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Fractionated carbon dioxide laser therapy as treatment of mild rhinophyma: report of three cases.

Dermatol Ther. 2015 Mar 5;

Authors: Meesters AA, van der Linden MM, De Rie MA, Wolkerstorfer A

Abstract
Rhinophyma is a bothersome condition of the nose that is regarded as a manifestation of rosacea (subtype 3). Whereas the efficacy of medical treatments, including antibiotics and retinoids, is often dissatisfying, conventional invasive procedures are limited by their unfavorable side effect profile. We present three patients who were treated by a minimally invasive approach using fractionated carbon dioxide (CO2 ) laser therapy, showing variable response. We observed that fractionated CO2 laser therapy may improve patient-reported outcome in some patients with mild rhinophyma and is associated with a relatively favorable side effect profile compared with conventional surgical techniques.

PMID: 25753618 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25753618?dopt=Abstract = URL to article

Successful treatment of recalcitrant granulomatous rosacea with oral thalidomide and topical pimecrolimus.

J Dermatol. 2015 Mar 7;

Authors: Qian G, Liu T, Zhou C, Zhang Y

PMID: 25753523 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25753523?dopt=Abstract = URL to article

Adverse effects of topical corticosteroids in paediatric eczema: Australasian consensus statement.

Australas J Dermatol. 2015 Mar 6;

Authors: Mooney E, Rademaker M, Dailey R, Daniel BS, Drummond C, Fischer G, Foster R, Grills C, Halbert A, Hill S, King E, Leins E, Morgan V, Phillips RJ, Relic J, Rodrigues M, Scardamaglia L, Smith S, Su J, Wargon O, Orchard D

Abstract
Atopic eczema is a chronic inflammatory disease affecting about 30% of Australian and New Zealand children. Severe eczema costs over AUD 6000/year per child in direct medical, hospital and treatment costs as well as time off work for caregivers and untold distress for the family unit. In addition, it has a negative impact on a child's sleep, education, development and self-esteem. The treatment of atopic eczema is complex and multifaceted but a core component of therapy is to manage the inflammation with topical corticosteroids (TCS). Despite this, TCS are often underutilised by many parents due to corticosteroid phobia and unfounded concerns about their adverse effects. This has led to extended and unnecessary exacerbations of eczema for children. Contrary to popular perceptions, (TCS) use in paediatric eczema does not cause atrophy, hypopigmentation, hypertrichosis, osteoporosis, purpura or telangiectasia when used appropriately as per guidelines. In rare cases, prolonged and excessive use of potent TCS has contributed to striae, short-term hypothalamic-pituitary-adrenal axis alteration and ophthalmological disease. TCS use can also exacerbate periorificial rosacea. TCS are very effective treatments for eczema. When they are used to treat active eczema and stopped once the active inflammation has resolved, adverse effects are minimal. TCS should be the cornerstone treatment of atopic eczema in children.

PMID: 25752907 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25752907?dopt=Abstract = URL to article

[Primary human demodicosis : A disease sui generis.]

Hautarzt. 2015 Mar 6;

Authors: Hsu CK, Zink A, Wei KJ, Dzika E, Plewig G, Chen W

Abstract
Human Demodex mites (Demodex folliculorum and Demodex brevis) are unique in that they are an obligate human ectoparasite that can inhabit the pilosebaceous unit lifelong without causing obvious host immune response in most cases. The mode of symbiosis between humans and human Demodex mites is unclear, while the pathogenicity of human Demodex mites in many inflammatory skin diseases is now better understood. Primary human demodicosis is a skin disease sui generis not associated with local or systemic immunosuppression. Diagnosis is often underestimated and differentiation from folliculitis, papulopustular rosacea and perioral dermatitis is not always straightforward. Dependent on the morphology and degree of inflammation, the clinical manifestations can be classified into spinulate, papulopustular, nodulocystic, crustic and fulminant demodicosis. Therapy success can be achieved only with acaricides/arachidicides. The effective doses, optimal regimen and antimicrobial resistance remain to be determined.

PMID: 25744530 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25744530?dopt=Abstract = URL to article

Off-label use of TNF-alpha inhibitors in a dermatological university department: retrospective evaluation of 118 patients.

