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    • Walter Freyne, the owner of Demodex Solutions, has assisted me in comparing the Original ZZ cream ingredients with the cosmetic version and has approved this comparison which is now published through the RRDi. While I love the original ZZ cream, I think the cosmetic version is better because it dissolves better and feels creamer or softer. 
    • The RRDi is please to announce that Tara O'Desky, D.C., has graciously volunteered for the RRDi MAC. She has a website where she explains how the Rosacea Forum helped her control her rosacea. We grateful for Dr. O'Desky volunteering for our non profit organization as a medical advisor. 
    • Nicholas,  Thanks for the link to the article, which is a good find! I have added artemesinin to the list of anti-malaria treatments used for successful rosacea treatment. Technically, artemisinin is not an anti-viral, but an anti-malaria treatment used on Plasmodium falciparum, a protozoa. Hopefully, we will hear of anecdotal reports of Rosaceans using artemisinin for rosacea with positive results. Your volunteering to post such articles is what the RRDi is all about, helping rosaceans with rosacea research! Artemisinin is available over the counter. 
    • https://www.sciencedirect.com/science/article/pii/S0753332219310339
    • Welcome to the RRDi,  What treatment are you using for your rosacea? Is it working?
    • Yes they may be linked because roscaea is a kind of chronic inflammatory condition which may or may not be associated with co-morbidities and can occur with other co-expressing conditions. Rosacea can co-exist with other inflammatory conditions. If you are an elderly person and you have been diagnosed with a form of dementia, it is linked to chronic inflammation that means neuroinflammatory condition and neuropeptides are associated with this inflammation because they are the mediators of inflammation and neuropeptides circulate between the brain and peripheral tissues and hence found in the skin and is the cause of your rosacea because chronic skin inflammatory conditions are associated with neuropeptides.
    • I have just been diagnosed with bvFTD a form of early dementia .... developed rosacea at the beginning of the year when my bvFTD was getting worse, frighening to realise they are linked   
    • The Netherlands has endorsed the new phenotype classification of rosacea, as published in the British Journal of Dermatology. For more information. 
    • Related Articles Rosacea treatment guideline for The Netherlands. Br J Dermatol. 2020 Jan 23;: Authors: van Zuuren EJ, van der Linden MMD, Arents BWM Abstract The classification of rosacea has evolved from a subtyping into a phenotype approach1-3 and an updated systematic review on interventions in rosacea using this approach was recently published.4 Therefore, we developed a new evidence-based guideline for all physicians and skin therapists involved in the management of patients suffering from rosacea. A patient information leaflet based on this guideline was produced. The Working Group (WG) consisted of dermatologists (4), general practitioner (1), ophthalmologist (1), plastic surgeon (1), skin therapists (2), patient (1) and staff members of the Dutch Society of Dermatology and Venereology (2). All affiliated organizations participated in external review. PMID: 31970753 [PubMed - as supplied by publisher] {url} = URL to article
    • An article about any conflict of interest (COI) with the authors of dermatological textbooks is an interesting read, highlighting the need for more transparency acknowledging the funding of the authors. [1] Note this paragraph:  "In recent years, dermatologists’ relationship with industry has increased immensely. The global pharmaceutical market in dermatology is projected to exceed $34 billion per year by 2023 (Prescient & Strategic Intelligence, 2018). The relationship with industry is a complicated subject. Support from industry has been important for the advancement of dermatology and has provided funding support for a range of activities, including clinical trials, educational materials, and travel support for residents and fellows. These funds are integral for the growth and maintenance of the specialty. For example, exhibit revenue from technical exhibits at large meetings helps support registration and educational costs for attendees and provides funding for other non-income-producing activities. The pervasiveness of industry is incontrovertible and spans a gamut ranging from continuing medical education programs to educational grants to advertisements in journals (Sams and Freedberg, 2000)." Here are some highlights of the study:  (1) The study was limited to eight textbooks and states about these that all eight "are listed on the American Academy of Dermatology (AAD) website as board preparation resources recommended by members of the AAD Resident and Fellows committee under the category of general dermatology textbooks."  "The most recent editions of eight commonly used books were selected and are listed as follows: Dermatology (4th edition, 2017), Andrews’ Diseases of the Skin: Clinical Dermatology (12th edition, 2015), Dermatology Secrets Plus (5th edition, 2015), Genodermatoses: A Clinical Guide to Genetic Skin Disorders (2nd edition, 2004), Comprehensive Dermatologic Drug Therapy (3rd edition, 2012), Hurwitz Clinical Pediatric Dermatology: A Textbook of Skin Disorders of Childhood and Adolescence (5th edition, 2015), Dermatology: Illustrated Study Guide and Comprehensive Board Review (2nd edition, 2017), and Clinical Dermatology: A Manual of Differential Diagnosis (3rd edition, 2003)." (2) "The total compensation for 381 authors in 2016 was $5,892,221....The top 10% of dermatologists who collected payments received $5,267,494, which represented 89% of the total payment amount.....The payment distribution was skewed with a minority of dermatologists receiving the majority of payments." (3) "Given the financial incentives of pharmaceutical companies, the pharmaceutical industry has a particular interest in targeting young physicians in training as they foster their own disease treatment and prescribing patterns." (4) "This study helps to further characterize the relationship between authors of general dermatology textbooks and industry. Continued discussion to foster transparency among physicians, regulators, and the public with regard to various topics, such as policies, physician behaviors, and the potential for CoI in educational resources, is important." The paper acknowledges the limitations such as only USA physicians were included and other limitations. But you do get an idea of why transparency should be acknowledged in the textbooks that dermatologists are using so that as the authors of the study put it, "Whether industry payments to authors affect the quality of information in dermatology textbooks for better or for worse remains uncertain" so that "readers can draw their own conclusions." End Notes [1] International Journal of Women's Dermatology Conflicts of interest among dermatology textbook authors  Jorge Roman, MD, David J. Elpern, MD, and John G. Zampella, MD Etcetera Related to skin industry funding of textbook authors are the following two posts:  Rosacea Research in Perspective of Funding Rosacea Research in Perspective of Idiopathic Diseases    
    • Interesting that Actinic Folliculitis should be considered in a differential diagnosis with rosacea. It has been suggested that photo damage may be responsible in rosacea which is one of the threories. 
