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    • Arch Dermatol Res. 2021 Sep 14. doi: 10.1007/s00403-021-02277-0. Online ahead of print. ABSTRACT Botulinum toxin A (BTX-A) injections have become the most popular noninvasive cosmetic procedures performed worldwide. With growing interest, investigators continue to uncover an expanding array of aesthetic indications for BTX-A. Botulinum toxin A has been used off-label in the management of masseter hypertrophy for facial slimming, platysmal bands, nasal 'bunny' lines, perioral rhytides, gummy smile and scars, to name a few. Interestingly, the injection of multiple microdroplets of dilute BTX-A into the dermis, sometimes referred to as 'microbotox', has been investigated as a tool for facial rejuvenation. A handful of prospective studies and case series have demonstrated the benefit of BTX-A in the treatment of facial erythema and improving skin texture. The aim of this review is to summarize and appraise currently available data on the role of BTX-A in treating facial erythema and skin quality, with a special focus on potential pathophysiologic mechanisms. PMID:34519860 | DOI:10.1007/s00403-021-02277-0 {url} = URL to article
    • Dermatology. 2021 Sep 7:1-6. doi: 10.1159/000518220. Online ahead of print. ABSTRACT BACKGROUND: The prevalence and impact of pruritus, pain, and other sensory symptoms in skin diseases are poorly known. OBJECTIVE: To assess the frequency of these symptoms with dermatoses and their association with depression using data from the "Objectifs Peau" survey. METHODS: A representative sample of 20,012 French individuals was created using the usual quota method. RESULTS: When patients suffered from both pruritus and skin pain, they had a higher relative risk of psychological suffering (2.9) than those who suffered only from pruritus (1.4) or skin pain (1.2). Pruritus was reported in 48.55% of patients with acne, 43.24% with mycoses, 44.35% with warts, and 36.51% with rosacea. For skin pain, the results were 11.22%, 27.59%, and 16.13% for atopic dermatitis, acne, and warts, respectively. Other unpleasant sensations, such as tingling or burning, were also frequently reported. CONCLUSION: Pruritus, pain, or other sensory symptoms were found to be common not only in classic pruritic skin diseases but also in acne, rosacea, or warts. The association of pruritus and pain dramatically increased psychological suffering. These symptoms must be systematically searched for in patients, especially since new therapeutic possibilities are emerging for the symptomatic treatment of pruritus. PMID:34515100 | DOI:10.1159/000518220 {url} = URL to article
    • Arch Dermatol Res. 2021 Sep 12. doi: 10.1007/s00403-021-02279-y. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory skin condition that is associated with multiple systemic comorbidities, with the strongest evidence linking rosacea to hypertension, dyslipidemia, inflammatory bowel disease, and anxiety and depression. To assess dermatologists' awareness of and screening practices for rosacea comorbidities, we developed a survey that was distributed to attendings and residents across four academic dermatology departments in Massachusetts. A total of 73 dermatologists with varying experience participated in the study. Findings demonstrated significant knowledge and practice gaps among academic dermatologists in managing systemic comorbidities in rosacea. In addition, dermatologists' awareness of rosacea comorbidities was negatively correlated with number of years out of residency training, highlighting the need to address this knowledge gap through increased continuing medical education. Importantly, we observed a low screening frequency despite a high awareness of the association between rosacea and ocular comorbidities, suggesting that additional financial, institutional, or practice barriers likely contribute to the low screening rate. PMID:34510277 | DOI:10.1007/s00403-021-02279-y {url} = URL to article
    • J Cosmet Dermatol. 2021 Sep 12. doi: 10.1111/jocd.14454. Online ahead of print. NO ABSTRACT PMID:34510704 | DOI:10.1111/jocd.14454 {url} = URL to article
