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    • rss
      PubMed RSS Feed - -Rosacea in East Asian populations: Clinical manifestations and pathophysiological perspectives for accurate diagnosis

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      J Dermatol. 2024 Aug 10. doi: 10.1111/1346-8138.17411. Online ahead of print. ABSTRACT Rosacea is a chronic inflammatory disorder primarily affecting the facial skin, prominently involving the cheeks, nose, chin, forehead, and periorbital area. Cutaneous manifestations encompass persistent facial erythema, phymas, papules, pustules, telangiectasia, and flushing. The pathogenesis of rosacea is associated with various exacerbating or triggering factors, including microbial infestation, temperature fluctuations, sunlight exposure, physical exertion, emotional stress, consumption of hot beverages and spicy foods, and exposure to airborne pollen. These environmental factors interact with genetic predispositions in the development of rosacea. The roles of the lipophilic microbiome, ultraviolet radiation, nociceptive responses, and vascular alterations have been proposed as significant factors in the pathogenesis. These insights contribute to understanding the anatomical specificity of facial involvement and the progressive nature of rosacea. East Asian skin, predominantly classified as Fitzpatrick skin phototypes III to IV, is characterized by relatively diminished skin barrier function and increased sensitivity to irritants. Airborne pollen exposure may particularly act as a trigger in East Asian individuals, possibly mediated through toll-like receptors. The lack of specificity in objective clinical and histopathological findings leads to diagnostic challenges for individuals with colored skin, including East Asians, particularly when erythema is the sole objective manifestation. An alternative diagnostic scheme may thus be necessary. A diagnostic approach emphasizing vascular manifestations and nociceptive symptoms potentially holds promise for individuals with darker skin tones. More research focusing on potential variations in skin physiology across different racial groups is essential to establish more effective diagnostic schemes applicable to both dark and light skin colors. PMID:39126257 | DOI:10.1111/1346-8138.17411 {url} = URL to article
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      PubMed RSS Feed - -Important Roles of Interleukin-36, Interleukin-37, and Interleukin-38 Cytokines in the Pathogenesis of Rosacea

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      Indian J Dermatol. 2024 May-Jun;69(3):232-237. doi: 10.4103/ijd.ijd_470_23. Epub 2024 Jun 26. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory skin disease. Previous studies have determined that IL-36, IL-37, and IL-38 may play a role in the pathogenesis of various inflammatory diseases. AIMS AND OBJECTIVES: The present study aims to evaluate the relationship of these cytokines with rosacea. MATERIALS AND METHODS: A total of 100 individuals, including 50 patients with rosacea and 50 healthy controls, were included in the study. IL-36, IL-37, and IL-38 levels were measured using the ELISA method by taking serum samples from all participants. RESULTS: The mean serum levels of IL-36, IL-37, and IL-38 in the patient group were 52.17 ± 24.07 pg/ml, 18.46 ± 8.18 pg/ml, and 25.74 ± 8.36 ng/l, respectively. The mean serum levels of IL-36, IL-37, and IL-38 in the control group were 32.99 ± 19.90 pg/ml, 44.61 ± 22.27 pg/ml, and 45.61 ± 17.32 ng/l, respectively. The difference between the serum levels of IL-36, IL-37, and IL-38 in the patient and control groups was statistically significant (P < 0.001). CONCLUSION: Based on these findings, an increase in IL-36 and a decrease in IL-37 and IL-38 may contribute to the pathogenesis of rosacea. Future rosacea treatments could target and/or interact with these possible steps in the pathogenesis of rosacea. PMID:39119329 | PMC:PMC11305503 | DOI:10.4103/ijd.ijd_470_23 {url} = URL to article
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      PubMed RSS Feed - -Antibody immune responses and causal relationships in four immune skin diseases: Evidence from Mendelian randomization and Bayesian Weighting (Antibody Responses in Skin Diseases: MR & Bayesian)

