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Related ArticlesMedical history of the representation of rosacea in the 19th century. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S2-S14 Authors: Cribier B Abstract Throughout the 1800s, clinical illustrations helped to formalize what was then the recently developed field of dermatology. Knowledge of skin diseases was given new dimension as artists and clinicians alike strove to accurately document the physical characteristics of numerous dermatoses. Introduction of novel processes and refined techniques advanced the clinical use of disease images. The increasingly superior quality of these images aided in the early distinction between rosacea and acne. This article highlights these illustrative contributions in dermatology, and includes key images that serve as a road map to early clinical understanding of skin diseases. PMID: 24229633 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24229633?dopt=Abstract = URL to article

Related ArticlesNew insights into rosacea pathophysiology: A review of recent findings. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S15-26 Authors: Steinhoff M, Schauber J, Leyden JJ Abstract Rosacea is a common, chronic inflammatory skin disease of poorly understood origin. Based on its clinical features (flushing, chronic inflammation, fibrosis) and trigger factors, a complex pathobiology involving different regulatory systems can be anticipated. Although a wealth of research has shed new light over recent years on its pathophysiology, the precise interplay of the various dysregulated systems (immune, vascular, nervous) is still poorly understood. Most authors agree on 4 major clinical subtypes of rosacea: erythematotelangiectatic rosacea, papulopustular rosacea, phymatous rosacea, and ocular rosacea. Still, it needs to be elucidated whether these subtypes develop in a consecutive serial fashion or if any subtypes may occur individually as part of a syndrome. Because rosacea often affects multiple family members, a genetic component is also suspected, but the genetic basis of rosacea remains unclear. During disease manifestation and early stage, the innate immune system and neurovascular dysregulation seem to be driving forces in rosacea pathophysiology. Dissection of major players for disease progression and in advanced stages is severely hampered by the complex activation of the innate and adaptive immune systems, enhanced neuroimmune communication, profound blood vessel and possibly lymphatic vessel changes, and activation of almost every resident cell in the skin. This review discusses some of the recent findings and aims to build unifying hypotheses for a modern understanding of rosacea pathophysiology. PMID: 24229632 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24229632?dopt=Abstract = URL to article

Related ArticlesThe evolving view of rosacea. J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S1 Authors: Leyden JJ PMID: 24229631 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24229631?dopt=Abstract = URL to article

Correlation between serum reactivity to Demodex-associated Bacillus oleronius proteins, and altered sebum levels and Demodex populations in erythematotelangiectatic rosacea patients. J Med Microbiol. 2013 Nov 18; Authors: Jarmuda S, McMahon F, Zaba R, O'Reilly N, Jakubowicz O, Holland A, Szkaradkiewicz A, Kavanagh K Abstract Rosacea is a chronic inflammatory condition that affects the skin of the face and the eyes. The etiology of rosacea is not clearly established but increasing evidence suggests a potential role for bacteria in the induction of the condition. A role for Bacillus oleronius, originally isolated from within a Demodex folliculorum mite, in the etiology of the condition has been suggested. The aim of the study was to determine whether a correlation existed between the level of sebum and the density of D. folliculorum in the skin of erythematotelangiectatic rosacea patients, and the reactivity of these patient's sera to proteins of B. oleronius. Serum reactivity to the 62 and 83 kDa B. oleronius proteins was found in 82.6% (62/75) of the rosacea patients and in 26.9% (14/52) of controls (p = 0.0016). In the group of rosacea patients whose sera reacted to B. oleronius proteins, the level of sebum was statistically lower than in controls (p = 0.01). The density of D. folliculorum on the face of Bacillus positive rosacea patients was statistically higher compared to controls (p = 0.0001). Rosacea patients demonstrated increased Demodex populations on their faces and reduced sebum levels. Their sera also showed reactivity to B. oleronius proteins suggesting a potential role for this bacterium in the etiology of rosacea. PMID: 24248990 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24248990?dopt=Abstract = URL to article

