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    • We used to allow guests to post feedback without registering an account in this forum but now require guests to subscribe to post. Scroll below about Active vs Inactive members.  Voting Member The RRDi has now over 1000 charter members who have graciously joined providing contact information so that they can vote in our decision making of who serves on the board of directors every five years. If you want voting member status we require more than just an email address to vote. We understand that many of you do not want to provide such information so that is why we have setup the non voting member group discussed below.  Non Voting Member Who Registered an Account  We have in the past opened up our membership to anyone who provided an email address without giving us all the contact information. These non voting members who do not provide full contact information (only providing an email address) are not be able to vote for who serves on the board of directors, but will had posting privileges in the forums with access to the website. We hoped to increase our membership since many are reluctant to join if they have to provide contact information. This way, only those who really want to vote will graciously provide such information if they want to, or, opt to be a member and be totally anonymous, with only providing an email address.   By only providing an email address we are also allowing those to use their Apple or Facebook accounts to register an account with our forum, as well as Microsoft, and Google accounts. If you have any issues with registering an account, please use our support form or contact form and describe the issue so we can improve our registration process to make it as easy and user friendly as possible. By using one of the following sign in accounts below (Apple, Facebook, Microsoft, Google) it should be easy peasy (if not let us know). We are still working with Twitter and Linked in about this but you can use Apple, Facebook, Microsoft or Google login credentials with the RRDi it should be the easiest registration.   Changing to a VOTING MEMBER If you join with just an email address you are a member, however you are NOT a VOTING MEMBER. If you are a non voting member and want to become a voting member read the paragraph above on Voting Member, that explains providing contact information allows you to vote. If you do indeed provide us with your contact information, i.e., first and last name, mailing address, phone, alternate email address in your PROFILE, and want to be considered a VOTING MEMBER then contact us and explain so we can change your account setting to a voting member.  Changing to an ACTIVE MEMBER If you logged into your account and are not able to have access to parts of our website, you have become an INACTIVE MEMBER. All that is required now is to SUBSCRIBE. 
    • Int J Dermatol. 2022 Jul 3. doi: 10.1111/ijd.16341. Online ahead of print. ABSTRACT Rhinoplasty is considered a very challenging surgery since minimal changes of this central area of the face may significantly impact a person's appearance and self-awareness. This is even more challenging in thick-skinned patients because results are less predictable, and changes to the osseocartilaginous framework (OCF) may not be sufficiently visible due to the blanket effect of the thick skin. Furthermore, pre-existing skin conditions may exacerbate following surgery. Therefore, managing patients with extremely thick skin or patients who suffer from pre-existing dermatological conditions such as rosacea or acne requires a synergy of surgeons and dermatologists to achieve optimal results. In this article, we review the most significant pre- and post-surgical regimens that surgeons and dermatologists should apply in selected patients to achieve optimal results after rhinoplasty. PMID:35781878 | DOI:10.1111/ijd.16341 {url} = URL to article
    • J Clin Aesthet Dermatol. 2022 Jun;15(6):42-45. ABSTRACT BACKGROUND: Expression of inducible nitric oxide synthase (NOS) is higher in rosacea skin samples than in normal skin controls. Hydroxocobalamin is a potent inhibitor of all isoforms of NOS, capable of reducing the vasodilatations induced by nitric oxide. OBJECTIVE: We aimed to evaluate the role of hydroxocobalamin in treating facial flushing and persistent erythema of rosacea. METHODS: Thirteen patients with rosacea who displayed facial flushing and persistent erythema received 1 to 4 weekly intramuscular injections of hydroxocobalamin 1 to 2 mg. The outcomes were measured using the Clinician's Erythema Assessment (CEA) by photography and an infrared thermometer to evaluate the difference in skin surface temperature (SST) of the cheeks before and after treatment. RESULTS: Thirty minutes after the first dose of intramuscular injection of hydroxocobalamin, the mean CEA significantly reduced from 2.2± 0.6 to 1.2±0.4 (p<0.001), and average SST also significantly reduced from 36.7±0.70°C to 36.2±0.61°C (p<0.001) on the cheeks. CONCLUSION: In our patient sample, intramuscular administration of hydroxocobalamin was effective for immediate reduction of facial erythema associated with rosacea. PMID:35783562 | PMC:PMC9239126 {url} = URL to article Nutritional Deficiencies in Rosacea
    • Front Med (Lausanne). 2022 Jun 16;9:835843. doi: 10.3389/fmed.2022.835843. eCollection 2022. ABSTRACT Sight is arguably the most important sense in human. Being constantly exposed to the environmental stress, irritants and pathogens, the ocular surface - a specialized functional and anatomical unit composed of tear film, conjunctival and corneal epithelium, lacrimal glands, meibomian glands, and nasolacrimal drainage apparatus - serves as a crucial front-line defense of the eye. Host defense peptides (HDPs), also known as antimicrobial peptides, are evolutionarily conserved molecular components of innate immunity that are found in all classes of life. Since the first discovery of lysozyme in 1922, a wide range of HDPs have been identified at the ocular surface. In addition to their antimicrobial activity, HDPs are increasingly recognized for their wide array of biological functions, including anti-biofilm, immunomodulation, wound healing, and anti-cancer properties. In this review, we provide an updated review on: (1) spectrum and expression of HDPs at the ocular surface; (2) participation of HDPs in ocular surface diseases/conditions such as infectious keratitis, conjunctivitis, dry eye disease, keratoconus, allergic eye disease, rosacea keratitis, and post-ocular surgery; (3) HDPs that are currently in the development pipeline for treatment of ocular diseases and infections; and (4) future potential of HDP-based clinical pharmacotherapy for ocular diseases. PMID:35783647 | PMC:PMC9243558 | DOI:10.3389/fmed.2022.835843 {url} = URL to article
    • We are pleased to announce that members can now post REVIEWS in our affiliate store. Here is a screen shot of a review: In the screen shot above the review can be viewed if you click on the tab PRODUCT REVIEWS and MEMBERS can RESPOND TO THIS REVIEW. So if you find an item in our store and you have used the item and want to review it all you do is, (1) Find the item in the store, (2) login with your RRDi account (only requires registering with an email address), (3) Scroll down to the product information tab and next to this tab find the PRODUCT REVIEWS tab and click on it. (4} Find the WRITE A REVIEW black button and click on it (5) Write your review in the comment box
