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Related ArticlesPrimary localized cutaneous amyloidosis intermingled with papulopustular lesions in a patient with Behçet's disease. Rheumatol Int. 2012 Nov;32(11):3651-3 Authors: Yamamoto T, Suzuki Y Abstract Primary localized cutaneous amyloidosis (PLCA) sometimes shows overlapping with collagen vascular diseases; however, association with Behçet's disease (BD) is rare. We herein report a case of PLCA developing intermingled with papulopustular lesions associated with BD. A 57-year-old woman visited our hospital, complaining of recalcitrant multiple oral aphthae. Further detailed physical examination revealed folliculitis-like small pustules with surrounding erythema on the upper back. Also, she stated past histories of genital ulcers 10 years ago and erythema nodosum on the lower legs 4 years ago. A biopsy specimen from the pustular lesion on the back showed neutrophilic abscess in the epidermis with a number of perivascular inflammatory cells in the upper dermis. Congo-red and Dylon stain revealed amyloid deposition in the papillary dermis. Although association of systemic amyloidosis with BD is occasionally found in the literature, co-occurrence of cutaneous amyloidosis and papulopustular lesions of BD is extremely rare. PMID: 20473498 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/20473498?dopt=Abstract = URL to article

Related ArticlesUltraviolet radiation-induced upregulation of antimicrobial proteins in health and disease. Photochem Photobiol Sci. 2013 Jan;12(1):29-36 Authors: Felton S, Navid F, Schwarz A, Schwarz T, Gläser R, Rhodes LE Abstract This article reviews recent data on the expression, regulation and activation of antimicrobial peptides (AMP) in human skin, and considers their potential protective and pro-inflammatory roles following upregulation by ultraviolet radiation (UVR). Antimicrobial peptides are small peptides that are key components of the innate immune system, originally identified by their vital role in protecting the body-environment interface from infection. However, it has now become clear that AMP have more extensive actions, including the provision of pivotal links with the adaptive immune system. Moreover, aberrant AMP expression may contribute to immuno-modulated inflammatory dermatoses including psoriasis, eczema and the photoaggravated condition lupus erythematosus. Recent work has demonstrated the direct upregulation of AMP in healthy skin by cutaneous UVR exposure. This may serve to protect the skin from risks imposed by both the biophysical barrier-compromise and the immunosuppression that are attributable to UVR exposure. Furthermore, it is observed that UVR provokes upregulation of AMP in an atypical manner in the photosensitivity disorder polymorphic light eruption. Dysregulated UVR responses of these pro-inflammatory proteins may play a role in the pathogenesis of certain immune-mediated diseases caused or aggravated by sunlight. PMID: 22945598 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/22945598?dopt=Abstract = URL to article

Related ArticlesMessage from the guest editor. J Drugs Dermatol. 2012 Jun;11(6):692-3 Authors: Del Rosso JQ PMID: 22648214 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/22648214?dopt=Abstract = URL to article

Risk of rosacea in patients with diabetes using insulin or oral antidiabetic drugs. J Invest Dermatol. 2013 May 8; Authors: Spoendlin J, Voegel JJ, Jick SS, Meier CR PMID: 23657502 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23657502?dopt=Abstract = URL to article

Rosacea - S1 Guideline. J Dtsch Dermatol Ges. 2013 May 6; Authors: Reinholz M, Tietze JK, Kilian K, Schaller M, Schöfer H, Lehmann P, Zierhut M, Klövekorn W, Ruzicka T, Schauber J PMID: 23647643 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23647643?dopt=Abstract = URL to article