    • Vestn Otorinolaringol. 2021;86(4):95-98. doi: 10.17116/otorino20218604195. ABSTRACT One of the frequent causes of a significant increase in the external nose, forming a persistent deformity of the face, as well as leading to a non-standard clinical picture is rhinophyma disease. The article considers some historical data, epidemiology, peculiarities of pathogenesis, as well as the basics of surgical treatment tactics along with possible preventive measures against rhinophyma. At present, the treatment of this pathology presents great difficulties. Despite the many surgical methods, rhinophyma is poorly treatable, often relapses and leaves no less noticeable disfigurement of the face in the postoperative period. In this regard, there is a constant search for new surgical methods, which has not only medical but also important social significance. PMID:34499455 | DOI:10.17116/otorino20218604195 {url} = URL to article MORE INFORMATION ON PHENOTYPE 5
    • Australas J Dermatol. 2021 Sep 7. doi: 10.1111/ajd.13711. Online ahead of print. NO ABSTRACT PMID:34490894 | DOI:10.1111/ajd.13711 {url} = URL to article
    • Dermatol Ther (Heidelb). 2021 Sep 4. doi: 10.1007/s13555-021-00605-w. Online ahead of print. ABSTRACT INTRODUCTION: At present, some studies have reported that nasal rosacea may be an independent disease, but phenotypic characteristics and risk factors for nasal rosacea remain unknown. This study aimed to clarify the clinical features and explore the risk factors for nasal rosacea. METHODS: A hospital-based retrospective study was conducted, including 1615 rosacea patients and 1501 healthy individuals. The patients were divided into three groups based on the involved areas of the lesions (non-nasal, intermediate and nasal rosacea group). Their demographic data and clinical features were obtained from patients' medical records, and risk factors of nasal rosacea were analyzed. RESULTS: There were 927 (57.4%), 647 (40.1%) and 41 (2.5%) cases in the non-nasal, intermediate and nasal rosacea groups, respectively. Of 41 patients with nasal rosacea, all (100.0%) had fixed erythema and 17 cases (41.5%) had phymatous changes. Compared with control group, male gender (adjusted odds ratio [aOR] = 2.39, 95% confidence interval [CI] = 1.14, 4.99), obesity (aOR = 3.19, 95% CI 1.86, 11.79) and alcohol use (aOR = 1.58, 95% CI 1.22, 5.40) were risk factors for nasal rosacea, but these three factors were not risk factors for non-nasal rosacea and intermediate rosacea groups. Among patients with nasal lesions (compared with patients without nasal phymatous changes), family history of rosacea was a risk factor (aOR = 2.12, 95% CI 1.01, 4.46) for nasal phymatous changes and Fitzpatrick IV skin type was a protective factor (aOR = 0.49, 95% CI 0.28, 0.86). CONCLUSION: Nasal rosacea has relatively specific clinical features and independent risk factors, suggesting that it may be a special type of rosacea. PMID:34480736 | DOI:10.1007/s13555-021-00605-w {url} = URL to article
    • Ocul Surf. 2021 Sep 1:S1542-0124(21)00099-9. doi: 10.1016/j.jtos.2021.08.017. Online ahead of print. ABSTRACT Rosacea is a common chronic skin disease affecting mostly people aged 40 and above, with currently no cure. When it affects the eyelids and periocular skin, it leads to dry eye and potentially corneal damage. Research performed over the last decade shed light into the potential mechanisms leading to skin hypersensitivity and provided promising avenues for development of novel, rational therapeutics aimed at reducing the skin inflammatory state. In this review, we discuss the current knowledge on the mechanisms of rosacea in general and of periocular skin-affecting disease in particular, identify key questions that remain to be answered in future research, and offer a disease model that can explain the key characteristics of this disease, with particular emphasis on a potential positive feedback loop that could explain both the acute and chronic features of rosacea. PMID:34481075 | DOI:10.1016/j.jtos.2021.08.017 {url} = URL to article
    • Dermatol Ther (Heidelb). 2021 Sep 2. doi: 10.1007/s13555-021-00597-7. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory skin disease characterized by centrofacial erythema, papules, pustules, and telangiectasias. The onset of rosacea typically occurs after 30 years of age. It is estimated that approximately 2-5% of adults worldwide are affected. While the exact etiology of rosacea remains unknown, its pathogenesis is thought to be multifactorial with both environmental and genetic factors implicated. Ultraviolet radiation, heat, steam, ingested agents, including spicy foods and alcohol, host vasculature, dermal matrix degeneration, genetic susceptibility, and microbial organisms, including Demodex mites and Heliobacter pylori, have been implicated in the development of rosacea. Recently, mast cells (MCs) have emerged as key players in the pathogenesis of rosacea through the release of pro-inflammatory cytokines, chemokines, proteases, and antimicrobial peptides leading to cutaneous vasodilation, angiogenesis, and tissue fibrosis. Several existing and emerging topical, oral, and injectable therapeutics have been associated with improvement of rosacea symptoms based on their ability to stabilize and downregulate activated MCs. Herein, we review the data implicating MCs in the pathogenesis of rosacea and discuss interventions that may stabilize this pathway. PMID:34476755 | DOI:10.1007/s13555-021-00597-7 {url} = URL to article
