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  1. Related Articles Intense pulsed light for improving dry eye disease in rosacea. J Am Acad Dermatol. 2019 Dec 03;: Authors: Vazirnia A, Wat H, Danesh MJ, Anderson RR PMID: 31809814 [PubMed - as supplied by publisher] {url} = URL to article
  2. Related Articles Rosacea-like acute reaction after hyaluronic acid dermal filler. G Ital Dermatol Venereol. 2019 Dec 04;: Authors: Valenti M, Guanziroli E, Mancini LL, Costanzo A PMID: 31804049 [PubMed - as supplied by publisher] {url} = URL to article
  3. Related Articles Rosacea associated with increased risk of generalized anxiety disorder: a case-control study of prevalence and risk of anxiety in patients with rosacea. An Bras Dermatol. 2019 Oct 26;: Authors: Incel Uysal P, Akdogan N, Hayran Y, Oktem A, Yalcin B Abstract BACKGROUND: Rosacea may result in emotional distress and anxiety. However, data on the presence of generalized anxiety disorder in rosacea patients are scarce. OBJECTIVE: The aim of the study was to detect the frequency and level of anxiety and depression in patients with rosacea. METHODS: A total of 194 consecutive rosacea patients and 194 age- and sex-matched controls were enrolled. Severity of rosacea was assessed in patients according to the criteria of the National Rosacea Society Ethics Committee. Both patients and controls were evaluated by the Generalized Anxiety Disorder 7-item scale, and severity was measured by the Generalized Anxiety Disorder-Adult. RESULTS: Individuals who were diagnosed with an anxiety and/or depressive disorder were more common in patient group (24.7% vs. 7.2%, p<0,01). Female patients were particularly at risk for having generalized anxiety disorder (OR=2.8; 95% CI 1.15-7.37; p=0.02). STUDY LIMITATIONS: Single center study and limited sample size. CONCLUSIONS: Rosacea patients show greater risk of having anxiety disorders, including generalized anxiety disorder. Female patients, those with lower educational levels, those with phymatous subtype, untreated patients, and patients with prior psychiatric morbidity may be at particular risk for anxiety. It is essential to consider the psychological characteristics of patients to improve their well-being. PMID: 31789266 [PubMed - as supplied by publisher] {url} = URL to article
  4. Related Articles ACTH-dependent Hypercortisolemia in a Patient with a Pituitary Microadenoma and an Atypical Carcinoid Tumour of the Thymus. Medicina (Kaunas). 2019 Nov 27;55(12): Authors: Baranowska-Jurkun A, Szychlińska M, Matuszewski W, Modzelewski R, Bandurska-Stankiewicz E Abstract Cushing's syndrome (CS) is a set of clinical symptoms which occur as a result of hypercortisolemia. Endogenous ACTH-dependent CS related to an ectopic ACTH-secreting tumour constitutes 12%-17% of CS cases and is one of the most common causes of paraneoplastic syndromes. This study presents a case of a 31 year-old man with diabetes, hypertension, rosacea, purple stretch marks and hypokalemia. Findings of diagnostic procedures include high concentrations of cortisol and ACTH, pituitary microadenoma and a tumour in the anterior mediastinum. Dynamic hormone tests determined the source of excess hormone secretion and ectopic ACTH-dependent CS was diagnosed. Due to increasing symptoms of superior vena cava syndrome, an emergency resection of almost the whole tumour was performed, with only a small part of the upper pole left because of the proximity of large vessels and a risk of damaging them. On the basis of histopathological tests, an atypical carcinoid tumour of the thymus was identified. Immediately after the surgical procedure, there was a significant reduction of clinical and laboratory traits of hypercortisolemia, yet, during the 46 weeks of postoperative observation, despite chemotherapy, the progression of residual masses of the tumour occurred with metastases and increased hormone indices. The presented case shows and discusses the differentiation of ACTH-dependent hypercortisolemia and its causes, difficulties in surgical therapy and chemotherapy, as well as prognosis for atypical carcinoid of the thymus, which is a rare disease. PMID: 31783507 [PubMed - in process] {url} = URL to article