Sphingolipids and Antimicrobial Peptides: Function and Roles in Atopic Dermatitis. Biomol Ther (Seoul). 2013 Jul 30;21(4):251-257 Authors: Park K, Lee S, Lee YM Abstract Inflammatory skin diseases such as atopic dermatitis (AD) and rosacea were complicated by barrier abrogation and deficiency in innate immunity. The first defender of epidermal innate immune response is the antimicrobial peptides (AMPs) that exhibit a broad-spectrum antimicrobial activity against multiple pathogens, including Gram-positive and Gram-negative bacteria, viruses, and fungi. The deficiency of these AMPs in the skin of AD fails to protect our body against virulent pathogen infections. In contrast to AD where there is a suppression of AMPs, rosacea is characterized by overexpression of cathelicidin antimicrobial peptide (CAMP), the products of which result in chronic epidermal inflammation. In this regard, AMP generation that is controlled by a key ceramide metabolite S1P-dependent mechanism could be considered as alternate therapeutic approaches to treat these skin disorders, i.e., Increased S1P levels strongly stimulated the CAMP expression which elevated the antimicrobial activity against multiple pathogens resulting the improved AD patient skin. PMID: 24244808 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24244808?dopt=Abstract = URL to article

The association between psychiatric diseases, psychotropic drugs and the risk of incident rosacea. Br J Dermatol. 2013 Nov 14; Authors: Spoendlin J, Bichsel F, Voegel JJ, Jick SS, Meier CR Abstract BACKGROUND: Psychological conditions, such as traumatic events or stress, have been discussed controversially as aetiologic factors for rosacea. OBJECTIVES: To assess the association between diagnosed depression, other affective disorders or schizophrenia and subsequent incident rosacea. We further aimed at evaluating a possible role of various psychotropic drugs within this association. METHODS: We conducted a matched case-control study of psychiatric diseases and incident rosacea, stratified by exposure to various psychotropic drugs, using the UK-based General Practice Research Database (GPRD). Cases had a first diagnosis of rosacea recorded between 1995 and 2009. Each case was matched to one control on age, sex general practice, and years of history on the database. RESULTS: A history of depression or other affective disorders was not associated with an increased risk of developing rosacea, whereby lithium was the only antidepressant drug that significantly altered this association. Current long-term use of lithium was associated with a decreased OR of 0.58 (95% CI 0.38-0.88) among people without schizophrenia diagnosis (with or without affective disorders), compared to people not exposed to lithium. Patients with diagnosed schizophrenia revealed a decreased rosacea risk (OR 0.71, 95% CI 0.60-0.91) independent of antipsychotic drug use. CONCLUSIONS: Depression or other affective disorders were not associated with incident rosacea, whereas patients with schizophrenia were at a decreased risk of this skin disease in our study population. The materially decreased risk of rosacea among people with chronic lithium exposure may lead to new insights into the pathomechanism of rosacea. This article is protected by copyright. All rights reserved. PMID: 24236423 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24236423?dopt=Abstract = URL to article

Related ArticlesMelkerrson -Rosenthal syndrome, a rare case report of chronic eyelid swelling. Diagn Pathol. 2013 Nov 13;8(1):188 Authors: Kajal B, Harvey J, Alowami S Abstract Melkerrson-Rosenthal syndrome is a rare disorder of unknown etiology. The classical triad of recurrent facial paralysis, swelling of the face, lips and deep furrowed tongue (Lingua Plicata) is seen in very few cases, majority of the patients often present with one or two symptoms only, which often leads to misdiagnosis and mismanagement. Clinically these symptoms vary from days to years, which further delay the definitive diagnosis and symptoms may eventually become permanent. The cause of this entity is not very well understood, but thought to be attributable to multiple entities including genetic and Infectitious. As this entity has been associated with numerous other clinical entities, diagnosis often remains an exclusion process. Methods: A middle age male with a chronic history of heavy eyelids with skin indurations predominately around left eye was presented to ophthalmology clinic. Physical examination revealed a deep furrowed tongue. The skin biopsy from left eyelid revealed a non-specific granulomatous lesion. The clinical correlation of facial swelling and deep plicated tongue prompted the differential of MRS Results: Histologically a non-specific granulomatous lesion was seen in dermis. As a rule, other causes of granulomatous diseases were ruled out especially Crohn's disease and sarcoidosis. Polarization failed to reveal any foreign body. Conclusions: The finding of granulomatous lesion and clinical picture led to the definite diagnosis of Melkerrson-Rosenthal syndrome. Association with rosacea was other findings. Clinically his sign and symptoms are under control and no occurrence of symptoms has been noted so far.Virtual slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1647494495993706. PMID: 24225172 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24225172?dopt=Abstract = URL to article