    • Just saw a new page on the NRS website designated, 'key staff' and you can see a screen shot below:  If you will note in the above paragraph, Mr Huff is stated as 'president of the Glendale Communications Group, which provides infrastructure and personnel for for the NRS program services at no cost to its members.' If this is correct, why do the past 22 years of public Form 990s (1998 thru 2019) show that over $10 million of the donations to the NRS have been spent on private contractors that are owned by Mr. Huff, including Glendale Communications Group? For example, in 2019 the NRS spent $285,871 on 'private contractors' including Glendale Communications Group which happens to be 94% of the donations given to the NRS in 2019. If this is 'no cost to its members' then why report this expense on Form 990 for 2019?  In the previous year, 2018, the NRS spent $432,408 on private contractors, one of which is Glendale Communications Group, which happens to be 93% of the total donations given to the NRS in 2018. For a complete list of these Form 990s click here.  For a breakdown of how the NRS spends its donations click here. 
    • J Cosmet Dermatol. 2021 Sep 2. doi: 10.1111/jocd.14428. Online ahead of print. ABSTRACT INTRODUCTION: This study aims to compare the choroidal thickness (CT) of patients with rosacea with healthy individuals. METHODS: This study was conducted with 42 patients with Papulopustular Rosacea (PPR), 38 patients with Erythematotelangiectatic Rosacea (ETR), and gender and age-matched 37 healthy individuals in the control group. CT measurements were done using the spectral-domain optical coherence tomography. RESULTS: Choroidal thickness means were measured as 352 ± 78 μm, 331 ± 67 μm, and 346 ± 83 μm at the subfoveal region; 323 ± 72.3 μm, 303.5 ± 68.4 μm, and 314 ± 80.3 μm at 1000 μm nasal; and 325.2 ± 71 μm, 304.4 ± 52.2 μm, and 309 ± 67 μm at 1000 μm temporal in the PPR, ETR, and control groups, respectively (p > 0.05). CONCLUSION: Although rosacea is a common chronic skin disease that could have systemic findings, CT is not affected by this disease. PMID:34473882 | DOI:10.1111/jocd.14428 {url} = URL to article
    • Metabol Open. 2021 Aug 13;11:100118. doi: 10.1016/j.metop.2021.100118. eCollection 2021 Sep. ABSTRACT BACKGROUND: The prevalence of diabetes mellitus is on the inexorable rise despite the promises of a wide range of conventional medications. Thus, there is a need to scientifically investigate plants for antidiabetic effect. METHODS: After the Rubus Erlanrige Engl (Rosaceae) leaf has been decocted, the plant extract's antidiabetic activity was first investigated in vitro and then in vivo. The in vitro activity was assessed using 3, 5-Dinitrosalicylic acid, and 2,2-diphenyl-1-picrylhydrazine method for α-amylase inhibition and antioxidant effect respectively. On the other hand, the in vivo antidiabetic activity was carried out in normoglycemic, glucose loaded (2.5 g/kg) and single dose streptozotocin (200 mg/kg) induced diabetic mice. RESULTS: Acute toxicity study showed the extract is safe with ≥2 g/kg. The in vitro results demonstrated the extract has an IC50 of 7.34 ± 0.02 and 10.38 ± 0.0.62 μg/ml for antioxidant and α-amylase inhibition activity respectively. On the other hand, the in vivo study revealed that the extract significantly reduced blood glucose level following glucose loading. The extract did not, however, produce a significant reduction of glucose level in normal mice indicating low risk of hypoglycemia. The extract also significantly decreased blood glucose levels in streptozotocin-induced diabetic mice. In the single dose study, the extract lowered blood glucose level all except by lower dose at the 3rd and 4th h (p < 0.05). In repeated dose studies, the reduction in fasting blood glucose was significant with all doses of the extract from the 2nd week onwards. In addition, the extract produced less reduction in body weight after diabetic induction. CONCLUSION: The findings collectively indicate that the extract has an antidiabetic activity, with low risk of hypoglycemia, probably mediated by various secondary metabolites that act in synergy. PMID:34466798 | PMC:PMC8384911 | DOI:10.1016/j.metop.2021.100118 {url} = URL to article
