rss

Cathelicidin, kallikrein 5, and serine protease activity is inhibited during treatment of rosacea with azelaic acid 15% gel. J Am Acad Dermatol. 2013 Jul 18; Authors: Coda AB, Hata T, Miller J, Audish D, Kotol P, Two A, Shafiq F, Yamasaki K, Harper JC, Del Rosso JQ, Gallo RL Abstract BACKGROUND: Excess cathelicidin and kallikrein 5 (KLK5) have been hypothesized to play a role in the pathophysiology of rosacea. OBJECTIVE: We sought to evaluate the effects of azelaic acid (AzA) on these elements of the innate immune system. METHODS: Gene expression and protease activity were measured in laboratory models and patients with rosacea during a 16-week multicenter, prospective, open-label study of 15% AzA gel. RESULTS: AzA directly inhibited KLK5 in cultured keratinocytes and gene expression of KLK5, Toll-like receptor-2, and cathelicidin in mouse skin. Patients with rosacea showed reduction in cathelicidin and KLK5 messenger RNA after treatment with AzA gel. Subjects without rosacea had lower serine protease activity (SPA) than patients with rosacea. Distinct subsets of patients with rosacea who had high and low baseline SPA were identified, and patients with high baseline exhibited a statistically significant reduction of SPA with 15% AzA gel treatment. LIMITATIONS: Study size was insufficient to predict clinical efficacy based on the innate immune response to AzA. CONCLUSIONS: These results show that cathelicidin and KLK5 decrease in association with AZA exposure. Our observations suggest a new mechanism of action for AzA and that SPA may be a useful biomarker for disease activity. PMID: 23871720 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23871720?dopt=Abstract = URL to article

Related ArticlesA persistent facial rash. Am Fam Physician. 2013 Apr 15;87(8):579-80 Authors: Yeo BK, Tey HL PMID: 23668449 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/23668449?dopt=Abstract = URL to article

Basal cell carcinoma masked in rhinophyma. Case Rep Otolaryngol. 2013;2013:201024 Authors: De Seta D, Russo FY, De Seta E, Filipo R Abstract Rhinophyma, the advanced stage of rosacea, is a lesion characterized by progressive hypertrophy and hyperplasia of sebaceous glandular tissue, connective tissue, and blood vessels. Rhinophyma can lead to a significant facial disfigurement and severe emotional distress, but it is not only an aesthetic problem, since rare cases of simultaneous presence of malignant tissue are described in the literature. The case of an 84-year-old farmer affected by basal cell carcinoma (BCC) and diagnosed in the context of rhinophyma is presented. The anatomical distortion produced by the chronic inflammation and fibrous scarring makes the BCC diagnosis difficult and uncertain. The histological examination of the entire mass and its margins is fundamental. A partial biopsy can lead to a false negative result, and the histological examination must be repeated intra- or postoperatively. PMID: 23841002 [PubMed] http://www.ncbi.nlm.nih.gov/pubmed/23841002?dopt=Abstract = URL to article

Toll-like receptors and vascular markers in ocular rosacea. Ophthal Plast Reconstr Surg. 2013 Jul-Aug;29(4):290-3 Authors: Wladis EJ, Carlson JA, Wang MS, Bhoiwala DP, Adam AP Abstract PURPOSE: To delineate signals by which the vascular abnormalities inherent to ocular rosacea arise and to correlate these signals with elements of the innate immune system. METHODS: Experimental study. Immunohistochemical staining was performed for a variety of vascular markers and for toll-like receptor-4 on eyelid biopsies taken from patients with ocular rosacea and normal controls. Statistical comparisons were then performed between the 2 groups. RESULTS: Immunohistochemical staining for CD31 and integrin-β-3 did not demonstrate any statistically significant differences between eyelids from patients with ocular rosacea and normal controls. Cutaneous biopsies from ocular rosacea patients demonstrated statistically significant enrichments of intercellular adhesion molecule-1 and CD105 among arterioles, whereas there were no statistically significant differences in the venules between normal controls and ocular rosacea patients. The correlation between the number of toll-like receptor-4-positive cells and each vascular marker was statistically significant. CONCLUSIONS: Cutaneous biopsies of the eyelid did not demonstrate an increase in the total number of blood vessels. However, the vascular abnormalities that are typical of ocular rosacea represent activated, inflamed vessels, and these phenomena may be mediated by intercellular adhesion molecule and CD105. Furthermore, the strong correlations between toll-like receptor-4 and each vascular marker suggest that the innate immune system may govern the cutaneous effects of ocular rosacea. Intercellular adhesion molecule, CD105, and toll-like receptor-4 may represent important therapeutic targets in the management of this disease. PMID: 23839635 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23839635?dopt=Abstract = URL to article

