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    • Related ArticlesRosacea and the gastrointestinal system. Australas J Dermatol. 2020 Aug 06;: Authors: Searle T, Ali FR, Carolides S, Al-Niaimi F Abstract Rosacea is a common skin condition characterised by erythema, papules and pustules. Increasing evidence suggests that the gut-skin axis is implicated in the pathogenesis of rosacea. Sufficient evidence exists to support the notion that the gut microbiome plays a role in the inflammatory cutaneous response and there appear to be associations with small intestinal bacterial overgrowth and Helicobacter pylori infection. A dysbiotic microbiome and an innate immune system dysregulation contribute to the pathophysiology of rosacea, and further exploration of their roles is warranted. Greater understanding of this condition and the effect of the gut-skin axis could allow for more efficacious and timely treatment. This article reviews our current findings and understanding in the skin and gut relationship in rosacea. PMID: 32761824 [PubMed - as supplied by publisher] {url} = URL to article
    • This is odd to me that a 2020 article is discussing a 'Cross-sectional study of Finnish adults aged 70 to 93 as part of the Norther Finland Cohort 1966 Study.'' Why not examine adults the same age today?
    • In the spirit of posting 'everything rosacea' the RRDi is announcing this 'natural' treatment which the official website states, "Grahams Natural Rosacea Cream is a natural formula which includes clinically tested ingredients to reduce redness. Designed to reduce inflammation and soothe sensitive skin, our rosacea cream will hydrate and calm the skin." It is made in Australia and here are the ingredients: Water Purified, Medium-chain Triglycerides, Cetostearyl Alcohol, Simmondsia chinensis (Jojoba) Seed Oil, Coconut Oil, Macrogol Cetostearyl Ether / Polyoxyl 20 Cetostearyl Ether, Tocopherol, Gluconolactone, Niacinamide, Taurine, Phenoxyethanol, Glyceryl Monocaprylate, Ethyl Ascorbic Acid, Retinyl Palmitate, Lactic Acid. If you have used this treatment please find the green reply button and post your experience. 
    • Related ArticlesThe High Prevalence of Skin Diseases in Adults Aged 70 and Older. J Am Geriatr Soc. 2020 Aug 04;: Authors: Sinikumpu SP, Jokelainen J, Haarala AK, Keränen MH, Keinänen-Kiukaanniemi S, Huilaja L Abstract BACKGROUND/OBJECTIVES: To determine the prevalence of skin findings and skin diseases in adults aged 70 and older, and to study the association between cutaneous diseases and socioeconomic status (SES), sex, and living status in the older population. DESIGN: Cross-sectional study of Finnish adults aged 70 to 93 as part of the Northern Finland Birth Cohort 1966 Study. SETTINGS: Skin examination data were available for 552 adults. MEASUREMENTS: A whole-body skin examination was performed by dermatologists. The associations between skin diseases and SES, sex, and living status were analyzed. RESULTS: Nearly 80% of the adults had at least one skin disease that required further treatment or follow-up. More than one-third of the study cases (39.1%) had three or more simultaneous skin diseases. Skin diseases were more common in men than in women (P < .001). The most common skin diseases were tinea pedis (48.6%), onychomycosis (29.9%), rosacea (25.6%), actinic keratosis (22.3%), and asteatotic eczema (20.8%). Some association was found between skin diseases and SES and living status. CONCLUSION: A whole-body clinical skin examination is important because it reveals important diagnoses. PMID: 32754902 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesFrequency of different types of facial melanoses referring to the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital in 2019, and assessment of their effect on health-related quality of life. BMC Dermatol. 2020 Aug 03;20(1):4 Authors: Amatya B, Jha AK, Shrestha S Abstract BACKGROUND: Abnormalities of facial pigmentation, or facial melanoses, are a common presenting complaint in Nepal and are the result of a diverse range of conditions. OBJECTIVES: The objective of this study was to determine the frequency, underlying cause and impact on quality of life of facial pigmentary disorders among patients visiting the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital (NMCTH) over the course of one year. METHODS: This was a cross-sectional study conducted at the Department of Dermatology and Venereology, NMCTH. We recruited patients with facial melanoses above 16 years of age who presented to the outpatient department. Clinical and demographic data were collected and all the enrolled participants completed the validated Nepali version of the Dermatology Life Quality Index (DLQI). RESULTS: Between January 5, 2019 to January 4, 2020, a total of 485 patients were recruited in the study. The most common diagnoses were melasma (166 patients) and post acne hyperpigmentation (71 patients). Quality of life impairment was highest in patients having melasma with steroid induced rosacea-like dermatitis (DLQI = 13.54 ± 1.30), while it was lowest in participants with ephelides (2.45 ± 1.23). CONCLUSION: Facial melanoses are a common presenting complaint and lead to substantial impacts on quality of life. Accurate diagnosis and management can prevent or treat many facial melanoses, including those that lead to substantial loss of quality of life, such as melasma with steroid induced rosacea-like dermatitis. Health care systems in low and middle-income countries should dedicate resources to the identification, prevention and treatment of these conditions to improve quality of life. PMID: 32746823 [PubMed - in process] {url} = URL to article
    • "We compiled a comprehensive list of candidate medicinal herbs for skincare by analyzing terms employed in the Donguibogam and identified the characteristics of 52 such herbs using SRKs. Each herb exhibited a different skincare function. Our findings will guide the development of new skincare products via experimental and clinical studies....Further in-depth experimental studies are needed, though our work reduces the time required for future experimentation and product development. Our results enhance the understanding of the previously unknown characteristics of medicinal herbs used for skincare and facilitate the discovering additional novel herbs." [1] The Dongui Bogam (동의보감) is a Korean book compiled by the royal physician, Heo Jun (1539 – 1615) and was first published in 1613 during the Joseon Dynasty of Korea. The title literally means “a priceless book about medicines of an Eastern Country”. [2] Wouldn't it be novel of a grassroots rosacea non profit organization to sponsor clinical studies on this? What if 10K members of the RRDi each donated one dollar and sponsored these kind of studies into medicinal herbs for skincare?  Why not donate a dollar now to start the process? End Notes [1] Integr Med Res. 2020 Dec; 9(4): 100436. Identification of candidate medicinal herbs for skincare via data mining of the classic Donguibogam text on Korean medicine Gayoung Cho, Hyo-Min Park, Won-Mo Jung, Woong-Seok Cha, Donghun Lee, Younbyoung Chae [2] Dongui Bogam, Wikipedia image courtesy of Wikimedia Commons
    • The RRDi is sponsoring free rosacea blogs so you can have your own private or public blog. That way you can direct your friends to your own blog and discuss what you are doing to control your rosacea. If you want it private here are the steps:  PRIVATE BLOG The default blog is public so all you do is change it to private and only invite your friends to view your blog.  (1) To setup your blog you first need to be a member of the RRDi by registering with just your email address.  (2) Go to Blogs and look for the CREATE A BLOG green button: (3) Look for the ONLY MEMBERS I CHOOSE CAN READ THIS BLOG radio button: Then click continue to setup your blog. If you need assistance, use the Invision Community help center or use the RRDi support center (only available for members of the RRDi). 
