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Dermatoscopy in inflammatory and infectious skin disorders.

G Ital Dermatol Venereol. 2015 Oct;150(5):521-31

Authors: Lacarrubba F, Verzì AE, Dinotta F, Scavo S, Micali G

Abstract
Dermatoscopy is a non-invasive technique that allows a rapid and magnified in vivo observation of the skin surface. By definition, it is performed with handheld devices (dermatoscopes) allowing X10 magnification. More expensive, computer-assisted digital systems (videodermatoscopes) may be equipped with lenses that ensure magnifications up to X1000; in this case the term videodermatoscopy is generally used. Dermatoscopy is mainly utilized for the evaluation of pigmented skin lesions, and has increasing applications in dermatology. In this paper the use of dermatoscopy in a variety of inflammatory (psoriasis, lichen planus, pityriasis lichenoides, rosacea, lichen sclerosus, Darier's disease, pigmented purpuric dermatoses) and infectious (human papillomaviruses infections, molluscum contagiosum, tinea capitis, tinea nigra, scabies, head and pubic lice, tungiasis, cutaneous leishmaniasis and cutaneous larva migrans) cutaneous disorders will be analyzed. In these conditions, dermatoscopy may assist the clinical diagnosis, reducing the need of semi-invasive or invasive procedures such as skin scrapings and/or biopsy. Depending on the disease, the choice to use low or high magnifications may be crucial. Dermatoscopy may also be useful for prognostic evaluation and monitoring of response to treatment, representing an important and relatively simple aid in daily clinical practice.

PMID: 26333553 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/26333553?dopt=Abstract = URL to article

Morphology-Based Diagnosis of Acneiform Eruptions.

Pediatr Ann. 2015 Aug 1;44(8):e188-e193

Authors: McFarland SL, Polcari IC

Abstract
Acne is the most common skin disease. Distinguishing between true acne vulgaris and the various acneiform eruptions is important yet sometimes challenging. Given the common nature of acne and acneiform eruptions, the pediatrician must be aware of these lesion patterns and possess the skills to effectively evaluate the pediatric presentation of these eruptions. This article discusses several of the most common acneiform eruptions, including neonatal acne and cephalic pustulosis, periorificial dermatitis (perioral dermatitis), facial angiofibromas, iatrogenic acneiform drug eruptions, and childhood rosacea. [Pediatr Ann. 2015;44(8):e188-e193.].

PMID: 26312592 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26312592?dopt=Abstract = URL to article

Genetic vs Environmental Factors That Correlate With Rosacea: A Cohort-Based Survey of Twins.

JAMA Dermatol. 2015 Aug 26;

Authors: Aldrich N, Gerstenblith M, Fu P, Tuttle MS, Varma P, Gotow E, Cooper KD, Mann M, Popkin DL