  5. Ocular surface changes in the treatment of rosacea: comparison between low-dose oral isotretinoin and doxycycline. Arq Bras Oftalmol. 2019 Nov 25;: Authors: Andrade FMX, Picosse FR, Cunha LPD, Valente CM, Bezerra FM, Miot H, Bagatin E, Freitas D Abstract PURPOSE: To compare the impact of ocular changes between systemic treatment with doxycycline and low-dose oral isotretinoin in patients with moderate-to-severe papulopustular rosacea. METHODS: Patients were randomized to receive either isotretinoin 0.3-0.4 mg/kg (group A) or doxycycline 100 mg/day (group B) for 16 weeks. Ocular symptoms were searched and evaluated, including best-corrected visual acuity (BCVA), Schirmer test, breakup time, rose bengal staining score, and meibomian gland dysfunction grading. The patients were retested at the end of treatment. RESULTS: The present study included 39 patients (30 females and 9 males). Best-corrected visual acuity was > 20/30 in >90% of patients in both groups and did not change after treatment. After treatment, improvement in ocular symptoms and meibomian gland dysfunction was more pronounced in group B (p<0.05); the other parameters did not reach statistical significance. CONCLUSION: Doxycycline improved meibomian gland dysfunction, ocular symptoms, and ocular surface in patients with rosacea. Even though some patients experienced worsening meibomian gland dysfunction and symptoms, no subject experienced any serious complications after administration of low-dose isotretinoin. PMID: 31778446 [PubMed - as supplied by publisher] {url} = URL to article
  6. Related Articles Rhinophyma is associated with alcohol intake. J Am Acad Dermatol. 2019 07;81(1):249-250 Authors: Second J, Severac F, Paix A, Cribier B PMID: 30630023 [PubMed - indexed for MEDLINE] {url} = URL to article
  7. Related Articles Rosacea treatment: a patient-centric approach. Br J Dermatol. 2019 Nov 26;: Authors: Elewski B PMID: 31773725 [PubMed - as supplied by publisher] {url} = URL to article
  8. Related Articles Unilateral Periocular Intralymphatic Histiocytosis, Associated With Rosacea (Morbihan Disease). Am J Dermatopathol. 2019 Nov 19;: Authors: Belousova IE, Kastnerova L, Khairutdinov VR, Kazakov DV Abstract Intralymphatic histiocytosis is a rare reactive skin condition characterized by a nonspecific clinical presentation and, microscopically, by the collections of mononuclear histiocytes within the lumina of dilated lymphatic vessels. We report a rare case of intralymphatic histiocytosis associated with rosacea and prominent periocular edema (Morbihan disease). The patient is a 56-year-old woman with a 12-year history of rosacea who suddenly developed edema of the right upper eyelid that persisted 6 months before she sought medical advice. Because of an unclear clinical diagnosis, surgical excision of the edematous upper eyelid was performed. The histologic slides showed interstitial edema of the dermis with dilated vascular channels and small epithelioid cell granulomas around hair follicles. In addition, there were aggregates of cells inside numerous lymphatic vessels that were immunohistochemically positive for CD45, CD4, CD68, CD163, CD64, CD14, CD11c, and lysozyme and negative for CD3, CD20, CD30, CD56, S100, CD1a, and langerin. PMID: 31764086 [PubMed - as supplied by publisher] {url} = URL to article
  9. Related Articles Microvascular Effects of Pulsed Dye Laser in Combination With Oxymetazoline. Lasers Surg Med. 2019 Nov 22;: Authors: Kelly A, Pai A, Lertsakdadet B, Choi B, Kelly KM Abstract BACKGROUND AND OBJECTIVE: Oxymetazoline, an α-1A agonist, is approved by the United States Food and Drug Administration (FDA) for treatment of persistent facial erythema associated with rosacea and induces vasoconstriction by interacting with α receptors. The objective of our study was to study the microvascular effects of oxymetazoline and pulsed dye laser (PDL). MATERIALS AND METHODS: A dorsal window chamber was surgically installed on 20 mice. Each animal was assigned to one of four experimental groups: saline alone, oxymetazoline alone (10 μl applied once daily × 7 days), saline + PDL (saline applied 5 minutes before PDL irradiation [10 mm spot, 1.5 ms pulse duration, 