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Clinical effects of a novel topical composition on persistent redness observed in patients who had been successfully treated with topical or oral therapy for papulopustular rosacea.

J Drugs Dermatol. 2014 Mar 1;13(3):326-31

Authors: Baldwin H, Berson D, Vitale M, Yatskayer M, Chen N, Oresajo C

Abstract
Rosacea is a condition most commonly characterized by central facial erythema and pupulopustules. There are highly effective drugs, both oral and topical, for papulopustular disease. At the present time, consistently effective pharmacologic therapy for erythematotelangiectatic rosacea is lacking. Patients whose papulopustular disease has been adequately treated are often still bothered by central facial erythema for which there is no adequate treatment short of laser and light. We present a study utilizing a novel topical composition evaluated for its ability to reduce background erythema remaining after adequate care of papulopustular disease. Patient, investigator and photographic evidence of erythema reduction was seen in 24/25 patients in this 8-week study.<BR /><BR /> <EM>J Drugs Dermatol.</EM> 2014;13(3):326-331.

PMID: 24595579 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/24595579?dopt=Abstract = URL to article

Efficacy and safety of ivermectin 1% cream in treatment of papulopustular rosacea: results of two randomized, double-blind, vehicle-controlled pivotal studies.

J Drugs Dermatol. 2014 Mar 1;13(3):316-23

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

Abstract
BACKGROUND: Treatments for papulopustular rosacea (PPR) are limited.<BR />
OBJECTIVE: To demonstrate the efficacy and safety of once-daily ivermectin 1% cream in subjects with moderate to severe PPR.<BR />
METHODS: Two identically designed, randomized, double-blind, controlled studies of ivermectin 1% cream (IVM 1%) or vehicle once daily for 12 weeks were conducted in subjects with moderate to severe PPR. Efficacy assessments were Investigator's Global Assessment (IGA) of disease severity and inflammatory lesion counts. Safety assessments included incidence of adverse events (AEs) and local tolerance parameters. Subjects evaluated their rosacea and completed satisfaction and quality of life (QoL) questionnaires.<BR />
RESULTS: In both studies, a greater proportion of subjects in the IVM 1% group achieved treatment success (IGA "clear" or "almost clear"): 38.4% and 40.1% vs 11.6% and 18.8% for vehicle (both P<.001), respectively. Ivermectin was superior to vehicle in terms of reduction from baseline in inflammatory lesion counts (76.0% and 75.0% vs 50.0% for both vehicle groups, respectively). For all endpoints, starting at week 4 and continuing through week 12, IVM 1% was statistically significantly superior (P<.001). Fewer subjects treated by IVM 1% reported dermatologic AEs, and a higher proportion of subjects were observed to have no skin dryness or itching compared to vehicle. Significantly more subjects receiving IVM 1% reported having an "excellent" or "good" improvement, along with an improved QoL.<BR />
CONCLUSION: Ivermectin 1% cream was effective and safe in treating inflammatory lesions of papulopustular rosacea.<BR /><BR /> <EM>J Drugs Dermatol.</EM> 2014;13(3):316-323.

PMID: 24595578 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/24595578?dopt=Abstract = URL to article

Kallikrein 5-Mediated Inflammation in Rosacea: Clinically Relevant Correlations with Acute and Chronic Manifestations in Rosacea and How Individual Treatments May Provide Therapeutic Benefit.

J Clin Aesthet Dermatol. 2014 Jan;7(1):20-25

Authors: Two AM, Del Rosso JQ

Abstract
Rosacea is a chronic inflammatory condition of facial skin estimated to affect more than 16 million Americans. Although the pathogenesis of rosacea is not fully understood, recent evidence in vitro as well as in vivo has supported the role of increased levels of the trypsin-like serine protease, kallikrein 5, in initiating an augmented inflammatory response in rosacea. The increase in the quantity and magnitude of biological activity of kallikrein 5 leads to production of greater quantities of cathelicidin (LL-37), an antimicrobial peptide associated with increases in innate cutaneous inflammation, vasodilation, and vascular proliferation, all of which are characteristic features of rosacea. In this article, the authors review the literature supporting the role of kallikrein 5 in the pathophysiology of rosacea, including how therapeutic interventions modulate the effects of kallikrein 5, thus providing further support for this pathophysiological model that at least partially explains many of the clinical features of cutaneous rosacea.

PMID: 24563692 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24563692?dopt=Abstract = URL to article

Related Articles

Surgical correction of rhinophyma: comparison of two methods in a 15-year-long experience.