    • J Cosmet Laser Ther. 2021 Aug 30:1-2. doi: 10.1080/14764172.2021.1957114. Online ahead of print. ABSTRACT Lately it has been established that intra-dermal botulinum toxin is also effective in treating many dermatological conditions including refractory erythematous-telangiectatic rosacea, post - menopausal facial flushing and other similar conditions.However, the desired effect of treating the reddening in patients suffering from facial flushing can become an undesirable and embarrassing side effect when these same patients present to the clinic for esthetic concerns such as upper face rhytids. In this case, intramuscular botulinum toxin injections used for wrinkles treatment will also secondarily treat the facial reddening in their localized skin diffusion zones and result in embarrassing white patches all over the face. The patchy appearance following botulinum toxin injections for esthetic purposes could be bothersome for some patients and could be a tell-tale sign of botulinum toxin injections. PMID:34459693 | DOI:10.1080/14764172.2021.1957114 {url} = URL to article
    • World J Gastrointest Oncol. 2021 Aug 15;13(8):835-844. doi: 10.4251/wjgo.v13.i8.835. ABSTRACT Helicobacter pylori (H. pylori) is an infectious agent influencing as much as 50% of the world's population. It is the causative agent for several diseases, most especially gastric and duodenal peptic ulcer, gastric adenocarcinoma and mucosa-associated lymphoid tissue lymphoma of the stomach. A number of other, extragastric manifestations also are associated with H. pylori infection. These include neurological disorders, such as Alzheimer's disease, demyelinating multiple sclerosis and Parkinson's disease. There is also evidence for a relationship between H. pylori infection and such dermatological diseases as psoriasis and rosacea as well as a connection with infection and open-angle glaucoma. Generally little is known about the relationship between H. pylori infection and diseases of the pancreas. Most evidence about H. pylori and its potential role in the development of pancreatic diseases concerns pancreatic adenocarcinoma and autoimmune forms of chronic pancreatitis. There is data (albeit not fully consistent) indicating modestly increased pancreatic cancer risk in H. pylori-positive patients. The pathogenetic mechanism of this increase is not yet fully elucidated, but several theories have been proposed. Reduction of antral D-cells in H. pylori-positive patients causes a suppression of somatostatin secretion that, in turn, stimulates increased secretin secretion. That stimulates pancreatic growth and thus increases the risk of carcinogenesis. Alternatively, H. pylori, as a part of microbiome dysbiosis and the so-called oncobiome, is proven to be associated with pancreatic adenocarcinoma development via the promotion of cellular proliferation. The role of H. pylori in the inflammation characteristic of autoimmune pancreatitis seems to be explained by a mechanism of molecular mimicry among several proteins (mostly enzymes) of H. pylori and pancreatic tissue. Patients with autoimmune pancreatitis often show positivity for antibodies against H. pylori proteins. H. pylori, as a part of microbiome dysbiosis, also is viewed as a potential trigger of autoimmune inflammation of the pancreas. It is precisely these relationships (and associated equivocal conclusions) that constitute a center of attention among pancreatologists, immunologists and pathologists. In order to obtain clear and valid results, more studies on sufficiently large cohorts of patients are needed. The topic is itself sufficiently significant to draw the interest of clinicians and inspire further systematic research. Next-generation sequencing could play an important role in investigating the microbiome as a potential diagnostic and prognostic biomarker for pancreatic cancer. PMID:34457189 | PMC:PMC8371525 | DOI:10.4251/wjgo.v13.i8.835 {url} = URL to article
    • Thanks for your insight into all this. Very few, as you have pointed out, are motivated to express any thought on this subject. The RRDi has social media accounts. Would you like to volunteer to moderate and manage one or more of them?  