7 J/cm2 delivered to epidermis]), or oxymetazoline + PDL (10 μl oxymetazoline applied 5 minutes before PDL and then once daily × 7 days). Brightfield and laser speckle imaging were performed for 7 days to monitor vascular architectural and functional changes. RESULTS: We observed persistent blood flow in all of the saline-only and oxymetazoline-only experiments. A higher rate of vascular shutdown was observed with oxymetazoline + PDL (66.7%) compared with saline + PDL alone (16.7%). Oxymetazoline application increased venule diameter at 5 minutes post-application and decreased both arteriole and venule diameters at 60 minutes post-application. CONCLUSION: The combination protocol of oxymetazoline + PDL induces persistent vascular shutdown observed 7 days after irradiation. This result may be associated with the acute vascular effects of oxymetazoline. Oxymetazoline + PDL should be evaluated as a treatment for cutaneous vascular disease, including rosacea and port wine birthmarks. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc. PMID: 31758568 [PubMed - as supplied by publisher] {url} = URL to article
  10. Related Articles Global Perspectives of the Patient of Color J Drugs Dermatol. 2019 Jul 01;18(7):615 Authors: Burgess CM Abstract Many cultures associate beauty with an even complexion. It has been shown in many reported references, the major cosmetic concern in patients of color is discoloration. This issue addresses discoloration of individuals of color and the use of a multitude of preparations that can blend the complexion. Authors in Asia, Sweden, France, and Brazil discuss the use of injectable deoxycholic acid in nonsubmental regions and hyaluronic acid for skin boosting, an off-label usage or procedures in the United States. Skin boosting improves hydration and the smoothness of the skin. Additionally, international methods of treating cosmetic patients with multiple modalities are discussed. PMID: 31329381 [PubMed - indexed for MEDLINE] {url} = URL to article
  11. Related Articles Effects of Zinc Supplementation on Inflammatory Skin Diseases: A Systematic Review of the Clinical Evidence. Am J Clin Dermatol. 2019 Nov 19;: Authors: Dhaliwal S, Nguyen M, Vaughn AR, Notay M, Chambers CJ, Sivamani RK Abstract BACKGROUND: Zinc has been used in patients with acne vulgaris for its anti-inflammatory effects; however, it is unclear if zinc supplementation is also beneficial in other inflammatory skin conditions. OBJECTIVE: The objective of this article was to determine the effect of zinc supplementation on inflammatory dermatologic conditions. DATA SOURCES: We searched the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, and Ovid with no time limit up to 29 May, 2019. Trials examining supplementation with zinc in the treatment of inflammatory dermatological conditions (acne vulgaris, atopic dermatitis, diaper dermatitis, hidradenitis suppurativa, psoriasis, and rosacea) in children and adults were selected. RESULTS: Of 229 articles, 22 met inclusion criteria. Supplementation with zinc was found to be beneficial in ten of 14 studies evaluating its effects on acne vulgaris, one of two studies on atopic dermatitis, one of one study on diaper dermatitis, and three of three studies evaluating its effects on hidradenitis suppurativa. However, the one article found on psoriasis and the one article found on rosacea showed no significant benefit of zinc treatment on disease outcome. CONCLUSIONS AND IMPLICATIONS: Some preliminary evidence supports the use of zinc in the treatment of acne vulgaris and hidradenitis suppurativa; however, more research is needed with similar methodologies and larger sample sizes in these diseases. Further, zinc may be of some benefit in the treatment plan for atopic dermatitis and diaper dermatitis; however, additional studies should be conducted to further evaluate these potentially positive associations. To date, no evidence is available to suggest that zinc may be of benefit in rosacea and psoriasis; however, limited data are available evaluating the use of zinc in these conditions. PMID: 31745908 [PubMed - as supplied by publisher] {url} = URL to article