    • You may have some thoughts on the subjects of anonymity, transparency and posting on the internet. This post is our explanation of how we understand these three subjects and if you have any thoughts on this, you are welcome to hit the REPLY TO THIS TOPIC button and add your thoughts (requires subscription to post).  RRDi The RRDi is transparent when it comes to how we spend our donations with our financial page. We have the Guidestar Seal of Platinum Transparancy.  Privacy Policy Our privacy policy is second to none and we challenge anyone to find any loop holes or tell us how we can improve it.  Private Member Forum  We have implemented measures so that only members can view the member forum using the Invision Community platform which is the most secure and private rosacea forum on the internet.  If you use Sign in with Apple, you can hide your email address totally, the ultimate in privacy registration. However, Windows, Linux, and Android users are welcome and can basically have the same anonymity by reading how to do this and taking extra steps recommended to have the same security and privacy in the most private and secure rosacea forum group on planet earth.  Guests Guests used to able to create a cryptic display name and post in our Guest Forum on our website for free in areas open to guests without registering an email address until the end of June 2022. Effective since then guests are not allowed to post anymore without donating for a subscribtion and gain total access to our website. Guests can only view a small percentage of our free information on rosacea. Members who subscribe gain full access.  Voting Members Voting members are required to give us first and last name, address, phone number and an alternate email address. If you are concerned about your privacy when joining the RRDi as a voting member, you can rest assured our privacy policy is solid and we would never disclose your contact information with anyone without your permission.  Anonymity vs Transparency Where do you stand on this issue? If you haven't given this much thought you may want to read the article published on Mashable, Transparency vs. Anonymity: Where Do You Stand? [INFOGRAPHIC & POLL]. Of course, everyone wants both anonymity and transparency, however, as the Mashable article points out usually you favor one over the other, so there is a balance to consider. The RRDi tries to balance anonymity and transparency, so, depending on where you stand on this issue you have choices.    Transparency One of the core principles of the RRDi is transparency, which can be seen reading our charter. The RRDi has received the Platinum seal rating from Guidestar on Transparency.  Not all non profit organizations for rosacea have this seal. For example, our charter states, "Sources of funding to the institute will be publicized including the name of the donor unless the donor requests anonymity. Expenses of the institute will be publicized down to the last cent, showing where all the spending went and for what purpose." Rule Number Two states, "To be a legal corporate member a name, mailing address, two email addresses, and a statement of whether the member is a rosacean or not a rosacean is required."  While the RRDi doesn't have the volunteer editorial staff to accomplish what Snopes offers, we are doing our best to imitate what Snopes does (Snopes' staff motive is they are paid which we wish we could pay our editorial staff as much money as Snopes offers their staff, but alas, we are all volunteers and simply don't have the funds to pay our staff).   Over 1000 members agreed to these two rules when joining by registration which allows the individual as a legal non profit corporate voting member of the RRDi.   Anonymity Many are under the impression when joining the RRDi as a voting member that giving out their contact information is an intrusion on their privacy (which is far from the truth since our privacy policy is solid). Also, it appears that many rosaceans have moved on to social media such as Facebook, Twitter, Instagram, or the like which seems to be less anonymous (frequently blog posters display their real name), and favors more transparency, so who can figure out why the yahoo groups and forum style posting (with cryptic [usually humorous] display names) are less used now in favor of transparent social media? Are you aware that when you join a private social media rosacea group that when you post any other member of the group can now view your profile? How private is that? Members of the RRDi can only view what you ALLOW to be viewed in your public profile. Only the RRDi staff can view your email address.  Usually most rosaceans want anonymity (read below how you can hide your true identity when joining the RRDi in the subheading, CHANGE YOUR PROFILE, and learn how to Change Your Display Name to a cryptic display name), but at the same time want transparency with the non profit organization they join while totally remaining anonymous as a member. There is a fine balance between anonymity and transparency and the RRDi allows you to have both if you join as a member and has given this a great deal of thought.  We hope you agree this is how a non profit organization with members should have choices regarding their anonymity as well as having transparency when it comes to the organization they join.  Posting How You Can Remain Anonymous while Posting in the RRDi Member Forum? Follow these directions.  As mentioned above about Sign in with Apple, you can remain totally anonymous and completely private using your Apple ID when registering and hide behind a cryptic display name and also hide your email address totally.   Change Your Profile You can completely remain anonymous when you post in our member forum. You can change your display name to something cryptic or clever. Only the staff at the RRDi has your membership information. The RRDi will NEVER display or disclose to anyone your profile and contact information without your permission. Our Privacy Policy is solid. And if you join only with your email address, the staff has no idea who you are. Your email address is your only ID, so, how much more anonymous can you get?  Change Your Display Name The steps to change your display name are the following:  1. Login to your member account by looking for Existing User? Sign in (Top Right Corner of your screen) (if you are having issues logging in please contact us, giving your first and last name, your email address used when registering your account as a voting member and we will assist you in being able to login to your member account. If you registered only with your email address just contact us with your email address and we will be happy to assist ) 2. Once logged in you will see your display name in the top right corner. Click on the toggle and select ACCOUNT SETTINGS. In the left column of the account settings page look for DISPLAY NAME. In the column to the right of display name type in the field box under CHANGE DISPLAY NAME (to the left of the field box it says NEW DISPLAY NAME) change to whatever new display name you want to remain anonymous.  3. Click the SAVE button. Voila!  You are now anonymous. No one knows who you are.  Hide Your Online Status You may also want to hide your online status.  Sign in with Apple The ultimate privacy is using Sign in with Apple. Private Tapatalk Member Forum We have now sponsored a private Rosaceans Tapatalk member forum which you can join. For more information.  Guests Allowed to Post No More We in the past have allowed guests to post here without registering. Effective at the end of June 2022 we have not allowed guests this privilege anymore and guest must subscribe to post.  Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post.    Mahalo We also now have a mobile app for your device (currently this project has been paused). Why not join now since you have a better understanding of our privacy policy. 