Efficacy and tolerability of low molecular weight hyaluronic Acid sodium salt 0.2% cream in rosacea. J Drugs Dermatol. 2013 Jun 1;12(6):664-7 Authors: Schlesinger TE, Powell CR Abstract OBJECTIVE: Rosacea is a chronic cutaneous disorder characterized by flushing, erythema, telangiectasia, edema, papules, and pustules. The cause of this inflammatory disorder is unknown, but is thought to be multifaceted. Primary treatments for rosacea are typically oral antibiotics and topical therapies. Hyaluronic acid sodium salt cream 0.2% is a topical device containing low molecular weight hyaluronic acid (LMW-HA) that is effective in normalizing the cutaneous inflammatory response. The objective of this study was to evaluate the efficacy and safety of hyaluronic acid sodium salt cream 0.2%.<br> DESIGN and SETTING: Prospective, observational, non-blinded efficacy and tolerability study in an outpatient setting.<br> PARTICIPANTS: Individuals 18 to 75 years of age with mild to moderate facial rosacea.<BR> MEASUREMENTS: Outcome measures included papules, pustules, erythema, edema, telangiectasia, burning or stinging, dryness and provider global assessment (PGA), which were all measured on a five-point scale. Subjects were assessed at baseline, week 2, week 4, and week 8.<br> RESULTS: Final data for 14 of 15 subjects are presented. Through visual grading assessments, hyaluronic acid sodium salt cream 0.2% was shown to improve the provider global assessment by 47.5 percent from baseline to week 4. Reductions in papules, erythema, burning or stinging, and dryness were 47, 51.7, 65, and 78.8 percent, respectively at week 4. At week 8, the provider global assessment was improved from baseline in 78.5 percent of subjects.<BR> CONCLUSION: Improvement was noted in measured clinical parameters with use of topical low molecular weight hyaluronic acid. Topical low molecular weight hyaluronic acid is another option that may be considered for the treatment of rosacea in the adult population. Compliance and tolerance were excellent. Consideration should be given to use for individuals with rosacea characterized by an erythematous and/or papular component.<BR><BR> <EM>J Drugs Dermatol.</EM> 2013;12(6):664-667. PMID: 23839183 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23839183?dopt=Abstract = URL to article