  12. Related Articles Cutaneous pseudolymphoma with rhinophyma-like lesion. J Dermatol. 2019 09;46(9):e335-e337 Authors: Oginezawa M, Kawai K PMID: 30951205 [PubMed - indexed for MEDLINE] {url} = URL to article
  13. Related Articles Topical treatments for rosacea. Can Fam Physician. 2019 Nov;65(11):803 Authors: Fritsch P, Kolber MR, Korownyk C PMID: 31722913 [PubMed - in process] {url} = URL to article
  14. Related Articles [Rhinophyma, management methods and oncological risk]. Rev Med Liege. 2019 Nov;74(11):606-610 Authors: Bachelet JT, Delafond C, Buchholzer S, Modaressi SA, Nizet C, Termont A Abstract Rhinophyma is the most advanced stage of rosacea (stage IV). It is a benign lesion but aesthetically disabling. We present through a major case of rhinophyma and a review of the literature the diagnostic modalities, the therapeutic alternatives and the risks to be known. Particularly, we detail the risks of oncologic transformation of these poorly known lesions.The management of these rare lesions is based on a collaboration between the surgeon and the dermatologist. PMID: 31729850 [PubMed - in process] {url} = URL to article
  15. Related Articles Cutaneous pseudolymphoma with rhinophyma-like lesion. J Dermatol. 2019 09;46(9):e335-e337 Authors: Oginezawa M, Kawai K PMID: 30951205 [PubMed - indexed for MEDLINE] {url} = URL to article
  16. Related Articles Topical treatments for rosacea. Can Fam Physician. 2019 Nov;65(11):803 Authors: Fritsch P, Kolber MR, Korownyk C PMID: 31722913 [PubMed - in process] {url} = URL to article
  17. Related Articles [Rhinophyma, management methods and oncological risk]. Rev Med Liege. 2019 Nov;74(11):606-610 Authors: Bachelet JT, Delafond C, Buchholzer S, Modaressi SA, Nizet C, Termont A Abstract Rhinophyma is the most advanced stage of rosacea (stage IV). It is a benign lesion but aesthetically disabling. We present through a major case of rhinophyma and a review of the literature the diagnostic modalities, the therapeutic alternatives and the risks to be known. Particularly, we detail the risks of oncologic transformation of these poorly known lesions.The management of these rare lesions is based on a collaboration between the surgeon and the dermatologist. PMID: 31729850 [PubMed - in process] {url} = URL to article
  18. Related Articles The Skin and Gut Microbiome and Its Role in Common Dermatologic Conditions. Microorganisms. 2019 Nov 11;7(11): Authors: Ellis SR, Nguyen M, Vaughn AR, Notay M, Burney WA, Sandhu S, Sivamani RK Abstract Microorganisms inhabit various areas of the body, including the gut and skin, and are important in maintaining homeostasis. Changes to the normal microflora due to genetic or environmental factors can contribute to the development of various disease states. In this review, we will discuss the relationship between the gut and skin microbiome and various dermatological diseases including acne, psoriasis, rosacea, and atopic dermatitis. In addition, we will discuss the impact of treatment on the microbiome and the role of probiotics. PMID: 31717915 [PubMed] {url} = URL to article
  19. Impact of nanostructured lipid carriers on dapsone delivery to the skin; in vitro and in vivo studies. Int J Pharm. 2019 Nov 09;:118781 Authors: Elmowafy M, Shalaby K, Ali HM, Alruwaili NK, Salama A, Ibrahim MF, Akl MA, Ahmed TA Abstract The main objective of this study was to develop, characterize and evaluate the potential use of dapsone-loaded nanostructured lipid carriers (NLCs) as a topical treatment for acne. Differently charged NLC formulations were successfully prepared using an emulsification/sonication method. The particle sizes ranged from 106.2±5.6 nm to 151.3±7.4 nm, and the NLCs possessed the predicted surface charges, depending on the emulsifier used (Tween 80, Transcutol P, or cetyltrimethylammonium bromide). The entrapment efficiencies ranged from 76.5±3.8 % to 91.1±3.9 %. Selected formulations were assessed for possible interactions, in vitro release, ex vivo skin permeation, pharmacological efficacy and safety compared with a hydroalcoholic solution. Dapsone was embedded in the lipid matrix of NLCs and behaved as controlled release system with a good occlusive effect. Dapsone-loaded cationic NLC formulation enhanced the skin permeation of dapsone, increase the amount of dapsone retained in the skin in controlled manner, and improved the anti-rosacea activity. Based on these encouraging results, cationic NLC represents a promising carrier for the safe topical delivery of dapsone. PMID: 31715347 [PubMed - as supplied by publisher] {url} = URL to article