    • Related ArticlesThe Decrease of Demodex Density After Nd:YAG Laser Application for Facial Telengiactasias: A Case Report. Dermatol Ther. 2020 Jul 30;: Authors: Yalici-Armagan B, Elcin G PMID: 32734702 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesAcute inflammatory Demodex-induced pustulosis in an immunocompetent patient related to topical steroid use. Pediatr Dermatol. 2020 Jul 29;: Authors: Guzman AK, Gittler JK, Amin B, Srikantha R, Balagula Y Abstract Demodex spp. mites are a common colonizer of sebaceous adult skin. Though usually clinically insignificant, demodicosis may be associated with a wide spectrum of skin diseases in immunocompetent hosts, such as erythematotelangiectatic and papulopustular rosacea, Demodex folliculorum, and blepharitis. We present a case of a healthy 9-year-old boy with an exuberant, inflammatory, Demodex-associated pustular eruption of the face, induced by the use of a high-potency topical steroid and successfully treated with oral ivermectin. PMID: 32729151 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesThe versatility of azelaic acid in dermatology. J Dermatolog Treat. 2020 Jul 30;:1-31 Authors: Searle T, Ali FR, Al-Niaimi F Abstract Azelaic acid has numerous pharmacological uses in dermatology. Its anti-inflammatory and anti-oxidant properties are thought to correlate with its efficacy in papulopustular rosacea and acne vulgaris, amongst other cutaneous conditions. We conducted a review of the literature on the use of azelaic acid in dermatology using key terms "acne," "azelaic acid," "dermatology," "melasma," "rosacea," searching databases such as MEDLINE, EMBASE and PubMed. Only articles in English were chosen. The level of evidence was evaluated and selected accordingly listing the studies with the highest level of evidence first using the Oxford Centre of Evidence-Based Medicine 2011 guidance.This review found the strongest evidence supporting the use of azelaic acid in rosacea, followed by its use off-label in melasma followed by acne vulgaris. Weaker evidence is currently available to support the use of azelaic acid in several other conditions such as hidradenitis suppurativa, keratosis pilaris and male androgenic alopecia.Azelaic acid, as a monotherapy or in combination, could be an effective first-line or alternative treatment, which is well-tolerated and safe for a range of dermatological conditions. PMID: 32730109 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesA hypothesis: Role of physical factors in pathophysiology of rhinophyma - Focus on habitual mechanical trauma. Med Hypotheses. 2020 Jul 15;143:110097 Authors: Borzęcki A, Turska M Abstract BACKGROUND: Rhinophyma is a skin disorder which causes nose enlargement and deformation due to proliferation of sebaceous glands and connective tissue. It is not only an aesthetic problem but may also lead to impaired nasal breathing and problems with liquids intake. HYPOTHESIS: Although rhinophyma is considered to be a subtype of rosacea, here we hypothesise whether it is a separate disease with mechanical trauma as a main reason of the disease progress. METHODS: 22 patients with diagnosed rhinophyma were qualified for the study. All patients were physically examined and detailed patients' medical history was obtained. Patients were asked to answer a number of questions regarding their usual skin care, purification procedure as well as handling of the nose and nasal cavity. Results were subjected to statistical analysis. RESULTS: Due to our observations there is a group of patients who have never presented any typical symptoms of rosacea while they are now suffering from rhinophymatous changes. Most of those patients confirmed longlasting mechanical nose cleaning which included any skin lesions removal by squeezing and nose picking which resulted in local skin inflammation, swelling, pain or itching. CONCLUSION: It is suspected that many different factors may induce rhinophyma development. In our opinion, mechanical repetitive trauma is one of the most important. Therefore we encourage physicians to include adequate questions while taking medical history from the patient and implement proper recommendations for nasal care as soon as possible. PMID: 32721796 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesEfficacy of non-ablative fractional 1440-nm laser therapy for treatment of facial acne scars in patients with rosacea: a prospective, interventional study. Lasers Med Sci. 2020 Jul 27;: Authors: Wang B, Deng YX, Yan S, Xie HF, Li J, Jian D Abstract Acne scarring is one of the most common facial skin disorders. The appropriate treatments for acne scars in patients with rosacea have not been studied. This study was designed to evaluate the efficacy and safety of non-ablative fractional 1440-nm laser (1440-nm NAFL) therapy for treatment of atrophic acne scars in patients with rosacea. In this prospective, interventional study, 32 patients with rosacea and acne scars underwent three sessions of 1440-nm NAFL therapy. Therapy efficacy, epidermal barrier function, and side effects were evaluated. Thirty patients completed and the median acne scar scores significantly reduced from 45 (30, 50) to 15 (15, 30) after three treatments (P < 0.001). The improvement score of acne scars was 2.7 ± 0.7; 22 (73.3%) were satisfied or highly satisfied. The rosacea erythema scores changed from 2.1 ± 0.4 to 1.9 ± 0.5 (P = 0.326), and flushing, burning, and stinging were not worse. The oil content after treatments was significantly reduced (P < 0.001), while there was no significant difference in other indicators of skin barrier function. The quality-of-life score decreased from 17.5 ± 3.8 to 14.1 ± 3.0 (P < 0.001). No serious side effects were observed. The 1440-nm NAFL therapy is effective in the treatment of acne scaring in patients with rosacea with little damage to the skin barrier. PMID: 32719961 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesPrimum non nocere; the importance to evaluate the effect of treatment and consider side-effects. Contact Dermatitis. 