Efficacy and Safety of Once-Daily Topical Brimonidine Tartrate Gel 0.5% for the Treatment of Moderate to Severe Facial Erythema of Rosacea: Results of Two Randomized, Double-blind, and Vehicle-Controlled Pivotal Studies. J Drugs Dermatol. 2013 Jun 1;12(6):650-6 Authors: Fowler J, Jackson M, Moore A, Jarratt M, Jones T, Meadows K, Steinhoff M, Rudisill D, Leoni M Abstract BACKGROUND: Brimonidine tartrate, a highly selective &alpha;2-adrenergic receptor agonist with potent vasoconstrictive activity, was shown to reduce erythema of rosacea.<br> OBJECTIVE: To assess the efficacy and safety of topical brimonidine tartrate gel 0.5% for the treatment of erythema of rosacea.<br> METHODS: Both studies were randomized, double-blind, and vehicle-controlled, with identical design. Subjects with moderate to severe erythema of rosacea were randomized 1:1 to apply topical brimonidine tartrate gel 0.5% or vehicle gel once-daily for 4 weeks, followed by a 4-week follow-up phase. Evaluations included severity of erythema based on Clinician's Erythema Assessment and Patient's Self-Assessment, as well as adverse events.<BR> RESULTS: Topical brimonidine tartrate gel 0.5% was significantly more efficacious than vehicle gel throughout 12 hours on days 1, 15, and 29, with significant difference observed as early as 30 minutes after the first application on day 1 (all P<.001). No tachyphylaxis, rebound or aggravation of other disease signs were observed. Slightly higher incidence of adverse events was observed for topical brimonidine tartrate gel 0.5% than for vehicle; however, most of the adverse events were dermatological, mild, and transient in nature.<br> LIMITATIONS: These data generated in controlled trials may be different from those in clinical practice.<BR> CONCLUSIONS: Once-daily brimonidine tartrate gel 0.5% has a good safety profile and provides significantly greater efficacy relative to vehicle gel for the treatment of moderate to severe erythema of rosacea, as early as 30 minutes after application.<br><br> <em>J Drugs Dermatol.</em> 2013;12(6):650-656. PMID: 23839181 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23839181?dopt=Abstract = URL to article

What more can we learn about acne and rosacea? Just keep reading, questioning, and searching for clinical relevance beyond the limitations of clinical trials. J Drugs Dermatol. 2013 Jun 1;12(6):609-10 Authors: Del Rosso JQ PMID: 23839174 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23839174?dopt=Abstract = URL to article

An evaluation of potential correlations between pathophysiologic mechanisms, clinical manifestations, and management of rosacea. Cutis. 2013 Mar;91(3 Suppl):1-8 Authors: Del Rosso JQ, Gallo RL, Tanghetti E, Webster G, Thiboutot D Abstract This article discusses rosacea, a common facial dermatosis of uncertain etiology and recent investigations that have begun to shed considerable light on the sequence of events leading to clinical manifestations of rosacea. The article content is based on a dedicated meeting about rosacea sanctioned by the American Acne & Rosacea Society (AARS) and represents the consensus of the authors and AARS Board of Directors. PMID: 23833998 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23833998?dopt=Abstract = URL to article

[Ocular rosacea]. Hautarzt. 2013 Jul;64(7):506-8 Authors: Sobolewska B, Zierhut M Abstract Half of patients with rosacea develop ocular involvement. The complaints are often nonspecific. The most common ocular manifestation is blepharoconjunctivitis with dry eye, while on rare occasion rosacea keratitis can lead to corneal ulcer, which then requires urgent ophthalmologic consultation. Topical therapy with preservative-free artificial lubricants and lid hygiene is recommended for the primary treatment of ocular rosacea. Secondarily, systemic medications are indicated depending on severity of the ocular and skin findings. PMID: 23824155 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23824155?dopt=Abstract = URL to article

[Rosacea and related diseases]. Hautarzt. 2013 Jul;64(7):480 Authors: Homey B, Schauber J, Schöfer H PMID: 23824154 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23824154?dopt=Abstract = URL to article

Decrease Corneal Hysteresis in Steroid-Induced Ocular Hypertension: A Case Report. Mil Med. 2013 Jul;178(7):e862-e864 Authors: Molinari JF Abstract PURPOSE: To describe a case of steroid-induced ocular hypertension in which a clinical significant increase in intraocular pressure resulted with a corresponding corneal hysteresis decreased response. METHOD: A case report is presented in which a 62-year-old white male who was diagnosed with rosacea meibomitis and treated with topical antibiotic steroid combination ointment responded such. CONCLUSION: This case report illustrates a reverse model of the topical antiglaucoma medication studies recently described of decrease in intraocular pressure with an increase in corneal hysteresis with the application of topical prostaglandins and beta-blocker compounds. This may provide additional insight into how the biomechanical properties of the cornea and tunics of the eye respond to local applications of different ocular medications. PMID: 23820367 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23820367?dopt=Abstract = URL to article