Abstract
Importance: To our knowledge, this is the first study on rosacea to formally define genetic and environmental contributions.
Objectives: To study a cohort of identical and fraternal twins to determine whether genetic factors contribute to rosacea development and, if genetic factors are present, quantitatively estimate the genetic contribution, as well as to identify environmental factors that correlate with rosacea by controlling for genetic susceptibility.
Design, Setting, and Participants: Identical and fraternal twins were surveyed regarding risk factors implicated in rosacea. Faculty dermatologists determined a rosacea score for each twin participant according to the National Rosacea Society (NRS) grading system. Data were collected at the annual Twins Days Festival in Twinsburg, Ohio, on August 4-5, 2012, and August 2-3, 2013. Analysis was conducted for several months after each meeting. A cohort of 550 twin individuals, with most from Ohio, Pennsylvania, and the northeastern United States, participated.
Main Outcomes and Measures: The NRS score and rosacea subtype were assessed using the NRS grading system and physical examination by board-certified dermatologists.
Results: Among the 275 twin pairs (550 individuals), there were 233 identical twin pairs with a mean rosacea score of 2.46 and 42 fraternal twin pairs with a mean rosacea score of 0.75. We observed a higher association of NRS scores between identical vs fraternal twins (r = 0.69 vs r = 0.46; P = .04), demonstrating a genetic contribution. Using the ACE model (proportion of variance in a trait heritable secondary to additive genetics [A] vs the proportions due to a common environment [C] and unique environment [E]), we calculated this genetic contribution to be 46%. A higher NRS score was also significantly associated with the following factors: age (r = 0.38; P < .001) and lifetime UV radiation exposure (r = 0.26; P < .001). These associations remained after use of propensity score matching to adjust for multicollinearity. Other correlated variables included body mass index (r = 0.21; P < .001), smoking (r = 0.10; P < .02), alcohol consumption (r = 0.11; P = .01), cardiovascular comorbidity (r = 0.17; P < .001), and skin cancer comorbidity (r = 0.19; P < .001).
Conclusions and Relevance: The study of twins allows us to separate genetic susceptibility and the influence of environmental factors affecting rosacea. We found that approximately half of the contribution to the NRS score could be accounted for by genetics and the other half by environment. We identified correlations between rosacea and UV radiation exposure, alcohol, smoking, skin cancer history, cardiac comorbidity, and age. These findings may help improve current management and expectations of individuals affected by rosacea.

PMID: 26307938 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26307938?dopt=Abstract = URL to article

Rosacea: The Blessing of the Celts - An Approach to Pathogenesis Through Translational Research.

Acta Derm Venereol. 2015 Aug 25;

Authors: Melnik BC

Abstract
Increased expression of cathelicidin antimicrobial peptide (CAMP) is related to the pathogenesis of rosacea. CAMP plays a crucial role in antimicrobial defences, such as the killing of mycobacteria. CAMP gene expression is regulated by vitamin D-dependent (VDR) and vitamin D-independent (C/EBPα) transcription factors. VDR-dependent CAMP expression is sufficient during the summer months in Nordic countries, but insufficient during Nordic winters, due to low ultraviolet (UV) levels. Historically, the Celts may have overcome this geographical disadvantage of deficient CAMP production during the winter through an as-yet undefined acquired mutation that activates the alternative vitamin D-independent CAMP promoter C/EBPα. C/EBPα is the downstream transcription factor of Toll-like receptor (TLR)-mediated innate immune reactions and endoplasmic reticulum (ER) stress responses. At the molecular level, all clinical trigger factors for rosacea can be regarded as ER stressors. A mutation-based upregulation of ER stress responsiveness in rosacea may thus explain patients' reduced threshold for ER stressors. It is notable that ER stress upregulates the potent lipid-mediator sphingosine-1-phosphate (S1P), which explains multiple pathological aberrations observed in rosacea skin. Enhanced ER stress/S1P signalling in rosacea appears to compensate for insufficient VDR-dependent CAMP expression, maintaining adequate CAMP levels during UV-deficient winter to combat life-threatening microbial infections, such as Lupus vulgaris. Therefore, rosacea should not be considered as a disadvantage, but as evolution's blessing from the Celts which improved their survival. The concept presented here also explains the mechanism of Finsen's UV-treatment of lupus vulgaris by UV- and ER stress-mediated upregulation of CAMP expression. Rosacea could therefore be described as the Celts' "inborn Finsen lamp".

PMID: 26304030 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26304030?dopt=Abstract = URL to article

Limbal stem cell transplantation for soft contact lens wear-related limbal stem cell deficiency.

