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Eur J Pediatr. 2023 Aug 9. doi: 10.1007/s00431-023-05083-0. Online ahead of print.

ABSTRACT

Rosacea is a facial inflammatory disorder that shows an increasing incidence with age. While rosacea is common > 60 years of age, pediatric rosacea is uncommon. Diagnostic criteria are based on clinical symptoms. Laboratory investigations and histopathology are only needed to exclude other differential diagnoses. There are several subtypes such as erythemato-telangiectatic, papulo-pustular, periorificial, and granulomatous variants. In contrast to adult rosacea, phymatous subtypes do not belong to pediatric rosacea. A special subtype seen in infants and children is an idiopathic facial aseptic granuloma. Genetic and environmental factors contribute to its pathogenesis. Treatment options are in analogy to adult rosacea classified into topical and systemic drugs. In the case of oral tetracyclines, discoloration of teeth and impairment of enamel are possible adverse events.

CONCLUSION: Pediatric rosacea belongs to the rosacea spectrum but has peculiarities compared to the adult subtype.

WHAT IS KNOWN: • Rosacea is a chronic inflammatory disorder different from acne. • Rosacea gets more common with advanced age.

WHAT IS NEW: • Pediatric rosacea is an uncommon subtype with peculiar clinical presentation. • Demodicosis is very rare in immunocompetent children.

PMID:37555972 | DOI:10.1007/s00431-023-05083-0

J Cosmet Dermatol. 2023 Aug 7. doi: 10.1111/jocd.15923. Online ahead of print.

ABSTRACT

BACKGROUND: Topical azelaic acid (AA) is indicated for acne and rosacea, but there is some evidence for its use for other dermatological conditions.

AIMS: To assess the effectiveness and safety of topical AA for acne vulgaris, rosacea, hyperpigmentation/melasma, and skin aging.

METHODS: RCTs of at least 6 weeks' treatment duration were eligible for inclusion. Databases including MEDLINE, Embase, CINAHL, and ClinicalTrials.gov were searched up to December 2022. Two reviewers were involved in all stages of the systematic review process.

RESULTS: Forty-three RCTs met the inclusion criteria. Meta-analyses within 20 rosacea studies demonstrated that erythema severity, inflammatory lesion counts, overall improvement, and treatment success (achieving skin clarity) were significantly improved with AA compared with vehicle after 12 weeks. AA was more effective than metronidazole 0.75% for improved erythema severity, overall improvement, and inflammatory lesion counts. Sixteen acne studies suggest that AA is more effective than vehicle for improving global assessments and reducing acne severity. AA 20% also significantly reduced more lesions than erythromycin gel. Within seven melasma studies, AA 20% was significantly better than vehicle for both severity and global improvement. AA 20% demonstrated significantly better results compared with hydroquinone 2% for global improvement. Very few significant differences between AA and comparators were observed for commonly reported adverse events. No eligible RCTs were found that evaluated skin aging.

CONCLUSIONS: AA is more effective than vehicle for rosacea, acne and melasma. Comparisons between AA and other treatments were often equivalent. Where there is equivalence, AA may be a good option for some clinical situations. RCT evidence is needed to evaluate the effectiveness of AA on skin aging.

PMID:37550898 | DOI:10.1111/jocd.15923

Clin Cosmet Investig Dermatol. 2023 Jul 25;16:1949-1954. doi: 10.2147/CCID.S417070. eCollection 2023.

ABSTRACT

Morbihan disease is a rare entity involving the upper two-thirds of the face and characterized by chronic erythematous edema, which is recalcitrant to the traditional therapy of rosacea. We report a case of Morbihan disease effectively treated with macro-focused high-intensity focus ultrasound (MF-HIFU). After MF-HIFU treatment, an obvious reduction in swelling was observed with decreased erythema and hyperalgesia. In addition, in-vitro experiments were conducted to measure the actual temperature of the skin tissue under the epidermis. The results of the in-vitro experiments showed that the temperature plateau in the skin sample was reached at approximately 42°C after 5-min treatment or longer. MF-HIFU might be a promising energy-based therapy for Morbihan disease.

PMID:37519942 | PMC:PMC10386836 | DOI:10.2147/CCID.S417070

Skin Res Technol. 2023 Jul;29(7):e13409. doi: 10.1111/srt.13409.