[Histamine intolerance--possible dermatologic sequences]. Acta Med Croatica. 2012 Dec;66(5):375-81 Authors: Lugović-Mihić L, Seserko A, Duvancić T, Situm M, Mihić J Abstract Although histamine intolerance (HIT) is not very frequently encountered, it can have serious consequences. Food intolerance is a non allergic hypersensitivity to food that does not include the immune system even though the symptoms are similar to those of IgE-mediated allergic reactions. HIT apparently develops as a result of an impaired diamine oxidase (DAO) activity due to gastrointestinal disease or through DAO inhibition, as well as through a genetic predisposition which was proven in a number of patients. The intake of histamine-rich foods as well as alcohol or drugs which cause either the release of histamine or the blocking of DAO can lead to various disorders in many organs (gastrointestinal system, skin, lungs, cardiovascular system and brain), depending on the expression of histamine receptors. Dermatologic sequels can be rashes, itch, urticaria, angioedema, dermatitis, eczema and even acne, rosacea, psoriasis, and other. Recognizing the symptoms due to HIT is especially important in treating such patients. The significance of HIT in patients with atopic dermatitis in whom the benefit of a low histamine diet has been proven is becoming increasingly understood recently. Because of the possibility of symptoms affecting numerous organs, a detailed history of symptoms following the intake of histamine-rich foods or drugs that interfere with histamine metabolism is essential for making the diagnosis of HIT. Considering that such symptoms can be the result of multiple factors, the existence of HIT is usually underestimated, but considerable expectations are being made from future studies. PMID: 23814966 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23814966?dopt=Abstract = URL to article

Related ArticlesNon-antibiotic properties of tetracyclines and their clinical application in dermatology. Australas J Dermatol. 2013 Jun 28; Authors: Perret LJ, Tait CP Abstract Dermatologists have used tetracyclines since the 1950s to treat disorders that do not necessarily have an infectious aetiology. Their anti-inflammatory and anti-collagenase properties contribute significantly to their success in treating diseases such as rosacea and acne. This article reviews the non-antibiotic properties of tetracyclines and their clinical application in dermatology. PMID: 23808657 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23808657?dopt=Abstract = URL to article

[Rosacea: Clinical features and classification.] Hautarzt. 2013 Jun 22; Authors: Lehmann P Abstract Rosacea is a frequent chronic dermatological disorder mainly affecting the face. Since it affects the appearance, it can be very distressing for the patient leading to psychosocial disturbances. Rosacea occurs in adults, peaking between 40 and 50 years of age. The course of rosacea is quite variable and the disease may stop at any stage. Generally, three main stages are differentiated: erythemato-teleangiectatic rosacea (rosacea stage I), papulopustular rosacea (rosacea stage II), hyperglandular-hypertrophic rosacea (rosacea stage III). Besides these main manifestations numerous special forms exist, which often lead to difficulties in the differential diagnoses and require specific therapeutic strategies. These include rosacea conglobata, rosacea fulminans, granulomatous rosacea, persisting edema, (Morbihan disease), gram negative rosacea, ocular rosacea, and steroid rosacea. Recently increasing numbers of patients have been observed, whose rosacea was were induced by inhibitors of epidermal growth factors (cetuximab, geftinib) used as chemotherapy in patients with different malignancies. These side effects have been described as acneiform eruptions but at least some of the described patients have a rosacea-like appearance; therefore, this form can be classified as a subset of drug induced rosacea. PMID: 23794060 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23794060?dopt=Abstract = URL to article