Am J Ophthalmol. 2015 Aug 20;

Authors: Shen C, Chan CC, Holland EJ

Abstract
PURPOSE: To describe the outcomes of limbal stem cell transplantation in eyes with limbal stem cell deficiency related to soft contact lens wear.
DESIGN: Retrospective interventional case series METHODS: Institutional database search at the Cincinnati Eye Institute revealed 9 patients (14 eyes) who underwent limbal stem cell transplantation with systemic immunosuppression for soft contact lens wear-related limbal stem cell deficiency. Outcome measures included patient demographics, symptoms, best corrected visual acuity, ocular surface stability, adverse events, and additional surgeries required.
RESULTS: Average patient age at time of surgery was 46.6 ± 11.1 years (range 20 to 60 years). Average duration of follow-up was 28 ± 19.1 months (range 12 to 70 months). Preoperative best corrected visual acuity (BCVA) was 20/40 or worse in all eyes (average 20/70, range 20/40 to 20/250) and patient symptoms included foreign body sensation, tearing, redness and/or pain. Four eyes (29%) underwent living-related conjunctival limbal allograft and 10 eyes (71%) underwent cadaver-donor keratolimbal allograft surgery. Topical and systemic immunosuppression was used in all patients. At final follow-up after limbal stem cell transplantation, there was a stable ocular surface in 12/14 (86%) eyes, and improvement in BCVA to 20/30 or better and complete resolution of patient symptoms in all except 1 patient who had significant rosacea blepharokerato-conjunctivitis whose BCVA remained at 20/150 and 20/60, in right and left eyes, respectively. The most common adverse event was an increase in intraocular pressure in 8 of 14 (57%) eyes, requiring topical anti-glaucoma treatment. Ten of 14 (71%) eyes underwent cataract extraction related to topical steroid use. No eyes required subsequent penetrating keratoplasty.
CONCLUSION: Limbal stem cell transplantation is a viable option for the management of soft contact lens wear-related limbal stem cell deficiency in young healthy patients. Early intervention prior to subepithelial fibrosis can lead to good visual outcomes with no need for subsequent cornea transplant. Co-management with a solid organ transplant specialist is helpful for the monitoring and management of systemic adverse events related to patient systemic immunosuppression.

PMID: 26299533 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26299533?dopt=Abstract = URL to article

Rosacea-like eruption due to topical pimecrolimus.

Dermatol Online J. 2015;21(5)

Authors: El-Heis S, Buckley DA

Abstract
Topical calcineurin inhibitors have been used outside their approved indications for a number of conditions, including topical steroid-induced rosacea. However, tacrolimus ointment itself has been reported to trigger rosacea in a small number of cases. We report a case of a rosacea-like eruption in a 39-year-old woman occurring after the use of pimecrolimus cream for 12 months for atopic dermatitis. Withdrawal of pimecrolimus combined with treatment with oral lymecycline, topical metronidazole, and an emollient resulted in resolution of the eruption. There have been 5 previously reported cases of a topical pimecrolimus-induced rosacea-like eruption suggesting that this rare side-effect may be a class effect of all topical calcineurin inhibitors. Dermatologists prescribing these drugs should be aware of this uncommon complication and may wish to warn patients of its occurrence as a potential side-effect when using topical calcineurin inhibitors in facial skin in adults.

PMID: 26295863 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26295863?dopt=Abstract = URL to article

Reply to: "Could a simple microbiological culture and an antibiogram guide the treatment of our patients with papulopustular rosacea?".

J Am Acad Dermatol. 2015 Sep;73(3):e115

Authors: Whitfeld MJ, Gunasingam N

PMID: 26282812 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/26282812?dopt=Abstract = URL to article

Could a simple microbiological culture and an antibiogram guide the treatment of our patients with papulopustular rosacea (PPR)?

J Am Acad Dermatol. 2015 Sep;73(3):e113-4

Authors: Bertolini W, Duquia RP, de Oliveira OL, de Campos Gonçalves F, Bonamigo RR

PMID: 26282811 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/26282811?dopt=Abstract = URL to article

Rosacea.

Am Fam Physician. 2015 Aug 1;92(3):Online

Authors:

PMID: 26280150 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/26280150?dopt=Abstract = URL to article

Rosacea: Diagnosis and Treatment.