NO ABSTRACT

PMID:37522510 | DOI:10.1111/srt.13409

J Am Acad Dermatol. 2023 Jul 29:S0190-9622(23)02412-X. doi: 10.1016/j.jaad.2023.07.1019. Online ahead of print.

NO ABSTRACT

PMID:37524168 | DOI:10.1016/j.jaad.2023.07.1019

Antibiotics (Basel). 2023 Jul 5;12(7):1152. doi: 10.3390/antibiotics12071152.

ABSTRACT

Tetracycline-class drugs are frequently used in dermatology for their anti-inflammatory properties to treat skin diseases such as acne, rosacea, and hidradenitis suppurativa (HS). The American Academy of Dermatology (AAD) clinical guidelines do not offer guidance regarding the co-administration of food with tetracycline-class drugs. The objectives of this study were to review the available evidence regarding whether taking tetracycline-class drugs with food decreases systemic absorption and is associated with an impact on clinical efficacy. A literature search was conducted using the PubMed database between February to May 2023 using the keywords "tetracycline-class drugs", "pharmacokinetics", "absorption", and "dermatology". Inclusion criteria included articles written in English and relevant to the absorption and efficacy of tetracycline-class drugs. This search yielded 131 articles written between 1977 to 2022, of which 29 met the criteria for review. United States Food and Drug Administration (FDA)-approved prescribing information for oral formulations of tetracycline, doxycycline, minocycline, and sarecycline were reviewed. Systemic absorption of tetracycline decreased when co-administered with food. Systemic absorption of oral doxycycline and minocycline was variable with food co-administration. The impact on bioavailability varied with the drug formulation and dosage. The absorption of oral sarecycline decreased when administered with food. Sarecycline is the only oral antibiotic where population pharmacokinetic studies demonstrated limited or no impact of food intake on clinical efficacy. There are no available data for other tetracycline-class drugs in dermatology. If patients find it more tolerable to take doxycycline, minocycline, and sarecycline with food to avoid gastrointestinal distress, this may merit consideration to encourage patient adherence. Since the impact of food intake on absorption varied with the dosage form of doxycycline and minocycline, consulting the appropriate package insert may give clinicians additional insight into differences in the various formulations.

PMID:37508248 | PMC:PMC10376323 | DOI:10.3390/antibiotics12071152

Metabolites. 2023 Jun 30;13(7):811. doi: 10.3390/metabo13070811.

ABSTRACT

Posterior blepharitis and dry eye are common disorders with meibomian gland dysfunction (MGD), a principal driver of their pathophysiology. Meibomian gland dysfunction is increasingly prevalent in older populations with contributory hormonal imbalances. The abnormal meibum in MGD has been documented to have an excess of cholesterol with a resultant disruption of the lipid layer of the tear film. This leads to tear film instability due to the inadequate trapping of the aqueous portion of the tear film with resultant evaporative dry eye. Significant morbidity may follow MGD with ocular surface inflammation disrupting both social and work function. Rosacea is a common chronic inflammatory condition of the central face but can have ocular and systemic inflammatory associations. It is especially prevalent in North European populations and can have onset at any age, but commonly presents between thirty and fifty years of age. In ocular rosacea, MGD is a recognised manifestation as is dyslipidaemia. Ocular rosacea can predate cutaneous disease. As yet, there is no directly reported evidence of the efficacy of the early identification and treatment of ocular rosacea with associated dyslipidaemia and systemic inflammation. We posit that MGD in ocular rosacea sufferers may be a marker for dysregulated cholesterol synthesis and inflammation, and that statins maybe a potential therapy. This article introduces potential strategies to utilise ocular rosacea MGD as a possible marker for ophthalmologists, cardiologists, and primary healthcare physicians to treat rosacea-associated dyslipidaemia and systemic inflammation. This could aid in overall cardiovascular morbidity and mortality control for rosacea sufferers, potentially at an earlier age, while also addressing their tear film de-stabilisation through cholesterol lowering and inflammation reduction.

PMID:37512518 | PMC:PMC10384312 | DOI:10.3390/metabo13070811

Evid Based Complement Alternat Med. 2023 Jul 19;2023:9768280. doi: 10.1155/2023/9768280. eCollection 2023.

ABSTRACT

[This retracts the article DOI: 10.1155/2022/3335074.].