Dermatol Ther. 2015 Mar 3;

Authors: Sand FL, Thomsen SF

Abstract
Tumor necrosis factor-alpha (TNF)-alpha inhibitors are licensed for patients with severe refractory psoriasis and psoriatic arthritis. However, TNF-alpha inhibitors have also been used off-label for various recalcitrant mucocutaneous diseases. This study aimed to evaluate the efficacy and safety of TNF-alpha inhibitors used for off-label dermatological indications. We retrospectively evaluated patient records of 118 patients treated off-label with TNF-alpha inhibitors in a dermatological university department. Patients presented with severe aphthous stomatitis/genital aphthous lesions (26), chronic urticaria (25), hidradenitis suppurativa (29), acne conglobata (11), dissecting cellulitis of the scalp (two), orofacial granulomatosis (four), sarcoidosis (four), granuloma annulare (two), granulomatous rosacea (one), granuloma faciale (one), subcorneal pustulosis (one), pyoderma gangrenosum (four), Sweet's syndrome (four), Well's syndrome (one), benign familial pemphigus (one), lichen planus (one), and folliculitis decalvans (one). A significant number of these patients went into remission during therapy with TNF-alpha inhibitors. A total of 11 patients (9%) experienced severe adverse effects during therapy. Off-label therapy with TNF-alpha inhibitors may be considered for selected patients with severe recalcitrant mucocutaneous diseases. The risk of severe adverse effects signals that a thorough benefit-risk assessment should be performed before initiating off-label treatment with TNF-alpha inhibitors for these conditions.

PMID: 25731720 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25731720?dopt=Abstract = URL to article

Neurogenic rosacea: an uncommon and poorly recognized entity?

Clin Exp Dermatol. 2015 Mar 2;

Authors: Parkins GJ, Maan A, Dawn G

PMID: 25731204 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25731204?dopt=Abstract = URL to article

The Topical Corticosteroid Classification Called Into Question:Towards a New Approach.

Exp Dermatol. 2015 Feb 24;

Authors: Humbert P, Guichard A

Abstract
In 1952, Sulzberger et al. achieved a breakthrough in the field of dermatology by reporting for the first time the efficacy of topical corticosteroids (TCS) on eczematous dermatitis. Nowadays, TCS are widely used, at any age, to treat a wide variety of common dermatologic disorders i.e. contact dermatitis, psoriasis, atopic dermatitis, or to treat skin manifestations of auto-immune diseases. These topical formulations have several effects such as anti-inflammatory and immunomodulator, antiproliferative, anti-pruritus and vasoconstrictor properties. Despite proven safety and tolerability, TCS may induce local and systemic side effects such as cutaneous atrophy, hypothalamic-pituitary-adrenal (HPA) axis suppression, iatrogenic Cushing's, steroid rosacea, and allergy. This article is protected by copyright. All rights reserved.

PMID: 25707534 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25707534?dopt=Abstract = URL to article

Assessment of the Genetic Basis of Rosacea by Genome-Wide Association Study.

J Invest Dermatol. 2015 Feb 19;

Authors: Chang AL, Raber I, Xu J, Li R, Spitale R, Chen J, Kiefer AK, Tian C, Eriksson NK, Hinds DA, Tung J

Abstract
Rosacea is a common, chronic skin disease that is currently incurable. Although environmental factors influence rosacea, the genetic basis of rosacea is not established. In this genome-wide association study, a discovery group of 22,952 individuals (2,618 rosacea cases and 20,334 controls) was analyzed, leading to identification of two significant single nucleotide polymorphisms (SNPs) associated with rosacea, one of which replicated in a new group of 29,481 individuals (3,205 rosacea cases and 26,262 controls). The confirmed SNP, rs763035 (p=8.0 × 10(-11) discovery group; p=0.00031 replication group), is inter-genic between HLA-DRA and BTNL2. Exploratory immunohistochemical analysis of HLA-DRA and BTNL2 expression in papulopustular rosacea lesions from six individuals, including one with the rs763035 variant, revealed staining in the peri-follicular inflammatory infiltrate of rosacea for both proteins. In addition, three HLA alleles, all MHC class II proteins, were significantly associated with rosacea in the discovery group and confirmed in the replication group: HLA-DRB1*03:01 (p=1.0 × 10(-8) discovery group; p=4.4 × 10(-6) replication group), HLA-DQB1*02:01 (p=1.3 × 10(-8) discovery group; p=7.2 × 10(-6) replication group), and HLA-DQA1*05:01 (p=1.4 × 10(-8) discovery group; p=7.6 × 10(-6) replication group). Collectively, the gene variants identified in this study support the concept of a genetic component for rosacea, and provide candidate targets for future studies to better understand and treat rosacea.Journal of Investigative Dermatology accepted article preview online, 19 February 2015. doi:10.1038/jid.2015.53.