    • Volunteer Benefits Volunteering has benefits not only in helping others but for the volunteer.  Watch the three videos on this page! An Active Member is one who has posted within the last thirty days and has full access to the RRDi website. An Inactive Member is one who has not posted in the last thirty days and is therefore restricted to guest privlieges of access to the site until such time as the member becomes active again and full access to the site is restored. Any SUBSCRIBED member is not restricted to post within thirty days. Volunteer Active Members may waive the subscription fee. If you want to have your membership as a volunteer active member and have the subscription fee waived use the fill out this form.  Volunteering Reduction From 1998 through 2005 there was an incredible volunteer spirit that drove the formation of the RRDi. Since 2005 the force that motivated so many to bring together rosacea sufferers into a grassroots non profit organization has dwindled to just a flickering wick. Why is it that rosaceans (rosacea sufferers) don't volunteer anymore?  Rosaceans have moved on to rosacea social media platforms.  Andy Seth, an entrepreneur, has a blog post, The Way We Think About Volunteering Is Dead Wrong, states, "research shows that the happiest volunteers are those who give 2 hours per week. That’s it. 2 hours."   Two Hours a Week If the RRDi could get any rosacean to volunteer 2 hours a weeks, that would be greatly appreciated, but also a miracle. Are there volunteers who actually volunteer two hours a week? There must be, otherwise the study is bogus. If we could get any RRDi member to just post their thought or experience with rosacea for 15 minutes a week that would be incredible. Volunteer to Post for 15 minutes We have dotted the RRDi forum with requests to RRDi members to simply post anything and the 1300 plus members as of this date are simply miniscule when it comes to posting. Getting our members to post is a challenge. If you have some insight how to get our members to post, we are all ears. You can reply to this post and comment to your heart's content. Of course, that is the issue, the RRDi members' hearts are not content to post. Why is that?  Feedback suggests that the Invision Community platform which we have been using since 2004 is not easy to use and rosaceans prefer social media platforms. Our answer to this is simple, watch this short video asking for volunteers to post on the RRDi social media accounts.  Win a Free Jar of the ZZ cream Demodex Solutions, one of our sponsors, has graciously allowed us to choose the best poster in a month and award the winning poster a free jar fo the ZZ cream. You want a free jar?  Follow these instructions.  Live Long and Prosper The research Mr. Seth referred to may have been the study commented on by the American Psychological Association that reports, "Volunteers lived longer than people who didn't volunteer if they reported altruistic values or a desire for social connections as the main reasons for wanting to volunteer, according to the study." This same study, Andrea Fuhrel-Forbis, the co-author concludes:  "It is reasonable for people to volunteer in part because of benefits to the self; however, our research implies that should these benefits to the self become the main motive for volunteering, they may not see those benefits."  Helper's High One of the benefits is what is called 'helper's high' which has been scientifically confirmed. [1] Of course, if a RRDi member who has rosacea helps another rosacea sufferer that would be the basis for receiving the 'helper's high.' Rosaceans helping rosaceans.  In trying to understand why volunteering amongst rosaceans has continued on this downward course, and googling this for an answer, The Guardian has an article about this subject and concluded, "But while the benefits of volunteering are clear, there is worrying evidence that the people who could benefit most from giving their time are precisely those least likely to be involved." The Current State of Volunteering Volunteer Match (which the RRDi has joined) has an article on this subject and states that the Bureau of Labor Statistics Report shows "that volunteer rates have been steadily declining for over a decade," [2] and comments, "There’s an endless supply of reasons that could explain why volunteer rates are falling. Last year, upon seeing the results, VolunteerMatch President Greg Baldwin argued that volunteer rates are falling because we as a nation don’t invest enough resources in the nonprofit sector. Without resources, nonprofits simply don’t have the capacity to effectively engage volunteers. Someone in the comments of that post argued that the falling rates can be attributed to the fact that more people are overworked with less time on their hands. Others say people are simply lazier than they used to be. I personally think it could be attributed to a shifting trend away from community involvement, due to the emergence of online communities, young people moving more often, and other factors." [3] In the above article mentioned [3] there are a number of comments and I think Ron from Florida's [April 16, 2016] comment is insightful:  "When I was younger, volunteering and giving back was part of life. It was something that we did and didn’t think twice about it. I don’t see that same philosophy these days. It’s to the point that schools here require some level of community service to complete your graduation requirements." Stem Learning reports, "It is suggested that stagnating volunteer numbers and in some areas, reducing numbers of volunteers, along with cuts made by local authorities falling disproportionately upon the volunteering sector funding, suggests a potential fall in people volunteering per se. Furthermore the 2015/16 Community Life survey, highlighted 14.2 million people formally volunteered at least once a month in 2014/15 and although rates are mostly unchanged, it appears irregular volunteering appear to show a 5% drop!" Carey Nieuwhof lists 6 REASONS YOU'RE LOSING HIGH CAPACITY VOLUNTEERS. I don't see how those six reasons are related to the RRDi, but I am all ears to anyone who can point out to me what the RRDi isn't doing or doing with regard to Carey's six reasons that we could improve. Our page on volunteering covers most of what Carey is discussing.  