[Topical therapy of rosacea.] Hautarzt. 2013 Jun 20; Authors: Schöfer H Abstract Metronidazole and azelaic acid are the only topical medications approved for rosacea. All other topical treatments for rosacea and its special forms are used off-label. Topical steroids are not indicated in rosacea, because of their side effects (induction of steroid rosacea, high risk of facial skin atrophy, and high risk of rebound after cessation of therapy). Topical as well as systemic steroids are allowed only as initial and short term therapy for acute forms of rosacea (e.g. rosacea fulminans). Papular and pustular rosacea is the major indication for topical therapy. Sebaceous gland and connective tissue hyperplasia in glandular-hypertrophic rosacea as well as erythema in erythematous rosacea do not respond well to topical measures. A new active substance, the alpha-2-adrenoreceptor agonist brimonidine, will be approved soon for the topical treatment of erythema in rosacea. All severe forms of rosacea should initially be treated with a combination of topical and systemic agents. After improvement of the clinical symptoms, topical treatment alone is usually adequate to maintain the control. PMID: 23780475 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23780475?dopt=Abstract = URL to article

Minocycline-induced hyperpigmentation: comparison of 3 Q-switched lasers to reverse its effects. Clin Cosmet Investig Dermatol. 2013;6:159-62 Authors: Nisar MS, Iyer K, Brodell RT, Lloyd JR, Shin TM, Ahmad A Abstract Minocycline is a tetracycline derivative antibiotic commonly prescribed for acne, rosacea, and other inflammatory skin disorders. Minocycline turns black when oxidized, leading to discoloration of the skin, nails, bulbar conjunctiva, oral mucosa, teeth, bones, and thyroid gland. Hyperpigmentation has been reported after long-term minocycline therapy with at least 100 mg/day. Three types of minocycline-induced cutaneous hyperpigmentation can result. Type I is the most common, and is associated with blue-black discoloration in areas of previous inflammation and scarring. Type II most commonly affects the legs and is characterized by blue-gray pigmentation of previously normal skin. Type III is the least common and is characterized by diffuse muddy-brown discoloration predominantly on sun exposed skin. Minocycline-induced hyperpigmentation may be cosmetically disfiguring and prompt identification is essential. Without treatment, symptoms may take several months, to years to resolve, after discontinuation of the drug. However, the pigmentation may never completely disappear. In fact, there have been few reports of complete resolution associated with any therapeutic intervention. We report a case of a patient on long-term minocycline therapy utilized as an anti-inflammatory agent to control symptoms of rheumatoid arthritis, which led to minocycline-induced hyperpigmentation of the face. To remove the blue-gray cutaneous deposits, 3 Q-switched lasers (Neodymium: yttrium aluminum garnet (Nd:YAG) 1064 nm, Alexandrite 755 nm, and Ruby 694 nm) were used in test areas. The Alexandrite 755 nm laser proved to provide effective clearing of the minocycline hyperpigmentation requiring just 2 treatments, with minimal treatment discomfort and down time. PMID: 23754872 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23754872?dopt=Abstract = URL to article

Related ArticlesDemodex. Optom Vis Sci. 2013 Jun 6; Authors: Hom MM, Mastrota KM, Schachter SE Abstract PURPOSE: Demodex folliculorum and Demodex brevis are ectoparasites with an astounding prevalence of 100% in patients aged 70 years and older. Every person in this age group is estimated to carry a colony of 1000 to 2000 mites. With such a high prevalence, little attention has been paid to the mite among eye care practitioners. We demonstrate a clinical sequence in a set of case reports to identify the mite. The clinical sequence includes a clinical history of blepharitis, dry eyes, and/or ocular allergy; slit lamp examination of cylindrical dandruff; and confirmation using light microscope evaluation of epilated lashes. CASE REPORTS: Patient 1 was a 68-year-old woman who demonstrates associations with dry eyes and diabetes. Patient 2 was a 44-year-old man with uncommonly seen D. brevis present. Patient 3 was a 40-year-old woman with dry eyes and allergy, showing mite tails protruding from base of lashes. Patient 4 was a 60-year-old woman who demonstrates the association with rosacea. Patient 5 was a 53-year-old woman intermittently taking topical steroid and antibiotic combination medications, with an actual mite photographed on the surface. CONCLUSIONS: Following a clinical sequence helps identify Demodex, the underdiagnosed, undertreated, and underappreciated ocular surface disease. PMID: 23748846 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23748846?dopt=Abstract = URL to article