Topical photodynamic therapy of actinic keratoses with 5-aminolevulinic acid: Randomized controlled trial with six months follow-up. J Dermatolog Treat. 2013 Nov 12; Authors: Buinauskaite E, Maciulaitis R, Buinauskiene J, Valiukeviciene S Abstract Abstract Background: Topical 5-aminolevulinic acid (ALA) photodynamic therapy (PDT) is an effective treatment for actinic keratosis (AK) with some transient adverse events. Objective: The purpose of the study was to evaluate the efficacy and side effects of two different light doses when treating AKs with ALA-PDT on the face/scalp. Methods: Thirty-eight patients with two histologically confirmed AKs were enrolled in the within-patient comparison study. ALA-PDT was performed twice with two weeks interval for each AK. Patients were randomized to receive a light dose of 70 or 100 J/cm(2) as their first split face/scalp treatment. Follow-up examinations were carried out at months 3 and 6. Efficacy end point included clinical/histological AK clearance rate. Results: No significant difference in therapeutic efficacy and adverse events of ALA-PDT was found between the two light doses at both follow-up visits. At months 3 and 6 after PDT the rate of complete remission were respectively 100% and 92.1% for 70 J/cm(2), 92.1% and 84.2% for 100 J/cm(2). The adverse events of the treatment were rosacea 5/76 (6.58%), hyperpigmentation 4/76 (5.26%), hypopigmentation 4/76 (5.26%), transient milia 3/76 (3.95%). Conclusions: The topical ALA-PDT with the red light dose of 70 J/cm(2) is an effective treatment for mild and moderate AKs on the face/scalp with expected adverse events of pigmentation changes, rosacea and transient milia. PMID: 24215475 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24215475?dopt=Abstract = URL to article

[improvement of rosacea treatment based on the morphological and functional features of the skin]. Georgian Med News. 2013 Oct;(223):31-5 Authors: Tsiskarishvili NV, Katsitadze A, Tsiskarishvili Ts Abstract Rosacea - a widespread disease sometimes aleak with severe complications, mainly affecting the skin. Irrational and inadequate treatment leads to chronicity of diseases and psychosocial disadaptation of patients. Lately, a clear upward trend in the number of patients in whom in the process of complex treatment manifestations (with the varying degrees of severity) of impaired barrier function of the skin are observed and they need the protection and restoration of the damaged stratum corneum. In patients with rosacea in order to study the function of the facial skin's horny layer we used the skin analyzer BIA (bioimpedance analysis, which in duration of 6 seconds determines the moisture content, oiliness and the softness of the skin) and significant deviations from the norm (decrease in moisture content, fatness and increased roughness) was revealed. These changes were most clearly pronounced in patients with steroid rosacea. To restore the skin barrier the drug "Episofit A" (Laboratory of Evolutionary Dermatology, France) has been used (1-2 times a day for 6 weeks). Evaluation of treatment efficacy was conducted every 2 weeks by means of a scale from 0 to 5 for parameters of dryness, erythema, peeling and expression of subjective feelings. In accordance with received results, using of Episofit A emulsion, especially on the baÑkground of long-term treatment with topical steroids, had a pronounced therapeutic effect. Thus, treatment of patients with consideration of morphological and functional features of facial skin, helps to improve the results traditional therapy, and the drug is highly effective means of the new direction in skin care - corneotherapy aimed to reconstruct and protect damaged stratum corneum. PMID: 24214590 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24214590?dopt=Abstract = URL to article