  20. Related Articles Treatment of Erythematotelangiectatic Rosacea With Pulsed-Dye Laser and Oxymetazoline 1.0% Cream: A Retrospective Study. Lasers Surg Med. 2019 Nov 10;: Authors: Suggs AK, Macri A, Richmond H, Munavalli G, Friedman PM Abstract BACKGROUND AND OBJECTIVES: Pulsed-dye laser (PDL) and oxymetazoline 1.0% cream are each used for the treatment of erythematotelangiectatic (ET) rosacea. PDL targets oxyhemoglobin and can reduce facial erythema and telangiectasias. Oxymetazoline 1.0% cream is an α adrenergic agonist, which has shown to reduce facial erythema. The aim of this study was to determine the degree of erythema improvement and telangiectasia clearance after combination treatment with PDL plus oxymetazoline 1.0% cream. STUDY DESIGN/MATERIALS AND METHODS: This retrospective study was conducted at two sites. Pre- and post-treatment cross-polarized images from subjects on combination treatment with PDL and oxymetazoline 1.0% cream were graded by a board-certified dermatologist at each practice. Blinded images were analyzed using the Clinical Erythema Assessment (CEA) Scale (0 = clear and 4 = severe). Unblinded images were analyzed using the five-point Telangiectasia Scale to determine the degree of improvement post-treatment compared with baseline (1 = <5% clearance and 5 = 75-100% clearance). RESULTS: Thirty-one subjects (20 females, 11 males) of age 51 ± 13 years (mean ± standard deviation) were included in the study after an average of 4 months (range: 1-13) of daily oxymetazoline 1.0% cream and two (range: 1-4) PDL treatments. At baseline, 87% of subjects had CEA Grade 2 (mild erythema) or higher. For erythema, 55% of subjects improved by at least one CEA grade and 13% achieved two grades of improvement post-treatment. For telangiectasias, 90% of subjects achieved at least a two-point clearance (5-25%), 62% at least a three-point clearance (25-50%), and 41% at least a four-point clearance (50-75%) post-treatment. Compared with subjects with baseline CEA Grade 1-2 (almost clear to mild erythema), significantly more subjects with baseline CEA Grade 3-4 (moderate to severe erythema) achieved at least one CEA grade of improvement (P = 0.021) and two grades of CEA improvement (P = 0.041). A higher percentage of baseline CEA Grade 3-4 subjects achieved at least a two-point clearance in telangiectasias (P = 0.055). CONCLUSIONS: Combination treatment with PDL and daily oxymetazoline 1.0% cream can safely and effectively reduce erythema and telangiectasias. Limitations include the retrospective design of the study, small sample size, and lack of a control group. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc. PMID: 31709571 [PubMed - as supplied by publisher] {url} = URL to article
  21. Related Articles Sebaceous Glands participate in the inflammation of Rosacea. J Eur Acad Dermatol Venereol. 2019 Nov 11;: Authors: Lee SH, Lee SB, Heo JH, Yoon HS, Byun JW, Choi GS, Shin J Abstract Rosacea is a chronic inflammatory dermatosis that can present with a variety of cutaneous manifestations.1 Recently, mast cells are known to be importantly related to the pathogenesis of rosacea.2 The disease characteristically presents a centrofacial distribution1,3 , an area rich in sebaceous glands. PMID: 31709649 [PubMed - as supplied by publisher] {url} = URL to article
  22. Related Articles Alterations of Immune and Keratinization Gene Expression in Papulopustular Rosacea by Whole Transcriptome Analysis. J Invest Dermatol. 2019 Nov 06;: Authors: Shih YH, Xu J, Kumar A, Li R, Chang ALS PMID: 31705873 [PubMed - as supplied by publisher] {url} = URL to article