J Craniomaxillofac Surg. 2013 Jul;41(5):429-36

Authors: Lazzeri D, Larcher L, Huemer GM, Riml S, Grassetti L, Pantaloni M, Li Q, Zhang YX, Spinelli G, Agostini T

Abstract
PURPOSE: Rhinophyma is characterized by slowly progressive tumour-like enlargement of the nasal skin that will not resolve spontaneously. Though its treatment consists of surgical removal of the hyperplastic alterations, in the literature there is not general agreement about the best method. We presented our experience with two different treatment modalities such as decortication by scalpel and CO2 laser treatment.
METHODS: The authors reviewed the long-term results of 67 patients affected by rhinophyma treated with two different methods between 1996 and 2011. Outcomes were determined by case notes, clinical review and patient satisfaction questionnaire.
RESULTS: Forty-five cases were treated with tangential excision and 22 with a CO2 laser. Minor complications, including scarring and hypopigmentation, were seen in 6 patients. All patients were satisfied with their outcomes at the follow-up visit, and no major complications were detected during follow-up.
CONCLUSION: Both tangential excision and carbon dioxide laser are well-established, reliable procedures for rhinophymaplasty that preserve the underlying sebaceous gland fundi allowing spontaneous re-epithelialization without scarring with similar outcomes and high patient satisfaction. The original nose shape and nearly normal skin surface texture are preserved by quickly removal of the hypertrophic tissue sparing the pilosebaceous tissue. The CO2 laser is more capital intensive and results in higher fees compared with the simpler cold blade tangential excision. In our experience the ease of use, accuracy and precision of the lasers offer is not justified by the increased costs.

PMID: 23232283 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/23232283?dopt=Abstract = URL to article

Reflectance confocal microscopy vs. standardized skin surface biopsy for measuring the density of Demodex mites.

Skin Res Technol. 2014 Feb 13;

Authors: Turgut Erdemir A, Gurel MS, Koku Aksu AE, Bilgin Karahalli F, Incel P, Kutlu HaytoÄŸlu NS, Falay T

Abstract
BACKGROUND: Reflectance confocal microscopy (RCM) has been recently shown to be effective for measuring the Demodex mite density.
OBJECTIVES: To compare and demonstrate the advantages and disadvantages of standardized skin surface biopsy (SSSB) and RCM for measuring the density of Demodex mites.
MATERIALS AND METHODS: Forty-eight patients (30 female, 18 male) and 47 healthy controls (30 female, 17 male) were enrolled in the study. The patients diagnoses were pityriasis folliculorum (n = 40), papulopustulary rosecea (n = 7) and erythema-telengiectatic rosacea (n = 1). The area with the most intense erythema on the right cheek was selected for imaging with RCM (VivaScope 3000) and SSSB.
RESULTS: Forty-two patients demonstrated high Demodex density [(Dd) > 5 mites/cm(2) ] with SSSB (85.7%). RCM identified demodicosis in 48 patients (100%). The mean Dd measured with RCM (409.8 ± 209.2) was significantly higher than SSSB (15.33 ± 18.1) (P < 0.001). In the patients, RCM demonstrated the mean number of mites 40.90 ± 20.9 and 4.11 ± 6.4 in the controls per 10 mm(2) area. The corresponding mean number of 2.63 ± 0.77 mites was detected in the infested follicles per area of view compared to a mean of 0.77 ± 0.98 mites in the infested follicles in the controls (P < 0.001).
CONCLUSION: Reflectance confocal microscopy is a fast, direct and noninvasive method for Demodex-associated diseases and it is superior to SSSB for Demodex mite detection.

PMID: 24521295 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24521295?dopt=Abstract = URL to article

Rosacea-like facial rash related to metformin administration in a young woman.

BMC Pharmacol Toxicol. 2014 Feb 8;15(1):3

Authors: Mumoli L, Gambardella A, Labate A, Succurro E, De Sarro G, Arturi F, Gallelli L

Abstract
BACKGROUND: Since the skin represents a common site of adverse drug reactions, few data are reported at this time regarding the development of skin rash during the treatment with antidiabetic drugs.
CASE PRESENTATION: We report a 29-year old woman that developed a facial skin rash during the treatment with metformin. Clinical and laboratory findings excluded the presence of systemic diseases, but several diagnosis and many drugs were administered without clinical improvement. The self-dismission of metformin induced an improvement of symptoms, while the re-challenge documented an impairments of skin rash. The Naranjo probability scale suggested a probable association between metformin and skin rash and metformin was definitively dismissed.
CONCLUSION: We report for the first time a non vasculitis facial skin manifestation related to metformin in a young woman. However, this case may emphasizes the need to consider the ADRs as a differential diagnosis in order to reduce medical errors and the related medical costs.