PMID:37501827 | PMC:PMC10371531 | DOI:10.1155/2023/9768280

Cornea. 2023 Jul 27. doi: 10.1097/ICO.0000000000003345. Online ahead of print.

ABSTRACT

PURPOSE: The effect of skin lipids on the formation and stability of the human tear film was investigated.

METHODS: Skin swab substances (SSSs) were applied to the eyes of volunteers and studied using fluorescein or with TearView, which records infrared emissivity showing tear film integrity in real time. Results were compared with similar experiments using castor oil, freshly collected meibum, or acetic acid, which simulated the low pH of the skin.

RESULTS: Fluorescein and TearView results were comparable. TearView showed the natural unaltered tear film over the whole eye, instant changes to the tear film, and meibomian gland activity. Minimal amounts of SSS destroyed the integrity of the film and caused pain. Corneal epithelial damage could be detected. TearView showed that SSS stimulated meibomian gland secretion if applied directly to the posterior eyelid margin. Excess meibum had no effect on the tear film spread or integrity. Castor oil formed floating lenses on the tear film which were spread by a blink but then condensed back toward themselves. There was no pain or surface damage with these oils.

CONCLUSIONS: SSS contamination of the ocular surface disrupts the tear film, causes stinging, and fluorescein staining of the corneal epithelial cells after a blink. SSS stimulates meibomian gland activity. It is possible that various ocular conditions associated with dry eye, such as blepharitis and ocular rosacea, may compromise a meibomian lipid barrier of the eye lid margin. Skin lipids would then have access to the ocular surface and cause dry eye symptoms.

PMID:37506368 | DOI:10.1097/ICO.0000000000003345

Clin Cosmet Investig Dermatol. 2023 Jul 20;16:1865-1869. doi: 10.2147/CCID.S419756. eCollection 2023.

ABSTRACT

Periorificial dermatitis (PD) is an inflammatory disorder of the facial skin that mainly occurs around the mouth and manifests as erythema, papules, pustules, scales and other lesions. Special attention is needed in the clinical diagnosis of PD to distinguish it from acne, seborrheic dermatitis (SD), granulomatous rosacea (GR), sarcoidosis and childhood granulomatous periorificial dermatitis (CGPD). We used reflectance confocal microscopy (RCM) images of a patient with PD to assist in the diagnosis of PD. RCM of PD showed slight oedema of the spinous layer. Numerous dendritic cells, scattered hair follicular keratotic plugging and hair follicle dilatation were observed. The dilation and congestion of superficial dermis blood vessels, an increasing vascular density and accelerated blood flow, and a greater abundance of infiltrated inflammatory cells were also detected.

PMID:37492464 | PMC:PMC10364813 | DOI:10.2147/CCID.S419756

Skin Pharmacol Physiol. 2023 Jul 25. doi: 10.1159/000533190. Online ahead of print.

ABSTRACT

INTRODUCTION: Rosacea is a common, facial, chronic inflammatory skin disease. Due to its complex pathogenesis, adequate therapy of rosacea can be challenging. An innovative recent therapeutic tool is cold atmospheric plasma (CAP), which is already established in the treatment of chronic wounds and promising in different other skin diseases.

METHODS: In a split-face pilot study we investigated dielectric-barrier-discharged CAP in erythemato-telangiectatic (ETR) and/or papulopustular rosacea (PPR). CAP treatment was applied on lesional skin of a randomized side once daily (90 seconds/area) for six weeks. The other untreated side served as control. Co-primary endpoints were ≥1 improvement of the Investigator Global Assessment (IGA) score on the treated side compared to control and a decline of the Dermatology Life Quality Index (DLQI) after six weeks. Secondary endpoints included inflammatory lesion count (papules and pustules), skin redness intensity and erythema size. Adverse events (AEs) were recorded constantly. Additionally, participants were weekly assessed for symptoms, skin condition, trigger factors, skin care, treatment success, and local tolerance parameters. All p-values were calculated using the Wilcoxon signed rank test.

RESULTS: Twelve subjects (ETR, n=3; ETR and PPR, n=9) completed the study. DLQI was significantly improved after six weeks (p=0.007). On the CAP-treated side, lesions (p=0.007) and erythema size (p=0.041) were significantly reduced compared to the control. IGA (p=0.2) and skin redness intensity (p=0.5) did not differ significantly between control and CAP-treated side. No serious AEs occurred and treatment was well tolerated.