2020 Jul 26;: Authors: Sukakul T, Dahlin J, Svedman C PMID: 32713000 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesManagement of severe rhinophyma with electrocautery dermabrasion - A case report. Int J Surg Case Rep. 2020;72:511-514 Authors: Chellappan B, Castro J Abstract INTRODUCTION: Rhinophyma is benign hypertrophic thickening of the skin and edema of the nasal pyramid. The affected tissue enlarges slowly before reaching its permanent size. The lobulated skin surface with hundreds of pores can become cosmetically embarrassing and cause significant psychosocial stress, anxiety, and depression for patients. In addition, extensive alar thickening can obstruct the external nasal valves making treatment necessary to alleviate respiratory issues. No consensus has been reached regarding management of rhinophyma and many surgeons follow the "to each his own technique" mindset. Our objective was to present a case report to support the use of electrocautery and dermabrasion as the mainstay of treatment. PRESENTATION OF CASE: Here we describe the case of a 62-year-old Caucasian male with a long-standing history of acne rosacea who developed severe rhinophyma overtime which lead to nasal obstruction and major cosmetic deformity. Electrocautery and dermabrasion in the operating room were utilized to obtain an outstanding cosmetic result and respiratory function improvement. Loop and Colorado cautery tips were used with cutting current to remove the hypertrophic skin and create a smooth contour. The patient tolerated the procedure well without any complications. The patient's skin was scab-free with normal pigmentation by four weeks post-op. He was satisfied with the cosmetic outcome and reported substantial improvement in his breathing. DISCUSSION: There have been several case reports published which describe using different surgical methods to treat rhinophyma including lasers, electrocautery dermabrasion, surgical blade, cryosurgery, and radio excision. The main limitations of laser therapy are imprecise tissue removal, risk of scarring, dyspigmentation, and bleeding. Other therapies such as surgical excision and skin grafts may require multiple procedures before obtaining a satisfactory cosmetic outcome. CONCLUSION: This case report supports electrocautery dermabrasion as the mainstay of treatment as it is a management technique which allows for smooth contouring, efficient hemostasis, more control in the operating room, and does not require multiple procedures. PMID: 32698277 [PubMed] {url} = URL to article
    • There are a number of co-existing conditions associated with rosacea that are not uncommon. Some are uncommon. Here is the list to consider:  Acne Vulgaris   Blepharitis  Blepharokeratoconjunctivitis (BKC) Dry Skin (Xeroderma) Eczema  Frontal fibrosing alopecia  Hyperkeratosis  Lupus Melasma Periorol Dermatitis Seborrheic Dermatitis
    • Related ArticlesImpact of COVID-19 Pandemic on Dermatologists and Dermatology Practice. Indian Dermatol Online J. 2020 May-Jun;11(3):328-332 Authors: Bhat YJ, Aslam A, Hassan I, Dogra S Abstract The COVID-19 pandemic has directly or indirectly affected every human being on this planet. It's impact on the healthcare system has been devastating. The medical fraternity across the world, including India, is facing unprecedented challenges in striving to cope up with this catastrophic outbreak. Like all other specialties, dermatology practice has been profoundly affected by this pandemic. Measures have been taken by dermatologists to control the transmission of the virus, whereas providing health care to patients in the constrained environment. Preventive measures such as social distancing and hand hygienic practices along with patient education is being prioritized. Dermatological conferences and events scheduled across the globe in the first half of year 2020 have been either cancelled or postponed to discourage gatherings. Rationalization of resources and practice of teledermatology are being encouraged in current scenario. Non-urgent visits of the patients are being discouraged and elective dermatology procedures are being postponed. Many national and international dermatology societies have recently proposed recommendations and advisories on usage of biologicals and immunomodulators in present context of COVID-19 pandemic. Urticarial, erythematous, varicelliform, purpuric and livedoid rash as well as aggravation of preexisting dermatological diseases like rosacea, eczema, atopic dermatitis, and neurodermatitis rash have been reported in Covid-19 patients. Self medications and poor compliance of dermatology patients in addition to lack of proper treatment protocols and monitoring are a serious concern in the present scenario. Strategies for future course of action, including the dermatology specific guidelines need to be framed. This issue includes a special symposium on dermatology and COVID-19 having recommendations from special interest groups (SIGs) of Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) Academy on leprosy, dermatosurgery, lasers and dermoscopy. PMID: 32695687 [PubMed] {url} = URL to article
    • "Blepharokeratoconjunctivitis (BKC) is a chronic inflammatory disease of the lid margin with secondary conjunctival and corneal involvement..." "This is a retrospective review of 14 patients with the history of chronic red eyes with corneal involvement. All patients were diagnosed with ocular demodicosis based on the results of eyelash sampling. All patients were treated with 50% tea tree oil lid scrubs and two doses of oral ivermectin (200 mcg/kg)....Rosacea was present in only three patients." Indian J Ophthalmol. 2020 May; 68(5): 745–749. Demodex blepharokeratoconjunctivitis affecting young patients: A case series Nikunj Vinodbhai Patel, Umang Mathur, Arpan Gandhi, and Manisha Singh image courtesy of PMC
    • Related ArticlesDermoscopic Monitoring of Response to Intense Pulsed Light in Rosacea: A Case Report. Dermatol Pract Concept. 2020 Jul;10(3):e2020058 Authors: Deshapande A, Ankad BS PMID: 32685276 [PubMed] {url} = URL to article
    • Related ArticlesAssociation between Rosacea and Cardiovascular Diseases and Related Risk Factors: A Systematic Review and Meta-Analysis. Biomed Res Int. 2020;2020:7015249 Authors: Li Y, Guo L, Hao D, Li X, Wang Y, Jiang X Abstract Background: Rosacea is a common inflammatory skin disorder. Several studies, but not all, have suggested a high prevalence of cardiovascular diseases (CVDs) in rosacea patients. This study is aimed at investigating the association between rosacea and CVDs and related risk factors. Methods: We performed a literature search through PubMed, Embase, and Web of Science databases, from their respective inception to December 21, 2019. Two reviewers independently screened the articles, extracted data, and performed analysis, following the PRISMA guidelines. Odds ratios (OR) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes. The included studies' quality was evaluated using the Newcastle Ottawa Scale (NOS). Results: The final meta-analysis included ten studies. The pooled analysis found no association between rosacea prevalence and the incidence of CVDs (OR 0.97; 95% CI 0.86-1.10). Rosacea was found to be significantly associated with several risk factors for CVDs (OR 1.17; 95% CI 1.05-1.31), including hypertension (OR 1.17; 95% CI 1.02-1.35), dyslipidemia (OR 1.34; 95% CI 1.00-1.79), and metabolic syndrome (OR 1.72; 95% CI 1.09-2.72). However, no association was found between rosacea and diabetes mellitus (OR 0.98; 95% CI 0.82-1.16). Among the biological parameters, a significant association was found between rosacea and total cholesterol (SMD = 0.40; 95% CI = -0.00, 0.81; p < 0.05), low-density lipoprotein cholesterol (SMD = 0.28; 95% CI = 0.01, 0.56; p < 0.05), and C-reactive protein (CRP) (SMD = 0.25; 95% CI = 0.10, 0.41; p < 0.05). We found no association between rosacea and high-density lipoprotein cholesterol (SMD = 0.00; 95% CI = -0.18, 0.18; p = 0.968) or triglycerides (SMD = 0.10; 95% CI = -0.04, 0.24; p = 0.171). Conclusions: Although no significant association was found between rosacea and CVDs, rosacea was found to be associated with several of related risk factors. Patients with rosacea should pay more attention to identifiable CVD risk factors, especially those related to inflammatory and metabolic disorders. PMID: 32685519 [PubMed - in process] {url} = URL to article
    • This post has been promoted as an article. 
    • A case of Demodex-induced Lupus miliaris disseminatus faciei was treated with "ornidazole tablets (500 mg twice a day) and recombinant bovine basic fibroblast growth factor gel (0.2 g/cm twice a day) for an 8-week period" and the results showed "the facial erythematous papules were improved, and no new skin lesions were observed. The patient showed no signs of recurrence during the 6-month follow-up." Medicine (Baltimore). 2020 Jul 02;99(27):e21112 Demodex-induced Lupus miliaris disseminatus faciei: A case report. Luo Y, Wu LX, Zhang JH, Zhou N, Luan XL
    • Related ArticlesDemodex-induced Lupus miliaris disseminatus faciei: A case report. Medicine (Baltimore). 2020 Jul 02;99(27):e21112 Authors: Luo Y, Wu LX, Zhang JH, Zhou N, Luan XL Abstract RATIONALE: Lupus miliaris disseminatus faciei (LMDF) is an inflammatory granulomatous skin disease without a clear etiology that frequently involves the middle area of the face and the upper eyelids. Pathological features of the disease include caseation necrosis and epithelioid granuloma. Consensus treatment for LMDF is currently unavailable. PATIENT CONCERNS: A 47-year-old Chinese female patient who presented with facial pruritic, erythematous papules 8 months before this study. She was diagnosed with skin tuberculosis at another hospital and given antituberculosis medication. However, the treatment was not efficacious. DIAGNOSES: In this study, the diagnosis of Demodex-induced LMDF was made by a dermatologist according to physical examination, skin biopsy pathology, and microscopic examination. INTERVENTIONS: The patient was given ornidazole tablets (500 mg twice a day) and recombinant bovine basic fibroblast growth factor gel (0.2 g/cm twice a day) for an 8-week period. OUTCOMES: Eight weeks after the treatment, the facial erythematous papules were improved, and no new skin lesions were observed. The patient showed no signs of recurrence during the 6-month follow-up. LESSONS SUBSECTIONS: This case showed that ornidazole combined with recombinant bovine basic fibroblast growth factor gel might be useful in treatment of Demodex-induced LMDF. In addition, the results suggested that pathological caseation necrosis was caused by a series of inflammatory and immune responses to Demodex infection. PMID: 32629745 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related ArticlesClinical and biological impact of the exposome on the skin. J Eur Acad Dermatol Venereol. 2020 Jul;34 Suppl 4:4-25 Authors: Passeron T, Krutmann J, Andersen ML, Katta R, Zouboulis CC Abstract The skin exposome is defined as the totality of environmental exposures over the life course that can induce or modify various skin conditions. Here, we review the impact on the skin of solar exposure, air pollution, hormones, nutrition and psychological factors. Photoageing, photocarcinogenesis and pigmentary changes are well-established consequences of chronic exposure of the skin to solar radiation. Exposure to traffic-related air pollution contributes to skin ageing. Particulate matter and nitrogen dioxide cause skin pigmentation/lentigines, while ozone causes wrinkles and has an impact on atopic eczema. Human skin is a major target of hormones, and they exhibit a wide range of biological activities on the skin. Hormones decline with advancing age influencing skin ageing. Nutrition has an impact on numerous biochemical processes, including oxidation, inflammation and glycation, which may result in clinical effects, including modification of the course of skin ageing and photoageing. Stress and lack of sleep are known to contribute to a pro-inflammatory state, which, in turn, affects the integrity of extracellular matrix proteins, in particular collagen. Hormone dysregulation, malnutrition and stress may contribute to inflammatory skin disorders, such as atopic dermatitis, psoriasis, acne and rosacea. PMID: 32677068 [PubMed - in process] {url} = URL to article
    • AARS 2018 Form 990 Review Total Contributions from public support (99.25%) in the amount of $304,583.Total Expenses were $207,657.At the end of the 2016 the AARS reports 'net assets or fund balances' totaling $462,175. The AARS spent most of the expenses on 'conferences, meetings and conventions' in the amount of $148,728 for its prestigious members who are comprised mostly of dermatologists. The next largest expense was on 'management' in the amount of $48,000. The third largest expense was on its website which amounted to $4,473.  In 2018 the AARS didn't spend any of its donations on research grants. Schedule B, page 2 reveals the top contributors:  Galderma $50,000 L'oreal $35,000 Cutanea Life Sciences $15,000 Ortho Dermatologics $35,000 Bayer Healthcare $20,000 Allergan USA $35,000 Total $190,000 The six skin care industry corporations above contributed 91.4% of the total donations.  You can read the Form 990 yourself:  2018_AARS Form 990 signed by JHarper 8.6.19.pdf
    • image courtesy of Nutrients A report concluded, "Overall, probiotics and prebiotics are promising in protecting the skin against UVR-induced skin damage." Nutrients. 2020 Jun; 12(6): 1795. Published online 2020 Jun 17. doi: 10.3390/nu12061795 PMCID: PMC7353315 PMID: 32560310 Potential of Skin Microbiome, Pro- and/or Pre-Biotics to Affect Local Cutaneous Responses to UV Exposure VijayKumar Patra,1,2 Irène Gallais Sérézal,3,4 and Peter Wolf2,*