PMID: 25695682 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25695682?dopt=Abstract = URL to article

Hypothesis of demodicidosis rosacea flushing etiopathogenesis.

Med Hypotheses. 2015 Jan 31;

Authors: Robledo MA, Orduz M

Abstract
Most of the patients with erythematotelangiectatic rosacea are characterized by flushing, oedema and telangiectasia. The etiopathogenesis of the flushing in rosacea patients is unknown. Clinically the flushing in rosacea is similar to the "Asian flushing syndrome". Most Asians have an overactive alcohol dehydrogenase (ADH) that tends to break down alcohol into acetaldehyde faster. People with "Asians flushing syndrome" have a genetic disorder with the Aldehyde Dehydrogenase 2(∗)2 (ALDH2(∗)2) allele. This is the reason why they do not metabolize very well the acetaldehyde that comes from the alcohol, which means that acetaldehyde takes much longer to clear from their blood. ALDH2 enzyme is primarily responsible for oxidation of acetaldehyde derived from ethanol metabolism, as well as oxidation of various other endogenous and exogenous aldehydes. Acetaldehyde produces the vasodilatation in the "Asian flushing syndrome". The antibodies against the GroEl chaperonin protein, a 62-kDa heat shock protein were found in the Bacillus oleronius isolated from Demodex mites, in rosacea patients. The GroEl chaperonin protein is a protein that plays a key role in normal folding of ALDH2. If the GroEl chaperonin antibodies found in patients with rosacea, cross react with the human GroEl chaperonin protein, they will not fold normally the ALDH2, and then the enzyme will not metabolize the acetaldehyde. Many of the patients with rosacea have a concomitant infection with Helicobacter pylori in their stomach. The H.pylori produces high amounts of acetaldehyde, which comes from their metabolism of ethanol or carbohydrates. As a result, high amounts of acetaldehyde will circulate for longer time in the blood, until the liver CYP2E1(p450) enzyme system finally metabilizes the acetaldehyde, during that period of time the patients will experience a flushing as well as the people with the "Asian flushing syndrome" suffer when they drink ethanol. To prove the hypothesis it is necessary to find the cross reaction between the GroEl chaperonin antibodies against the B.oleronius and human GroEl chaperonin. Four groups of patients will be studied with or without the GroEl chaperonin antibodies, and H.Pylori. The production of acetaldehyde will be tested by the ethanol-derived microbial production method. If the hypothesis proves to be true, the treatment of Demodex mites and the H. pylori could improve the flushing in the rosacea patients and it will prevent the angiogenesis (telangiectasia), and the association of the gastric injury and carcinogenesis in those patients.

PMID: 25683389 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25683389?dopt=Abstract = URL to article

Tectonic lamellar keratoplasty: simplified management of corneal perforations with an automated microkeratome.

Can J Ophthalmol. 2015 Feb;50(1):80-4

Authors: Park JC, Habib NE

Abstract
OBJECTIVE: To describe a simplified tectonic lamellar keratoplasty (LK) technique, which can be used to manage full-thickness corneal perforations.
DESIGN: Case series demonstrating a new surgical technique.
PARTICIPANTS: A 69-year-old female with rosacea keratitis and peripheral corneal perforation; a 49-year-old male with keratoconus, ipsilateral herpes simplex keratitis and an inferonasal corneal perforation; and a 12-year-old female with an apparently spontaneous central corneal perforation.
RESULTS: These 3 patients with full-thickness corneal perforations were successfully managed with this automated tectonic LK technique.
CONCLUSIONS: Tectonic LK has benefits relative to tectonic penetrating keratoplasty but remains unpopular because it is technically difficult to prepare the host and donor corneas. This tectonic LK technique negates the need for challenging free-hand dissection and gives an excellent donor fit to the host bed. This provides an easier and more effective way to manage corneal perforations.

PMID: 25677289 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/25677289?dopt=Abstract = URL to article

The rosacea patient journey: a novel approach to conceptualizing patient experiences.