Migraine, triptans, and the risk of developing rosacea: A population-based study within the United Kingdom. J Am Acad Dermatol. 2013 May 1; Authors: Spoendlin J, Voegel JJ, Jick SS, Meier CR Abstract BACKGROUND: Rosacea is a common skin disease, involving neurogenic inflammation and neurovascular dysregulation. Migraine has been associated with vascular changes and sterile inflammation. The 2 diseases have been associated over decades, but evidence is scarce. Triptans have vasoconstricting and antiinflammatory properties, but a potential impact of this drug class on rosacea remains uninvestigated. OBJECTIVE: We sought to analyze the association between migraine or triptan exposure and the risk of developing rosacea within the United Kingdom. METHODS: We conducted a case-control study using the United Kingdom-based General Practice Research Database. We identified patients with incident rosacea between 1995 and 2009 (cases), and matched 1 rosacea-free control subject to each case. We compared the prevalence of diagnosed migraine and exposure to triptans before the first-time rosacea diagnosis between cases and controls using multivariate conditional logistic regression. RESULTS: Among 53,927 cases and 53,927 controls, we observed a small overall association between rosacea and migraine in women (adjusted odds ratio 1.22, 95% confidence interval 1.16-1.29), but not in men. This effect was somewhat more distinct in female migraineurs aged 50 to 59 years (odds ratio 1.36, 95% confidence interval 1.21-1.53). Female triptan users also revealed slightly increasing risk estimates with increasing age, with the highest odds ratio of 1.66 (95% confidence interval 1.30-2.10) in women aged 60 years or older. LIMITATIONS: This is a retrospective case-control study, for which a certain degree of bias and confounding cannot be ruled out. CONCLUSIONS: We observed a slightly increased risk for female migraineurs to develop rosacea, particularly in women with severe migraine aged 50 years or older. PMID: 23643255 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23643255?dopt=Abstract = URL to article

CASE REPORT Treatment of Otophyma: Case Report and Review of the Literature. Eplasty. 2013;13:e18 Authors: Sharma KS, Pollock J, Hasham S, Brotherston TM Abstract Objectives: Otophyma is a rare condition that can present as the end stage of any chronic inflammatory disease affecting the ear such as rosacea, eczema, or otitis externa. It can result in conductive hearing loss, low self-esteem, and social embarrassment. This report highlights a case of otophyma treated successfully using a full-thickness skin graft. Methods: We present a case of a 41-year-old lady referred to our department with a 23-year history of bilateral otophyma. During this time, her hearing progressively diminished as the swelling occluded her external auditory meatus. She had been unsuccessfully managed for years with topical emollients, steroids, and regular ear toileting. Result: She was treated by excision of the phymatous tissue and full-thickness grafting, which resulted in a patent external auditory meatus and an improvement in her hearing. Conclusions: The use of a full-thickness skin graft is one of the many treatment options available for the treatment of otophyma. We present a literature review on this uncommon condition and a discussion on the various treatment options available to the patient. PMID: 23641297 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23641297?dopt=Abstract = URL to article

Evidence-based recommendations for the diagnosis and treatment of pediatric acne. Pediatrics. 2013 May;131 Suppl 3:S163-86 Authors: Eichenfield LF, Krakowski AC, Piggott C, Del Rosso J, Baldwin H, Friedlander SF, Levy M, Lucky A, Mancini AJ, Orlow SJ, Yan AC, Vaux KK, Webster G, Zaenglein AL, Thiboutot DM Abstract INTRODUCTION: Acne vulgaris is one of the most common skin conditions in children and adolescents. The presentation, differential diagnosis, and association of acne with systemic pathology differs by age of presentation. Current acknowledged guidelines for the diagnosis and management of pediatric acne are lacking, and there are variations in management across the spectrum of primary and specialty care. The American Acne and Rosacea Society convened a panel of pediatric dermatologists, pediatricians, and dermatologists with expertise in acne to develop recommendations for the management of pediatric acne and evidence-based treatment algorithms. METHODS: Ten major topic areas in the diagnosis and treatment of pediatric acne were identified. A thorough literature search was performed and articles identified, reviewed, and assessed for evidence grading. Each topic area was assigned to 2 expert reviewers who developed and presented summaries and recommendations for critique and editing. Furthermore, the Strength of Recommendation Taxonomy, including ratings for the strength of recommendation for a body of evidence, was used throughout for the consensus recommendations for the evaluation and management of pediatric acne. Practical evidence-based treatment algorithms also were developed. RESULTS: Recommendations were put forth regarding the classification, diagnosis, evaluation, and management of pediatric acne, based on age and pubertal status. Treatment considerations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin. Simplified treatment algorithms and recommendations are presented in detail for adolescent, preadolescent, infantile, and neonatal acne. Other considerations, including psychosocial effects of acne, adherence to treatment regimens, and the role of diet and acne, also are discussed. CONCLUSIONS: These expert recommendations by the American Acne and Rosacea Society as reviewed and endorsed by the American Academy of Pediatrics constitute the first detailed, evidence-based clinical guidelines for the management of pediatric acne including issues of special concern when treating pediatric patients. PMID: 23637225 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23637225?dopt=Abstract = URL to article