    • Hi, I have just come across this forum today (via the following page: https://rosacea-support.org/book-reviews#rosaceadiet) and became quite interested in the community. In terms of what the RRDI stands for today (this being patient-led and supported): the mission sounds great and quite admirable. As someone who is in my early 30's and got properly assessed and diagnosed with rosacea just back in 2017... I find the condition does not get nearly enough attention (especially considering that there is mild research that had taken place on important topics such as the possibility of a link between rosacea and autoimmune conditions: https://www.dermatologytimes.com/view/more-evidence-rosacea-autoimmune-link). This being said, as a new member it seems there are two main things missing: lack of awareness of the organization and therefore, lack of engagement. The first issue might be solved by collaboration with other grass-roots groups in either adjacent / related conditions or another dermatological condition of high prominence (for example, atopic dermatitis has been quite popular in recent years). The vehicle for collaboration and engagement could be as simple as social media (posting of recent articles on either topic and soliciting feedback that way).  Thanks again for keeping this community alive. It is impressive to learn that RRDI has been going on since 2004 and I hope it will remain so. This condition is truly under-represented but the last thing patients need is another big group (such as the aforementioned NRS and AARS) that simply unites 'thought leaders' (in this case, physicians with clout) and the pharmaceutical manufacturers.
    • Every dermatological disease assessed had a significant increase in TME when compared to the prior year. This increase was most significant for acne vulgaris (808%), psoriasis (792%), malignant skin neoplasms (716%), atopic dermatitis (609%), rosacea (566%) and contact dermatitis (529%).  Published online 2021 Aug 19. doi: 10.1016/j.jid.2021.07.109 LB767 A multicenter analysis of patients using telemedicine for dermatological conditions during the COVID-19 pandemic
    • Rosacea-like eruptions following COVID-19 vaccination More Information
    • Rosacea-like eruptions following COVID-19 vaccination More Information
    • Indian Dermatol Online J. 2021 Jul 14;12(4):500-514. doi: 10.4103/idoj.idoj_298_21. eCollection 2021 Jul-Aug. ABSTRACT Ivermectin is a broad-spectrum antiparasitic drug with anti-inflammatory, anti-viral, anti-bacterial, and anti-tumor effects. In this review, we discuss the history, pharmacology, multimodal actions, indications in dermatology and tropical medicine, therapeutic and prophylactic use of ivermectin in COVID-19, safety, adverse effects, special considerations, and drug interactions of ivermectin. PMID:34430453 | PMC:PMC8354388 | DOI:10.4103/idoj.idoj_298_21 {url} = URL to article
    • Clin Exp Dermatol. 2021 Aug 24. doi: 10.1111/ced.14910. Online ahead of print. ABSTRACT BACKGROUND: Particulate matter (PM) is a mixture of solid and liquid particles suspended in air which originates from industrial plants or vehicle emission. Although skin primarily contacts with air pollutants, the associations between PM and chronic inflammatory skin diseases has not been well established. OBJECTIVE: To investigate associations between PM and atopic dermatitis as well as other chronic inflammatory dermatoses using Korea Health Insurance Review & Assessment Service data. METHODS: Monthly disease statistics from seven largest cities (Seoul, Busan, Daegu, Incheon, Gwangju, Daejeon, Ulsan) and Jeju Island of South Korea of 23,288,000 people were included. Based on daily air pollution level and weather forecast from 2015 to 2019, multivariate negative