Morbihan syndrome. Indian Dermatol Online J. 2013 Apr;4(2):122-4 Authors: Veraldi S, Persico MC, Francia C Abstract We report a case of severe Morbihan syndrome (chronic erythematous edema of the upper portion of the face) in a 60-year-old man. The syndrome was characterized clinically by erythematous edema involving the forehead, glabella, and both eyelids, because of which the patient was not able to open completely his eyes. Furthermore, erythema and telangiectasiae were visible on the nose and cheeks. Laboratory and instrumental examinations were within normal ranges or negative. Histopathological examination showed dermal edema, perivascular and periadnexal lympho-histiocytic infiltrate, and sebaceous gland hyperplasia. Oral isotretinoin was ineffective despite the relatively long duration of the therapy (26 weeks). PMID: 23741671 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23741671?dopt=Abstract = URL to article

Determination of Tear and Serum Inflammatory Cytokines in Patients with Rosacea Using Multiplex Bead Technology. Ocul Immunol Inflamm. 2013 Jun 3; Authors: Topcu-Yilmaz P, Atakan N, Bozkurt B, Irkec M, Aban D, Mesci L, Tezcan I Abstract Abstract Purpose: To compare serum and tear inflammatory and anti-inflammatory cytokine levels of rosacea patients with the healthy controls and evaluate the correlation of tear cytokine levels with tear function parameters. Methods: Tear and serum interleukin (IL)-1α, IL-6, IL-8, IL-10, monocyte chemotactic protein-1 (MCP-1), macrophage inflammatory protein-1α (MIP-1α), epidermal growth factor (EGF), and vascular endothelial growth factor (VEGF) levels were measured using multiplex bead (Luminex) technology in 12 rosacea patients without ocular involvement (group 1), 20 rosacea patients with ocular involvement (group 2), and 22 healthy subjects (group 3). The correlation of the cytokines with tear function parameters was analyzed using Spearman correlation test. Results: Tear IL-10 and VEGF levels were significantly lower in group 1 (median: 35.78 pg/mL and 427.29, respectively) and group 2 (median: 26.25 pg/mL and 348.31, respectively) than in group 3 (median: 75.96 pg/mL and 480.12, respectively) (p < 0.05). Mean serum IL-8 level was significantly lower in group 2 (median = 0) compared to group 3 (median = 3.98) (p = 0.02). Tear breakup time was found to be positively correlated with IL-10 (r = 0.46, p = 0.013) and inversely correlated with MCP-1 (r = -0.52, p = 0.004). Conclusions: Tear and serum levels of cytokines and growth factors measured with Luminex technology showed a large variation in rosacea and healthy subjects. Decreased levels of tear IL-10, an anti-inflammatory cytokine, may lead to an inflammatory ocular surface environment, exacerbate ocular surface inflammation, and deteriorate tear function tests. A bigger sample size, including rosacea patients with corneal involvement, is needed to confirm the role of cytokines in the pathogenesis of rosacea-associated ocular inflammation. PMID: 23730902 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23730902?dopt=Abstract = URL to article