Without a doubt this explains the situation. Any thoughts on this subject would be much appreciated.  Online Volunteering Dr. Natalie Hruska says that the studies indicating a drop in volunteering over the past decade "do not factor in kinds of volunteerism today, like virtual volunteering" and writes there is "a necessity to redefine what volunteerism is and how we understand it today." [4] Volunteering Statistics "About 25 percent of Americans volunteered in 2015, according to federal data, compared to a global average of just 10 percent." [5] "The volunteering rate has declined slightly from 27 percent in 2002 despite the efforts of many American leaders..." [5] A Long and Winding Road Volunteering for the RRDi to help fellow rosaceans is a long and winding road that leads to your door, which is without a doubt, the most difficult door to open. Can you open that door and join us to find the cure for rosacea?   Volunteering for a Non Profit Organization You may want to read up on these subjects:     Social Media Posters or Moderators Needed Reply to this Topic There is a reply to this topic button somewhere on the device you are reading this post. End Notes [1] Helper's High: The Benefits (and Risks) of Altruism, Psychology Today [2] According to the 2015 report, 24.9% of the U.S. population over the age of 16 volunteered at least once in the past year. In 2011, this percentage was 26.8%, and in 2005 it was 28.8%.  "The volunteer rate declined by 0.4 percentage point to 24.9 percent for the year ending in September 2015..." VOLUNTEERING IN THE UNITED STATES — 2015, U.S. Bureau of Labor Statistics, Thursday, February 25, 2016 [3] The U.S. Volunteer Rate Is Still Dropping. Why?, Tess Srebro | March 25, 2016 | Industry Research | Engaging Volunteers, Volunteer Match [4] Dr. Natalie Hruska, April 12, 2016 POST to the article in end note 2. Dr. Hruska had a YouTube video that discussed online volunteering but it is no longer available. Dr. Hruska has written a book on this subject, Managing the First Global Technology: Reflections on a relevant application of the Internet, in Kindle or Paperback.  [5] How to get more Americans to volunteer, The Conversation Civil society organization workforce as a share of the economically active population, by country, 1995-2000, John Hopkins Center for Civil Society Studies
    • Ann Agric Environ Med. 2022 Jun 24;29(2):169-184. doi: 10.26444/aaem/141324. Epub 2021 Aug 31. ABSTRACT Despite a significant increase in reported cases of frontal fibrosing alopecia (FFA) in literature, discussion about the possible role of environmental factors, instruction for diagnosis and guideline for treatment, are limited. The review aims to provide a detailed synthesis of this condition that could be used by clinicians in their practise. Whether single-centre or multi-centre, studies of more than 60 cases less than 5 years old were mainly taken into consideration. Results obtained were that FFA affects mainly postmenopausal Caucasian women; the most common comorbidities are hyperlipidaemia, arterial hypertension, osteoporosis, hypothyroidism, depression, alongside dermatological disorders such as atopic dermatitis, rosacea, seborrheic dermatitis and androgenetic alopecia. Autoimmune, genetic, hormonal (e.g. estrogen deficiency, pregnancy, lactation, HRT and raloxifene) and environmental (e.g. daily use of facial sunscreens and less frequent use of hair dyes and shampoo) hypotheses were proposed for pathogenesis, as well as association with various predisposing factors (patient's health-social profile, disease's history and comorbidities). Clinical presentation of FFA can be divided into 3 specific patterns, each with a different prognosis. Diagnosis is usually made clinically with the use of trichoscopy; however, scalp biopsy remains the gold standard. The condition is regarded as a variant of lichen planopilaris (LPP) due to the similarity of the prominent histopathological findings, but the clinical image is distinct and therapeutic options vary. 5α-reductase inhibitors, intralesional steroids, and hydroxychloroquine provide the highest level of evidence for the treatment of FFA. The conclusion is that a better understanding of the disease is crucial for proper disease management. PMID:35767748 | DOI:10.26444/aaem/141324 {url} = URL to article
    • J Cosmet Dermatol. 2022 Jun 28. doi: 10.1111/jocd.15189. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin condition of varying severity that can significantly impact patient quality of life. Intense pulsed light (IPL) is an established treatment for rosacea-associated telangiectasia, inflammation, and erythema. This study assessed whether application of a phyto-corrective mask, gel, and resveratrol antioxidant serum after IPL treatment can improve outcomes and reduce procedure-related adverse effects. METHODS: In a prospective, open-label, split-face, 3-month study, 10 subjects with moderate to severe facial rosacea underwent IPL treatment on both sides of the face. The following were applied to the right side of the face only: phyto corrective mask once weekly starting immediately after IPL; phyto corrective gel twice daily; and resveratrol antioxidant treatment at night. Both sides of the face were treated with sunscreen. Subjects were assessed on Day 1, 1 and 3 months after IPL by three, independent evaluators using the 5-point Global Aesthetic Improvement Scale (GAIS). All subjects rated skin redness, hydration and overall improvement on Day 1 and completed a patient satisfaction questionnaire at the 1- and 3-month visits. RESULTS: Ten women