    • UPDATE "Hydroxychloroquine did not substantially reduce symptom severity in outpatients with early, mild COVID-19."  Annals of Internal Medicine, 16 Jul 2020 Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19 A Randomized Trial Caleb P. Skipper, MD et al "Hydroxychloroquine did not lead to faster symptom improvement among patients who had Covid-19 symptoms and were not hospitalized, according to a new study published Thursday in the Annals of Internal Medicine."  New Covid-19 study, despite flaws, adds to case against hydroxychloroquine By MATTHEW HERPER, STAT "Hydroxychloroquine does not appear to keep people from getting the disease after they’ve been exposed to someone who has it. It does not change how many people hospitalized with Covid-19 die of the disease. It does not reduce symptoms for people with milder cases who aren’t in the hospital." Hydroxychloroquine Still Doesn’t Do Anything, New Data Shows, Wired "The first randomized clinical trial testing hydroxychloroquine as an early treatment for mild covid-19 found the drug was no better than a placebo in patients who were not hospitalized." Hydroxychloroquine studies show drug is not effective for early treatment of mild covid-19 Laurie McGinley, The Washington Post, MSN 
    • 3D medical animation still of Cytokines that are important in cell signaling. Image courtesy of Wikimedia Commons Another cytokine is emerging as a possible link to rosacea, interleukin 17A (IL17A), with a report of using a biologic treatment for rosacea, secukinumab. [1] For several years the cytokine, cathlecidin, has been considered linked to rosacea because it is found in high levels with rosacea patients. [2]  Cytokines "Cytokines are a broad and loose category of small proteins (~5–20 kDa) important in cell signaling. Cytokines are peptides and cannot cross the lipid bilayer of cells to enter the cytoplasm. Cytokines have been shown to be involved in autocrine, paracrine and endocrine signaling as immunomodulating agents." [3]  "Their definite distinction from hormones is still part of ongoing research." [3] Therefore, cytokines are important in health and in disease prevention and when working properly everything is fine. However, just like the hormone insulin, when in proper amount secreted it works like a charm. If you are too low on insulin or too high things get a bit tricky when it comes to health. The same is true with cytokines. Cytokines in the right amount, everything is hunky dory, but when too many are present it can create quite a storm, or if not enough, things can get worse. The theory is that cytokines need to be be investigated more in what role they play in rosacea inflammation.  Cytokines and the Rosacea Immune System Disorder Theory Cytokines are related to the theory that rosacea is an immune system disorder. [4] Mast cells have important effects on the pathogenesis of rosacea and produce cytokines.   What is interesting is that "Cytokines also play a role in anti-inflammatory pathways and are a possible therapeutic treatment for pathological pain from inflammation or peripheral nerve injury. There are both pro-inflammatory and anti-inflammatory cytokines that regulate this pathway." [3] The first cytokine discovered was Interferon-alpha, an interferon type I, identified in 1957 as a protein that interfered with viral replication. [5] Both interleukin 17A and cathlecidin are cytokines that are related to inflammation in disease.  Topical ivermectin has been found effective in the treatment of T‐cell‐mediated skin inflammatory diseases. [6] Could it be possible that the cytokine response in rosacea sufferers is somehow related to virus? [7] For over sixty years the focus has been on bacteria or demodex. Could it be that the investigation should focus more on virus as the culprit why the cytokines are reacting? Virus are so tiny that the bacteria or demodex may carry a pathogen virus that is triggering the cytokine response. Has anyone even looked into this?  Have you seen any paper that has ruled out virus in rosacea? Magnesium decreases inflammatory cytokine production by modulation of the immune system. [8] A Cytokine storm is associated with Covid 19 deaths as well as with the 1918 Spanish Flu epidemic.  Interleukin 17A is an inflammatory cytokine. "Inflammatory cytokines are predominantly produced by and involved in the upregulation of inflammatory reactions.Excessive chronic production of inflammatory cytokines contribute to inflammatory diseases, that have been linked to different diseases...A balance between proinflammatory and anti-inflammatory cytokines is necessary to maintain health. Aging and exercise also play a role in the amount of inflammation from the release of proinflammatory cytokines." [9] "Cathelicidin antimicrobial peptides (CAMP) LL-37 and FALL-39 are polypeptides...serve a critical role in mammalian innate immune defense against invasive bacterial infection..." [2] "These peptides are potent, broad spectrum antibiotics which demonstrate potential as novel therapeutic agents.  Antimicrobial peptides have been demonstrated to kill Gram negative and Gram positive bacteria, enveloped viruses, fungi and even transformed or cancerous cells." [10] Dr. Gallo, et al, has applied for a patent, PREVENTION OF ROSACEA INFLAMMATION, United States Patent Application 20160030386, related to this. [11] Without a doubt we will be learning more on further research with interleukin 17A (IL17A) and possible other cytokines that are involved in the inflammation of rosacea.  Independent Rosacea Research Could a group of rosacea sufferers in a non profit organization like the RRDi collectively get together and sponsor their own research on rosacea? For example, if 10K members each donated a dollar, could it be possible that this money could be used to sponsor their own independent rosacea research on a cytokine?  What do you think? If you want to do something about this read this post.  End Notes [1] Secukinumab (Cosentyx) [2] Cathelicidin [3] Cytokine, Wikipedia [4] Innate Immune Response Disorder [5] Proc R Soc Lond B Biol Sci. 1957 Sep 12;147(927):258-67.  doi: 10.1098/rspb.1957.0048. Virus interference. I. The interferon A ISAACS, J LINDENMANN [6] Ivermectin Anti-Inflammatory Properties [7] Virus and Rosacea [8] J Immunol. 2012 Jun 15;188(12):6338-46.  doi: 10.4049/jimmunol.1101765.  Epub 2012 May 18. Magnesium decreases inflammatory cytokine production: a novel innate immunomodulatory mechanism Jun Sugimoto, Andrea M Romani, Alice M Valentin-Torres, Angel A Luciano, Christina M Ramirez Kitchen, Nicholas Funderburg, Sam Mesiano, Helene B Bernstein J Inflamm Res. 2018 Jan 18;11:25-34.  doi: 10.2147/JIR.S136742.  eCollection 2018. Magnesium deficiency and increased inflammation: current perspectives Forrest H Nielsen  [9] Inflammatory cytokine, Wikipedia [10] Antimicrobial peptides (AMPs), Wikipedia [11] Gallo Patent for the 'Prevention of Rosacea Inflammation'