PMID: 24507578 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24507578?dopt=Abstract = URL to article

Comparative pharmacokinetics and bioavailability of brimonidine following ocular administration and dermal application of brimonidine tartrate ophthalmic solution and gel in subjects with moderate to severe facial erythema of rosacea.

Br J Dermatol. 2014 Feb 7;

Authors: Benkali K, Leoni M, Rony F, Bouer R, Fernando A, Graeber M, Wagner N

Abstract
A pharmacokinetics (PK) study was conducted to perform an intra-individual comparison of the systemic exposure obtained with brimonidine tartrate (BT) gel (0.07%, 0.18%, and 0.5%) under maximal use conditions for 29 days and with BT ophthalmic solution 0.2% as reference treatment, in subjects with moderate to severe facial erythema of rosacea. Quantifiable exposure (≥10 pg/mL) was detected in 96 subjects who received BT ophthalmic 0.2% solution as a TID (Three times a day) regimen for one day (3 doses) with a mean Cmax of 54 ± 28 pg/mL and a mean AUC0-24h of 568 ± 277 pg.h/mL. Conversely, daily topical application of BT gel for 29 days resulted in quantifiable systemic exposure in 22%, 48%, 71%, and 79% of subjects who received BT gel 0.07% BID (Twice a day), 0.18% QD (Once a Day), 0.18% BID, and 0.5% QD, respectively. Systemic exposures obtained with BT gels increased with the applied dose with no drug accumulation throughout the treatment duration. At the end of the 29-day treatment, the mean Cmax values ranged between 13 and 25 pg/mL and the mean AUC0-24h values ranged between 42 and 290 pg.h/mL for the BT gels. The systemic exposure observed with the highest dose of BT gel (0.5% QD) was significantly lower than the systemic levels observed for the ophthalmic solution 0.2% after a one day TID regimen. Collectively, PK assessment showed that the systemic safety profile of the BT gel may be considered better than the marketed ophthalmic solution. This article is protected by copyright. All rights reserved.

PMID: 24506775 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24506775?dopt=Abstract = URL to article

Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 3: a status report on systemic therapies.

Cutis. 2014 Jan;93(1):18-28

Authors: Del Rosso JQ, Thiboutot D, Gallo R, Webster G, Tanghetti E, Eichenfield LF, Stein-Gold L, Berson D, Zaenglein A

Abstract
The third article in this 5-part series reviews systemic therapies used to treat cutaneous rosacea based on consensus recommendations from the American Acne & Rosacea Society (AARS) on the management of the common presentations of cutaneous rosacea. The consensus recommendations are based on current understanding of research that describes pathophysiologic mechanisms that appear to be operative in rosacea, correlation of these underlying pathophysiologic mechanisms with specific clinical manifestations of rosacea, and outcomes from clinical trials that evaluate therapies for rosacea both as monotherapy and in combination with other agents. Systemic agents used for treatment of rosacea have been administered as oral formulations (ie, tablets, capsules). The only oral agent for rosacea approved by the US Food and Drug Administration (FDA) is a modified-release doxycycline 40-mg capsule. Other non-FDA-approved oral agents also are discussed including other tetracyclines, macrolides, metronidazole, and isotretinoin.

PMID: 24505581 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/24505581?dopt=Abstract = URL to article

Application of Intense Pulsed Light in the Treatment of Dermatologic Disease: A Systematic Review.

Dermatol Surg. 2014 Feb 4;

Authors: Wat H, Wu DC, Rao J, Goldman MP

Abstract
BACKGROUND: The Food and Drug Administration (FDA) has approved intense pulsed light (IPL) devices for the treatment of a variety of benign pigmentary and vascular lesions, but the range of disease amenable to IPL treatment continues to expand, and there are no evidence-based clinical guidelines for its use in FDA-approved and off-label indications.
OBJECTIVE: To provide evidence-based recommendations to guide physicians in the application of IPL for the treatment of dermatologic disease.
EVIDENCE REVIEW: A literature search of the CENTRAL (1991 to May 6, 2013), EMBASE (1974 to May 6, 2013), and MEDLINE in-process and nonindexed citations and MEDLINE (1964 to present) databases was conducted. Studies that examined the role of IPL in primary dermatologic disease were identified, and multiple independent investigators extracted and synthesized data. Recommendations were based on the highest level of evidence available.
FINDINGS: Level 1 evidence was found for the use of IPL for the treatment of melasma, acne vulgaris, and telangiectasia. Level 2 evidence was found for the treatment of lentiginous disease, rosacea, capillary malformations, actinic keratoses, and sebaceous gland hyperplasia. Level 3 or lower evidence was found for the treatment of poikiloderma of Civatte, venous malformations, infantile hemangioma, hypertrophic scars, superficial basal cell carcinoma, and Bowen's disease.
CONCLUSIONS: IPL is an effective treatment modality for a growing range of dermatologic disease and in some cases may represent a treatment of choice. It is typically well tolerated. Further high-quality studies are required.