Am Fam Physician. 2015 Aug 1;92(3):187-96

Authors: Oge' LK, Muncie HL, Phillips-Savoy AR

Abstract
Rosacea is a chronic facial skin condition of unknown cause. It is characterized by marked involvement of the central face with transient or persistent erythema, telangiectasia, inflammatory papules and pustules, or hyperplasia of the connective tissue. Transient erythema, or flushing, is often accompanied by a feeling of warmth. It usually lasts for less than five minutes and may spread to the neck and chest. Less common findings include erythematous plaques, scaling, edema, phymatous changes (thickening of skin due to hyperplasia of sebaceous glands), and ocular symptoms. The National Rosacea Society Expert Committee defines four subtypes of rosacea (erythematotelangiectatic, papulopustular, phymatous, and ocular) and one variant (granulomatous). Treatment starts with avoidance of triggers and use of mild cleansing agents and moisturizing regimens, as well as photoprotection with wide-brimmed hats and broad-spectrum sunscreens (minimum sun protection factor of 30). For inflammatory lesions and erythema, the recommended initial treatments are topical metronidazole or azelaic acid. Once-daily brimonidine, a topical alpha-adrenergic receptor agonist, is effective in reducing erythema. Papulopustular rosacea can be treated with systemic therapy including tetracyclines, most commonly subantimicrobial-dose doxycycline. Phymatous rosacea is treated primarily with laser or light-based therapies. Ocular rosacea is managed with lid hygiene, topical cyclosporine, and topical or systemic antibiotics.

PMID: 26280139 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/26280139?dopt=Abstract = URL to article

Phytochemical and Botanical Therapies for Rosacea: A Systematic Review.

Phytother Res. 2015 Aug 14;

Authors: Fisk WA, Lev-Tov HA, Clark AK, Sivamani RK

Abstract
Botanical and cosmeceutical therapies are commonly used to treat symptoms of rosacea such as facial erythema, papules/pustule counts, and telangiectasia. These products may contain plant extracts, phytochemicals, and herbal formulations. The objective of this study was to review clinical studies evaluating the use of botanical agents for the treatment of rosacea. MEDLINE and Embase databases were searched for clinical studies evaluating botanical therapies for rosacea. Major results were summarized, and study methodology was analyzed. Several botanical therapies may be promising for rosacea symptoms, but few studies are methodologically rigorous. Several plant extract and phytochemicals effectively improved facial erythema and papule/pustule counts caused by rosacea. Many studies are not methodologically rigorous. Further research is critical, as many botanicals have been evaluated in only one study. Botanical agents may reduce facial erythema and effectively improve papule/pustule counts associated with rosacea. Although promising, further research in the area is imperative. Copyright © 2015 John Wiley & Sons, Ltd.

PMID: 26272329 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26272329?dopt=Abstract = URL to article

Erythema of Rosacea: Validation of Patient's Self-Assessment Grading Scale.

J Drugs Dermatol. 2015 Aug 1;14(8):841-844

Authors: Tan J, Leoni M

Abstract
BACKGROUND: Facial erythema is a primary feature of rosacea. Currently, no validated scales exist that can accurately capture a patient's self-assessment of their own facial erythema. During phase 2 studies for brimonidine tartrate gel, a 5-point numeric rating scale was developed as a tool to allow subjects to provide an independent assessment of visible changes to the facial erythema associated with their rosacea.<br /> OBJECTIVE: The objective of this study was to validate the revised patient's self-assessment (PSA) scale and evaluate it for statistical reliability and validity in quantification of facial erythema of rosacea.<br /> METHODS: The validity of the PSA scale was evaluated by assessing the test-retest reliability, construct validity, and known-groups validity based on the data collected during a Phase 2b study on brimonidine gel for the treatment of persistent facial erythema of rosacea.<br /> RESULTS: Based on the results of this evaluation, this PSA scale demonstrated test-retest reliability, construct validity, and known-groups validity.<br /> LIMITATIONS: Study results are most generalizable to those with moderate to severe erythema.<br /> CONCLUSION: The PSA is an appropriate scale to assess facial erythema associated with rosacea.<br /><br /> <em>J Drugs Dermatol.</em> 2015;14(8):841-844.