were enrolled, aged 44-72 years old, with moderate (n=6) to severe (n=4) rosacea. IPL was effective at reducing symptoms with rosacea classified as absent in 5 women and mild in 5 at the final 3-month visit. GAIS scores also revealed improvements on both sides of the face, but the skincare treated side showed continuous improvement over 3 months with all patients remaining at least 'Improved', whereas there appeared to be a waning effect after 1 month following with IPL alone. On Day 1 after IPL, all women reported less redness, improved hydration and improved skin appearance on the right side of the face. Patient satisfaction was consistently rated higher on the right side of the face. CONCLUSION: Application of a phyto-corrective mask, gel, and resveratrol antioxidant serum may complement IPL treatment for rosacea by enhancing treatment outcomes and reducing procedure-related symptoms. PMID:35765796 | DOI:10.1111/jocd.15189 {url} = URL to article
    • Antibiotics (Basel). 2022 May 27;11(6):722. doi: 10.3390/antibiotics11060722. ABSTRACT Tetracycline class antibiotics are widely used for multiple skin diseases, including acne vulgaris, acne rosacea, cutaneous infections, inflammatory dermatoses, and autoimmune blistering disorders. Concerns about antibiotic resistance and protecting the human/host microbiome beg the question whether broad-spectrum tetracyclines such as doxycycline and minocycline should be prescribed at such a high rate by dermatologists when a narrow-spectrum tetracycline derivative, sarecycline, exists. We evaluated the clinical effectiveness of oral sarecycline against cutaneous staphylococcal infections, eyelid stye, and mucous membrane pemphigoid to determine whether sarecycline is a viable option for clinicians to practice improved antibiotic stewardship. We observed significant improvement in staphylococcal infections and inflammatory dermatoses with courses of oral sarecycline as short as 9 days, with no reported adverse events. These clinical findings are consistent with in vitro microbiological data and anti-inflammatory properties of sarecycline. Our data provides a strong rationale for clinicians to use narrow-spectrum sarecycline rather than broad-spectrum tetracyclines as a first-line agent in treating staphylococcal skin infections and inflammatory skin diseases for which tetracyclines are currently commonly employed. Such advancement in the practice paradigm in dermatology will enhance antibiotic stewardship, reduce risk of antibiotic resistance, protect the human microbiome, and provide patients with precision medicine care. PMID:35740129 | PMC:PMC9220064 | DOI:10.3390/antibiotics11060722 {url} = URL to article More Information on Sarecycline (requires subscription)
    • Actas Dermosifiliogr. 2022 Jun;113(6):T550-T554. doi: 10.1016/j.ad.2022.05.008. Epub 2022 May 10. ABSTRACT BACKGROUND AND OBJECTIVE: Rosacea is a chronic acneiform skin disorder in which impaired skin barrier function can lead to sensitization to allergens. We aimed to analyze contact allergies in our patients with rosacea. MATERIAL AND METHODS: Retrospective cohort study of all patients who underwent patch testing in our skin allergy clinic between May 1991 and May 2019. RESULTS: A total of 200 patients with rosacea were referred to our clinic for patch testing during the study period; they represented 2.1% of all patch tested patients in the period. Eighty-one percent were women (mean age, 44.7years). At least 1 positive patch test was recorded for 46.5%; 15% were of current relevance. The most frequent positive reaction was to nickel (26%), followed by cobalt chloride (6.5%), isothiazolinones (6%), p-phenylenediamine (5.5%), fragrance mix II (5%), and thimerosal (3.5%). The most common currently relevant patch test reactions were to isothiazolinones in 10 of the 200 patients (5%); to phenylenediamine, fragrance mix II, and toluensulfonamide formaldehyde resin in 4 patients (2%) each; and to tixocortol and fragrance mix I in 2 patients (1%) each. The allergen groups most often implicated were metals (of current relevance in 12.6%) and drugs (of current relevance in 25.8%). Preservatives and fragrances were the next most common allergen groups, and 70.8% and 43.7% of the positive reactions in these groups, respectively, were of current relevance. Cosmetics were the most frequent source of sensitization, followed by topical medications-notably corticosteroids and antifungal agents. CONCLUSIONS: We emphasize the high prevalence of allergic contact dermatitis in patients with rosacea, a finding which supports patch testing, especially if eruptions worsen when these patients use cosmetics and topical medications. PMID:35748000 | DOI:10.1016/j.ad.2022.05.008 {url} = URL to article More information on Sensitive Skin and Rosacea (requires subscription)
    • PLoS One. 2022 Jun 23;17(6):e0270268. doi: 10.1371/journal.pone.0270268. eCollection 2022. ABSTRACT PURPOSE: To compare the safety and efficacy of intense pulsed light (IPL) followed by meibomian gland expression (MGX), against monotherapy of MGX. METHODS: Patients with moderate to severe meibomian gland dysfunction (MGD) were 1:1 randomized to 4 sessions of intense pulse light + MGX at 2-week intervals, or 4 sessions of Sham + MGX at 2-week intervals. Both patients and examiners were blinded to the allocation. Outcome measures, evaluated at the baseline (BL) and at a follow-up (FU) conducted 4 weeks after the last IPL session, included fluorescein tear breakup time (TBUT) as the primary outcome measure, OSDI (Ocular Surface Disease Index) questionnaire, Eye Dryness Score (EDS, a visual analog scale (VAS)-based questionnaire), Meibomian gland score (MGS, a score of meibum expressibility and quality in 15 glands on the lower eyelid), daily use of artificial tears, and daily use of warm compresses. In addition, during each treatment session, the number of expressible glands was counted in both eyelids, the predominant quality of meibum was