. AIM: To assess the frequency, titer and specificity of antinuclear antibodies in rosacea patients and correlate these findings with clinical features. MATERIAL AND METHODS: The study included 101 rosacea patients and 26 sex- and age-matched controls. Immunofluorescence antinuclear antibody testing was performed on HEp-2 substrates. Patients' sera with ANA titers of 1 : 160 or higher were evaluated by Euroline analysis. RESULTS: Over a half (53.5%) of rosacea patients had an ANA titer greater than or equal to 1 : 160. Within this group 13.86% had a titer of 1 : 320, 8.91% had a titer of 1 : 640, and 6.93% had a titer of 1 : 1,280 or higher. The specificity of these antibodies could not be identified. Elevated ANA titers were present more often in women (55.8%) than in men (44.15%). Only two of 26 healthy volunteers had elevated ANA titers. One had a titer of 1 : 160 and the other of 1 : 320. During a two-year observation period, after the initial ANA testing, none of the patients with ANA titers above 1 : 640 developed an apparent autoimmune disorder. CONCLUSIONS: Elevated ANA titers are commonly found in rosacea patients, what with simultaneously existing facial erythema and photosensitivity might lead to misdiagnosis of lupus erythematosus. Clinicians should beware of these findings to avoid misdiagnosing lupus erythematosus in rosacea patients with elevated ANA titers. PMID: 24278039 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24278039?dopt=Abstract = URL to article

Related ArticlesEmerging therapies in rosacea. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S57-65 Authors: Layton A, Thiboutot D Abstract Rosacea is a common skin disorder with multiple symptoms. The emergence of research that furthers understanding of pathophysiological mechanisms has created new targets for disease treatment. Specifically, there is a need for new treatments that address the various erythematic symptoms associated with rosacea. Systemic and topical therapies have both yielded positive results in treating rosacea with various medications. Subantimicrobial-dose doxycycline is one such promising treatment. Development of novel products in the near future should help achieve more satisfactory outcomes for patients. PMID: 24229638 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24229638?dopt=Abstract = URL to article

Related ArticlesManagement of facial erythema of rosacea: What is the role of topical α-adrenergic receptor agonist therapy? J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S44-56 Authors: Del Rosso JQ Abstract Several more recent advances have led to a better understanding of the pathophysiologic mechanisms involved in rosacea and therapeutic modalities used for treatment. Although the clinical features may vary among patients, there are some unifying mechanisms that appear to relate to the more common presentations of rosacea. Both neurovascular dysregulation and augmented immune detection and response appear to play central roles that lead to many of the signs and symptoms of rosacea. Diffuse central facial erythema is a very common finding that intensifies during flares and persists to varying degrees between flares. This background of facial redness occurs secondary to vasodilation and fixed vascular changes that develop over time. Physical modalities are commonly used to treat the erythema that persists as a result of fixed changes in superficial cutaneous vasculature that do not remit after treatment with agents whose mechanisms are active primarily against some of the inflammatory processes operative in rosacea (ie metronidazole, azelaic acid, tetracyclines). As enlarged superficial cutaneous vessels that contribute to the fixed background facial redness of rosacea remain vasoactive to sympathetic nervous system innervation, topical α-adrenergic receptor agonists, namely brimonidine and oxymetazoline, are currently under evaluation for the treatment of facial erythema of rosacea. This article focuses on the clinical differentiation of facial erythema of rosacea and its management. PMID: 24229637 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24229637?dopt=Abstract = URL to article

Related ArticlesOcular rosacea: A dermatologic perspective. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S42-3 Authors: Webster G, Schaller M Abstract As many as 50% of patients given the diagnosis of cutaneous rosacea also have ocular rosacea. Conservative figures indicate that approximately 10 million patients are affected by ocular rosacea in the United States alone. Despite this prevalence, ocular symptoms of rosacea are often improperly diagnosed, particularly when they occur in the absence of skin involvement. PMID: 24229636 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24229636?dopt=Abstract = URL to article

Related ArticlesOcular rosacea: Common and commonly missed. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S36-41 Authors: Vieira AC, Mannis MJ Abstract Rosacea is a prevalent disorder that may be disfiguring and cause significant ocular morbidity, if not diagnosed and managed appropriately. Ocular rosacea, in particular, is often left undiagnosed as no specific test is available to confirm the diagnosis. Accurate diagnosis is further complicated because symptoms of ocular rosacea are not always specific to the disorder alone. Other ophthalmic disorders may present with similar findings. Further challenges exist because the severity of ocular symptoms is often not related to the severity of cutaneous findings in rosacea. Isolating a disease marker may facilitate earlier diagnosis and treatment, and could also contribute to better understanding of disease pathogenesis. The glycomics of tear fluid and saliva in patients with rosacea shows promise as an initial step in the search for a biomarker specific to the disease. We have previously found potentially important disease biomarkers in roseatic tear and saliva samples. Further investigation should prove important in the early stages of developing a set of markers for accurate disease identification. PMID: 24229635 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24229635?dopt=Abstract = URL to article

Related ArticlesRosacea: Current state of epidemiology. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S27-35 Authors: Tan J, Berg M Abstract Case definitions are critical in epidemiologic research. However, modern disease indicators must now consider complex data from gene-based research along with traditional clinical parameters. Rosacea is a skin disorder with multiple signs and symptoms. In individuals, these features may be multiple or one may predominate. While studies on the epidemiology of rosacea have previously been sparse, there has been a recent increase in research activity. A broader body of epidemiological information that includes a greater variety of countries beyond Northern Europe and general population-based demographics is needed. As there are operational issues in current case definitions of rosacea subtypes-rationalization and standardization-universal consistent applications in future research is also imperative. Further improvement in disease definition combining new research information along with clinical pragmatism should increase the accuracy of rosacea case ascertainment and facilitate further epidemiological research. PMID: 24229634 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24229634?dopt=Abstract = URL to article