PMID: 24495252 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24495252?dopt=Abstract = URL to article

Related Articles

Secondary intention healing in skin surgery: our own experience and expanded indications in hidradenitis suppurativa, rhinophyma and non-melanoma skin cancers.

J Eur Acad Dermatol Venereol. 2013 Aug;27(8):1015-21

Authors: Bieniek A, Matusiak Å, Chlebicka I, Szepietowski JC

Abstract
BACKGROUND: There are many situations in integument surgery in which secondary intention healing (SIH) may bring results comparable or even superior to those obtained with primary intention healing.
OBJECTIVE: To present our own methods of employing SIH in surgical treatment of different skin lesions. Moreover, to delineate the extended indications for SIH as a first-line method of wound treatment.
METHODS: Between 1999 and 2009, we conducted 236 operations followed by SIH in the group of 195 patients. Two independent investigators and the patients carried out post-operative assessment (at 12 months) of both cosmetic and functional results of operations (data for 142 patients). Moreover, at 3 and 12 months, patients were asked for self-evaluation of the outcomes of surgical procedures using the visual analogue scale (VAS).
RESULTS: The most frequent indications for SIH were defects after the excision of non-melanoma skin cancers and hidradenitis suppurativa lesions. Depending on localization, the mean extent of the post-operative wounds prepared for SIH ranged from 0.8to 85.7 cm(2). The healing lasted 2-12 weeks. The most important factor was the size of the wound (r = 0.59; P < 0.001). The assessment at 12 months revealed that cosmetic/functional outcomes were evaluated as 'good' or 'excellent' in 89/83% and 72/70% cases, according to patients and physicians respectively. VAS showed that evaluation scores at 3 months post-surgery were significantly lower than at 12 months (P < 0.0001).
CONCLUSION: SIH is a safe and efficient form of treatment for various post-operative skin defects. In certain areas of the body, SIH shows favourable cosmetic and functional effects. In these cases, it may even be regarded as the method of choice.

PMID: 22817107 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/22817107?dopt=Abstract = URL to article

Innate immunity and the role of the antimicrobial peptide cathelicidin in inflammatory skin disease.

Drug Discov Today Dis Mech. 2013 Dec 1;10(3-4):e79-e82

Authors: Roby KD, Nardo AD

Abstract
Cathelicidin antimicrobial peptide is an important mediator of the innate immune response. In addition to its potent antimicrobial activity, cathelicidin has been shown to have chemoattractant and angiogenic properties. Recent research has demonstrated that, in addition to its aforementioned functions, cathelicidin plays an important role in the complex pathogenesis of several chronic inflammatory skin diseases. This review will present a concise overview of the role of cathelicidin in infection and in the development of atopic dermatitis, psoriasis, and rosacea. This understanding will direct future research efforts to identify therapeutic approaches that use cathelicidin as a novel drug itself, or aim to modify its expression and regulation.

PMID: 24489580 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24489580?dopt=Abstract = URL to article

Rosacea-Like Tinea Incognito due to Trichophyton mentagrophytes vr. mentagrophytes.