    • Related Articles Erythematous Papules Involving the Eyebrows in a Patient with a History of Rosacea and Hair Loss. Skin Appendage Disord. 2020 Jun;6(3):190-193 Authors: Kłosowicz A, Thompson C, Tosti A PMID: 32656245 [PubMed] {url} = URL to article Source of image above Etcetera Sickening started a thread about eyebrow hair loss
    • Related ArticlesFacial dermatoses in general population due to personal protective masks: first observations after lockdown. Clin Exp Dermatol. 2020 Jul 13;: Authors: Giacalone S, Minuti A, Spigariolo CB, Passoni E, Nazzaro G Abstract Since SARS-COV-2 pandemic began, frontline healthcare workers demonstrated to develop facial dermatoses, such as acne, rosacea and seborrheic dermatitis, secondary to prolonged use of personal protective equipment (PPE). PMID: 32658350 [PubMed - as supplied by publisher] {url} = URL to article
    • A rare condition involving SD is eyebrow hairloss. Sickening started an interesting thread on this subject if you are suffering from this disorder. A similar thread was started by angelstar. Sometimes it can be confused with Frontal Fibrosis Alopecia.
    • StatPearls Book. 2020 01 Authors: Abstract Lupus miliaris disseminatus faciei (LMDF) is an idiopathic granulomatous disease affecting facial skin primarily. Nosologically, it is on a spectrum of facial granulomatous dermatoses and shares overlapping features with rosacea and sarcoidosis. In most cases, this disorder resolves spontaneously within several years but can leave potentially disfiguring scarring. The name derives from a historic putative association with tuberculosis, as discussed below. More recent authors have proposed adopting the term facial idiopathic granulomas with regressive evolution (FIGURE) instead of the entrenched LMDF. However, it does not appear that a name change has been widely accepted.[1] Older terms for a similar facial granulomatous dermatosis include micropapular tuberculid, Lewandowsky’s eruption, and lupoid rosacea.[2] Acne agminata has been used to refer to similar lesions in the axilla. PMID: 32644491 {url} = URL to article
    • The RRDi has been around for quite a while and we publish on our website for free what rosacea sufferers all over the world have said works to control their rosacea. A significant number of rosaceans say this simple method to control rosacea using this two step regimen does indeed work. Will it work for you?  The only way to know is to try it. There is no rosacea treatment regimen that works for every rosacea sufferer, not one. We have dubbed this the Rosacea X-Factor. However, this is what we recommend you try and we hope you will reply in this thread your results.  (1) Diet First, keep in mind this recommendation is only for thirty days. After the thirty days, go back to eating whatever you want. What you are probably eating is mostly carbohydrate since the typical American diet is high carbohydrate. Carbohydrate is simply different forms of sugar. There are absolutely no nutrients in carbohydrate, none. Carbohydrate is simply carbon, hydrogen and oxygen (absolutely no vitamins, minerals, or any nutrients). Sugar is the fire that inflames rosacea.  For example, oats, brown rice, fruit, sweet potato have significant carbohydrate. It is extremely difficult to cut out all carbohydrate. But if you can reduce your carbohydrate to no more than 30 grams a day for 30 days to see if this improves your rosacea, then you will know. What will you lerarn? Sugar/carbohydrate is a rosacea trigger.  If you do see improvement within the thirty days, at the end of the thirty days go back to your oats, brown rice, fruit, sweet potato or whatever you are eating and see what happens. This simple diet just for thirty days will either work or it won't in improving your rosacea. Please read a list of anecdotal reports that this actually works.  To help you understand how to figure out how many grams of carbohydrate you may be eating, just take a bowl of oats which contains 27 grams of carbohydrate in a half a cup. So if you decide to eat that half a cup of oats, you now only have 3 grams of carbohydrate to your 30 gram limit for the day. The only way you can do this is stick to broccoli since one cup (91 grams) of raw broccoli contains 6 grams of carbs. Kale is ok too, since one cup (67 grams) of raw kale contains 7 grams of carbs. You can have a lot of broccoli and kale in your day and still keep within the 30 gram limit. So anything that goes into your mouth that you digest, simply watch how many grams of carbohydrate and limit it to 30 grams a day. And watch how many carbohydrate is in anything you drink! Liquid or any food, 30 gram carbohydrate limit. Only for 30 days. 30 grams/30 days. Dr. Atkin's Carb Counter book helps you understand how to count carbs. So what do you eat? Protein and Fat, as much as you want, no limit. And remember, when someone or some authority says eating high protein/fat is bad, the reply is, 'this is just for thirty days.' Thirty days on a high protein/diet is not bad. No one can cite any clinical paper that eating high protein/fat for just thirty days is any health risk. Remember, just thirty days. No risk. And if you like meat, fish, and chicken it will be easier. If you are a vegan, it will be more difficult to find the protein/fat to eat but it can be done. The Rosacea Diet has a vegan 30 day diet. Remember, this is only for thirty days. At the end of the thirty days you can then eat whatever you want (sugar and carbohydrate), as much as you want and see what happens. Does your rosacea return when you eat high sugar/carbohydate? If so, you have learned something. Then you decide what to do about this. Not everyone chooses this course since it is so difficult. Why? Because sugar is addictive. Your choice. You obviously can keep eating whatever you want. This is just a recommendation, just like the following topical. (2) Topical As for a topical, recommend the ZZ cream. Before you use, be sure to apply a dab of the ZZ cream on your inner wrist and see if your skin turns red? If so, you are allergic to the ZZ cream. Remember that if you use the ZZ cream it gets worse before it gets better.  It takes at least a month to see any improvement with the ZZ cream and three to four months for clearance. 'Getting worse before it gets better' is a common occurrence in medicine, not just in using the ZZ cream. Conclusion These two simple treatments may work to control your rosacea if you reduce your sugar/carbohydrate to 30 grams a day for 30 days and use the ZZ cream as a topical. It will take at least 30 days to see improvement with step one, and 90 to 120 days for clearance in step two. 