Cutis. 2015 Jan;95(1):37-43

Authors: Kuo S, Huang KE, Davis SA, Feldman SR

Abstract
The motivation for rosacea patients to seek and adhere to treatment is not well characterized. A patient journey is a map of the steps a patient takes as he/she progresses through different segments of the disease from diagnosis to management, including all the influences that can push him/her toward or away from certain decisions. We sought to examine each step of the rosacea patient journey to better understand key patient care boundaries faced by rosacea patients. A PubMed search of articles indexed for MEDLINE as well as a search of the National Rosacea Society Web site (http://www.rosacea.org) were conducted to identify articles and materials that quantitatively or qualitatively described rosacea patient experiences. Current literature pertaining to the rosacea patient journey was summarized. The rosacea patient journey is discussed. It is a useful tool to gain insight on patient experiences. Better understanding of the patient perspective by dermatologists can lead to better patient adherence to treatment and thus improved quality of life and satisfaction.

PMID: 25671443 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25671443?dopt=Abstract = URL to article

Are Demodex Mites Principal, Conspirator, Accomplice, Witness or Bystander in the Cause of Rosacea?

Am J Clin Dermatol. 2015 Feb 11;

Authors: Chen W, Plewig G

Abstract
As the only permanent human ectoparasite, the role of human Demodex mites in health and diseases remains largely unclarified. In view of the ecological interaction between organisms of two different species, a type of commensalism between Demodex mites and humans (the former benefit, the latter unaffected) is most likely, while parasitism occurs temporarily and spatially in the diseased state (the former benefit, the latter harmed). As part of normal skin microbiota, the causal role of Demodex mites in the initiation of rosacea can neither fulfill the classical Henle-Koch's principal nor the advanced criteria proposed by Fredericks and Relman for molecular detection of non-cultivatable microorganisms. Epidemiological analysis using Hill's criteria fails to support the causative role of Demodex mites in rosacea regarding the strength of association, specificity and temporality of association, biological gradient and plausibility as well as clinical coherence, therapeutic experimentation and medical analogy. In application of Rothman's sufficient cause model to evaluate the contribution of Demodex mites to rosacea on a population basis, Demodex mites can be regarded as a non-necessary, non-sufficient causal factor for certain forms of rosacea. Further strategies to dissect the association between Demodex mites and rosacea may include studying the possible existence of more virulent forms of mites with a higher pathogenicity, the endosymbiotic bacteria in certain life periods of mites, the interactions between mites and human hosts or between mites and environment, and to set up ex vivo culture models for Demodex mites.

PMID: 25666117 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25666117?dopt=Abstract = URL to article

Trends in the frequency of original research in acne vulgaris, rosacea, dermatitis, psoriasis, skin cancer, and skin infections, 1970-2010.

Perm J. 2015;19(1):44-7

Authors: Choi YM, Wu JJ

Abstract
A retrospective review of the Journal of the American Academy of Dermatology and the Archives of Dermatology was performed using the MEDLINE database for all original research articles published between 1970 and 2010. The frequency of research into acne vulgaris and rosacea decreased from 24% to 5.1%, psoriasis research increased from 17.6% to 26.5% (most likely because of the discovery of biologics), and skin cancer research increased from 4% to 48% (paralleling the increasing incidence of skin cancer).

PMID: 25663204 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/25663204?dopt=Abstract = URL to article

Response to 'Letter to the editor' by Agilli et al. entitled 'Assessment of decreased serum paraoxonase activity in patients with rosacea in terms of methodology'

J Eur Acad Dermatol Venereol. 2015 Feb 8;

Authors: Takci Z, Bilgili SG, Karadag AS, Kucukoglu ME, Selek S, Aslan M

PMID: 25661752 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25661752?dopt=Abstract = URL to article

Assessment of decreased serum paraoxonase activity in patients with rosacea in terms of methodology.

J Eur Acad Dermatol Venereol. 2015 Feb 8;

Authors: Agilli M, Aydin FN, Cayci T, Kurt YG

PMID: 25661568 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25661568?dopt=Abstract = URL to article

Helicobacter pylori infection but not small intestinal bacterial overgrowth may play a pathogenic role in rosacea.