Acta Dermatovenerol Croat. 2013 Dec;21(4):263-4

Authors: Calcaterra R, Fazio R, Mirisola C, Baggi L

Abstract
Tinea incognito is a dermatophytosis with atypical clinical manifestation in the absence of the typical "ringworm" (1). The term tinea incognito was originally used in 1968 by Ive and Marks in 14 patients with atypical dermatophytic infection caused by a previous steroid treatment (2) . Since then, several cases of tinea incognito have been described after topical application of pimecrolimus and tacrolimus, although the use of corticosteroids continues to be the most common trigger of the disease (3). A 47-year-old woman presented at our Institute with a 3-month history of erythematous papules with rare pustules on the face. The patient reported a three-month application of topical corticosteroids and metronidazole cream with progressive exacerbation of the eruption. Physical examination revealed numerous papules and some pustules forming an erythematous plaque localized on the face (Fig.1). No pathologic signs were observed on the rest of the body and nails. The patient's history was otherwise unremarkable. Scrapings from the facial lesion, examined directly in 10% potassium hydroxide solution, showed the presence of dermatophyte hyphae. Culture on Mycosel Agar (agar-dextrose + cycloeximide + chloramphenicol) at 27 °C for three weeks yielded colonies with a powdery and granular surface and yellowish reverses (Fig. 2). Microscopically, we observed round and pyriform microconidia, spiral hyphae and rare smooth-walled macroconidia. These findings confirmed the diagnosis of dermatophyte infection caused by Trichophyton mentagrophytes vr. mentagrophytes. A diagnosis of rosacea-like tinea incognito was made and the patient started therapy with oral terbinafine 250 mg/die for 4 weeks, with progressive and total resolution of the facial lesions. Tinea faciei, a relatively uncommon dermatophyte infection, usually shows up as an erythematous, scaly patch with an annular edge, the size of which gradually increases. Clinical presentation of the condition is often atypical. The absence of classical features of ringworm, likely because of the complex anatomy of the face, makes the initial diagnosis difficult and often leads to misdiagnosis of tinea faciei (1). A broad range of skin diseases, like seborrheic dermatitis, cutaneous candidiasis, atopic dermatitis, contact dermatitis, granuloma annulare, systemic and discoid lupus erythematosus, rosacea, drug-induced lupus, perioral dermatitis, pityriasis alba, pityriasis rosea, sarcoidosis, tuberculosis, psoriasis vulgaris, and polymorphic light eruption can mimic tinea facei (1-3). This can lead to misdiagnosis of the disease, consequential use of steroids, and finally to worsening of the disease and onset of tinea incognito. The pathogenesis of tinea incognito is presumably linked to a steroid-modified response of the host to fungal infection rather than to a direct pharmacological effect on the mycete (3). Topical steroids suppress the local immune response and allow the fungus to grow easily. As a result, the fungal infection may take on a bizarre appearance. The prevalence of dermatophytes responsible for the condition shows marked geographical variation (4,5). In Italy, Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, Microsporum gypseum, Trichophyton violaceum, and Trichophyton erinacei have been reported as the main etiologic agents (5). Tinea faciei responds to treatment with topical orâ„and oral antifungals. Patients with highly inflamed lesions, resistant, extensive and complicated disease, or those with multiple plaques may require oral antifungal therapy, as in our case. Terbinafine, itraconazole, and fluconazole have been shown to be superior to griseofulvin because they concentrate at the level of the skin (4). The presented case highlights the importance of considering tinea on the differential diagnosis of all facial eruptions and the essential role of mycological examination to make a correct diagnosis and treatment.

PMID: 24476616 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/24476616?dopt=Abstract = URL to article

Human demodicosis: revisit and a proposed classification.

Br J Dermatol. 2014 Jan 28;

Authors: Chen W, Plewig G

Abstract
Human Demodex mites (Demodex folliculorum and Demodex brevis) hold a high rank in the evolutionary and phylogenetic hierarchy of the skin microbiome, although, in most people, their presence is of no consequence. While human demodicosis is a skin disease sui generis, it can mimic many other inflammatory dermatoses, such as folliculitis, rosacea and perioral dermatitis, leading to unspecific and confusing descriptions in the literature. Here, we propose to classify human demodicosis into a primary form and a secondary form, which is mainly associated with immunosuppression. The clinical manifestations of primary demodicosis may include: (1) Demodicosis spinulosa, currently known as pityriasis folliculorum, involving sebaceous hair follicles without visible inflammation, (2) papulopustular/nodulocystic or conglobate demodicosis with pronounced inflammation affecting most commonly the perioral and periorbital areas of the face, (3) ocular demodicosis, inducing chronic blepharitis, chalazia, or less commonly keratoconjunctivitis, and (4) auricular demodicosis causing external otitis or myringitis. Secondary demodicosis is usually associated with systemic or local immunosuppression. Treatment is only weakly evidence-based, and the best effective concentrations of arachidicides remain to be determined. Optimization of an in vitro or ex vivo culture model is necessary for future studies. Endosymbiosis between certain bacteria and Demodex mites in the pathogenesis of demodicosis deserves more attention. Further clinical observations and experiments are needed to prove our hypothesis. This article is protected by copyright. All rights reserved.

PMID: 24471456 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24471456?dopt=Abstract = URL to article

Single or combined effects of Lactobacillus sakei and inulin on growth, non-specific immunity and IgM expression in leopard grouper (Mycteroperca rosacea).