Related ArticlesSebaceous and sweat gland disorders. Practitioner. 2013 Jan;257(1757):32-3 Authors: Stollery N PMID: 23469726 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed/23469726?dopt=Abstract = URL to article

The effect of pulsed dye laser on the dermatology life quality index in erythematotelangiectatic rosacea patients: an assessment. J Clin Aesthet Dermatol. 2013 Apr;6(4):30-2 Authors: Shim TN, Abdullah A Abstract Background: Erythematotelangiectatic rosacea is a common cutaneous disorder. It has a major psychosocial impact on a patient's life. Objective: This study aims to investigate the impact of pulsed dye laser on the quality of life of affected patients as measured by the Dermatology Life Quality Index. Methods: The authors report a prospective study of 20 patients (in a wide range of skin phototypes) attending a laser clinic. All patients completed the Dermatology Life Quality Index questionnaires before and after three sessions of laser treatment. Results: The mean Dermatology Life Quality Index scores pre- and post-laser treatment were 17.3 and 4.3, respectively. All patients experienced a statistically significant improvement in their quality of life (p<0.0001, paired t test). Conclusion: The Dermatology Life Quality Index questionnaire (pre- and post-laser treatment) is an important tool for monitoring the efficacy of therapy and patient satisfaction. PMID: 23630639 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23630639?dopt=Abstract = URL to article

Long-Term Follow-Up of Multilayer Amniotic Membrane Transplantation (MLAMT) for Non-Traumatic Corneal Perforations or Deep Ulcers with Descemetocele. Klin Monbl Augenheilkd. 2013 Apr;230(4):413-418 Authors: Berguiga M, Mameletzi E, Nicolas M, Rivier D, Majo F Abstract Background: To evaluate the long-term efficacy of multilayer amniotic membrane transplantation for reconstruction of epithelium and stroma in non-traumatic corneal perforations (less than 2 mm) or deep ulcers with descemetocele.Design: Retrospective, non-comparative, interventional case series.Patients and Methods: Eleven consecutive patients with non-traumatic corneal perforations or deep corneal ulcers with descemetocele refractory to conventional treatments: herpetic or zoster keratitis (n = 4), Sjögren's syndrome (n = 2), rosacea (n = 1), hydrops (n = 1), mucous membrane pemphigoid (n = 1), bacterial keratitis (n = 1) and perforation after protontherapy for melanoma (n = 1). Intervention was: multilayer amniotic membrane transplantation with cryopreserved amniotic membrane. Complication rate and clinical outcome were evaluated in this long-term follow-up.Results: Mean follow-up was 32 months (12 to 60). Integration of the multilayer amniotic membrane was obtained in 10 cases after one year. Corneal epithelium healed above the membrane in 10 cases within 3 weeks and remained stable after 32 months in 9 cases. Thickness of the stroma was increased and remained stable during the follow-up in 9 cases. In one case herpetic keratitis recurred with a corneal perforation. The clearing of the amniotic membrane was gradually obtained over a period of 11 months. Complications occurred in 15 % of the eyes during the long-term follow-up.Conclusion: Multilayer amniotic membrane transplantation is a safe and efficient technique for a long restoration of the corneal integrity after non-traumatic corneal perforations or deep corneal ulcers with descemetocele. Long-term prognosis of these eyes depends of the gravity of the initial disease. PMID: 23629794 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23629794?dopt=Abstract = URL to article