binomial regression analysis was conducted to estimate monthly visits of atopic dermatitis with respect to outdoor air pollutants (PM2.5 , PM10 , O3 , NO2, SO2 , CO). RESULTS: Every 10 μg/m3 increase in PM2.5 and PM10 was significantly associated with 2.71% (95% confidence interval (CI)=0.76%-4.71%; P = 0.0063) and 2.01% (95% CI=0.92%-3.11%, P = 0.0003) increase in monthly patient visits of atopic dermatitis, respectively. Every 1 ppb increase in SO2 and 100 ppb increase in CO was significantly associated with 2.26% (95% CI=1.35%-3.17%; P < 0.0001) and 2.86% (95% CI=1.35%-4.40%; P = 0.0002) increase in patient visits of atopic dermatitis, respectively, while O3 and NO2 were not associated. On the other hand, increases in PM2.5 and PM10 concentrations were significantly associated with increases of patient visits of psoriasis, seborrheic dermatitis, and rosacea. CONCLUSION: Our data suggest PM is associated with atopic dermatitis and chronic inflammatory skin diseases. PMID:34426985 | DOI:10.1111/ced.14910 {url} = URL to article
    • J Eur Acad Dermatol Venereol. 2021 Aug 20. doi: 10.1111/jdv.17615. Online ahead of print. ABSTRACT Cutaneous reactions after COVID-19 vaccines mainly consisted of delayed inflammatory reactions in the injection site, urticaria, chilblain-like lesions and pityriasis rosea-like eruptions1,2 . We describe herein two patients who developed rosacea-like eruptions following COVID-19 vaccination. PMID:34416044 | DOI:10.1111/jdv.17615 {url} = URL to article
    • J Cosmet Dermatol. 2021 Aug 19. doi: 10.1111/jocd.14389. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin disease that has been reported to be associated with many systemic disorders including respiratory diseases. AIMS: This study aims to investigate respiratory function in patients with rosacea. PATIENTS/METHODS: Patients with rosacea and age- and gender-matched healthy volunteers were included in this cross-sectional study. Spirometric pulmonary function tests including the percentage of forced vital capacity (FVC%), percentage of forced expiratory volume in one second (FEV 1%), forced expiratory flow at 25-75% of FVC (FEF 25-75%), and FEV 1/FVC ratio was assessed in both patient and controls. The potential relationship between rosacea severity and pulmonary functions was assessed. RESULTS: A total of 120 patients with rosacea and 120 healthy controls were enrolled in the study. Compared to the controls, FEV 1%, FEV 1/FVC%, and FEF 25-75% values were significantly lower in patients with rosacea. Lower FEV 1/FVC% values were found to be associated with disease severity. FEV 1%, FEV 1/FVC%, and FEF 25-75% values were found to be more useful in differentiating the patients from healthy subjects. CONCLUSIONS: This study showed that patients with rosacea may have abnormal respiratory function compared to healthy subjects. Besides, disease severity was associated with worse respiratory functions. We believe that patients with rosacea, particularly those with additional risk factors, should be screened for respiratory disorders. PMID:34411396 | DOI:10.1111/jocd.14389 {url} = URL to article
    • J Drugs Dermatol. 2021 Aug 1;20(8):861-864. doi: 10.36849/JDD.6062. ABSTRACT Dermatologists are cognizant of the multiple clinical manifestations of rosacea, particularly persistent facial erythema, which has been deemed to be the most prevalent diagnostic feature and often poses a significant negative impact on quality of life. To address the need to recognize rosacea as a single disease with multiple potential phenotypes, a new classification system has been developed by 28 clinical and scientific experts worldwide. PMID:34397189 | DOI:10.36849/JDD.6062 {url} = URL to article ~ Full Text How the phenotype classification works.