Fish Physiol Biochem. 2014 Jan 24;

Authors: Reyes-Becerril M, Ascencio F, Gracia-Lopez V, Macias ME, Roa MC, Esteban MA

Abstract
The aim of this study was to evaluate the single or combined effects of Lactobacillus sakei with inulin suitable for immunological in vivo studies in farmed fish. By in vitro assays, L. sakei strain 5-4 showed antibacterial activities against all assayed fish pathogens (except the Vibrio harveyi strain CAIM-1793). L. sakei was able to survive at high fish bile concentrations. Fermentation of the agave inulin resulted in a large increase in number of lactobacilli. For the in vivo study, fish were fed for 8 weeks four practical diets: control diet (control), L. sakei 5-4 (10(7) CFU/g), inulin (1 % or 10 g/kg) and L. sakei + inulin (10(7) CFU/g + 10 g/kg). The weight gain showed clearly the synergistic effect of L. sakei 5-4 and inulin at 6 and 8 weeks of treatments. Leopard grouper fed with L. sakei alone or combined with inulin have significantly increased the assayed physiological and humoral immune parameters. By real-time PCR assays, the mRNA transcripts of immunoglobulin M (IgM) were found to be higher expressed in intestine, head kidney, mucus, gill, spleen and skin. Moreover, mRNA expression levels of IgM in head kidney and anterior intestine were measured by real-time PCR. L. sakei 5-4 and L. sakei + inulin supplemented diet up-regulated the expression of IgM at week 4 and 8 in intestine and head kidney, respectively. These results support the idea that the L. sakei 5-4 alone or combined with agave inulin improved growth performance and stimulates the immune system of leopard grouper.

PMID: 24464476 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24464476?dopt=Abstract = URL to article

Treatment of Ocular Rosacea With Once-Daily Low-Dose Doxycycline.

Cornea. 2014 Jan 21;

Authors: Sobolewska B, Doycheva D, Deuter C, Pfeffer I, Schaller M, Zierhut M

Abstract
PURPOSE:: The aim of this study was to determine the efficacy of once-daily systemic treatment of ocular rosacea with a slow-release form of 40 mg of doxycycline.
METHODS:: Fifteen patients with ocular rosacea were enrolled between February 2010 and October 2012 in a retrospective observational case series. Patient complaints and clinical findings including blepharitis with telangiectasia and meibomian gland dysfunction, conjunctival redness, and fluorescein staining of the cornea were evaluated. The ocular manifestations were scored as follows: 0-absent, 1-mild, 2-moderate, and 3-severe. All measurements were repeated at the 6-week follow-up visit. The mean duration of treatment was 8 months (range, 5-12 months), and the mean duration of the follow-up was 9 months (range, 6-17 months).
RESULTS:: At the baseline visit, 73.3% of the patients had severe complaints, and 80% had severe blepharitis despite topical therapy with artificial tears and eyelid hygiene. After 12 weeks of systemic therapy, severe complaints and blepharitis strongly improved and were seen in only 13.3% and 20% of the patients (P = 0.01). Follow-up investigations 6 to 17 months after discontinuation of the treatment showed further significant improvement of complaints (absent or mild in 66.7% and 20% of the patients, respectively) and blepharitis (absent or mild in 26.7% and 60% of the patients, respectively). One patient had a mild stomach ache so that therapy was shortened to 5 months.
CONCLUSIONS:: An antiinflammatory dose of slow-release doxycycline 40 mg given daily may be an effective and safe therapy of ocular rosacea.

PMID: 24452213 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24452213?dopt=Abstract = URL to article

Antihypertensive drugs and the risk of incident rosacea.

Br J Dermatol. 2014 Jan 16;

Authors: Spoendlin J, Voegel JJ, Jick SS, Meier CR

Abstract
BACKGROUND: Despite scarce evidence, use of calcium channel blockers is discouraged in rosacea patients, whereas beta-blockers are recommended as an off-label treatment for erythematotelangiectatic rosacea.
OBJECTIVES: To study the association between use of calcium channel blockers, beta-blockers, and other antihypertensive drugs and incident rosacea.
METHODS: We conducted a matched case-control study of antihiypertensive drugs and incident rosacea, using the UK-based General Practice Research Database. Cases had a first diagnosis of rosacea recorded between 1995 and 2009. Each case was matched to one control on age, sex, general practice, and years of history on the database before the index date. Drug use was stratified by timing (≤ or > 180 days before the index date) and duration (number of prescriptions) of drug exposure, in a multivariate conditional logisitic regression model.
RESULTS: Among 53,927 cases and 53,927 controls, we observed ORs around unity for calcium channel blockers across all strata, with a slightly decreased OR of 0.77 (95% CI 0.69-0.86) for current users of dihydropyridine calcium channel blockers with ≥40 prescriptions. Among beta-blockers, atenolol and bisoprolol yielded slightly decreased ORs across all exposure strata, whereas propranolol revealed ORs around 1.0, irrespective of timing and duration of exposure. Neither ACE-inhibitors nor angiotensin receptor blockers altered the relative rosacea risk.
CONCLUSIONS: Our data contradict the prevailing notion that calcium channel blockers increase the risk of rosacea. Beta-blocker use was associated with a slightly decreased risk of rosacea, but the effect may be somewhat stronger in patients with erythematotelangiectatic rosacea. This article is protected by copyright. All rights reserved.