    • Related Articles Off-label Uses of Topical Pimecrolimus. J Cutan Med Surg. 2019 Jul/Aug;23(4):442-448 Authors: Ladda M, Sandhu V, Ighani A, Yeung J Abstract Pimecrolimus is a topical calcineurin inhibitor currently approved for second-line use in the management of mild-to-moderate atopic dermatitis in patients age 2 years and older. Given the safety profile and nonsteroidal mechanism of pimecrolimus, there has been significant interest in its use in the treatment of a variety of dermatological conditions. This article reviews research that has been published on the off-label uses of topical pimecrolimus, with a focus on published RCTs. Convincing evidence exists supporting pimecrolimus' efficacy in oral lichen planus and seborrheic dermatitis. For other conditions studied to date, pimecrolimus may prove to be a useful treatment alternative when conventional agents fail. Adverse events seen with its off-label use were typically application site reactions, the most common being a transient burning sensation. In summary, pimecrolimus appears to be an effective agent in the treatment of multiple dermatological conditions and may be worth considering as a pharmacologic alternative in several conditions when first-line treatment fails, or for areas that are more susceptible to the adverse effects of topical corticosteroids. PMID: 31053034 [PubMed - indexed for MEDLINE] {url} = URL to article
    • Related Articles First reported cases of Actinic folliculitis treated successfully with topical retinoid. Clin Exp Dermatol. 2020 Jan 22;: Authors: Rahman S, Powell J, Al-Ismail D Abstract Actinic Folliculitis (AF) is a rare recurrent seasonal photodermatosis, relatively newly characterised by non pruritic, monomorphic pustules and papules appearing 4 - 24 hours after exposure to sunlight. Lesions usually affect the face but also appear on the upper chest and arms. Resolution normally occurs within 7 - 10 days with cessation of sunlight exposure. AF is resistant to standard treatments used for acne vulgaris and acne rosacea with only oral retinoids previously being reported as effective. We report the first 2 cases of actinic folliculitis responding extremely effectively to a topical retinoid. PMID: 31965609 [PubMed - as supplied by publisher] {url} = URL to article
    • Mosquitoes and Virus and Imiquimod Cream As noted in the post on Protozoa and Rosacea, treatment for malaria [protozoa] has improved some cases of rosacea using mepacrine, chloroquine, and hydroxychloroquine. An article published in Science Daily [1] points out, "There are hundreds of viruses spread by biting mosquitoes which can infect humans...At present, there are no anti-viral medicines and few vaccines to help combat these infections." The article discusses using a skin cream with the active ingredient imiquimod and reports, "By applying skin cream after a bite, researchers found that they could pre-emptively activate the immune system's inflammatory response before the virus becomes a problem. The cream encouraged a type of immune cell in the skin, called a macrophage, to suddenly spring into action to fight off the virus before it could spread around the body." Wouldn't it be novel for 10K RRDi members to get together and each donate a dollar and then sponsor a clinical researcher to investigate if using imiquimod as the active ingredient might improve rosacea?  Do you think any pharmaceutical company or other rosacea non profit organization would ever investigate this? How do you get 10K RRDi members to come together and  all agree that this should be done?  Maybe we might learn that some rosaceans somehow apply this imiquimod cream by diluting it with a moisturizer, coconut oil, shea butter, or something to see if this improves their rosacea. If so, then possibly, as this thread points out, could a virus be connected to rosacea?   End Notes  [1] Mosquito-borne diseases could be prevented by skin cream, Science Daily
    • Bacteriophage are a particular virus that are included in the human microbiome that "have been used for over 90 years as an alternative to antibiotics in the former Soviet Union and Central Europe as well as in France." Human Microbiome, Brady Barrows Some researchers are trying to find foods that encourage bacteriophage to act as an antibiotic in the gut, for example, stevia, they say as the "most potent prophage inducer" and explains, "The ability to kill specific bacteria, without affecting others, makes these compounds very interesting." "These findings are important. Scientists now know that the microbiome can influence our physical and mental health; it can also cause inflammation and increase cancer risk. If scientists can work out how to alter the microbiome in specific ways, they can, in theory, remove or reduce these risks." Common foods alter gut bacteria by influencing viruses, MedicalNewsToday