CONCLUSION: CAP is a promising new treatment of rosacea, especially for PPR.

PMID:37490882 | DOI:10.1159/000533190

J Am Acad Dermatol. 2023 Jul 22:S0190-9622(23)02394-0. doi: 10.1016/j.jaad.2023.07.1008. Online ahead of print.

NO ABSTRACT

PMID:37487834 | DOI:10.1016/j.jaad.2023.07.1008

Scand J Gastroenterol. 2023 Jul 21:1-7. doi: 10.1080/00365521.2023.2236263. Online ahead of print.

ABSTRACT

OBJECTIVES: The current knowledge on the associations between coeliac disease and different skin diseases is contradictory and the patient's perspective on the burden of these is lacking. This study aimed to investigate patient-reported frequency, severity and quality of life effects of skin disorders in coeliac disease patients compared to controls and moreover to study the impacts of gluten-free diet on these skin diseases.

MATERIALS AND METHODS: A study questionnaire designed for the purposes of this study and a validated Dermatology Life Quality Index (DLQI) questionnaire were posted to 600 adult members of the Finnish Coeliac Society and 1173 matched controls. Responses from 327 coeliac disease patients and 382 non-coeliac controls were compared.

RESULTS: Coeliac disease patients were shown to be at no increased risk of atopic dermatitis, acne, rosacea, psoriasis, alopecia areata, vitiligo or chronic urticaria. The severity of these skin diseases did not differ between study groups, but the risk for at least moderate effects on quality of life caused by dermatological diseases was increased among those with coeliac disease. Positive response from gluten-free diet was most commonly experienced by coeliac disease patients with atopic dermatitis.

CONCLUSIONS: Even though the risk for skin diseases was shown not to be increased among coeliac disease patients, there is still an increased burden related to experienced skin symptoms among these patients, which non-dermatologists treating coeliac disease patients should acknowledge.

PMID:37477901 | DOI:10.1080/00365521.2023.2236263

Mol Pharm. 2023 Aug 7;20(8):3804-3828. doi: 10.1021/acs.molpharmaceut.3c00324. Epub 2023 Jul 21.

ABSTRACT

Rosacea is a multifactorial chronic inflammatory dermatosis characterized by flushing, nontransient erythema, papules and pustules, telangiectasia, and phymatous alterations accompanied by itching, burning, or stinging, the pathophysiology of which is not yet fully understood. Conventional topical treatments usually show limited efficacy due to the physical barrier property of the skin that hinders skin penetration of the active ingredients, thereby hampering proper drug skin delivery and the respective therapeutic or cosmetic effects. New advances regarding the physiopathological understanding of the disease and the underlying mechanisms suggest the potential of new active ingredients as promising therapeutic and cosmetic approaches to this dermatosis. Additionally, the development of new drug delivery systems for skin delivery, particularly the potential of nanoparticles for the topical treatment and care of rosacea, has been described. Emphasis has been placed on their reduced nanometric size, which contributes to a significant improvement in the attainment of targeted skin drug delivery. In addition to the exposition of the known pathophysiology, epidemiology, diagnosis, and preventive measures, this Review covers the topical approaches used in the control of rosacea, including skin care, cosmetics, and topical therapies, as well as the future perspectives on these strategies.

PMID:37478169 | DOI:10.1021/acs.molpharmaceut.3c00324

J Cosmet Dermatol. 2023 Jul 19. doi: 10.1111/jocd.15878. Online ahead of print.

ABSTRACT

BACKGROUND: Although rosacea and seborrheic dermatitis share some symptoms of sensitive skin, whether they respond differently to lactic acid sting and capsaicin tests, common tests for diagnosis of sensitive skin, is unknown.

OBJECTIVES: To reveal the cutaneous responses to lactic acid sting (LAST) and capsaicin test (CAT) in females with either rosacea vs. seborrheic dermatitis.

METHODS: A total of 60 patients with rosacea, 20 patients with seborrheic dermatitis and 40 normal controls were enrolled in the study. Their skin sensitivity to stimuli were evaluated following topical application of either 10% lactic acid solution or 0.001% capsaicin solution. Transepidermal water loss (TEWL) rates and erythema indexes were also measured on the face.