Reduction in Serine Protease Activity Correlates with Improved Rosacea Severity in a Small, Randomized Pilot Study of a Topical Serine Protease Inhibitor. J Invest Dermatol. 2013 Nov 8; Authors: Two AM, Hata TR, Nakatsuji T, Coda AB, Kotol PF, Wu W, Shafiq F, Huang EY, Gallo RL PMID: 24213369 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24213369?dopt=Abstract = URL to article

Related Articles[Morbihan disease as a special form of rosacea : Review of pathogenesis and new therapeutic options.] Hautarzt. 2013 Nov 9; Authors: Balakirski G, Baron JM, Megahed M Abstract Morbihan disease is classified as a special form of rosacea, which presents with persistent facial erythema and solid edema because of marked involvement of the lymphatic vessels. The cheeks, nose and forehead are particularly affected. Currently, the treatment options of this cosmetically very disturbing disease are limited. However, every attempt should be made to provide treatment because of the great emotional suffering of the patients. We review some new currently available therapeutic options for Morbihan disease. In our patient, we were able to achieve a significant improvement with systemic isotretinoin 30 mg/day over a period of 12 months. PMID: 24201653 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24201653?dopt=Abstract = URL to article

[investigation of the Prevalance of Demodex folliculorum and Demodex brevis in Rosacea Patients]. Turkiye Parazitol Derg. 2013;37(3):195-8 Authors: Yücel A, Yılmaz M Abstract Objective: Demodex spp. is an acari that resides in the hair follicles and sebaceous glands of the skin unit. It is known that Demodex spp. may play a role in the pathogenesis of rosacea and acne. Common sites of Demodex infestation are the facial skin , forehead, cheeks, chin and nasolabial fold. This study was performed between January 2010 and December 2011. It was carried out in order to investigate the frequency of Demodex folliculorum and Demodex brevis among rosacea patients who presented to the Fırat University Hospital Parasitology-Mycology Laboratory. Methods: Skin scrapings were taken from suspected lesions on anatomic regions (face, cheek and chin) in a total of 28 patients 19 (67.85%) women and 9 (32.15%) men; age range 22-58 years. They were examined under light microscopic with a dripping 15% KOH solution. Results: The findings indicated that Demodex spp. was positive in 17 (60.7%) of 28 patients; D. folliculorm was positive in 10 (35.71%) female patients and 5 (17.85%) male patients, and also D. brevis was positive in 2 (7.14%) female patients. Conclusion: In our country, Demodex spp. should be regarded as a leading cause of infestation among the patients with rosacea. This study suggests that investigation of Demodex spp. in all of these tissues could be beneficial. (Turkiye Parazitol Derg 2013; 37: 195-8). PMID: 24192622 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24192622?dopt=Abstract = URL to article

Changes in digestive enzyme activities during larval development of leopard grouper (Mycteroperca rosacea). Fish Physiol Biochem. 2013 Nov 5; Authors: Martínez-Lagos R, Tovar-Ramírez D, Gracia-López V, Lazo JP Abstract The leopard grouper is an endemic species of the Mexican Pacific with an important commercial fishery and good aquaculture potential. In order to assess the digestive capacity of this species during the larval period and aid in the formulation of adequate weaning diets, this study aimed to characterize the ontogeny of digestive enzymes during development of the digestive system. Digestive enzymes trypsin, chymotrypsin, acid protease, leucine-alanine peptidase, alkaline phosphatase, aminopeptidase N, lipase, amylase and maltase were quantified in larvae fed live prey and weaned onto a formulated microdiet at 31 days after hatching (DAH) and compared with fasting larvae. Enzyme activity for trypsin, lipase and amylase were detected before the opening of the mouth and the onset of exogenous feeding, indicating a precocious development of the digestive system that has been described in many fish species. The intracellular enzyme activity of leucine-alanine peptidase was high during the first days of development, with a tendency to decrease as larvae developed, reaching undetectable levels at the end of the experimental period. In contrast, activities of enzymes located in the intestinal brush border (i.e., aminopeptidase and alkaline phosphatase) were low at the start of exogenous feeding but progressively increased with larval development, indicating the gradual maturation of the digestive system. Based on our results, we conclude that leopard grouper larvae possess a functional digestive system at hatching and before the onset of exogenous feeding. The significant increase in the activity of trypsin, lipase, amylase and acid protease between 30 and 40 DAH suggests that larvae of this species can be successfully weaned onto microdiets during this period. PMID: 24189829 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24189829?dopt=Abstract = URL to article