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      Skin Res Technol. 2024 Aug;30(8):e13875. doi: 10.1111/srt.13875. ABSTRACT BACKGROUND: Recent studies increasingly suggest that microbial infections and the immune responses they elicit play significant roles in the pathogenesis of chronic inflammatory skin diseases. This study uses Mendelian randomization (MR) and Bayesian weighted Mendelian randomization (BWMR) to explore the causal relationships between immune antibody responses and four common skin diseases: psoriasis, atopic dermatitis (AD), rosacea, and vitiligo. METHODS: We utilized summary statistics from genome-wide association studies (GWAS) for antibody responses to 13 infectious pathogens and four skin diseases. Single nucleotide polymorphisms (SNPs) were selected as instrumental variables (IVs) to assess causal relationships using multiple MR methods, including inverse variance weighted (IVW), MR Egger, and weighted median. BWMR was also employed to confirm findings and address potential pleiotropy. RESULTS: The IVW analysis identified significant associations between specific antibody responses and the skin diseases studied. Key findings include protective associations of anti-Epstein-Barr virus (EBV) IgG seropositivity and Helicobacter pylori UREA antibody levels with psoriasis and AD. anti-chlamydia trachomatis IgG seropositivity, anti-polyomavirus 2 IgG seropositivity, and varicella zoster virus glycoprotein E and I antibody levels were negatively associated with rosacea, while EBV Elevated levels of the early antigen (EA-D) antibody levels and HHV-6 IE1B antibody levels were positively associated with rosacea. H. pylori Catalase antibody levels were protectively associated with vitiligo, whereas anti-herpes simplex virus 2 (HSV-2) IgG seropositivity was positively associated with vitiligo. The BWMR analysis confirmed these associations. CONCLUSION: This study underscores the significant role of H. pylori and other pathogens in these skin diseases, suggesting both protective and exacerbating effects depending on the specific condition. Understanding these pathogen-immune interactions can lead to the development of more effective, personalized treatments and preventative strategies, ultimately improving patient outcomes and quality of life. PMID:39120064 | PMC:PMC11311118 | DOI:10.1111/srt.13875 {url} = URL to article
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      PubMed RSS Feed - -Adiponectin prevents skin inflammation in rosacea by suppressing S6 phosphorylation in keratinocytes

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      J Invest Dermatol. 2024 Aug 7:S0022-202X(24)01982-1. doi: 10.1016/j.jid.2024.07.018. Online ahead of print. ABSTRACT Numerous recent evidence highlights epidemiological connections between rosacea and metabolic disorders. However, the precise path through which metabolic factors impact rosacea risk is still unclear. Therefore, this study aims to investigate the role of adiponectin, a crucial adipokine that regulates metabolic homeostasis, in the pathogenesis of rosacea. We elucidated a detrimental feedback loop between rosacea-like skin inflammation and decreased levels of skin adiponectin. To elaborate, rosacea lesional skin exhibits diminished adiponectin expression compared to non-lesional areas in the same patients. Induction of rosacea-like inflammation reduced adiponectin levels in the skin by generating inflammatory cytokines that suppress adiponectin production from subcutaneous adipocytes. Conversely, complete depletion of adiponectin exacerbated rosacea-like features in the mouse model. Mechanistically, adiponectin deficiency led to heightened S6 phosphorylation, a marker of the mTORC1 signaling pathway, in the epidermis. Adiponectin significantly inhibited S6 phosphorylation in cultured keratinocytes. Notably, replenishing adiponectin whole protein or topically applying an agonist for adiponectin receptor 1 successfully improved rosacea-like features in mice. This study contributes to understanding the role of adiponectin in skin inflammation associated with rosacea pathophysiology, suggesting that restoring adiponectin function in the skin could be a potential therapeutic strategy. PMID:39122145 | DOI:10.1016/j.jid.2024.07.018 {url} = URL to article
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      PubMed RSS Feed - -Bisphenol-A and pentachlorophenol sodium levels in patients with rosacea