RESULTS: In comparison to normal controls, the positive rate to either LAST or CAT was significantly higher in subjects with rosacea (p < 0.001), but not in that with seborrheic dermatitis. Similarly, individuals with rosacea displayed a higher positive rate to both LAST and CAT than those with seborrheic dermatitis and normal controls (p < 0.001). In parallel, the LAST scores and CAT scores in individuals with rosacea were significantly higher than in that with either seborrheic dermatitis or normal controls (p < 0.001). The baseline TEWL rates and erythema indexes were higher in individual with rosacea than in normal controls (p < 0.001). But the baseline TEWL rates and erythema indexes did not differ significantly between subjects with rosacea and that with seborrheic dermatitis. Moreover, LAST scores and CAT scores correlated positively with TEWL (p < 0.0001). TEWL rates were higher in CAT positive than in CAT negative subjects (p < 0.0001). Finally, erythema index correlated positively with CAT scores (p < 0.0001), but not with LAST scores (p = 0.0842).

CONCLUSIONS: Skin responses to LAST and CAT differ between individuals with rosacea and those with seborrheic dermatitis, possibly due to the differences in epidermal permeability barrier and the neurovascular hyperreactivity. The higher LAST and CAT scores, as well as positive rates of both LAST and CAT can be attributable to inferior permeability barrier and the neurovascular hyperreactivity in subjects with rosacea.

PMID:37464957 | DOI:10.1111/jocd.15878

Case Rep Rheumatol. 2023 Jul 5;2023:7353644. doi: 10.1155/2023/7353644. eCollection 2023.

ABSTRACT

Minocycline, a tetracycline antibiotic, is commonly used to treat rosacea and acne vulgaris. A rare adverse reaction of minocycline use is the development of drug-induced lupus. Fortunately, most patients recover from minocycline-induced lupus (MIL) after the drug is discontinued. However, many patients, after recovering from MIL, may desire further treatment for their acne and may consider doxycycline, a close relative of minocycline. Though no cases of doxycycline-induced lupus have been reported, there is little guidance in the medical literature as to whether doxycycline poses a particular risk to patients who have recovered from MIL. We report the long-term follow-up of a patient who recovered from MIL (the diagnosis satisfying clinical and laboratory criteria) and was treated for 8 years with various forms of doxycycline without any untoward effects, suggesting that, at least in some cases, doxycycline can be used safely following MIL.

PMID:37449244 | PMC:PMC10338125 | DOI:10.1155/2023/7353644

J Invest Dermatol. 2023 Jul 10:S0022-202X(23)02408-9. doi: 10.1016/j.jid.2023.05.028. Online ahead of print.

ABSTRACT

Recent efforts have described the transcriptomic landscape of rosacea. However, little is known about its proteomic characteristics. In this study, the proteome and phosphoproteome of lesional skin [LS], paired nonlesional skin [NS] and healthy skin (HS) were analysed by LC‒MS/MS. The molecular characteristics and potential pathogenic mechanism of rosacea were demonstrated by integrating the proteome, phosphoproteome and previous transcriptome. The proteomic data revealed a significant upregulation of inflammation- and axon extension-related proteins in LS and NS versus HS, implying an inflammatory and nerve-hypersensitive microenvironment in rosacea skin. Of these, axon-related proteins (DPYSL2 and DBNL) were correlated with the CEA score, and neutrophil-related proteins (ELANE and S100A family) were correlated with the IGA score. Moreover, comorbidity-related proteins were differentially expressed in rosacea; of these, α-synuclein was positively correlated with CEA score, implying a potential correlation between rosacea and comorbidities. Subsequently, the integrated proteome and transcriptome demonstrated consistent immune disturbances at both the transcriptional and protein levels. The integrative analysis of the proteome and phosphoproteome revealed the key TF network and kinase network that drive the dysregulation of immunity and vasculature in rosacea. In conclusion, our multiomics analysis enables more comprehensive insight into rosacea and offers an opportunity for novel treatment strategies.

PMID:37437773 | DOI:10.1016/j.jid.2023.05.028

Br J Clin Pharmacol. 2023 Jul 10. doi: 10.1111/bcp.15845. Online ahead of print.