United European Gastroenterol J. 2015 Feb;3(1):17-24

Authors: Gravina A, Federico A, Ruocco E, Lo Schiavo A, Masarone M, Tuccillo C, Peccerillo F, Miranda A, Romano L, de Sio C, de Sio I, Persico M, Ruocco V, Riegler G, Loguercio C, Romano M

Abstract
BACKGROUND AND AIMS: Recent studies suggest a potential relationship between rosacea and Helicobacter pylori (H. pylori) infection or small intestinal bacterial overgrowth (SIBO), but there is no firm evidence of an association between rosacea and H. pylori infection or SIBO. We performed a prospective study to assess the prevalence of H. pylori infection and/or SIBO in patients with rosacea and evaluated the effect of H. pylori or SIBO eradication on rosacea.
METHODS: We enrolled 90 patients with rosacea from January 2012 to January 2013 and a control group consisting of 90 patients referred to us because of mapping of nevi during the same period. We used the (13)C Urea Breath Test and H. pylori stool antigen (HpSA) test to assess H. pylori infection and the glucose breath test to assess SIBO. Patients infected by H. pylori were treated with clarithromycin-containing sequential therapy. Patients positive for SIBO were treated with rifaximin.
RESULTS: We found that 44/90 (48.9%) patients with rosacea and 24/90 (26.7%) control subjects were infected with H. pylori (p = 0.003). Moreover, 9/90 (10%) patients with rosacea and 7/90 (7.8%) subjects in the control group had SIBO (p = 0.6). Within 10 weeks from the end of antibiotic therapy, the skin lesions of rosacea disappeared or decreased markedly in 35/36 (97.2%) patients after eradication of H. pylori and in 3/8 (37.5%) patients who did not eradicate the infection (p < 0.0001). Rosacea skin lesions decreased markedly in 6/7 (85.7%) after eradication of SIBO whereas of the two patients who did not eradicate SIBO, one (50%) showed an improvement in rosacea (p = 0.284).
CONCLUSIONS: Prevalence of H. pylori infection was significantly higher in patients with rosacea than control group, whereas SIBO prevalence was comparable between the two groups. Eradication of H. pylori infection led to a significant improvement of skin symptoms in rosacea patients.

PMID: 25653855 [PubMed]

http://www.ncbi.nlm.nih.gov/pubmed/25653855?dopt=Abstract = URL to article

Activity Guided Purification Identifies Lupeol, a Pentacyclic Triterpene, As a Novel Agent Targeting Multiple Pathogenic Factors of Acne.

J Invest Dermatol. 2015 Feb 3;

Authors: Hoon Kwon H, Young Yoon J, Yong Park S, Min S, Kim YI, Yong Park J, Lee YS, Thiboutot DM, Hun Suh D

Abstract
Acne vulgaris is a nearly universal cutaneous disease characterized by multifactorial pathogenic processes. Because current acne medications have various side effects, investigating new pharmacologically active molecules is important for treating acne. As natural products generally provide various classes of relatively safe compounds with medicinal potentials, we performed activity guided purification after a series of screenings from the extracts of five medicinal plants to explore novel acne medications. Lupeol, a pentacyclic triterpene, from the hexane extract of Solanum melongena L was identified after instrumental analysis. Lupeol targeted most of the major pathogenic features of acne with desired physicochemical traits. It strongly suppressed lipogenesis by modulating IGR-1R/PI3K/Akt/SREBP-1 signaling pathway in SEB-1 sebocytes, and reduced inflammation by suppressing the NF-κB pathway in SEB-1 sebocytes and HaCaT keratinocytes. Lupeol exhibited a marginal effect on cell viability and may have modulated dyskeratosis of epidermis. Subsequently, histopathological analysis of human patients' acne tissues after applying lupeol for 4 weeks demonstrated that lupeol markedly attenuated levels of both the number of infiltrated cells and major pathogenic proteins examined in vitro around comedones or sebaceous glands, providing solid evidence for suggested therapeutic mechanisms. These results demonstrate the clinical feasibility of applying lupeol for the treatment of acne.Journal of Investigative Dermatology accepted article preview online, 03 February 2015. doi:10.1038/jid.2015.29.

PMID: 25647437 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25647437?dopt=Abstract = URL to article

What's new in the physiopathology of acne?

Br J Dermatol. 2015 Jan 24;

Authors: Suh DH, Kwon HH

Abstract
There are four central factors that contribute to acne physiopathology: the inflammatory response, colonization with Propionibacterium acnes, increased sebum production and hypercornification of the pilosebaceous duct. In addition, research in the areas of diet and nutrition, genetics and oxidative stress is also yielding some interesting insights into the development of acne. In this paper we review some of the most recent research and novel concepts revealed in this work, which has been published by researchers from diverse academic disciplines including dermatology, immunology, microbiology and endocrinology. We discuss the implications of their findings (particularly in terms of opportunities to develop new therapies), highlight interrelationships between these novel factors that could contribute to the pathology of acne, and indicate where gaps in our understanding still exist. This article is protected by copyright. All rights reserved.