[Lupoid rosacea as a special form of rosacea : Review of pathogenesis and therapeutic options.] Hautarzt. 2013 Nov 1; Authors: Vanstreels L, Megahed M Abstract Lupoid or granulomatous rosacea is classified as a special form of rosacea which along with the typical rosacea symptoms features monomorphic yellow-brown and red papules and nodules on the cheeks and periorificial areas. Histology shows noncaseating epithelioid cell granulomas with surrounding mononuclear cell infiltrates. It is difficult to treat. Currently, the only officially approved systemic treatment is tetracycline. However, there is a broad experience with off-label use of isotretinoin (10-20 mg daily). We describe a patient with an excellent response to 20 mg isotretinoin daily. PMID: 24173607 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24173607?dopt=Abstract = URL to article

Patterns of Ambulatory Care Usage and Leading Treatments for Rosacea. J Dermatolog Treat. 2013 Oct 30; Authors: Davis SA, Feldman SR Abstract Abstract Background: Millions of rosacea sufferers are not being treated, and the reasons they do not get treatment are not well characterized. Objective: To determine the main reasons for visit, providers seen, and treatments used for rosacea. Methods: We used data from the National Ambulatory Medical Care Survey for 1993-2010, tabulating the leading reasons for visit, providers seen, and treatments used in rosacea visits. Results: There were 1,750,000 visits per year for rosacea. The leading reasons for visit were other diseases of the skin (25.3%), skin rash (19.6%), and discoloration or abnormal pigmentation (14.7%). Dermatologists managed 72.4% of visits. The most common treatments used were topical metronidazole (29.3%), tetracycline (11.0%), minocycline (8.5%), doxycycline (7.9%), and oral metronidazole (6.9%). Limitations: Some reasons for visit were too nonspecific to provide good insight on why the patient made a visit. Conclusions: Dermatologists manage rosacea most commonly, but primary care physicians need the proper training to diagnose it correctly. Improved strategies to reach untreated people with rosacea are needed. PMID: 24171399 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24171399?dopt=Abstract = URL to article

Related ArticlesSimple, easy, and still effective treatment option in severe rhinophyma: shave and paste. Dermatol Ther. 2013 Mar-Apr;26(2):168-9 Authors: Sarifakioglu N, Sarifakioglu E Abstract A 74-year-old man suffering from severe rhinophyma with breathing difficulty and depression seeking for help presented to our clinic. The cauliflower-like mass was full thickness excised and a full thickness skin graft from right inguinal region was applied. An exceptionally treatment and satisfactory cosmetic result was obtained in single stage. PMID: 23551373 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/23551373?dopt=Abstract = URL to article