PMID: 26267728 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26267728?dopt=Abstract = URL to article

Extrafacial rosacea with predominant scalp involvement.

Indian J Dermatol Venereol Leprol. 2015 Aug 11;

Authors: Miguel-Gomez L, Fonda-Pascual P, Vano-Galvan S, Carrillo-Gijon R, Munoz-Zato E

PMID: 26261148 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26261148?dopt=Abstract = URL to article

Rosacea is associated with chronic systemic diseases in a skin severity-dependent manner: Results of a case-control study.

J Am Acad Dermatol. 2015 Aug 6;

Authors: Rainer BM, Fischer AH, Luz Felipe da Silva D, Kang S, Chien AL

Abstract
BACKGROUND: Rosacea is a common chronic inflammatory dermatosis of unclear origin. It has been associated with systemic comorbidities, but methodical studies addressing this association are lacking.
OBJECTIVE: We evaluated: (1) the association between rosacea and systemic comorbidities; and (2) if the severity of rosacea is impacted by comorbidities.
METHODS: This was a case-control study: patients with rosacea were matched (1:1) to rosacea-free control subjects by age, sex, and race. Relative risk estimates were calculated using logistic regression as odds ratios with 95% confidence intervals.
RESULTS: Among 130 participants (65 patients/65 control subjects), we observed a significant association between rosacea and allergies (airborne, food), respiratory diseases, gastroesophageal reflux disease, other gastrointestinal diseases, hypertension, metabolic and urogenital diseases, and female hormone imbalance. Compared with mild rosacea, moderate to severe rosacea was significantly associated with hyperlipidemia, hypertension, metabolic diseases, cardiovascular diseases, and gastroesophageal reflux disease.
LIMITATIONS: This was a case-control study with moderate sample size. Associated medical conditions were self-reported and could not always be confirmed by medication use and medical records.
CONCLUSIONS: Rosacea is associated with numerous systemic comorbid diseases in a skin severity-dependent manner. Physicians should be aware of these associations to provide comprehensive care to patients with rosacea, especially to those with more severe disease.

PMID: 26256428 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26256428?dopt=Abstract = URL to article

Ivermectin: A Review in Rosacea.

Am J Clin Dermatol. 2015 Aug 8;

Authors: Deeks ED

Abstract
Ivermectin 1 % cream (Soolantra(®); Rosiverâ„¢; Izefla(®)) is a novel topical agent indicated for the once-daily treatment of inflammatory lesions of rosacea. Ivermectin is a derivative of the avermectin family of macrocyclic lactone parasiticides. It displays anti-inflammatory properties as well as broad-spectrum anti-parasitic activity, both of which may contribute to its efficacy in treating rosacea. In phase III trials of 12 or 16 weeks' duration in adults with moderate to severe papulopustular rosacea, once-daily ivermectin 1 % cream improved the symptoms of rosacea (as per Investigator Global Assessment and inflammatory lesion count) and health-related quality of life versus vehicle, and was more effective than twice-daily metronidazole 0.75 % cream in terms of these measures. Ivermectin 1 % cream continues to provide benefit for up to 52 weeks of treatment, according to extension studies, and is well tolerated, with the most common treatment-related adverse events (skin burning sensation, pruritus, dry skin and skin irritation) each occurring with low incidence (<2 %). Thus, ivermectin 1 % cream is an effective and well tolerated option for the topical treatment of inflammatory lesions of rosacea, with the convenience of once-daily application.

PMID: 26254001 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26254001?dopt=Abstract = URL to article

A phase 3 randomized, double-blind, vehicle-controlled trial of azelaic acid foam 15% in the treatment of papulopustular rosacea.