estimated in both eyelids, and the level of pain/discomfort due to MGX and IPL was recorded. RESULTS: TBUT increased from 3.8±0.2 (μ±standard error of mean (SEM)) to 4.5±0.3 seconds in the control arm, and from 4.0±0.2 to 6.0±0.3 in the study arm. The difference between arms was statistically significant (P < .01). Other signs/symptoms which improved in both arms but were greater in the study arm included MGS (P < .001), EDS (P < .01), the number of expressible glands in the lower eyelids (P < .0001) and upper eyelid (P < .0001), the predominant meibum quality in the lower eyelid (P < .0001) and upper eyelid (P < .0001), and the level of pain due to MGX (P < .0001). Outcome measures which improved in both arms with no significant differences between the two were OSDI (P = .9984), and the daily use of artificial tears (P = .8216). Meibography, daily use of warm compresses, and severity of skin rosacea did not show statistically significant changes in either arm. No serious adverse events were observed. There was a slight tendency for more adverse events in the control group (P = 0.06). CONCLUSIONS: The results of this study suggest that, in patients with moderate to severe symptoms, combination therapy of intense pulse light (IPL) and meibomian gland expression (MGX) could be a safe and useful approach for improving signs of dry eye disease (DED) due to meibomian gland dysfunction (MGD). Future studies are needed to elucidate if and how such improvements can be generalized to different severity levels of MGD. PMID:35737696 | PMC:PMC9223330 | DOI:10.1371/journal.pone.0270268 {url} = URL to article More information on Dry Eye Disease (requires subscription)
    • Dermatology: how to manage rosacea in skin of colour Drugs Context. 2022 May 31; Khalad Maliyar, Sonya J Abdulla
    • Dermatology: how to manage rosacea in skin of colour Drugs Context. 2022 May 31; Khalad Maliyar, Sonya J Abdulla
    • Rosacea in skin of color: A comprehensive review. Indian J Dermatol Venereol Leprol. 2020 Oct 27;: Authors: Sarkar R, Podder I, Jagadeesan S
    • Global Epidemiology and Clinical Spectrum of Rosacea, Highlighting Skin of Color: Review and Clinical Practice Experience. J Am Acad Dermatol. 2018 Sep 18;: Authors: Alexis AF, Callender VD, Baldwin HE, Desai SR, Rendon MI, Taylor SC
    • Drugs Context. 2022 May 31;11:2021-11-1. doi: 10.7573/dic.2021-11-1. eCollection 2022. ABSTRACT Rosacea is a common inflammatory skin disorder affecting the face. Common cutaneous symptoms include papules, pustules, persistent centrofacial erythema, telangiectasias, recurrent flushing, phymatous changes and a variety of ocular manifestations. Previous epidemiological studies have demonstrated that the incidence of rosacea is much lower in people with darker Fitzpatrick phototypes compared to fair-skinned individuals. In patients with darker skin, the centrofacial erythema can be masked and difficult to appreciate, impacting the ability for providers to make diagnoses and leading to misdiagnoses. Thus, it is difficult to say with certainty that the disparities in prevalence in rosacea amongst fair-skinned and darker individuals are true. The primary aim of this article is to raise awareness that rosacea is a global disease and to provide healthcare professionals with strategies to identify and manage rosacea amongst individuals with skin of colour. PMID:35720055 | PMC:PMC9165629 | DOI:10.7573/dic.2021-11-1 {url} = URL to article Global Epidemiology and Clinical Spectrum of Rosacea, Highlighting Skin of Color: Review and Clinical Practice Experience.    
    • Biomed Pharmacother. 2022 Jun 16;153:113292. doi: 10.1016/j.biopha.2022.113292. Online ahead of print. ABSTRACT Rosacea is a common chronic facial inflammatory disease that affects millions of people worldwide. Due to the unclear etiology of rosacea, effective treatments are limited. Celastrol, a plant-derived triterpene, has been reported to alleviate inflammation in various diseases. However, whether celastrol exerts protective effects in rosacea remains to be elucidated. In this study, weighted gene co-expression network analyses (WGCNA) were performed. Hub modules closely related to rosacea clinical characteristics were identified and found to be involved in inflammation- and angiogenesis-related signaling pathways. Then, the pharmacological targets of celastrol were predicted using the TargetNet and Swiss Target Prediction databases. A GO analysis indicated that the biological process regulated by celastrol highly overlapped with the pathogenic biological processes in rosacea. Next, we showed that celastrol ameliorated erythema, skin thickness and inflammatory cell infiltration in the dermis of LL37-treated mice. Celastrol suppressed the expression of rosacea-related inflammatory cytokines and inhibited the Th17 immune response and cutaneous angiogenesis in LL37-induced rosacea-like mice. We further demonstrated that celastrol attenuated LL37-induced inflammation by inhibiting intracellular-free calcium ([Ca2+]i)-mediated mTOR signaling in keratinocytes. Chelating intracellular Ca2+ with BAPTA/AM potentiated celastrol-induced repression of LL37-induced p-S6 elevation. The mTOR agonist MHY1485 dramatically reinforced LL37-induced rosacea-like characteristics, while celastrol attenuated these outcomes. Moreover, celastrol inhibited LL37-activated NF-κB in a mTOR signaling-dependent manner. In conclusion, our findings underscore that celastrol may be a rosacea protective agent by inhibiting the LL37-activated Ca2+/CaMKII-mTOR-NF-κB pathway associated with skin inflammation disorders. PMID:35717785 | DOI:10.1016/j.biopha.2022.113292 {url} = URL to article