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      Cutan Ocul Toxicol. 2024 Aug 8:1-5. doi: 10.1080/15569527.2024.2383242. Online ahead of print. ABSTRACT BACKGROUND/ OBJECTIVES: Rosacea is a common chronic inflammatory skin disorder. Endocrinedisrupting chemicals (EDC) are toxic substances, that may gain entry through the skin and subsequently interfere with hormonal and immune functions. Bisphenol A (BPA) and pentachlorophenol sodium (PCS) are two of these EDCs, incriminated in the pathogenesis of certain inflammatory skin disorders. We aimed to test the hypothesis that exposure to BPA and PCS might be involved in the pathogenesis of rosacea. METHODS: This prospective cross-sectional study involved 34 patients with rosacea (18F/16 M; mean age 48.5 ± 11 years) and 34 age and sex-matched healthy controls (20 F/14 M; mean age 48.2 ± 10.2 years). Main anthropometric measures, fasting plasma glucose (FPG), insulin, HOMA-IR, lipids, C-reactive protein (CRP), BPA, and PCS levels were quantified and recorded. RESULTS: Serum CRP (9.6 ± 3.4 vs. 3.7 ± 1.6 mg/L, respectively, p0.05 for all). Serum BPA levels were 55.8 ± 14.4 and 51.9 ± 19.2 ng/mL, and PCS levels were 63.3 ± 45.9 ng/mL and 68.6 ± 40.8 ng/mL for patients and healthy controls, respectively. There was no significant difference in BPA and PCS levels between the two groups (p > 0.05 for both). No significant association was found among HOMAIR, CRP, BPA, and PCS levels (p > 0.05 for all). CONCLUSIONS: Although the present study fails to provide presumptive evidence for the role of BPA and PCS in rosacea, the question as to other EDCs might be involved in its etiopathogenesis remains. This hypothesis requires confirmation in large-scale future prospective trials. PMID:39113570 | DOI:10.1080/15569527.2024.2383242 {url} = URL to article
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      PubMed RSS Feed - -Validación transcultural al idioma español de la escala RosaQoL

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      Actas Dermosifiliogr. 2024 Aug 5:S0001-7310(24)00647-1. doi: 10.1016/j.ad.2024.02.035. Online ahead of print. ABSTRACT INTRODUCTION: Rosacea is a chronic disease negatively impacting the patients' quality of life and mental health. The Rosacea Quality of Life (RosaQoL) scale could be a useful tool to monitor patients while on therapy vs rosacea, as it measures the impact on quality of life and helps individualize treatment to meet the patients' needs. RosaQoL is a validated scale that can be completed within a few minutes. MATERIALS AND METHODS: The original scale was translated and back translated by 2 native translators, with input from an expert committee when necessary. This version was tested on 21 patients to ensure proper understanding. Psychometric characteristics and validity were determined using various measures (sensitivity and specificity via ROC curve and internal consistency via Cronbach's alpha). The correlation between RosaQoL and SF-12 scales was assessed using Pearson correlation coefficients. RESULTS: A total of 531 participants responded to the scale (481 with rosacea and 50 controls). The scale demonstrated excellent sensitivity and specificity (ROC curve, 0.96; 95%CI, 0.92-0.99) and high internal consistency (Cronbach's alpha, 0.96). RosaQoL correlated with SF-12. A higher score on the RosaQoL scale was associated with worse quality of life in all dimensions of the SF-12 scale. CONCLUSIONS: The Spanish version of the RosaQoL scale exhibits psychometric characteristics, which are similar to the original scale. Also, the RosaQoL scale is useful to assess the quality of life of patients with rosacea. PMID:39111573 | DOI:10.1016/j.ad.2024.02.035 {url} = URL to article
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      PubMed RSS Feed - -Screening of Diagnostic Biomarkers and Immune Infiltration Characteristics Linking Rheumatoid Arthritis and Rosacea Based on Bioinformatics Analysis