ABSTRACT

MRGPRX2, a novel G_aq -coupled human mast cell receptor, mediates non-immune adverse reactions without the involvement of antibody priming. Constitutively expressed by human skin mast cells, MRGPRX2 modulates cell degranulation producing pseudoallergies manifesting as itch, inflammation, and pain. The term pseudoallergy is defined in relation to adverse drug reactions in general and immune/non-immune-mediated reactions in particular. A list of drugs with MRGPRX2 activity is presented including a detailed examination of three important and widely used approved therapies, neuromuscular blockers, quinolones, and opioids. For the clinician, the significance of MRGPRX2 is considered as an aid in distinguishing and ultimately identifying specific immune and non-immune inflammatory reactions. Anaphylactoid/anaphylactic reactions, neurogenic inflammation, and inflammatory diseases with a clear or strongly suspected association with MRGPRX2 activation are examined. Inflammatory diseases include chronic urticaria, rosacea, atopic dermatitis, allergic contact dermatitis, mastocytosis, allergic asthma, ulcerative colitis, and rheumatoid arthritis. MRGPRX2- and allergic IgE/FcεRI-mediated reactions may be clinically similar. Importantly, the usual testing procedures do not distinguish the two mechanisms. Currently, identification of MRGPRX2 activation and diagnosis of pseudoallergic reactions is generally viewed as a process of exclusion once other non-immune and immune processes, particularly IgE/FcεRI-mediated degranulation of mast cells, are ruled out. This does not take into account that MRGPRX2 signals via β-arrestin which can be utilized to detect MRGPRX2 activation by employing MRGPRX2 transfected cells to assess MRGPRX2 activation via two pathways, the G-protein-independent β-arrestin pathway and G-protein-dependent Ca²⁺ pathway. Testing procedures, interpretations for distinguishing mechanisms, patient diagnosis, agonist identification, and drug safety evaluations are addressed.

PMID:37430437 | DOI:10.1111/bcp.15845

Eur J Dermatol. 2023 Apr 1;33(2):101-108. doi: 10.1684/ejd.2023.4450.

ABSTRACT

BACKGROUND: Tinea incognito (TI) is a dermatophytic infection of the skin that is modified by steroid use. As a result, it shows atypical clinical presentations that can lead to misdiagnosis. TI occurring on the face is most frequently misdiagnosed as cutaneous fungal infection, however, very limited information is available on facial TI.

OBJECTIVES: This study aimed to characterize the clinical, dermoscopic and mycological features of facial TI.

MATERIALS & METHODS: We retrospectively evaluated 38 patients with mycologically proven facial TI at a single institution in Korea between July, 2014 and July, 2021.

RESULTS: The patients had a mean age of 59.6 ± 20.4 years and showed a slight female predominance (male-to-female ratio of 1:1.38). The most common clinical presentation was an eczema-like pattern (47.4%), followed by rosacea-like (15.8%), psoriasis-like (10.5%), lupus erythematosus-like (10.5%), cellulitis-like (7.9%), and folliculitis-like (7.9%) patterns. The mean duration from disease onset to diagnostic confirmation was 3.4 months. Overall, 78.9% of the patients had accompanying chronic systemic diseases, and 57.9% had concurrent tinea infections at other skin sites, mainly the feet and toenails. On dermoscopy, scales and dilated vascular patterns (arborizing vessels and telangiectasia) were commonly observed on glabrous skin, with follicular patterns, such as black dots, broken hairs, and empty follicles. The characteristic trichoscopic features were comma, corkscrew, Morse code-like, and translucent hairs.

CONCLUSION: The clinical characteristics and distinct dermoscopic features described in this article may aid in the differential diagnosis of facial TI while reducing diagnostic delays and unnecessary treatments.

PMID:37431112 | DOI:10.1684/ejd.2023.4450

Dermatitis. 2023 Jul 11. doi: 10.1089/derm.2023.0126. Online ahead of print.

NO ABSTRACT

PMID:37432781 | DOI:10.1089/derm.2023.0126

Orbit. 2023 Jul 10:1-3. doi: 10.1080/01676830.2023.2227706. Online ahead of print.

ABSTRACT

We present a case of a periocular painless perifolliculitis clinically mimicking basal cell carcinoma (BCC), excised by margin-controlled excision. This case reminds readers that perifolliculitis as a response to rosacea can mimic BCC. The value of diagnostic biopsy and dermoscopy to support management planning and avoid unnecessary surgery is discussed.