Cysts in Lung: A Diagnostic Challenge. Chest. 2013 Oct 1;144(4_MeetingAbstracts):975A Authors: Sharma A Abstract SESSION TITLE: Miscellaneous Student/Resident Case Report Posters IIISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PMINTRODUCTION: Sjögren's Syndrome (SS) is a rare cause of cystic pulmonary lesions. On the other hand 75% of patients who have primary SS may have pulmonary manifestations.CASE PRESENTATION: A 53 yo caucasian woman presented with incidental findings of cystic lesions at the lung bases. The otherwise athletic patient has history of hypothyroidism, miscarriages, GERD, silicone implants, rosacea, SS diagnosed at age of 26 with symptoms of keratoconjunctivitis sicca, xerostomia and recurrent parotid swelling. She does not have history of pneumothorax. Patient had domesticated birds at her farm. She never smoked and had no significant family history. Exam revealed rosacea, decreased salivary pool, normal sized lung fields without adventitious sounds. PFTs revealed mild restrictive pattern with DLCo 73% predicted. Imaging(HRCT): Numerous cystic changes scattered throughout both lungs, with normal surrounding parenchyma. Labs:β2 microglobulin, RVVT, antibodies against CCP, Cardiolipin, β2 Glycoprotein, Scl-70, endomysium, Sm, RNP, DNA were all negative.ANA,anti-SSA and SSB antibodies were positive .Aspergilus Flavus and anti-avian antibodies were also positive. Lung Biopsy: Peribronchial and perivascular lymphocytic aggregates and patchy deposition of material, which was Congo red stain negative. No abnormal smooth muscle cells seen. Diagnosis: SS related cystic lung disease. Likely ILP type vs other types. Progress over 3 years: Despite trial of corticosteroids and mycophenolate, DLCo has dropped from 70s to late 50s.DISCUSSION: In the present case with scattered lung cysts surrounded by preserved lung parenchyma on HRCT, lymphangiomyomatosis was a reasonable initial possibility. Lung biopsy did not reveal any abnormal smooth muscle cells. Possibility of burnt out hypersensitivity pneumonitis as significant bird exposure and positive anti-avian antibodies was there, but lower on the list in absence of other symptoms. ABPA considered unlikely as IgE normal and no significant obstructive pattern. Biopsy analysis suggested possible lymphocytic interstitial pneumonia vs other SS associated cystic lung disease.Amongst the pathological patterns, NSIP is the commonest and has the best HRCT-Pathology correlation as compared to HRCT non-NSIP patterns. Five year survival in a retrospective study was found to be 84%. Corticosteroids and immunosuppressants can be tried for life threatening pulmonary conditions, but consensus guidelines are lacking.CONCLUSIONS: It is important to include Sjögren's Syndrome as one of the differentials for cystic lung disease specially when other common causes have been ruled out. Understanding regarding natural history, prognosis and treatment is limited so far.Reference #1: Parke AL. Pulmonary manifestations of primary Sjögren's syndrome. Rheum Dis Clin North Am. 2008 Nov;34(4):907-20Reference #2: Ito et al. Pulmonary manifestations of primary Sjogren's syndrome: a clinical, radiologic, and pathologic study. Am J Respir Crit Care Med. 2005 Mar 15;171(6):632-8.DISCLOSURE: The following authors have nothing to disclose: Abhishek SharmaNo Product/Research Disclosure Information. PMID: 24154456 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24154456?dopt=Abstract = URL to article

Rhinophyma on the web. Br J Dermatol. 2013 Oct 24; Authors: Shah A, Lakhani R, Panesar J Abstract Rhinophyma usually occurs on a background of rosacea due to a combination of fibrosis, sebaceous hyperplasia and lymphoedema on the nose(1) . The distortion, functional impairment and disfigurement(2) can cause much social anxiety for patients, motivating self-directed research. With internet search engines commonly being used by health consumers to search for information online(1) there is much concern regarding its quality and readability (the ease at which a text can be understood)(1) . We aim to objectively review the most commonly listed information websites regarding rhinophyma available to patients and the general public. This article is protected by copyright. All rights reserved. PMID: 24152172 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24152172?dopt=Abstract = URL to article

[Off-label indications for topical tacrolimus]. Hautarzt. 2013 Oct;64(10):752-6 Authors: Hengge UR Abstract The topical calcineurin antagonist tacrolimus plays an important role in the treatment of different forms of eczema because of its favorable risk profile. In addition, different off-label indications have been clinically tested where tacrolimus ointment has achieved clinical improvement. This article discusses off-label treatment of vitiligo, seborrheic dermatitis, steroid rosacea, perioral dermatitis, rosacea and lichen sclerosus. PMID: 24150824 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24150824?dopt=Abstract = URL to article