Evaluation of Demodex folliculorum as a Risk Factor for the Diagnosis of Rosacea In Skin Biopsies. Mexico's General Hospital (1975-2010). Indian J Dermatol. 2013 3;58(2):157 Authors: Ríos-Yuil JM, Mercadillo-Perez P Abstract CONTEXT: Rosacea significantly affects the quality of life and its pathophysiology is not well understood. It has been suggested that the presence of Demodex folliculorum in the affected skin could be related to the development of rosacea. AIMS: To study the risk for association between the presence of D. folliculorum in skin biopsies and the diagnosis of rosacea. SETTINGS AND DESIGN: Analytical, observational, retrospective, case-control study. MATERIALS AND METHODS: Skin biopsies of patients diagnosed clinically as rosacea and the same number of controls were studied. The controls were selected among the facial skin biopsies that were not diagnosed as rosacea. All the slides were analyzed for the presence of D. folliculorum and the density of the infestation was assessed. STATISTICAL ANALYSIS USED: Absolute/relative frequencies, mean, standard deviation, odds ratio (OR), Chi square and Independent Student t-test with Epi Info v. 3.4.3(®). RESULTS: D. folliculorum was present in 80% of the skin biopsies of rosacea patients and in 30% of the controls. The risk of suffering rosacea was increased among persons infested with the mite (OR = 9.33 [95% confidence interval: 2.85-30.60]; P = 0.0001). The mean infestation density among the cases was 1.908 for every 10 high-power fields while it was 0.718 among the controls (P < 0.005). There were no statistically significant differences among the groups with regard to sex and age. CONCLUSIONS: The presence of D. folliculorum in skin biopsies is associated with the diagnosis of rosacea. The infestation density was increased among the patients with rosacea. PMID: 23716816 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23716816?dopt=Abstract = URL to article

Vitamin D status in patients with rosacea. Cutan Ocul Toxicol. 2013 May 28; Authors: Ekiz O, Balta I, Sen BB, DikilitaÅŸ MC, OzuÄŸuz P, RifaioÄŸlu EN Abstract Abstract Background: Rosacea is a common chronic skin condition affecting the face. In recent years, significant evidence shows that vitamin D plays an important role in modulating the immune system. Vitamin D and its analogues via these mechanisms are playing an increasing role in the management of atopic dermatitis, psoriasis, vitiligo, acne and rosacea. Objectives: In our study, we aimed to investigate the relationship between serum vitamin D levels in patients with rosacea and analyze the association of vitamin D with clinical features. Methods: Forty-four rosacea patients and 32 healthy control subjects were included into the study. 25-hydroxyvitamin D (25(OH)D), calcium and intact parathyroid hormone were measured. Deficiency of vitamin D is defined as the level of 25(OH)D being less than 20 ng/ml. Results: Thirty-three female and 11 male patients were included in the study. The mean age of patients was 48.6 ±â€‰11.5. The mean levels of vitamin D levels were found as 21.4 ±â€‰9.9 and 17.1 ±â€‰7.9 in patients and controls, respectively. The difference was statistically significant (p = 0.04). The prevalence of vitamin D deficiency in patients with rosacea was 38.6% and 28.1% in healthy controls (p = 0.34). Conclusions: To the best of our knowledge, our study is the first study for evaluating serum vitamin D levels of patients with rosacea in the literature. Patients with rosacea have relatively high serum vitamin D levels compared to control groups. The result of our study suggests that increased vitamin D levels may lead to the development of rosacea. To confirm status of vitamin D levels in patients with rosacea, larger epidemiological studies are needed. PMID: 23713748 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23713748?dopt=Abstract = URL to article