    • Hi Kara,  Welcome to the RRDi. It would be good to know if your partner did get a diagnosis of rosacea (or what exactly) and what particular antibiotic and how much, whether low dose or high dose, I.e., how many milligrams per day? Is your partner applying any topical(s)?  The laser mentioned in the article in this thread, pulsed dye, has been around for years.     Coherent model 899 ring dye laser, with rhodamine 6G dye, pumped with a 514 nm argon laser. The laser is tuned somewhere around 580 nm. Photo taken by Han-Kwang at the AMOLF Institute in Amsterdam, Netherlands. P - image courtesy of Wikipedia Commons By the way, the article is an abstract made available through an RSS feed from PubMed published in Dermatologic Therapy. So this pulsed dye laser is usually in either a dermatology or cosmetic surgeon clinic and as you can imagine expensive. One treatment with an experienced practitioner as you can imagine is expensive, between $350 to $600 US Dollars and usually three or more treatments are required. Most insurance companies in the USA will cover such treatment if they are designated a medical diagnosis but usually such treatments are considered cosmetic and are not covered. I imagine the same conditions exist in the UK regarding whether insurance covers such laser treatments or not. You would have to ask. Most Rosaceans who rave about Laser treatment have to spend the money out of pocket. There are others who have negative experience with laser. By the way, some Rosaceans have now purchased their own light device, sometimes laser, others purchase LED or IPL devices since they are now available to the pubic. There is a learning curve using these devices and you can easily damage your skin so if you decide to go that route take care. Our store has some listed in broad band light. Using laser is just one of the many light devices under the treatment called photo dynamic therapy.  The article in this thread used the pulsed dye laser along with intradermal botulinum toxin type-A, a particular botulinum used in cosmetics. This treatment is also expensive and the practitioner should have experience using it since you can imagine if you were his first patient you might feel uneasy.  The article concludes this combination of treatment “demonstrated high efficacy and satisfaction rate with this combined approach and a low side-effect profile.”  If it cost several thousand dollars, you would expect such results. Just remember that you sign off on a lot of waivers and notices that you are warned of the risks and side effects of laser and botulinum treatment.  Dr. Braun performs Botox Injections on a client at Vancouver Laser & Skin Care Skin. Botox Injections temporarily reduces or eliminates frown lines, forehead creases, crow’s feet near the eyes and thick bands in the neck. By temporarily blocking the nerve impulses, the muscles that cause wrinkles relax, giving the skin a smoother, more refreshed appearance. - image courtesy of Wikimedia Commons There are clinical papers showing improvement in rosacea using Botox, I.e., Botox for Rosacea. Depending on what your partner is suffering with, recommend your partner read our welcome page or our newbies page. Some have found that simply reducing sugar/carbohydrate in the diet improves rosacea or whatever skin issue along with the topical ZZ cream.
    • Hi i read your article and find it very interesting. My partner has a very aggressive form of rosacea that sometimes spreads up to the eye. Most of the time he is on antibiotics but as soon as he stops the flushing starts again. Is this treatment that you mentioned available in London???? If not where can it be done.
    • To give you an idea of the prescription rosacea market you can view the number of prescriptions for the four leading rosacea prescription treatments shown below in two graphs the first one in surrogates, and the second one in market size as revealed in a Menlo Therapeutics investor presentation dated March 2020.  
    • Before/after photos released by an investor presentation dated March 2020 . 
    • Related ArticlesPulsed dye laser followed by intradermal botulinum toxin type-A in the treatment of rosacea-associated erythema and flushing. Dermatol Ther. 2020 Jul 07;: Authors: Al-Niaimi F, Glagoleva E, Araviiskaia E Abstract Rosacea is a common inflammatory skin disease characterized by erythema, episodes of flushing and inflammatory lesions. It typically affects the face and is more prevalent among fair skin individuals affecting women more than men. Various treatments are available for rosacea with light-based therapies commonly used in the management of erythema. The use of intradermal botulinum toxin type-A has been reported to be beneficial in the treatment of rosacea-associated erythema and flushing with good results and a low side-effect profile. In this article we present our experience on the successful combination of both pulsed dye laser and intradermal botulinum toxin type-A in erythema and flushing in 20 rosacea patients. In addition to subjective improvement we measured the degree of erythema using a 3D Antera™ camera in order to quantify our results. We demonstrated high efficacy and satisfaction rate with this combined approach and a low side-effect profile. To our knowledge the combination of laser and intradermal botulinum toxin in the management of rosacea has not been previously reported. This article is protected by copyright. All rights reserved. PMID: 32633449 [PubMed - as supplied by publisher] {url} = URL to article
    • "Dry Eye Disease (DED) is a common ocular condition that needs prompt diagnosis and careful treatment interventions....In this review, we demonstrated the mechanism of action of IPL, including its benefits on DED. The emerging evidence shows that the role of IPL in DED is novel and therapeutic. These results direct us to conclude that IPL is a potentially beneficial tool and essential future therapy for dry eye disease." Int J Med Sci. 2020; 17(10): 1385–1392.Published online 2020 Jun 1. doi: 10.7150/ijms.44288 Use of Intense Pulsed Light to Mitigate Meibomian Gland Dysfunction for Dry Eye Disease Abhishek Suwal, Ji-long Hao, Dan-dan Zhou, Xiu-fen Liu, Raja Suwal, and Cheng-wei Lu Image [Diffuse lissamine green staining in a person with severe keratoconjunctivitis sicca.] Courtesy of Wikimedia Commons
    • Just received the TEA Form 990 for 2019, which this non profit is not required to file for 2019 since donations were less than $50K (only received $21,578.00 in donations in 2019).  TEA spent $18K on 'printing, publications, postage, shipping and other expenses.' So no research grants were sponsored in 2019. No money spent on staff or 'conventions' for members.  Considering TEA has at least 3000 members who donated $21K, this non profit gets high marks for what is being accomplished according to the mission statement and still has over $125K in the bank in net assets.  Read the Form 990 yourself. We could only wish that RRDi members would donate half as much as TEA members do.   TEA 990 . 2019.pdf
    • I continue to take the Puritan Pride Lutein/Zeazanthin because I do think it helps dry my oily skin and as you point out, for the 'antioxidant effects' and I think it is similar to taking an oral retinoid since Lutein/Zeazanthin is actually a xanthophylls (carotenoid) that 'is a virulence factor with an antioxidant action that helps the microbe evade death by reactive oxygen species used by the host immune system."   It may improve the eyes as well. We haven't had other anecdotal reports that it clears rosacea as Marcel the attorney raves about in his initial report. Keep us posted on your results. It has not cured my rosacea, but I still think it is worth taking daily. I take one a day. 