Effects of 5-aminolevulinic acid-mediated photodynamic therapy on antibiotic-resistant staphylococcal biofilm: an in vitro study. J Surg Res. 2013 Apr 18; Authors: Li X, Guo H, Tian Q, Zheng G, Hu Y, Fu Y, Tan H Abstract BACKGROUND: Treatments of infections are not always successful because of multi-antibiotic-resistant organisms. It is therefore particularly urgent to provide more effective anti-infective strategy against these organisms. 5-Aminolevulinic acid (ALA), with the chemical structure C5H9NO3, is the only photodynamic therapy agent that is a biochemical precursor of a photosensitizer (protoporphyrin IX [PpIX]), which is naturally produced by the body. 5-Aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) has been shown to have a strong effect on the treatment of localized cancerous and precancerous lesions, and further study demonstrated its efficacy for gram-positive and gram-negative bacteria. However, its effect on biofilm formed by antibiotic-resistant strains has not been reported. METHODS: In this study, we evaluated the effectiveness of ALA-PDT on biofilms formed by methicillin-resistant Staphylococcus aureus (ATCC 43300) and methicillin-resistant S epidermidis (MRSE 287). The strains were cultured with 40 mM of ALA in 24-well microtiter plates containing coverslips at 37°C for 24 h in the dark. PpIX fluorescence in biofilms formed by the two strains was observed by confocal laser scanning microscopy (CLSM). ALA-treated biofilms were irradiated at different doses (0, 100, 200, and 300 J/cm(2)) using a semiconductor laser. Biofilm exposed only to Tryptone Soy Broth or irradiation (300 J/cm(2)) was investigated. Viability determination, CLSM, and scanning electron microscopy were used to investigate the photodynamic inactivation of ALA-PDT. RESULTS: ALA was absorbed and converted to PpIX by both methicillin-resistant S aureus and methicillin-resistant S epidermidis. No cell inactivation was detectable in biofilms of either strain incubated with ALA without exposure to light, incubated with Tryptone Soy Broth only, or irradiated with red light only. However, a significant number of cells within biofilms were inactivated during irradiation with different doses of red light in the presence of 40 mM of ALA in a dose-dependent manner. The drastic reduction in cell survival within biofilms and the disruption of biofilms were confirmed by CLSM and scanning electron microscopy. CONCLUSIONS: ALA-PDT has the potential to eliminate the biofilm of Staphylococcus, especially antibiotic-resistant strains, effectively. It will be suitable for the treatment of superficial local infections such as surface wounds, burns, oral and dental infections, dermatologic infections such as acne and rosacea, and soft tissue and bone infections with bone exposure. PMID: 23622723 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23622723?dopt=Abstract = URL to article

Related ArticlesRosacea and small intestinal bacterial overgrowth: Prevalence and response to rifaximin. J Am Acad Dermatol. 2013 May;68(5):875-6 Authors: Weinstock LB, Steinhoff M PMID: 23602178 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23602178?dopt=Abstract = URL to article

Related ArticlesAn observational cross-sectional survey of rosacea: Clinical associations and progression between subtypes. Br J Dermatol. 2013 Apr 21; Authors: Tan J, Blume-Peytavi U, Ortonne JP, Wilhelm K, Marticou L, Baltas E, Rivier M, Petit L, Martel P Abstract BACKGROUND: Few studies have evaluated for differences between rosacea subtypes in epidemiological associations and clinical features. The natural history of rosacea is unknown and progression between subtypes has been implied but not formally evaluated. OBJECTIVE: This study assessed associations between the four rosacea subtypes (erythematotelangiectatic [ETR], papulopustular [PPR], phymatous [PHY], and ocular [OC]), including quantitative and qualitative details on primary and secondary features of rosacea. A secondary objective was to evaluate for the potential of progression between subtypes. METHODS: This cross-sectional study recruited rosacea subjects from Northern Germany and comprised clinical evaluation by a dermatologist and a survey of demographics and onset of rosacea-associated signs and symptoms. RESULTS: 135 rosacea subjects were enrolled. PHY was more frequently associated with PPR than ETR (p < 0.000). Compared to ETR, PPR was significantly associated with facial burning/stinging (p = 0.001), phymas (p < 0.001) and edema (p <0.001); and during flushing episodes, was more frequently associated with burning (p = 0.018), skin tension (p = 0.005), and itching (p = 0.027). ETR was more frequently associated with dry facial skin (p < 0.001). Flushing was reported by 66% and most frequent site involved was cheeks (100%). Papulopustules were evanescent in 42% and most frequent site involved was cheeks (80%) and nose (67%). Of those fulfilling criteria for at least 2 subtypes, 66% developed ETR before PPR; 92% developed ETR before PHY; 83% developed PPR before PHY; and the majority developed cutaneous rosacea -associated features before ocular sign/symptoms. CONCLUSION: Significant differences exist between ETR and PPR in rosacea-associated features and in subtype associations. A small proportion of rosacea subjects may progress between subtypes. This article is protected by copyright. All rights reserved. PMID: 23600367 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23600367?dopt=Abstract = URL to article