The efficacy of pulsed dye laser treatment for inflammatory skin diseases: A systematic review. J Am Acad Dermatol. 2013 May 24; Authors: Erceg A, de Jong EM, van de Kerkhof PC, Seyger MM Abstract BACKGROUND: The position of the pulsed dye laser (PDL) in the treatment of inflammatory skin diseases is still unclear. Evidence-based recommendations are lacking. OBJECTIVES: We sought to systematically review all available literature concerning PDL treatment for inflammatory skin diseases and to propose a recommendation. METHODS: We searched for publications dated between January 1992 and August 2011 in the database PubMed. All studies reporting on PDL treatment for an inflammatory skin disease were obtained and a level of evidence was determined. RESULTS: Literature search revealed 52 articles that could be included in this study. The inflammatory skin diseases treated with PDL consisted of: psoriasis, acne vulgaris, lupus erythematodes, granuloma faciale, sarcoidosis, eczematous lesions, papulopustular rosacea, lichen sclerosis, granuloma annulare, Jessner lymphocytic infiltration of the skin, and reticular erythematous mucinosis. The efficacy of PDL laser treatment for these inflammatory skin diseases was described and evaluated. LIMITATIONS: Most conclusions formulated are not based on randomized controlled trials. CONCLUSIONS: PDL treatment can be recommended as an effective and safe treatment for localized plaque psoriasis and acne vulgaris (recommendation grade . For all other described inflammatory skin diseases, PDL seems to be promising, although the level of recommendation did not exceed level C. PMID: 23711766 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23711766?dopt=Abstract = URL to article

Erythema dose - a novel global objective index for facial erythema by computer-aided image analysis. Skin Res Technol. 2013 May 25; Authors: Choi JW, Kwon SH, Jo SM, Youn SW Abstract BACKGROUND: Facial erythema is a common but morbid condition caused by several inflammatory disorders. Since most of the current severity indexes lack objectivity and global assessment, the computer-aided image analysis (CAIA) has been suggested. OBJECTIVE: The purpose of this study is to compare the validity and efficacy of novel CAIA erythema index - erythema dose (ED) with two other CAIA indexes. METHODS: For mild, moderated and severe erytherotelangiectatic rosacea patients, their photographs of right cheek were assessed with red-blue difference index in image (RBI), a*, and ED. For each index, the differences between severity groups were analyzed. The correlations between the three indexes were evaluated. To evaluate the capability of differentiating the pathologic erythema from the red component of the normal skin, each index was calculated at both the erythema and normal area. RESULTS: The a* and ED significantly changed according to the severity, while the RBI did not. The ED was different between both mild-moderate and moderate-severe, while the a* only between mild-moderate. There was a strong positive correlation between a* and ED. The difference between erythema and normal skin was more prominent in ED than in a*. CONCLUSION: We confirmed that the ED is well correlated with both subjective assessment, as well as the other CAIA index a*. The ED has the advantage of specifically visualizing and analyzing the pathologic erythema. PMID: 23711094 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23711094?dopt=Abstract = URL to article

Related ArticlesPhymatous transformation of facial cutaneous vascular malformations: clues to phyma pathogenesis. JAMA Dermatol. 2013 Mar;149(3):368-9 Authors: Voth H, Wenzel J, Bieber T, Landsberg J PMID: 23552898 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23552898?dopt=Abstract = URL to article

Steroid Dermatitis Resembling Rosacea: A Clinical Evaluation of 75 Patients. ISRN Dermatol. 2013;2013:491376 Authors: Hameed AF Abstract Background. The use of topical steroids on the skin of the face should be carefully evaluated by the dermatologist; however, its misuse still occurs producing dermatological problem resembling rosacea. Objectives. To report the different clinical manifestations of steroid dermatitis resembling rosacea and to discover causes behind abusing topical steroids on the face. Methods. In this prospective observational study, 75 patients with steroid dermatitis resembling rosacea who had history of topical steroid use on their faces for at least 1-3 months were evaluated at the Department of Dermatology, Baghdad Teaching Hospital, between August 2010 and December 2012. Results. The majority of patients were young women who used a combinations of potent and very potent topical steroid for average period of 0.25-10 years. Facial redness and hotness, telangiectasia, and rebound phenomenon with papulopustular eruption were the main clinical presentations. The most common causes of using topical steroid on the face were pigmentary problems and acne through recommendations from nonmedical personnel. Conclusion. Topical steroid should not be used on the face unless it is under strict dermatological supervision. PMID: 23691345 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23691345?dopt=Abstract = URL to article