    • I’m wondering if anyone has continued this treatment and would share results. I took my first oil today and plan to continue to just for the antioxidant effects.  I wake up with a few to many p&ps daily and am experimenting with the results.
    • Related ArticlesRosacea and the cardiovascular system. J Cosmet Dermatol. 2020 Jul 03;: Authors: Searle T, Al-Niaimi F, Ali FR Abstract Rosacea and the cardiometabolic syndrome are both associated with chronic inflammation and a pro-inflammatory phenotype. Emerging clinical evidence supports the relationship between rosacea and cardiometabolic syndrome hypertension and obesity. This article reviews our current findings and understanding in the skin and cardiovascular relationship in rosacea. Rosacea appears to be associated with hypertension, dyslipidaemia and obesity. The role of smoking in rosacea is currently less clear. It remains uncertain whether treatment of these risk factors will aid improvement of rosacea. Greater understanding of rosacea and its association with the cardiovascular system and underlying risk factors could allow for a greater understanding of the body's inflammatory response as well as the formulation of new guidelines for attending clinicians. Dermatologists treating rosacea patients might need to consider enquiring and evaluate their patients' underlying cardiovascular risk factors. PMID: 32621366 [PubMed - as supplied by publisher] {url} = URL to article
    • A rare case of lupoid leishmaniasis defying diagnosis for a decade. J Cutan Pathol. 2020 Jul 04;: Authors: Gehlhausen J, Sibindi C, Ko CJ, Grant M, Zubek A Abstract Cutaneous leishmaniasis is a common disease affecting millions in endemic areas worldwide. We present a case of lupoid leishmaniasis, a rare variant of cutaneous leishmaniasis, which clinically mimicked sarcoidosis and/or granulomatous rosacea for ten years until ultimate diagnosis. An 82-year-old U.S. citizen with an extensive travel history presented with a ten-year history of facial plaques on the cheeks and was previously diagnosed and treated as sarcoidosis. Multiple biopsies (previously and at presentation) revealed tuberculoid granulomas with negative special stains for microrganisms and negative sterile tissue cultures for AFB, bacteria, and fungal organisms. A diagnosis of granulomatous rosacea was rendered and multiple medical therapies were attempted, none with sustained improvement. Repeat biopsy of a new lesion revealed intracellular organisms consistent with leishmaniasis, which was confirmed by PCR. Lupoid leishmaniasis is a rare presentation of cutaneous leishmaniasis including facial plaques that can mimic granulomatous diseases affecting the face including sarcoidosis and granulomatous rosacea. Cutaneous leishmaniasis can sometimes be challenging to diagnose through standard histopathologic examination; IHC for CD1a can be used to augment tissue-based examination and PCR should be sent early in cases with sufficient concern. This article is protected by copyright. All rights reserved. PMID: 32623733 [PubMed - as supplied by publisher] {url} = URL to article
    • Efficacy and Safety Results of Micellar Water, Cream and Serum for Rosacea in comparison to a control group. J Cosmet Dermatol. 2020 Jul 05;: Authors: Guertler A, Jøntvedt NM, Clanner-Engelshofen BM, Cappello C, Sager A, Reinholz M Abstract BACKGROUND: Rosacea is a common inflammatory skin disorder with centrofacial erythema, flushing, telangiectasia, papules/pustules and possible ocular or phymatous manifestation. Patients' skin is particularly sensitive to chemical and physical stimuli leading to burning, stinging, dryness and skin tightness. OBJECTIVE: Dermatological evaluation of the efficacy and safety of skin care products designed for centrofacial erythema in rosacea patients, in comparison to a control group using objective measurements. Rosacea symptoms (itching, tension, warmth, burning, dryness) and quality of life were examined. METHODS: Sixty Caucasians with centrofacial erythema were enrolled in an eight-week prospective study, fifty of them exclusively using the study products (micellar water, cream and serum) with ten participants randomly assigned to a control group. Patients were evaluated at baseline (V0), at four weeks (V1) and at eight weeks (V2). Three-dimensional objective measurements (VECTRA® ) as well as standardized questionnaires were used. RESULTS: Results were compared with the control group. A significant reduction of 16% in skin redness as indicated by VECTRA® analysis was seen in the intervention group comparing V0 to V2. Furthermore, rosacea associated symptoms diminished by 57.1%, while life quality of affected patients within the intervention group improved by 54.5% comparing V0 to V2 respectively. CONCLUSIONS: A skin care regime suitable for sensitive and redness prone skin led to an enhanced clinical appearance, to a decrease of associated symptoms in rosacea patients and to an improved life quality. PMID: 32623833 [PubMed - as supplied by publisher] {url} = URL to article
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