The Challenges, Advantages, and Future of Phenome-Wide Association Studies. Immunology. 2013 Oct 22; Authors: Hebbring SJ Abstract Over the last decade, significant technological breakthroughs have revolutionized human genomic research in the form of Genome-Wide Association Studies (GWASs). GWASs have identified thousands of statistically significant genetic variants associated with hundreds of human conditions including many with immunological etiologies (e.g., multiple sclerosis, ankylosing spondylitis, and rheumatoid arthritis). Unfortunately, most GWASs fail to identify clinically significant associations. Identifying biologically significant variants by GWAS also presents a challenge. GWAS is a phenotype-to-genotype approach. As a complementary/alternative approach to the GWAS, investigators have begun to leverage extensive electronic medical record systems to conduct a genotype-to-phenotype approach when studying human disease-specifically, the Phenome-Wide Association Study (PheWAS). Although the PheWAS approach is in its infancy, this method has already demonstrated its capacity to rediscover important genetic associations related to immunological diseases/conditions. Furthermore, PheWAS has the advantage of identifying genetic variants with pleiotropic properties. This is particularly relevant for HLA variants. For example, PheWAS results have demonstrated that the HLA-DRB1 variant associated with multiple sclerosis may also be associated with erythematous conditions including rosacea. Likewise, PheWAS has demonstrated that HLA-B genotype is not only associated with spondylopathies, uveitis, and variability in platelet count, but may also play an important role in other conditions, such as mastoiditis, This review will discuss and compare general PheWAS methodologies, describe both the challenges and advantages of the PheWAS, and provide insight into the potential directions PheWAS may lead. This article is protected by copyright. All rights reserved. PMID: 24147732 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24147732?dopt=Abstract = URL to article

Related ArticlesCutaneous B-Cell Chronic Lymphocytic Leukaemia resembling a Granulomatous Rosacea. Dermatol Online J. 2013;19(10):20034 Authors: Di Meo N, Stinco G, Trevisan G Abstract B-cell chronic lymphocytic leukemia (B-CLL) is a low-grade lymphoproliferative disease. Cutaneous involvement of B-CLL is limited and, in most cases, it represents non-specific manifestations related to an impaired immune system. Leukemic skin infiltrates (leukemia cutis) occur in 4-20% of patients. Herein we report the case of a 65-year-old woman with B-CLL presenting with papular, nodular, and plaque skin infiltrates affecting the nose, mimicking granulomatous rosacea. We discuss several aspects of rare cutaneous manifestations of B-CLL involving the face. PMID: 24139374 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24139374?dopt=Abstract = URL to article

Related ArticlesCutaneous B-Cell Chronic Lymphocytic Leukaemia resembling a Granulomatous Rosacea. Dermatol Online J. 2013;19(10):20033 Authors: Di Meo N, Stinco G, Trevisan G Abstract B-cell chronic lymphocytic leukemia (B-CLL) is a low-grade lymphoproliferative disease. Cutaneous involvement of B-CLL is limited and, in most cases, it represents non-specific manifestations related to an impaired immune system. Leukemic skin infiltrates (leukemia cutis) occur in 4-20% of patients. Herein we report the case of a 65-year-old woman with B-CLL presenting with papular, nodular, and plaque skin infiltrates affecting the nose, mimicking granulomatous rosacea. We discuss several aspects of rare cutaneous manifestations of B-CLL involving the face. PMID: 24139373 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/24139373?dopt=Abstract = URL to article

Related ArticlesManagement of mild to moderate rhinophyma using ablative fractional photothermolysis. Dermatol Surg. 2013 Jul;39(7):1110-3 Authors: Singh S, Peterson JD, Friedman PM PMID: 23773176 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/23773176?dopt=Abstract = URL to article

Related ArticlesLupus miliaris disseminatus faciei: report of a new case and brief literature review. Dermatol Online J. 2013;19(3):4 Authors: Rocas D, Kanitakis J Abstract Lupus miliaris disseminatus faciei (LMDF) is a rare dermatosis with characteristic clinicopathological features but of unknown etiolgy. We report a new typical case of LMDF. A 29-year-old man presented with an asymptomatic, micropapular midfacial eruption. Histological examination revealed a dermal granulomatous reaction with central areas of necrosis and occasionally degenerated hair follicles. Workup for sarcoidosis was negative. A moderate improvement was achieved with systemic treatment with doxycycline. A brief overview of the main features of LMDF is presented. PMID: 23552001 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/23552001?dopt=Abstract = URL to article

Related ArticlesBrimonidine gel (Mirvaso) for rosacea. Med Lett Drugs Ther. 2013 Oct 14;55(1427):82-83 Authors: PMID: 24129112 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/24129112?dopt=Abstract = URL to article