PMID: 24428524 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24428524?dopt=Abstract = URL to article

Oxymetazoline (topical): rosacea.

Hosp Pharm. 2013 Jul;48(7):558-9

Authors: Generali JA, Cada DJ

Abstract
This Hospital Pharmacy feature is extracted from Off-Label Drug Facts, a publication available from Wolters Kluwer Health. Off-Label Drug Facts is a practitioner-oriented resource for information about specific drug uses that are unapproved by the US Food and Drug Administration. This new guide to the literature enables the health care professional or clinician to quickly identify published studies on off-label uses and determine if a specific use is rational in a patient care scenario. References direct the reader to the full literature for more comprehensive information before patient care decisions are made. Direct questions or comments regarding Off-Label Drug Uses to jgeneral@kumc.edu.

PMID: 24421520 [PubMed]

http://www.ncbi.nlm.nih.gov/pubmed/24421520?dopt=Abstract = URL to article

Azelaic acid foam 15% in the treatment of papulopustular rosacea: a randomized, double-blind, vehicle-controlled study.

Cutis. 2013 Dec;92(6):306-17

Authors: Draelos ZD, Elewski B, Staedtler G, Havlickova B

Abstract
Rosacea is a common chronic inflammatory skin disease that primarily affects facial skin. Its etiology is unknown, and currently there is no cure. Rosacea can be associated with severe symptoms, including transient erythema (flushing), nontransient erythema, papules, pustules, and telangiectases, leading to substantial discomfort and an unattractive appearance. This randomized, double-blind, vehicle-controlled, multicenter, parallel-group study conducted over 12 weeks with a 4-week follow-up period evaluated the efficacy and safety of a new formulation of azelaic acid (AzA) foam in a 15% concentration compared to vehicle alone in patients with papulopustular rosacea (PPR). Primary efficacy variables assessed were investigator global assessment (IGA) dichotomized into success and failure, and nominal change in inflammatory lesion count from baseline to end of treatment. Results indicated that the new foam formulation of AzA is effective and well-tolerated in a population of patients with PPR. Although no single formulation is appropriate for all patients, the development of a new foam formulation in addition to other available vehicles provides patients with options and allows health care providers to match the needs as well as preferences of individual patients and skin types with appropriate delivery modalities.

PMID: 24416747 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/24416747?dopt=Abstract = URL to article

Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 2: a status report on topical agents.

Cutis. 2013 Dec;92(6):277-84

Authors: Del Rosso JQ, Thiboutot D, Gallo R, Webster G, Tanghetti E, Eichenfield L, Stein-Gold L, Berson D, Zaenglein A

Abstract
A variety of topical therapies have been utilized in the treatment of rosacea. In part 2 of this 5-part series, topical agents that have been utilized in the treatment of the common clinical presentations of rosacea, including those that have been approved by the US Food and Drug Administration (FDA) as well as alternative agents, are reviewed. It is important to note that adjunctive skin care and photoprotection are integral components of rosacea treatment that may assist in optimizing therapeutic outcomes.

PMID: 24416742 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/24416742?dopt=Abstract = URL to article

Severe rosacea with prominent Demodex folliculorum in a patient with HIV.

J Dermatol. 2014 Jan 3;

Authors: Yamaoka T, Murota H, Tani M, Katayama I

PMID: 24386982 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24386982?dopt=Abstract = URL to article

Long-term safety and efficacy of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of a 1-year open-label study.

J Drugs Dermatol. 2014 Jan 1;13(1):56-61

Authors: Moore A, Kempers S, Murakawa G, Weiss J, Tauscher A, Swinyer L, Liu H, Leoni M

Abstract
Once-daily topical brimonidine tartrate (BT) gel 0.5% was shown to be efficacious and safe for the treatment of erythema of rosacea in previous studies including a 4-week treatment phase. In the present 1-year study, we aimed to assess the long-term safety and efficacy of the treatment. Subjects with moderate to severe erythema of rosacea were instructed to apply topical BT gel 0.5% once daily for 12 months. Severity of erythema and adverse events (AEs) were evaluated. Approximately 345 subject years of exposure to BT gel 0.5% was achieved in the study. The incidence of AEs and AEs judged to be related to the study drug was higher at the beginning and decreased over the course of the study. Similar safety profiles were observed between the subjects who had received or not received concomitant therapies for the inflammatory lesions of rosacea. Effect of topical BT gel 0.5% on erythema severity was observed after the first application and the durability of the effect was maintained until the end of the study at month 12, with no tachyphylaxis observed. In conclusion, once-daily topical BT gel 0.5% is safe and consistently effective for the long-term treatment of moderate to severe erythema of rosacea, even in the presence of concomitant therapies for the inflammatory lesions of rosacea.<BR /><BR /> <EM>J Drugs Dermatol.</EM> 2014;13(1):56-61.