    • Cutis. 2021 Jul;108(1):46-50. doi: 10.12788/cutis.0289. ABSTRACT Rosacea is a chronic progressive disease that causes inflammation on the skin and the ocular surface. This study aimed to evaluate the effects of Demodex mites on clinical findings associated with rosacea. Sixty patients who were newly diagnosed with rosacea in the dermatology outpatient clinic underwent superficial skin biopsy to determine the density of Demodex species. The patients were evaluated as Demodex positive (n=30) or Demodex negative (n=30) based on the species density. The 60 patients were examined in the ophthalmology outpatient clinic; a total of 120 eyes underwent tear breakup time (TBUT) and Schirmer tests and were examined for meibomitis and blepharitis findings. The demographic characteristics and ocular findings of both groups were recorded and statistically compared. We found that Demodex mite-related inflammation in rosacea does not significantly affect clinical ocular surface findings and that Demodex positivity is significantly associated with papulopustular rosacea (PPR)(P=.003). PMID:34397359 | DOI:10.12788/cutis.0289 {url} = URL to article
    • Cutis. 2021 Jul;108(1):51-54. doi: 10.12788/cutis.0290. ABSTRACT Rosacea fulminans (RF) is a rare facial dermatosis that typically affects women with a fulminating course that presents with superficial and deep-seated papules, pustules, and nodules, as well as an intense reddish or cyanotic erythema localized to the face. Although the etiology of RF remains unknown, immunologic, hormonal, and vascular factors have been implicated. We describe a case of a 32-year-old pregnant woman presenting with RF. Presentation in a pregnant patient is not commonly reported and requires special consideration to manage. PMID:34397360 | DOI:10.12788/cutis.0290 {url} = URL to article
    • Cell Immunol. 2021 Aug 8;368:104422. doi: 10.1016/j.cellimm.2021.104422. Online ahead of print. ABSTRACT MAS related G-protein coupled receptor X2 (MRGPRX2) is a G-protein coupled receptor (GPCR) expressed in human mast cells that has been implicated to play an important role in causing pseudo-allergic reactions as well as exacerbating inflammation during asthma and other allergic diseases. Lactic acid, a byproduct of glucose metabolism, is abundantly present in inflamed tissues and has been shown to regulate functions of several immune cells. Because the endogenous ligands for MRGPRX2 (substance P and LL-37) are elevated during pathologic conditions, such as cancer and asthma, and given that lactic acid levels are also enhanced in these patients, we explored the role of lactic acid in regulating mast cells response via MRGPRX2 and MrgprB2, the mouse orthologue of the human receptor. We found that lactic acid suppressed both the early (Ca2+ mobilization and degranulation) and late (chemokine/cytokine release) phases of mast cell activation; this data was confirmed in LAD2, human skin and mouse peritoneal mast cells. In LAD2 cells, the reduction in degranulation and chemokine/cytokine production mediated by lactic acid was dependent on pH. In agreement with our in vitro studies, lactic acid also reduced passive systemic anaphylaxis to compound 48/80 (a known MRGPRX2/MrgprB2 ligand) and skin inflammation in a mouse model of rosacea that is dependent on MrgprB2 expression on skin mast cells. Our data thus suggest that lactic acid may serve to inhibit mast cell-mediated inflammation during asthma and reduce immune response during cancer by affecting mast cell activation through MRGPRX2. PMID:34399172 | DOI:10.1016/j.cellimm.2021.104422 {url} = URL to article
    • Dermatol Online J. 2021 Jul 15;27(7). doi: 10.5070/D327754360. ABSTRACT BACKGROUND: Exacerbation of rosacea may occur during pregnancy and there are multiple associated cases of rosacea fulminans (RF). Treatment during pregnancy poses a significant challenge as many rosacea treatments are contraindicated or have limited evidence regarding potential adverse fetal effects. OBJECTIVE: Review the pregnancy categories of various treatments and develop algorithms for treating pregnant patients with rosacea and RF. METHODS: Rosacea treatments showing efficacy in randomized controlled trials were searched through DailyMed to review pregnancy labelling. Searching the PubMed/MEDLINE database for English articles using keywords "rosacea fulminans AND pregnancy" without publishing-time restrictions yielded 8 articles. We summarized treatments used in cases of RF during pregnancy. RESULTS: Topical ivermectin was more effective than metronidazole, but has a more concerning pregnancy category. Three pregnant women with RF were treated successfully with topical metronidazole in combination with other therapies. Azithromycin is the only oral rosacea therapy that is considered safe for pregnant patients and it has been used to treat RF. CONCLUSIONS: This review highlights the challenging aspects of treating pregnant patients with rosacea, as there is limited pregnancy-related treatment efficacy and safety data. The pregnancy categories of therapeutic options are summarized. Further studies are needed to learn which therapies are effective and safe for use during pregnancy. PMID:34391325 | DOI:10.5070/D327754360 {url} = URL to article
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