[successful treatment of granulomatous rosacea with dapsone]. Hautarzt. 2013 Apr;64(4):226-8 Authors: Ehmann LM, Meller S, Homey B Abstract Granulomatous rosacea is an uncommon variant of rosacea. It is characterized by disseminated, red-brown papules and nodules especially in periocular and centrofacial locations. This form of rosacea causes considerable distress among patients because of the inflammatory facial lesions and represents a therapeutic challenge. A 62-year old man with granulomatous rosacea failed to improve with systemic doxycycline. Systemic isotretinoin and corticosteroids produced only a temporary reduction in cutaneous findings. Finally, systemic treatment with dapsone resulted in remission of the skin lesions and long-term stabilization. PMID: 23576165 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23576165?dopt=Abstract = URL to article

The study of prevalence of helicobacter pylori in patients with acne rosacea. Kathmandu Univ Med J (KUMJ). 2012 Oct-Dec;10(40):49-52 Authors: Bhattarai S, Agrawal A, Rijal A, Majhi S, Pradhan B, Dhakal SS Abstract Background Acne rosacea is an inflammatory disease affecting the central part of the face characterized by erythema, papules, papulo pustules and telangiectasias of unknown etiology. More recently numerous studies have described an association with Helicobacter pylori (Hp) and the extra gastric symptoms of cutaneous origin. Objectives To establish the prevalence of Helicobacter pylori (Hp) infection in the stomach in patients with rosacea based on standard Hp serological test. Methods All patients with the clinical staging of 2, 3 and 4 rosacea attending the Dermatology Out Patient Department from May 2009 - April 2010 were included in the study. Quantitative serological test using the SERION ELISA classic Helicobacter pylori IgG was done. Result A total of 26 patients were enrolled in the study with the age ranging from 26- 82 years. There were 14 males and 12 females and the male: female ratio was 1.6:1. Three (11.53%) patients presented with Grade IV rosacea, a severe clinical presentation and symptoms suggestive of acid peptic diseases were found in 14/26 (53.8%) patients. A positive serology to H. pylori was found in 17/26 (65.4%) of patients. A statistically significant correlation was found when association of H.pylori positivity in patients of rosacea compared with the seropositivity in controls. However correlation in the seropositivity was not found amongst the patients having gastritis and rosacea. Conclusion There still proves to find a correlation of Hp infection with patients with rosacea but it can still be hypothesised as a cutaneous manifestation of an internal peptic ulcer disease . PMID: 23575053 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23575053?dopt=Abstract = URL to article

IFAG and Childhood Rosacea: A Possible Link? Pediatr Dermatol. 2013 Apr 8; Authors: Prey S, Ezzedine K, Mazereeuw-Hautier J, Eschard C, Barbarot S, Boralevi F, Taïeb A, Léaute-Labrèze C, on behalf of the Groupe de Recherche Clinique en Dermatologie Pédiatrique Abstract Idiopathic facial aseptic granuloma (IFAG) is a disorder that usually occurs during early childhood. Its pathogenesis remains poorly understood. The objective of this study was to investigate possible relationships between IFAG and childhood rosacea. This was a retrospective multicenter study of patients attending four French dermatologic centers diagnosed with IFAG between October 2000 and July 2007. Patients and their parents were asked to come for a follow-up visit or to make an appointment for a telephone interview. Clinical symptoms of childhood rosacea were recorded: flushing, permanent or recurrent erythema; facial telangiectasia; papules and pustules on the face without comedones or microcysts; preferential location of the lesions on the convexity of the face; and ophthalmologic involvement of rosacea (recurrent chalazions, conjunctival hyperemia, keratitis). Thirty-eight patients, 20 girls and 18 boys, were included in the study. The median age at the time of diagnosis of IFAG was 43 months, with a median follow-up of 3.9 years. Sixteen patients (42.1%) had at least two criteria of childhood rosacea, 11 of 32 (34.4%) with a single lesion and 5 of 6 (83.3%) with multiple lesions. Children with IFAG are at risk for childhood rosacea, and follow-up is advised, including periodic ophthalmologic assessment. PMID: 23560522 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23560522?dopt=Abstract = URL to article