PMID: 24385120 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/24385120?dopt=Abstract = URL to article

Therapeutic Update on Rosacea.

J Drugs Dermatol. 2014 Jan 1;13(1):10-11

Authors: Sarnoff DS

Abstract
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PMID: 24385112 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24385112?dopt=Abstract = URL to article

Incidental focal acantholytic dyskeratosis in the setting of rosacea.

Ann Dermatol. 2013 Nov;25(4):518-20

Authors: Park SY, Lee HJ, Shin JY, Ahn SK

PMID: 24371411 [PubMed]

http://www.ncbi.nlm.nih.gov/pubmed/24371411?dopt=Abstract = URL to article

[What's new in clinical dermatology?].

Ann Dermatol Venereol. 2013 Nov;140 Suppl 3:S237-53

Authors: Janier M

Abstract
2013 has been the year of large genetic studies of the GWAS type (Genome wide association studies) in common diseases such as psoriasis and atopic dermatitis, aimed at localization of candidate genes. It was also the year of population-based studies from huge public or private registers. Thus, epidemiologic correlations have been put forward: psoriasis and vascular risk, psoriasis and rhinosinusitis, rosacea and migraine, acne and food habits, eczema and basal-cell carcinoma, vitiligo and lower risk of skin cancer, cutaneous Ro/SS-A pos lupus and cancer, chronic eczema and calcium-channel inhlbitors, pemphigoid and loop diuretics. Risk of IBD induced by isotretinoin has not been confirmed but risk of skin cancer under azathioprine is real. New drug reactions have appeared (pigmentation due to interferon, hypodermitis and sarcoidosis to anti-BRAF, vandetanib) and old ones are revisited (patch-testing of Severe Cutaneous adverse cutaneous reactions, pigmentation due to anti-malarial drugs, neutrophilic dermatosis due to azathioprine). Diane35(®)has been transiently withdrawn in January 2013 but tetrazepam has been withdrawn definitively in July 2013. Original aspects of cutaneous infections will be discussed along with new data on STDs (meningococcemia in MSMs, HPV, Herpes, congenital syphilis). Finally, some important papers about dermoscopy, confocal microscopy and aesthetic dermatology will be presented.

PMID: 24365496 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/24365496?dopt=Abstract = URL to article

Epidermal hydration levels in rosacea patients improve after minocycline therapy.

Br J Dermatol. 2013 Dec 6;

Authors: Ní Raghallaigh S, Powell FC

Abstract
BACKGROUND: Patients with rosacea frequently report increased skin sensitivity, with features suggestive of an abnormal stratum corneum (SC) permeability barrier. Sebum, pH and hydration levels influence epidermal homeostasis. The correlation of the change in these parameters with clinically effective treatment has not been previously analysed.
OBJECTIVE: To analyse sebum, pH, and epidermal hydration levels of patients with papulopustular rosacea (PPR) before and after treatment with systemic minocycline.
METHODS: We analysed sebum casual levels, pH and hydration along with erythema levels (as a marker of disease activity and response to treatment) on 7 designated facial sites of 35 patients with active PPR and compared the results to values on the same sites of 34 control subjects with normal facial skin. To determine the effect of minocycline on these parameters, we re-examined the patients with PPR at the same sites following a six-week course of treatment.
RESULTS: Patients with untreated PPR had significantly increased erythema indices, normal sebum casual levels, a more alkaline centrofacial region and reduced epidermal hydration levels as compared with controls. Treatment with minocycline resulted in reduced erythema and increased hydration levels, with the most marked changes evident in the cheeks (13.3% reduction in erythema indices, p = 0.0003; 12.4% increase in hydration levels, p = 0.012). There was no change in skin pH or sebum casual levels following treatment.
CONCLUSION: Patients with PPR have increased erythema indices, normal sebum casual levels, a more alkaline centrofacial region and reduced epidermal hydration levels compared with control subjects. Treatment with systemic minocycline reduces erythema and increases hydration; in the absence any change in skin pH or sebum casual levels. This article is protected by copyright. All rights reserved.

PMID: 24354646 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/24354646?dopt=Abstract = URL to article