Cutis. 2015 Jul;96(1):54-61

Authors: Draelos ZD, Elewski BE, Harper JC, Sand M, Staedtler G, Nkulikiyinka R, Shakery K

Abstract
Rosacea is a chronic relapsing skin disorder primarily affecting the face. Although its etiology is not well defined, rosacea is associated with immune dysregulation and inflammation potentiated by external factors. These manifestations lead to skin sensitivity and impaired quality of life. Azelaic acid (AzA) is approved for the treatment of rosacea in a 15% gel formulation. This phase 3 study evaluated the efficacy and safety of AzA in a 15% foam formulation for the treatment of papulopustular rosacea (PPR). Coprimary efficacy end points were treatment success according to investigator global assessment (IGA) and the nominal change in inflammatory lesion count (ILC) from baseline to the end of treatment (EoT). Adverse events (AEs) were evaluated as a measure of safety. The IGA success rate at EoT was significantly greater in the AzA foam group versus vehicle (P<.001; Cochran-Mantel-Haenszel test). Likewise, nominal ILC change at EoT in the AzA foam group showed a significantly greater decrease versus vehicle (P<.001; F test). Drug-related AEs were mainly mild to moderate, cutaneous, and local. Overall, the study results support the efficacy and safety of twice-daily AzA foam 15% in patients with PPR.

PMID: 26244354 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26244354?dopt=Abstract = URL to article

Therapies to improve the cosmetic symptoms of rosacea.

Cutis. 2015 Jul;96(1):19-26

Authors: Lanoue J, Goldenberg G

Abstract
Rosacea is a commonly encountered chronic inflammatory skin disease with a predilection for highly visible areas of the skin such as the face. The cosmetic symptoms of rosacea can be substantial and may greatly reduce a patient's quality of life. Although there is no definitive cure for rosacea, effective treatment of symptoms can mitigate the deleterious effects of this condition and improve quality of life. In this article, we review both existing and emerging cosmetic treatments for rosacea, including topical medications, systemic pharmacologic therapies, light-based modalities, and procedural interventions, and assess their ability to improve the cosmetic symptoms of rosacea.

PMID: 26244351 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26244351?dopt=Abstract = URL to article

Related Articles

Psychologic factors in the development of facial dermatoses.

Clin Dermatol. 2014 Nov-Dec;32(6):763-6

Authors: Orion E, Wolf R

Abstract
In medical literature, as well as in daily practice, some common facial dermatoses are considered to be influenced or triggered by emotional factors. The main damager is stress, but depression and anxiety may play a role, among other factors. Some patients may experience a vicious cycle: Their facial dermatosis is triggered or worsened by stress, and in turn, the exacerbation itself is a major stressogenic stimulus. It appears that clinical wisdom and experience preceded clinical investigation in this field. Although patients testify that their emotional state may sometimes influence their facial condition, only limited experimental data exist so far, and only a few facial dermatoses were investigated.

PMID: 25441469 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/25441469?dopt=Abstract = URL to article

Related Articles

Red face revisited: II.

Clin Dermatol. 2014 Nov-Dec;32(6):709-10

Authors: Tüzün Y, Wolf R

PMID: 25441462 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/25441462?dopt=Abstract = URL to article

Serum levels of hypersensitive-C-reactive protein in moderate and severe acne.