Facial verrucous sporotrichosis in an adult during treatment for rosacea. Int J Dermatol. 2013 Apr 4; Authors: Martins-Costa GM, Bonamigo RR PMID: 23557535 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed/23557535?dopt=Abstract = URL to article

Efficacy of Extended-Release 45 mg Oral Minocycline and Extended-Release 45 mg Oral Minocycline Plus 15% Azelaic Acid in the Treatment of Acne Rosacea. J Drugs Dermatol. 2013;12(3):292 Authors: Jackson JM, Kircik LH, Lorenz DJ Abstract Rosacea is one of the most commonly occurring dermatoses treated by dermatologists. There are multiple therapeutic options available for the treatment of papulopustular rosacea. Rosacea is an inflammatory condition, classically presenting with flushing and/or blushing along with erythema, edema, telangiectasia, papules, pustules, and nodules of the face. Minocycline, a member of the tetracycline family, has demonstrated benefit in the treatment of inflammatory lesions in patients with rosacea. This manuscript highlights the use of a new sustained-release low-dose minocycline 45 mg tablet, with or without azelaic acid, for the treatment of papulopustular rosacea.<br><br> <em>J Drugs Dermatol.</em> 2013;12(3):292-298. PMID: 23545911 [PubMed - in process] http://www.ncbi.nlm.nih.gov/pubmed/23545911?dopt=Abstract = URL to article

Nerve-derived Transmitters Including Peptides Influence Cutaneous Immunology. Brain Behav Immun. 2013 Mar 18; Authors: Madva EN, Granstein RD Abstract Clinical observations suggest that the nervous and immune systems are closely related. For example, inflammatory skin disorders; such as psoriasis, atopic dermatitis, rosacea and acne; are widely believed to be exacerbated by stress. A growing body of research now suggests that neuropeptides and neurotransmitters serve as a link between these two systems. Neuropeptides and neurotransmitters are released by nerves innervating the skin to influence important actors of the immune system, such as Langerhans cells and mast cells, which are located within close anatomic proximity. Catecholamines and other sympathetic transmitters that are released in response to activation of the sympathetic nervous system are also able to reach the skin and affect immune cells. Neuropeptides appear to direct the outcome of Langerhans cell antigen presentation with regard to the subtypes of Th cells generated and neuropeptides induce the degranulation of mast cells, among other effects. Additionally, endothelial cells, which release many inflammatory mediators and express cell surface molecules that allow leukocytes to exit the bloodstream, appear to be regulated by certain neuropeptides and transmitters. This review focuses on the evidence that products of nerves have important regulatory activities on antigen presentation, mast cell function and endothelial cell biology. These activities are highly likely to have clinical and therapeutic relevance. PMID: 23517710 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/PubMed/23517710?dopt=Abstract = URL to article

Efficacy of azithromycin 1.5% eye drops in childhood ocular rosacea with phlyctenular blepharokeratoconjunctivitis. J Ophthalmic Inflamm Infect. 2013;3(1):38 Authors: Doan S, Gabison E, Chiambaretta F, Touati M, Cochereau I Abstract BACKGROUND: The purpose of this study is to report the efficacy of azithromycin 1.5% eye drops in children with ocular rosacea and phlyctenular blepharokeratoconjunctivitis. This retrospective study from January 2009 to March 2010 included 16 children treated with lid hygiene plus azithromycin 1.5% eye drops (Azyter®): 3-day treatments (1 drop twice a day) every 10 days, reduced based on efficacy to one treatment every 15 days and then to one treatment per month. RESULTS: Nineteen eyes of six boys and ten girls, aged 4 to 16 years (mean, 9.3 ± 4.0) were included. The disease was previously resistant to lid hygiene (all the patients), oral erythromycin (one patient), and intermittent topical steroids (six patients). The median duration of each phase of azithromycin treatment (i.e., three, two, and one treatments per month) was 2 months. Ocular inflammation was controlled by azithromycin alone in 15 patients. In one uncontrolled case, cyclosporine 2% eye drops was added at month 5. Bulbar conjunctival hyperemia resolved completely within 1 month in all eyes, whereas conjunctival phlyctenules and corneal inflammation took longer to improve, with a complete resolution within 3 to 10 months. Blepharitis grade decreased from 2.31 ± 0.79 to 1.50 ± 0.73. Treatment was stopped after a median of 6 months (from 4 to 10 months) without recurrence of corneoconjunctival inflammation (median follow-up without treatment, 11 months). Six cases of ocular irritation were reported, two of which led to treatment withdrawal. CONCLUSION: Azithromycin 1.5% eye drops is an effective treatment for phlyctenular keratoconjunctivitis complicating childhood ocular rosacea. PMID: 23514194 [PubMed - in process] http://www.ncbi.nlm.nih.gov/PubMed/23514194?dopt=Abstract = URL to article