PMID: 25645151 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25645151?dopt=Abstract = URL to article

Clinical Evaluation of 368 Patients with Nasal Rosacea: Subtype Classification and Grading of Nasal Rosacea.

Dermatology. 2015 Jan 23;

Authors: Lee WJ, Jung JM, Won KH, Won CH, Chang SE, Choi JH, Moon KC, Lee MW

Abstract
Background: The clinical features of nasal rosacea have not been described in detail. Objective: To describe the clinical features of nasal rosacea. Methods: 599 patients were classified into those with rosacea in both the nasal and extra-nasal areas (group A), localized nasal rosacea (group and rosacea without nasal involvement (group C). Results: The mixed subtype was more common in group A (n = 337) than in group C (n = 231). The severity score was higher in group A than in group C. Erythematotelangiectatic rosacea was the most common subtype in group B (n = 31) and was more common in group B than in group A. Rosacea mainly affected the lower half of the nose in group B, but affected the entire nose in group A. Conclusion: Nasal involvement may be an index of severe rosacea. Localized nasal rosacea is a separate spectrum with different clinical features. © 2015 S. Karger AG, Basel.

PMID: 25634308 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25634308?dopt=Abstract = URL to article

Topographic and Biomechanical Evaluation of Corneas in Patients With Ocular Rosacea.

Cornea. 2015 Jan 21;

Authors: Yildirim Y, Olcucu O, Agca A, Karakucuk Y, Alagoz N, Mutaf C, Demirok A, Kutlubay Z

Abstract
PURPOSE:: To compare the topographic and biomechanical properties of corneas in the eyes of patients with ocular rosacea (OR) with those of healthy individuals.
METHODS:: Thirty-four healthy individuals (control group) and 34 patients with OR (study group) were evaluated in this study. Topographic measurements including keratometry values, irregularity, and surface asymmetry index in the right eye of each participant were obtained using a Scheimpflug camera with a Placido disc topographer (Sirius). Corneal hysteresis (CH), corneal resistance factor (CRF), corneal-compensated intraocular pressure (IOP), and Goldmann-related IOP were measured using the Reichert Ocular Response Analyzer. Central corneal thickness was also measured using ultrasonic pachymetry and the Sirius corneal topography system.
RESULTS:: Topographic parameters were not significantly different between the groups (P > 0.05). Mean CH and CRF were significantly lower in patients with OR (P = 0.003 and 0.001, respectively). Central corneal thickness was significantly lower in patients with OR compared with healthy controls (P < 0.001). Mean Goldmann-related IOP and corneal-compensated IOP were not significantly different between the groups (P = 0.09 and 0.13, respectively).
CONCLUSIONS:: This study demonstrated that although the eyes of patients with OR had corneal topographic findings similar to those of healthy controls, corneal biomechanical measurements (CH and CRF) were significantly lower in patients with OR. These results need to be considered when planning corneal refractive surgery in patients with OR.

PMID: 25611397 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25611397?dopt=Abstract = URL to article

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J Am Acad Dermatol. 2014 Sep;71(3):e74-5

Authors: Montaudié H, Lacour JP, Rostain G, Duteil L, Passeron T

PMID: 25128130 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/25128130?dopt=Abstract = URL to article

Optimizing the Use of Topical Brimonidine in Rosacea Management: Panel Recommendations.

J Drugs Dermatol. 2015 Jan 1;14(1):33-40

Authors: Tanghetti EA, Jackson JM, Belasco KT, Friedrichs A, Hougier F, Johnson SM, Kerdel FA, Palceski D, Hong HC, Hinek A, Cadena MJ

Abstract
Rosacea is a chronic inflammatory disease with a complex pathophysiology that manifests with central facial redness with or without papulopustular lesions. Often, patients with rosacea present with a constellation of signs and symptoms; for best results, the treatment plan should take into account all symptoms manifesting in the individual patient. The first available pharmacologic treatment to address the redness associated with rosacea is topical brimonidine. In the United States, brimonidine topical gel 0.33% is indicated for persistent facial erythema of rosacea; approval was based on clinically significant efficacy and good safety data from large-scale clinical trials. Use of brimonidine in routine clinical practice has yielded new insights that elaborate on the findings from clinical trials. For example, real-world use has shown that a percentage of patients (in our experience, approximately 10 to 20%) treated with brimonidine experience a worsening of erythema that has been called "rebound." Our routine use of this agent for &gt;1 year has yielded strategies to set patient expectations, optimize treatment initiation, and minimize potential problems; this article details those strategies. Because we believe that the term "rebound" has been used to describe several physiologically distinct events, we have also proposed more specific terminology for such events. <br/><br/> <em>J Drugs Dermatol.</em> 2015;14(1):33-40.