    • Pediatr Dermatol. 2022 Jun 14. doi: 10.1111/pde.15036. Online ahead of print. ABSTRACT BACKGROUND/OBJECTIVES: We observed isolated cases of perialar intertrigo in children and teenagers that did not appear to correspond to any known clinical entity. The objective of this study was to describe the clinical features of this dermatosis and the clinical characteristics of the patients. METHODS: We conducted a prospective, multicenter cohort study in France from August 2017 to November 2019. All the patients under 18 years of age with chronic perinasal intertrigo were included. A standardized questionnaire detailing the clinical characteristics of the patients and the description of the intertrigo. If possible, a Wood's lamp examination of the intertrigo was done. RESULTS: Forty-one patients were included (25 boys and 16 girls, average age: 12.1 years). Intertrigo was bilateral in 38 patients (93%). The majority of patients had no symptoms (54%). Pruritus was present in 39% of cases. Orange red follicular fluorescence was present in the perialar region on Wood's light examination in 78% of cases with active fluorescence. The presumptive diagnoses suggested by the investigators were acne (24.4%), seborrheic dermatitis (19.5%), rosacea (9.8%), psoriasis (9.8%) and perioral dermatitis (7.3%). No diagnosis was proposed in 22% of the cases. CONCLUSIONS: We describe a previously undescribed clinical sign which is characterized by a chronic bilateral erythematous intertrigo located in the perialar region. It can be isolated or associated with various facial dermatoses. PMID:35699273 | DOI:10.1111/pde.15036 {url} = URL to article
    • Watch the full version • Dr. Tara 
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    • Clin Cosmet Investig Dermatol. 2022 Jun 2;15:1029-1036. doi: 10.2147/CCID.S367545. eCollection 2022. ABSTRACT BACKGROUND: The biomarker to predict the depression in patients with rosacea was absent. OBJECTIVE: We aimed to explore the potential association between BDNF and depression in patients with rosacea, and also to determine whether serum BDNF level is a potential biomarker for identifying depression in patients with rosacea. METHODS: The patients with rosacea, rosacea with depression and healthy control were included, clinical evaluation (DLQI, RSSs, BDI-II) and serum BDNF levels detection were performed on subjects, the comparisons and correlation analysis of the obtained data were performed. RESULTS: In clinical evaluation, whether DLQI or RSSs, rosacea with depression group was significantly higher compared to rosacea group. Besides, we found the serum BDNF levels were lower in patients with rosacea and rosacea with depression compared to healthy controls, also in the rosacea with depression group, serum BDNF levels were lower than in rosacea patients. Whatever in rosacea or rosacea with depression group, the statistical significance of serum BDNF levels between the different subtypes like the ETR and PPR was not found. In further correlation analysis, we found no correlation between serum BDNF and RSSs in patients with rosacea whatever the subtype of ETR or PPR. Interestingly, we found a negative correlation between serum BDNF levels and BDI-II in rosacea with depression group, the decreased serum BDNF levels were associated with the increased BDI-II, also the ROC confirmed it can evaluate the depression in patients with rosacea. CONCLUSION: Serum BDNF level is a potential biomarker for identifying depression in patients with rosacea. PMID:35677222 | PMC:PMC9170175 | DOI:10.2147/CCID.S367545 {url} = URL to article
    • JAMA Dermatol. 2022 Jun 8:e221891. doi: 10.1001/jamadermatol.2022.1891. Online ahead of print. ABSTRACT IMPORTANCE: Topical formulations of tretinoin precursors (retinol and its ester derivatives) are widely available over the counter and may offer similar clinical benefits to those of tretinoin for treatment of photoaging. However, which of the many purported molecular effects of retinoids most strongly drives clinical improvements in tretinoin-treated skin remains unclear. OBJECTIVES: To evaluate the clinical efficacy of topical tretinoin precursors (TTP) vs tretinoin (RA) in treating moderate to severe facial photodamage and to identify potential biomarkers that correlate with clinical efficacy. DESIGN, SETTING, AND PARTICIPANTS: This randomized, double-blind, single-center, parallel-arm study of 24 patients with moderate to severe facial photodamage was conducted at an academic referral center from November 2010 to December 2011, with data analysis performed from January 2012 to December 2021. INTERVENTIONS: Daily topical application of 0.02% RA or 1.1% TTP formulation containing retinol, retinyl acetate, and retinyl palmitate for 24 weeks. MAIN OUTCOMES AND MEASURES: Photoaging and tolerability were assessed by dermatologist evaluations and patient-reported outcomes. Target gene expression was assessed by real-time quantitative polymerase chain reaction of biopsied tissue from treated areas. RESULTS: A total of 20 White women were ultimately analyzed (9 randomized to TTP, 11 randomized to RA). At week 24, there was no significant difference in Griffiths photoaging scores among patients receiving TTP vs RA (median, 4 vs 5) (TTP - RA difference: -1; 95% CI, -2 to 1; P = .27). Treatment with TTP was associated with erythema 6 times less frequently than RA (11% vs 64%) (TTP - RA difference: -0.53; 95% CI, -0.88 to -0.17; P = .01). Target gene analysis showed significant CRABP2 messenger RNA (mRNA) induction (confirming retinoic acid receptor signaling) but no significant changes in procollagen I or MMP1/3/9 mRNA in TTP-treated samples. Instead, MMP2 mRNA, which encodes a type IV collagenase, was significantly reduced in TTP-treated samples (week 24 - baseline mRNA difference: -5; 96% CI, -33 to 1.6; P = .02), and changes in MMP2 were strongly correlated with changes in fine wrinkles (r = 0.54; 95% CI, 0.12 to 0.80; P = .01). Interestingly, patients with severe baseline wrinkles exhibited greater improvements (r = -0.74; 95% CI, -0.89 to -0.43; P < .001). This trend was mirrored in MMP2 mRNA, with initial expression strongly predicting subsequent changes (r = -0.78; 95% CI, -0.89 to -0.43; P < .001). CONCLUSIONS AND RELEVANCE: In this randomized clinical trial, there was no significant difference in efficacy between this particular formulation of TTP and tretinoin 0.02%. However, the results of these mechanistic studies highlight MMP2 as a possible mediator of retinoid efficacy in photoaging. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01283464. PMID:35675051 | PMC:PMC9178500 | DOI:10.1001/jamadermatol.2022.1891 {url} = URL to article