    • "Retinoids have the potential to cause varying degrees of myositis and their rapid identification could prevent major complications." Source
    • Related Articles Anticancer effect of Amygdalin (vitamin B17) on hepatocellular carcinoma cell line(HepG2) in the presence and absence of Zinc. Anticancer Agents Med Chem. 2020 Jan 19;: Authors: El-Desouky MA, Fahmi AA, Abdelkader IY, Nasraldin KM Abstract BACKGROUND: Amygdalin (Vitamin B-17) is a naturally occurring vitamin found in the seeds of the fruits of Prunus Rosacea family including apricot, bitter almond, cherry, and peach. OBJECTIVE: The purpose of this study was to examine the effect of amygdalin with and without zinc on hepatocellular carcinoma (HepG2) cell line. METHODS: MTT assay was used to evaluate the cytotoxicity of amygdalin without zinc, amygdalin + 20µmol zinc, and amygdalin + 800µmol zinc on HepG2 cell lines. The cell cycle distribution assay was determined by flow cytometry. Apoptosis was confirmed by Annexin V-FITC/PI staining assay. Moreover, the pathway of apoptosis was determined by the percentage of change in the mean levels of P53, Bcl2, Bax, cytochrome c, and caspase-3. RESULTS: Amygdalin without zinc showed a strong anti-HepG2 activity. Furthermore, HepG2 cell lines treatment with amygdalin + 20µmol zinc and amygdalin + 800µmol zinc showed a highly significant apoptotic effect than the effect of amygdalin without zinc. Amygdalin treatment induced the cell cycle arrest at G2/M and increased the levels of P53, Bax, cytochrome c, and caspase-3 significantly, while it decreased the level of anti-apoptotic Bcl2. CONCLUSION: Amygdalin is a natural anti-cancer agent which can be used for the treatment of hepatocellular carcinoma. It promotes apoptosis via the intrinsic cell death pathway (the mitochondria-initiated pathway) and cell cycle arrest at G/M. The potency of amygdalin in HepG2 treatment increased significantly by the addition of zinc. PMID: 31958042 [PubMed - as supplied by publisher] {url} = URL to article
    • Related Articles Myositis Induced by Isotretinoin: A Case Report and Literature Review. Am J Case Rep. 2020 Jan 20;21:e917801 Authors: Rivillas JA, Santos Andrade VA, Hormaza-Jaramillo AA Abstract BACKGROUND Retinoid-induced myositis is a rare condition encountered in clinical practice. Its occurrence implies a diagnostic challenge due to the multiple causes associated with myopathic syndromes. The most common clinical presentation is generalized affection. Focal myositis is even less frequent and easily misdiagnosed as muscular disease of other etiology. CASE REPORT We describe a case of 45-year-old male with a history of nephrolithiasis and rosacea diagnosed by dermatology, who was management with isotretinoin 1 mg/kg per day in 2 doses with clinical improvement. Later, he presents muscle pain in the upper limbs with marked functional limitation associated by choluria, without muscular pains in other location; he had no history of using another medication. At his physical examination, vital signs were normal, with edema and pain in the bilateral bicipital region associated with limitation for flexion-extension of shoulders and elbows and high levels of creatine phosphokinase (CPK). He was transferred to the intensive care unit where he received fluid therapy because of the high risk of deterioration of renal function, very high CPK levels, and a history of obstructive uropathy. One year after this hospitalization, the cutaneous symptoms worsened and the patient voluntarily restarted isotretinoin and 5 months later he presented again with the same symptoms of the first episode. CONCLUSIONS Drug-induced myositis should be taken into consideration in the differential diagnosis of myopathic syndromes. Retinoids have the potential to cause varying degrees of myositis and their rapid identification could prevent major complications. PMID: 31958335 [PubMed - in process] {url} = URL to article
    • Ok so it has been a long journey for you with respect to rosacea. Yes this theory does not go completely with only fair skin people get rosacea. There are some published research on rosacea in skin of color people. I am an Indian and I also have olive skin with yellow undertone and the bizarre thing is Indian skin is something very acclimatized to sun rays because of its extreme hot and humid climate and we do not get easily anything related to skin but when I got this condition five years ago it was unknown to me and initially it was in an exaggerated condition difficult to control and handle but gradually I understood with trial and error considering my diet what I eat what I apply on my face and environmental and immune conditions. Now still it remits and relapses with frequent episodes but now I know how to manage it.
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