PMID:37428952 | DOI:10.1080/01676830.2023.2227706

J Eur Acad Dermatol Venereol. 2023 Jul 8. doi: 10.1111/jdv.19316. Online ahead of print.

NO ABSTRACT

PMID:37421289 | DOI:10.1111/jdv.19316

Lasers Surg Med. 2023 Jul 7. doi: 10.1002/lsm.23700. Online ahead of print.

ABSTRACT

BACKGROUND: A new dual-wavelength, high-energy, solid-state laser incorporating both 532 and 1064 nm wavelengths was developed with cryogen spray cooling and the unique ability to deliver three types of pulse structures including single pulses of a specific pulse-duration or pulses composed of a train of subpulses in the millisecond or microsecond domain with an intervening delay over the selected pulse-duration. We investigate the efficacy of this laser using all three pulse structures and the 532 nm wavelength for treating rosacea.

METHODS: Twenty-one subjects were enrolled in this IRB-approved study. A total of up to three treatments were administered at monthly intervals. Each treatment consisted of a first pass tracing linear vessels with a 40 ms pulse-duration immediately followed by a second pass using a 5 ms pulse, using all three available pulse structures. Assessment of cross-polarized digital images by blinded physician observers compared baseline and 3-month follow-up images.

RESULTS: Blinded observers correctly identified the posttreatment images 89% of the time, in 17 of 19 subjects completing the study, with an average overall improvement rating of 39% after only three treatments. Side effects were limited to short-term erythema and edema.

CONCLUSION: This study demonstrates that this new, variable-pulse-structure, dual wavelength, solid state, KTP laser with dynamic cooling is a safe and effective for treating rosacea.

PMID:37418140 | DOI:10.1002/lsm.23700

Int Ophthalmol. 2023 Jul 7. doi: 10.1007/s10792-023-02796-x. Online ahead of print.

ABSTRACT

PURPOSE: To report our experience with the 2% cyclosporin A (CsA) in a series of challenging inflammatory ocular surface diseases due to different etiologies.

METHODS: The records of patients who received topical 2% CsA for different indications were reviewed retrospectively. Demographic characteristics, indications for treatment, patient symptoms and clinical findings were recorded.

RESULTS: Fifty-two eyes of 52 patients were included. Mean age was 43.2 ± 14.3 (11-66) years with a F/M ratio of 34/18. Indications included pediatric acne rosacea (n = 4), adenoviral corneal subepithelial infiltrates (n = 12), filamentary keratitis (n = 14), pterygium recurrence (n = 15), herpetic marginal keratitis (n = 2) and graft versus host disease (n = 5 patients). Mean duration of treatment was 7.3 ± 2.8 (3-10) months. Forty-three (83%) patients reported favorable outcome with improvement in symptoms after a mean time of 4.4 ± 2.7 (2-6) months.

CONCLUSIONS: Topical 2% CsA may address the needs of different cases with ocular surface inflammation, as a safe option for long-term therapy.

PMID:37420126 | DOI:10.1007/s10792-023-02796-x

Nat Commun. 2023 Jul 5;14(1):3958. doi: 10.1038/s41467-023-39761-2.

ABSTRACT

Rosacea is a chronic inflammatory skin disorder with high incidence rate. Although genetic predisposition to rosacea is suggested by existing evidence, the genetic basis remains largely unknown. Here we present the integrated results of whole genome sequencing (WGS) in 3 large rosacea families and whole exome sequencing (WES) in 49 additional validation families. We identify single rare deleterious variants of LRRC4, SH3PXD2A and SLC26A8 in large families, respectively. The relevance of SH3PXD2A, SLC26A8 and LRR family genes in rosacea predisposition is underscored by presence of additional variants in independent families. Gene ontology analysis suggests that these genes encode proteins taking part in neural synaptic processes and cell adhesion. In vitro functional analysis shows that mutations in LRRC4, SH3PXD2A and SLC26A8 induce the production of vasoactive neuropeptides in human neural cells. In a mouse model recapitulating a recurrent Lrrc4 mutation from human patients, we find rosacea-like skin inflammation, underpinned by excessive vasoactive intestinal peptide (VIP) release by peripheral neurons. These findings strongly support familial inheritance and neurogenic inflammation in rosacea development and provide mechanistic insight into the etiopathogenesis of the condition.

PMID:37402769 | PMC:PMC10319783 | DOI:10.1038/s41467-023-39761-2