    • J Drugs Dermatol. 2022 Jun 1;21(6):574-580. doi: 10.36849/JDD.6838. ABSTRACT BACKGROUND: While rosacea is a common inflammatory condition that affects diverse populations, published data in skin of color (SOC) are limited. This review explored nuances in clinical presentation and treatment considerations in SOC patients with rosacea and the role of cleansers and moisturizers in the management of rosacea in these populations. METHODS: A panel reviewed and discussed aspects of rosacea in SOC and possible implications for treatment and maintenance. The outcome of these discussions, coupled with the panel's expert opinion and experience was used to define draft statements. After group discussions and an online review process, the panel agreed on the inclusion and wording of five statements. RESULTS: Studies and anecdotal clinical experience suggest that rosacea is more common in SOC populations than previously reported. The clinical presentation of rosacea across diverse skin types includes the spectrum of clinical subtypes observed in other populations; however, clinical features may be less conspicuous in individuals with higher skin phototypes and the index of suspicion may be lower in SOC populations. To avoid underdiagnosis, dermatologists should consider rosacea in the differential diagnosis of any patient presenting with a history of skin sensitivity, central facial erythema, papules, and pustules. The compromised barrier in rosacea contributes to skin sensitivity. Studies including Chinese rosacea patients showed that using a moisturizer and sunscreen negatively correlated with rosacea development. CONCLUSIONS: The use of skincare could improve rosacea symptomatology. These products are recommended before and during prescription therapy and as part of a maintenance regimen as adjuncts. J Drugs Dermatol. 2022;21(6):574-580. doi:10.36849/JDD.6838. PMID:35674765 | DOI:10.36849/JDD.6838 {url} = URL to article
    • A report indicates the following about the 'choice of vehicle' in treating rosacea:  "The choice of vehicle is an important consideration in the treatment of acne and rosacea." [1] For example, some report irritation using the Cetaphil 'Basis for Vehicle' using Soolantra. [2] Some treatment vehicles cause not only irritability but also dryness or other issues that are termed 'adverse events' (AEs). This same report puts it succinctly:  "Although topical therapy should avoid AEs associated with systemic medication administration, the efficacy, safety, and tolerability of topical therapy is influenced by percutaneous penetration, retention at the target for a sufficient time to obtain the desired therapeutic effect, and avoidance of adverse local reactions that may affect adherence. It has been noted that the drug product is only one of multiple components that determine the efficacy and tolerability of topically applied therapies such that the performance of a topical medication is also influenced by characteristics of the vehicle formulation that may influence penetration, permeation, irritancy, and patient preference." [1] The report "summarizes drug delivery systems that have been developed with the aim of improving outcomes for patients being treated for either acne or rosacea." [1] "In liquid and gel formulations, the bulk excipient that serves as a medium for conveying the active ingredient is usually called the vehicle. Petrolatum, dimethyl sulfoxide and mineral oil are common vehicles." [3] End Notes  [1] J Clin Aesthet Dermatol. 2022 May; 15(5): 36–40. Enhancing Topical Pharmacotherapy for Acne and Rosacea: Vehicle Choices and Outcomes Lawrence J. Green, MD and Edward Lain, MD [2] Soolantra Mechanism of Action & Basis for the Vehicle (requires subscription) [3] Excipient, Vehicles - Wikipedia
    • Eur J Dermatol. 2022 Jan 1;32(1):138-139. doi: 10.1684/ejd.2022.4236. NO ABSTRACT PMID:35653084 | DOI:10.1684/ejd.2022.4236 {url} = URL to article
    • J Dermatolog Treat. 2022 Jun 2:1-13. doi: 10.1080/09546634.2022.2079598. Online ahead of print. ABSTRACT Background: Since medication absorption through the skin and eye tissue seems similar, commercially available eye-drops could be used to treat skin diseases when topical therapies are unavailable or unaffordable. The FDA-approved and off-label applications of various eye drops used as topical treatments in dermatological clinical practice were highlighted in this review.Methodology: A thorough PubMed and Google Scholar library search using various combinations of the keywords (Eye drop, ocular solution, conjunctival installation, and skin diseases, topical, local, beta-blockers, prostaglandin, cyclosporin, apraclonidine, atropine, oxymetazoline).Results and conclusions: Based on the findings of the studies reviewed, timolol is highly recommended for infantile hemangioma and other vascular skin conditions such as angiomas, Kaposi sarcoma, acne, rosacea, and wound healing. Bimatoprost is a drug that can be used to treat hypotrichosis of any kind, as well as mild localized alopecia areata and leukoderma. Oxymetazoline ispromising for treating facial erythema. We recommend apraclonidine for mild upper eyelid ptosis induced botulinum neurotoxin. We don't recommend atropine for hyperhidrosis, although it can help with hydrocystomas and pruritis produced by syringomas. Tobramycin will need to be tested in RCTs before it can be confirmed as a viable alternative to systemic treatments for treating green nail syndrome. PMID:35652324 | DOI:10.1080/09546634.2022.2079598 {url} = URL to article
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