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      J Inflamm Res. 2024 Aug 1;17:5177-5195. doi: 10.2147/JIR.S467760. eCollection 2024. ABSTRACT INTRODUCTION: Both rheumatoid arthritis (RA) and rosacea represent common chronic systemic autoimmune conditions. Recent research indicates a heightened RA risk among individuals with rosacea. However, the molecular mechanisms linking these diseases remain largely unknown. This study aims to uncover shared molecular regulatory networks and immune cell infiltration patterns in both rosacea and RA. METHODS: The gene expression profiles of RA (GSE12021, GSE55457), and the rosacea gene expression profile (GSE6591), were downloaded from Gene Expression Omnibus (GEO) databases, and obtained to screen differentially expressed genes (DEGs) by using "limma" package in R software. Various analyses including GO, KEGG, protein-protein interaction (PPI) network, and weighted gene co-expression network analyses (WGCNA) were conducted to explore potential biological functions and signaling pathways. CIBERSORT was used to assess the abundance of immune cells. Pearson coefficients were used to calculate the correlations between overlapped genes and the leukocyte gene signature matrix. Flow cytometry (FCM) analysis confirmed the most abundant immune cells detected in rheumatoid arthritis and rosacea. Receiver operator characteristic (ROC) analysis, enzyme-linked immunosorbent assay (ELISA), and qRT-PCR were used to confirm biomarkers and functions. RESULTS: Two hundred seventy-seven co-expressed DEGs were identified from these datasets. Functional enrichment analysis indicated that these DEGs were associated with immune processes and chemokine-mediated signaling pathways. Fourteen and 17 hub genes overlapped between cytoHubba and WGCNA were identified in RA and rosacea, respectively. Macrophages and dendritic cells were RA and rosacea's most abundant immune cells, respectively. The ROC curves demonstrated potential diagnostic values of CXCL10 and CCL27, showing higher levels in the serum of patients with RA or rosacea, and suggesting possible regulation in the densities and functions of macrophages and dendritic cells from RA and rosacea, which were validated by FCM and qRT-PCR. CONCLUSION: Importantly, our findings may contribute to the scientific basis for biomarkers and therapeutic targets for patients with RA and rosacea in the future. PMID:39104909 | PMC:PMC11299729 | DOI:10.2147/JIR.S467760 {url} = URL to article
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      PubMed RSS Feed - -Successful Rhinophyma Treatment Utilizing the Versajet II Hydrosurgery System: A Case Report and Systematic Review of the Literature

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      Cureus. 2024 Jul 5;16(7):e63921. doi: 10.7759/cureus.63921. eCollection 2024 Jul. ABSTRACT Rhinophyma, characterized by hypertrophy of sebaceous glands, often necessitates surgical intervention. This is the second case report of the off-label use of the Versajet II Hydrosurgery System (VJHS) (Smith & Nephew, London, UK) in the United States for the treatment of rhinophyma and the first systematic review of the literature, emphasizing its efficacy and safety for this indication. A surgical debulking and resurfacing was performed on a patient with rhinophyma. The patient underwent general anesthesia along with bilateral infraorbital blocks and local infiltration of lidocaine 1% with epinephrine. The VJHS was utilized for progressive debulking followed by debridement using sharp instruments until the desired nasal form and contour were achieved. Hemostasis was obtained through monopolar electrocautery and topical hemostatic agents. The patient exhibited excellent nasal shape and healing following VJHS debulking and without perioperative complications, suggesting both the effectiveness and safety of the VJHS in rhinophyma treatment. A literature review was conducted using the PubMed Central database. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, employing inclusion and exclusion criteria, were utilized to narrow down results to include original studies discussing rhinophyma surgical debridement with the VJHS. Six articles were included in the review for results analysis. This case report aligns with findings from international literature, emphasizing the versatility of the VJHS in rhinophyma treatment. Notably, this report marks the second documented off-label use of the VJHS in the United States for rhinophyma. The success of this case reinforces the potential of the VJHS in treating rhinophyma. This innovative approach yielded promising outcomes in several international reports. Further research is warranted to establish a standardized protocol to validate the long-term benefits of this technology applied to rhinophyma patients. PMID:39104983 | PMC:PMC11298325 | DOI:10.7759/cureus.63921 {url} = URL to article
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      PubMed RSS Feed - -Rosacea Epidemiological Investigation and Etiology Exploration in the Plateau Area

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      Ann Plast Surg. 2024 Aug 1;93(2S Suppl 1):S55-S58. doi: 10.1097/SAP.0000000000003999. ABSTRACT BACKGROUND: The epidemiology of 2 neighboring cities of differing altitude in Northwest China is unknown. The present study investigated the prevalence of rosacea in a high-altitude city and a low-altitude city. METHODS: The prevalence study was conducted via clinical examination of male and female participants in the following age groups: 5-17, 18-30, 31-50, and 51-70 years. Rosacea subtype was also determined as erythematotelangiectatic rosacea (ETTR) or papulopustular rosacea (PPR). RESULTS: The rosacea prevalence (RP) in the low-altitude city was 33.8% ± 1.2% (95% CI, ETTR = 1794, PPR = 174, n = 5794). RP in the high-altitude city has a notably higher reading of 47.7% ± 1.4% (95% CI, ETTR = 2090, PPR = 219, n = 4796). In both cities, the ETTR subtype predominated, and there was marked increase in RP among females. RP in low-altitude city females was steady across all age groups, while RP in low-altitude city males showed a declining trend with age. RP in high-altitude city females indicated a slightly increasing trend with age, while RP in males again showed a declining trend with age. Based on the results of this high-altitude city and low-altitude city study, there are an estimated 2.1 million people with rosacea, from 2 cities with a total population of 5.4 million. CONCLUSIONS: Due to the high altitude and accompanying increased UV radiation, cold climate, and reduced oxygen density, the greater northwest region of China is expected to experience high RP rates. PMID:39101850 | DOI:10.1097/SAP.0000000000003999 {url} = URL to article
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      PubMed RSS Feed - -A comparative exploration of immunohistochemical markers in patients with papulopustular rosacea undergoing treatment with oral isotretinoin versus doxycycline