Indian Dermatol Online J. 2015 Jul-Aug;6(4):253-7

Authors: Namazi MR, Parhizkar AR, Jowkar F

Abstract
BACKGROUND: Elevation of C-reactive protein (CRP) has been reported to occur in psoriasis, urticaria, acne, rosacea and many other dermatological and nondermatological conditions. Chronic systemic inflammation has been implicated in the development of neuropsychiatric/degenerative disorders, atherosclerosis, coronary artery disease, diabetes mellitus and even carcinogenesis. The present study is designed to determine whether the level of inflammation created by acne vulgaris could be high enough to raise the serum levels of high-sensitive CRP.
MATERIALS AND METHODS: Forty-two patients with moderate and severe acne vulgaris were enrolled, along with 44 age and sex matched healthy blood donors as controls. Hypersensitive-CRP (Hs-CRP) was measured in both groups.
RESULTS: Hypersensitive-C-reactive protein levels in the case group varied between 0 and 28.1 μg/ml with an average of 2.24 ± 4.87 μg/ml (mean ± standard deviation) and a median of 0.6 μg/ml (interquartile range [iQR] =0.3, 1.4 μg/ml). Hs-CRP levels of the control group varied between 0 and 14 μg/ml with an average of 3.12 ± 3.67 μg/ml and a median of 1.5 μg/ml (IQR = 0.55, 5.0 μg/ml). No significant difference of Hs-CRP level between the two groups was seen (t = -0.961, 95% confidence interval: Lower = -2.6942, upper = 0.9377; P = 0.339). Additionally, no significant difference in the level of Hs-CRP was noted between the moderate and severe acne groups (95% confidence interval: Lower = -5.2495, upper = 1.6711; P = 0.165).
CONCLUSION: Acne vulgaris, even in its severe grades (excluding acne fulminans and acne conglobata), does not induce significant inflammation at the systemic level.

PMID: 26225329 [PubMed]

http://www.ncbi.nlm.nih.gov/pubmed/26225329?dopt=Abstract = URL to article

Related Articles

JID VisualDx Quiz: June 2015.

J Invest Dermatol. 2015 Jun;135(6):e29

Authors: Zhou X, Hu S

PMID: 25964271 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/25964271?dopt=Abstract = URL to article

Efficacy of the long-pulsed 1064-nm neodymium:yttrium-aluminum-garnet laser (LPND) (rejuvenation mode) in the treatment of papulopustular rosacea (PPR): A pilot study of clinical outcomes and patient satisfaction in 30 cases.

J Am Acad Dermatol. 2015 Aug;73(2):333-336

Authors: Lee JH, Kim M, Bae JM, Cho BK, Park HJ

PMID: 26183984 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26183984?dopt=Abstract = URL to article

Rosacea and cardiovascular disease: Is there an association?

J Am Acad Dermatol. 2015 Aug;73(2):308-309

Authors: Dosal J, Keri J

PMID: 26183971 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26183971?dopt=Abstract = URL to article

Reflectance confocal microscopy: a new key for assessing the role of Demodex in rosacea?

Br J Dermatol. 2015 Jul;173(1):8-9

Authors: Bahadoran P

PMID: 26174637 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/26174637?dopt=Abstract = URL to article

Rosacea and exposure to tandoor heat: Is there an association?

Int J Dermatol. 2015 Jul 14;

Authors: Ozkol HU, Calka O, Akdeniz N, Baskan E, Ozkol H

Abstract
BACKGROUND: Particularly in eastern and southeastern regions of Turkey, women use tandoor ovens to bake bread and as a result are exposed to excessive heat. Exposure to heat for long periods may lead to the initiation or exacerbation of rosacea.
OBJECTIVES: The aim of this study was to investigate whether there is a relationship between exposure to heat from a tandoor and rosacea.
METHODS: A total of 350 female patients with various dermatological diseases were included in this study. These patients were divided into two groups comprising a control group and a group of tandoor users. Subjects in both the control and tandoor-user groups were screened to identify clinical and other characteristics, and symptoms and findings of rosacea and other dermatological disorders.
RESULTS: The frequency of rosacea was significantly (P < 0.001) higher and that of acne markedly (P < 0.001) lower in the tandoor-user group than in the control group. Incidences of temporary and persistent types of erythema and telangiectasia, which are considered to be among the symptoms and findings of rosacea, were also significantly (P < 0.001) higher in the tandoor-user group than the control group. Frequencies of asthma and ex-smoker status differed significantly (P < 0.001 and P < 0.002, respectively) between the tandoor-user and control groups. Furthermore, the period of exposure to tandoor heat was positively correlated with the frequency of telangiectasia (r = 0.321, P < 0.01).
CONCLUSIONS: Our study revealed a strong association between exposure to tandoor heat and rosacea. Further studies including higher numbers of patients are required to confirm our results.

PMID: 26173495 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/26173495?dopt=Abstract = URL to article