PMID: 25607906 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25607906?dopt=Abstract = URL to article

Update on the Management of Rosacea: A Status Report on the Current Role and New Horizons With Topical Azelaic Acid.

J Drugs Dermatol. 2014 Dec 1;13(12):s101-s107

Authors: Del Rosso JQ, Kircik LH

Abstract
Azelaic acid (AzA) 15% gel has been available in the United States for slightly over a decade, approved for treatment of the inflammatory lesions (papules and pustules) of rosacea. Efficacy and safety have been established in multiple studies both as monotherapy and in combination with oral doxycycline. Azelaic acid 15% gel has been shown not to induce epidermal permeability barrier impairment, and proper skin care reduces the likelihood of neurosensory adverse effects of stinging and burning that can affect a subset of patients with rosacea. Azelaic acid 15% gel appears to produce a quicker onset of clinical effect than metronidazole in some patients when either agent is used in combination with subantimicrobial dose doxycycline; however, both topical agents are effective when used in this combination approach for papulopustular rosacea (PPR). Although more information is needed on the modes of action of AzA in the treatment of rosacea, downregulation of the cathelicidin pathway appears to be one operative mode of action based on in vitro and in vivo studies, including data from patients treated with AzA 15% gel for PPR. Azelaic acid 15% foam is currently in the latter stages of development for PPR, with pivotal studies demonstrating efficacy and favorable tolerability, including a very low incidence of stinging, burning, and itching even without the use of designated skin care products.<br /><br /> <em>J Drugs Dermatol</em>. 2014;13(suppl 12):s101-s107.

PMID: 25607798 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25607798?dopt=Abstract = URL to article

Challenges and Advances in Rosacea Management.

J Drugs Dermatol. 2014 Dec 1;13(12):s100

Authors: Kircik LH

Abstract
.

PMID: 25607797 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25607797?dopt=Abstract = URL to article

Long-Term Safety of Ivermectin 1% Cream vs Azelaic Acid 15% Gel in Treating Inflammatory Lesions of Rosacea: Results of Two 40-Week Controlled, Investigator-Blinded Trials.

J Drugs Dermatol. 2014 Nov 1;13(11):1380-1386

Authors: Stein Gold L, Kircik L, Fowler J, Jackson JM, Tan J, Draelos Z, Fleischer A, Appell M, Steinhoff M, Lynde C, Sugarman J, Liu H, Jacovella J

Abstract
Papulopustular rosacea (PPR) is characterized by facial erythema and inflammatory lesions believed to be primarily caused by dysregulation of the innate immune system. More recent evidence also suggests that <EM>Demodex folliculorum</EM> mites may contribute to the etiology of PPR. Ivermectin (IVM) 1% cream is a novel topical treatment developed to treat PPR. Two phase 3 trials have demonstrated that IVM 1% cream was significantly better than vehicle at investigator global assessment (IGA) success rate and lesion reductions and that it was safe and well tolerated. Two 40-week extension studies of those trials were conducted to assess the long-term safety of IVM 1% cream vs azelaic acid (AzA) 15% gel. Subjects originally treated with IVM 1% continued on IVM 1% and those originally treated with vehicle switched to AzA 15% gel. IVM 1% cream was safe throughout the study with a lower incidence of related adverse events (AEs) compared to AzA 15% gel. No subjects in the IVM 1% cream group discontinued either study due to a related AE. IVM 1% also continued to be efficacious during the 40-week extension studies as the percentage of subjects with IGA scores of clear or almost clear was higher at the end of the study compared to baseline. The results of these 40-week extension studies support the use of IVM 1% cream as a long-term therapy for PPR as IVM 1% cream was shown to be safe and effective for up to 52 weeks of total treatment. <BR /> <BR /> <EM>J Drugs Dermatol.</EM> 2014;13(11):1380-1386.

PMID: 25607706 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/25607706?dopt=Abstract = URL to article