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      Int J Dermatol. 2024 Aug 4. doi: 10.1111/ijd.17420. Online ahead of print. ABSTRACT BACKGROUND: Rosacea is a chronic inflammatory disease, and doxycycline is a widely recommended treatment for it due to its anti-inflammatory action. Oral isotretinoin reduces sebaceous gland activity and modulates toll-like receptors, reducing inflammation. Our aim was to investigate the effect of these two drugs on the expression of cutaneous immunohistochemical biomarkers related to etiopathogenic factors involved in rosacea. METHODS: We conducted a randomized, comparative, and evaluator-blinded trial, including 40 participants with moderate and severe papulopustular and ocular rosacea. Participants were treated with doxycycline (DOXY) 100 mg or isotretinoin (ISO) 0.3 mg/kg daily. Immunohistochemistry at baseline and after 4 months was used to demonstrate the expression of the biomarker on the affected skin. RESULTS: The following changes were detected: a reduction in the vessel count after using VEGF with DOXY (P = 0.010); a decrease in VEGF intensity with ISO (P < 0.001) and DOXY (P = 0.020); a reduction of nitric oxide synthase enzyme with both drugs in the inflammatory infiltrate (ISO P < 0.001; DOXY P = 0.003); however, only with ISO was there a significant (P = 0.030) decrease at the level of the sebaceous glands, indicating a reduction of nitric oxide synthesis; a reduction of TRPV-1 expression at the level of the sebaceous glands was observed only with DOXY (P = 0.041); a decrease of cathelicidin LL37 expression, a key antimicrobial peptide in the etiopathogenesis of rosacea, was noted with both drugs, although at the level of sebaceous glands, only with DOXY (P = 0.007). CONCLUSIONS: Oral isotretinoin and doxycycline have modified the expression of cutaneous biomarkers related to rosacea etiopathogenesis, demonstrating their role in controlling inflammatory and vascular processes. PMID:39097930 | DOI:10.1111/ijd.17420 {url} = URL to article
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      PubMed RSS Feed - -Exploring the influencing factors on acne, melasma, and rosacea: A case-control study in China

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      J Cosmet Dermatol. 2024 Aug 2. doi: 10.1111/jocd.16499. Online ahead of print. ABSTRACT BACKGROUND: The severity and treatment response of acne, melasma, and rosacea may be influenced by various currently unclear internal and external factors. This study aimed to provide evidence to the influencing factors for the mentioned conditions through a real-world case-control study. METHODS: An online survey consisting of 60 questions was implemented, collecting information on demographics, socioeconomics, genetic factors, lifestyle habits, environmental exposures, and skin care behaviors. Then we constructed univariate and multivariate logistic regressions. Furthermore, we analyzed the dose-response relationship between exposure and outcome. RESULTS: A total of 399 individuals, including 94 acne patients, 107 melasma patients, and 91 rosacea patients were included. Acne and melasma were positively correlated with screen time (acne: odds ratio [OR]: 2.24, 95% confidence interval [CI]: 1.25-4.02; melasma: OR: 1.59, 95% CI: 1.09-2.31), while exercise exerted a protective effect on both acne (OR: 0.31, 95% CI: 0.13-0.77) and melasma (OR: 0.42, 95% CI: 0.22-0.80) in a dose-response relationship. In addition, males were associated with an elevated risk of acne (OR: 6.62, 95% CI: 1.01-43.26). Aging (OR: 1.15, 95% CI: 1.07-1.24) and irregular bowel movements (OR: 2.99, 95% CI: 1.11-8.08) were independent risk factors for melasma. Rosacea was positively associated with BMI (OR: 1.17, 95% CI: 1.01-1.35). CONCLUSION: In our study, we highlighted exercise as an independent protective factor for both acne and melasma in a dose-response trend. Inversely, extended use of electronic equipment was independently associated with higher risks of acne and melasma. Rosacea, however, was more likely to be related with BMI. PMID:39092840 | DOI:10.1111/jocd.16499 {url} = URL to article
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      PubMed RSS Feed - -The Burden of Melasma: Race, Ethnicity, and Comorbidities