Dermoscopic patterns of common facial inflammatory skin diseases. J Eur Acad Dermatol Venereol. 2013 Mar 12; Authors: Lallas A, Argenziano G, Apalla Z, Gourhant JY, Zaballos P, Di Lernia V, Moscarella E, Longo C, Zalaudek I Abstract BACKGROUND: Several common inflammatory dermatoses, such as rosacea, seborrheic dermatitis (SD), discoid lupus erythematosus (DLE) and granulomatous skin diseases manifest as erythematous macules or plaques on the facial skin. Although clinical examination represents the cornerstone of diagnosis, the broad variety of clinical features and uncommon presentations of these diseases may cause at times diagnostic and therapeutic uncertainty. Dermoscopy, in addition to its well-documented value in evaluation of skin tumours, is continuously gaining appreciation also in the field of general dermatology. OBJECTIVE: To describe and compare the dermoscopic patterns of common facial inflammatory skin diseases including SD, erythematotelangiectatic rosacea (ER), sarcoidosis, lupus vulgaris (LV), DLE and granuloma faciale (GF). METHODS: Dermoscopic images of lesions from patients with histopathologically confirmed diagnosis of SD, ER, sarcoidosis, LV, DLE or GF were retrospectively evaluated for the presence of several criteria. Selection of the dermoscopic variables included in the evaluation process was based on the data available in the literature and on our preliminary observations. RESULTS: One hundred and fifteen dermoscopic images were included in the study. SD was dermoscopically characterized by dotted vessels and yellow scales, whereas ER was typified by a characteristic pattern of vascular polygons. Sarcoidosis and LV very commonly exhibited orange-yellowish areas and linear branching vessels. Features related to follicle abnormalities and linear branching vessels were the most common dermoscopic criteria of DLE and GF. CONCLUSIONS: This study provides new insights into the dermoscopic variability in common facial inflammatory dermatoses. PMID: 23489377 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/PubMed/23489377?dopt=Abstract = URL to article

Clinical and histopathological differential diagnosis of eosinophilic pustular folliculitis. J Dermatol. 2013 Mar 12; Authors: Fujiyama T, Tokura Y Abstract Eosinophilic pustular folliculitis (EPF) is an inflammatory disease characterized by repeated pruritic follicular papules and pustules arranged in arcuate plaques, and folliculotropic infiltration of eosinophils. The diagnosis of EPF is occasionally difficult and problematic because EPF may share the clinical appearance and histological findings with other diseases. Moreover, EPF has several clinical subtypes, including the classical type, infantile type and immunosuppression-associated type. Because the therapies of EPF are relatively specific as compared to eczematous disorders, accurate diagnosis is essential for the management of EPF. Clinical differential diagnoses include tinea, acne, rosacea, eczematous dermatitis, granuloma faciale, autoimmune annular erythema, infestations and pustular dermatosis. Histologically, cutaneous diseases with eosinophilic infiltrates can be differentially diagnosed. Follicular mucinosis, mycosis fungoides and other cutaneous T-cell lymphomas are the most important differential diagnoses both clinically and histopathologically. It should be kept in mind particularly that the initial lesions of cutaneous T-cell lymphoma resemble EPF. PMID: 23488969 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/PubMed/23488969?dopt=Abstract = URL to article

Related ArticlesEruption in a patient with Crohn disease. JAMA Dermatol. 2013 Jan;149(1):97-102 Authors: Gavrilova M, Alonso V, Martin-Gorgojo A, Rubio M, Ramon D, Monteagudo C, Jorda-Cuevas E PMID: 23324767 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/PubMed/23324767?dopt=Abstract = URL to article

Related ArticlesPseudoacne, pseudorosacea, and follicular follicular lymphoma. J Cutan Pathol. 2012 Nov;39(11):985-6 Authors: McCalmont TH PMID: 23072418 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/PubMed/23072418?dopt=Abstract = URL to article