  23. Related Articles [Mushroom keratoplasty in rosacea keratitis complicated by corneal perforation (a clinical case)]. Vestn Oftalmol. 2019;135(5. Vyp. 2):215-219 Authors: Trufanov SV, Krakhmaleva DA, Zaitsev AV, Salovarova EP, Tekeeva LY, Budnikova EA Abstract Rosacea is a polyethiologic chronic inflammatory disease with varying clinical manifestations. It is primarily a dermatologic disease, which often manifests in the eyes affecting eyelids, cornea and conjunctiva. The leading role in the pathological process belongs to disruption of regulatory mechanisms in the vascular, immune and nervous systems. It is accompanied by increased levels of metalloproteinases and vascular endothelial growth factor (VEGF). Treatment depends on the severity of the disease and may vary from hygiene of the eyelid margins and use of artificial tears for dry eye disease management, to antibiotics and anti-inflammatory agents in moderate cases, and surgical treatment in severe or neglected state. A clinical case of severe rosacea shows that keratoplasty with mushroom-shaped profile of the surgical incision helps achieve good functional results and reduce the post-operative rehabilitation time, while significantly reducing the risk of postsurgical complications. Anti-VEGF therapy significantly reduces the risk of histoincompatibility reaction typical for rosacea keratitis. PMID: 31691663 [PubMed - in process] {url} = URL to article
  24. Related Articles [Chronic mucocutaneous candidiasis with STAT1 gain-of-function mutation associated with herpes virus and mycobacterial infections]. Ann Dermatol Venereol. 2019 Oct 30;: Authors: Baghad B, Benhsaien I, El Fatoiki FZ, Migaud M, Puel A, Chiheb S, Bousfiha AA, Ailal F Abstract INTRODUCTION: Chronic mucocutaneous candidiasis (CMC) is characterized by susceptibility to chronic or recurrent infections with yeasts of the genus Candida affecting the skin, nails and mucous membranes. We describe a Moroccan patient presenting CMC with heterozygous STAT1 gain-of-function (GOF) mutation. PATIENTS AND METHODS: A 5-year-old boy with no consanguinity presented recurrent episodes of oral thrush, chronic nail candidiasis and herpetic gingivostomatitis from the age of 8 months. He also had mycobacterial adenitis secondary to BCG vaccination and atypical rosacea. Genetic analysis revealed GOF mutation of the STAT1 gene. DISCUSSION: CMC was diagnosed in our patient despite poor clinical features. Sequencing of the genome revealed STAT1GOF mutation. This mutation affects production of IL-17, an important cytokine in mucocutaneous defense against Candida. The association with mycobacterial adenitis is rare and continues to be poorly understood. The presence of atypical rosacea in this setting is suggestive of this entity. Antifungal therapy and prevention of complications are necessary to reduce the morbidity and mortality associated with this condition. CONCLUSION: CMC due to STAT1GOF mutation is characterized by a broad clinical spectrum and should be considered in all cases of chronic or recurrent fungal infection, whether or not associated with other infections. PMID: 31677808 [PubMed - as supplied by publisher] {url} = URL to article
  25. Related Articles Association of dental foci of infection and rosacea: a case report. Gen Dent. 2019 Nov-Dec;67(6):52-54 Authors: Sopi M, Meqa K Abstract Rosacea, a chronic inflammatory disease of the skin, is characterized by rash, pustules, papules, and dilated blood vessels. The etiology is unknown, and the disease is more common among women than among men. Among the proposed causes of this disorder are dental foci of infection, with periapical lesions the most common pathologic lesion in the alveolar bone. The aim of this report is to examine the possible relationship between periapical lesions as dental foci and rosacea. A 50-year-old woman reported redness in her face, for which she had been treated by a gastroenterologist for Helicobacter pylori and a dermatologist for rosacea. After clinical, radiographic, and laboratory examinations, suspicions of dental foci were raised. The residual roots of teeth 4, 5, 12, 15, and 18 were extracted, and teeth 16, 29, and 31 underwent endodontic treatment. One year after dental treatment, all signs of redness in the patient's face had healed, she stopped all treatments, and her laboratory values were normal. PMID: 31658025 [PubMed - in process] {url} = URL to article
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