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      J Drugs Dermatol. 2024 Aug 1;23(8):691-693. doi: 10.36849/JDD.8233. ABSTRACT INTRODUCTION: In an effort to define the characteristics of populations affected by melasma, we utilized a large global health research network database from 108 health care organizations (TriNetx) to quantify the associations between race, ethnicity, and comorbidities. METHODS: We identified the cohort of all patients with melasma from the TriNetx database, and subsequently generated a control cohort. ICD-10 codes were used to identify the prevalence of various comorbidities associated with melasma. RESULTS: A total of 41,283 patients with melasma (93% female, mean [SD] age 48.8 [12.6] year) were identified. The most frequently associated risk factors included hypertension (25% of the melasma cohort) and hormonal contraception (24%). Rosacea (OR=5.1), atopic dermatitis (OR=3.3), lupus (OR=2.5), history of skin cancer (OR=2.5), history of internal malignancy (OR=2.1), and hormonal contraception use (OR=2.1) possessed the highest odds ratios for development of melasma (all P&lt; 0.01). A statistically significant association was identified for melasma in Asian or Other/Unknown races (OR=2.0 and OR=1.7, P&lt; 0.01), as well as Hispanic ethnicity (OR=1.3, P&lt; 0.01). White, Black/African American, and Not Hispanic groups all revealed slightly lower odds (all 0.8, P&lt; 0.01). CONCLUSION: This latest global update on the etiopathology of melasma further supports findings from prior epidemiologic study reporting preference in melanized phenotypes (Fitzpatrick skin type III-V), but less so in extreme skin types (I, II, VI). Increased associations with rosacea, atopic dermatitis, and history of cancer may emphasize the importance of treating concurrent inflammatory environments and the consideration of more frequent malignancy surveillance. J Drugs Dermatol. 2024;23(8):691-693.&nbsp; doi:10.36849/JDD.8233. PMID:39093647 | DOI:10.36849/JDD.8233 {url} = URL to article
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      PubMed RSS Feed - -Treatment of Common Dermatologic Conditions

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      Med Clin North Am. 2024 Sep;108(5):795-827. doi: 10.1016/j.mcna.2024.02.002. Epub 2024 Jun 12. ABSTRACT Dermatologic concerns are discussed in about a third of all primary care visits. This review discusses treatments for common dermatologic diagnoses addressed in primary care settings, with an emphasis on new and emerging treatments. Topical, oral, and injectable treatment of common forms of alopecia, facial rashes, atopic dermatitis, psoriasis, seborrheic dermatitis, and stasis dermatitis will be discussed to help increase comfort in prescribing and alert providers to common side effects or complications of more intensive treatments used by dermatologists. PMID:39084835 | DOI:10.1016/j.mcna.2024.02.002 {url} = URL to article
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      PubMed RSS Feed - -Drug-Induced Rosacea: A Systematic Review

      By rss · Posted

      J Cutan Med Surg. 2024 Jul 29:12034754241265719. doi: 10.1177/12034754241265719. Online ahead of print. NO ABSTRACT PMID:39075665 | DOI:10.1177/12034754241265719 {url} = URL to article
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      PubMed RSS Feed - -Presence of Demodex spp. on the face and scalp in patients affected by papulopustular rosacea of face

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      Ital J Dermatol Venerol. 2024 Aug;159(4):425-429. doi: 10.23736/S2784-8671.24.07877-0. ABSTRACT BACKGROUND: The increased proliferation of Demodex mites in the pilosebaceous unit can be the cause of rosacea flare-ups on the face. Signs and symptoms of the scalp (e.g., itching, dandruff) have sometimes been reported in patients with papulopustular rosacea of face; they may be due to a proliferation of Demodex mites on the scalp. METHODS: To study the Demodex mites count, a standardized skin surface biopsy was performed on the cheek and on the scalp. Microscopic examination and molecular identification of Demodex were performed. Pearson's χ2 Test or Fisher's Exact Test were used to test for any association between categorical variables and outcome. RESULTS: Patients affected by papulopustular rosacea had a greater frequency of Demodex-positive standardized skin surface biopsy than controls at the scalp (35.0% vs. 0%, P=0.033), at the face and/or at the scalp (50% vs. 10%, P=0.032). Demodex positive patients with a Demodex-positive face sample were more frequently found to have a Demodex-positive scalp sample (P=0.035). The predominant species was found to be Demodex folliculorum (92.6% of samples); the species Demodex brevis was identified only in 7.4% of samples. CONCLUSIONS: Demodex folliculorum is more frequently found on the scalp and face of patients with rosacea than controls, even though it is not statistically associated with scalp symptoms. The scalp may be a reservoir area for Demodex mites which could migrate on the face again after an acaricidal treatment. PMID:39069840 | DOI:10.23736/S2784-8671.24.07877-0 {url} = URL to article
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      PubMed RSS Feed - -Investigation of the effect of adapalene 0.3%/benzoyl peroxide 2.5% gel in Korean patients with acne: a randomized, double-blind clinical trial, with a histopathological and immunohistochemical study

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      Ital J Dermatol Venerol. 2024 Aug;159(4):444-452. doi: 10.23736/S2784-8671.24.07800-9. ABSTRACT BACKGROUND: Acne vulgaris poses significant physical and psychological challenges worldwide. Data of adapalene 0.3%/benzoyl peroxide 2.5% gel (A0.3/BPO2.5) for acne treatment in Asian patients is limited. METHODS: In this randomized double-blind clinical trial, 49 Korean patients with moderate-to-severe acne and scars were assigned to the A0.3/BPO2.5 (N.=37) or vehicle (N.=12) group. Acne and acne scar severity scores were assessed at baseline and 4, 8, 12, and 24 weeks. The primary outcomes were treatment success rate (reduction of ≥2 Investigator's Global Assessment grade and reaching a grade of 0 or 1) and proportional acne lesion and scar count reduction against the baseline. To assess histological changes, 2-mm punch biopsies were performed at baseline and week 24 on the respective inflammatory lesions or scars. RESULTS: At week 24, the A0.3/BPO2.5 group had a significantly higher treatment success rate than the vehicle group. The total acne count, inflammatory lesion count, and non-inflammatory lesion count percentages (against baselines) with A0.3/BPO2.5 and the vehicle were 12.1% vs. 96.7%, 8.0% vs. 101.2%, and 13.3% vs. 98.9%, respectively (all P<0.001). Scar count percentages (against baselines) with A0.3/BPO2.5 and the vehicle were 27.3% and 96.5%, respectively (P<0.001). Significant elevations in collagen 1 and 3, elastin, CK15, and p63 levels, with increases of 172.7%, 230.6%, 176.5%, 286.2%, and 105.9%, respectively, in comparison to baseline (all P<0.05). No major adverse events leading to discontinuation were observed. CONCLUSIONS: A0.3/BPO2.5 was an effective and safe treatment for acne and acne scars in Asian patients supported by robust histopathological and immunohistochemical evidence. PMID:39069843 | DOI:10.23736/S2784-8671.24.07800-9 {url} = URL to article
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      PubMed RSS Feed - -Lupus Miliaris Disseminatus Faciei: A Report of a Rare Case and Its Differential Diagnosis

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      Cureus. 2024 Jun 26;16(6):e63245. doi: 10.7759/cureus.63245. eCollection 2024 Jun. ABSTRACT Lupus miliaris disseminatus faciei (LMDF), often known as "acne agminata," is an uncommon illness that causes facial papules. Clinically, it has monomorphic reddish-brown, dome-shaped central papules with periorbital location. Histopathologically, a cutaneous granulomatous response is common around hair follicles and is accompanied by central necrosis. In the dermatology outpatient clinic, a 51-year-old woman had many tiny papules on her right side malar area for one to two months. Few of them started to regress and demonstrated healing with superficial scarring. The pathology showed a granulomatous response on microscopy, and histology and clinical correlation confirmed the case as Lupus miliaris disseminatus faciei. LMDF must be distinguished from tuberculous granuloma, granulomatous rosacea, and perioral dermatitis. The patient was prescribed systemic dapsone and topical tacrolimus therapy, and the lesion improved at the follow-up visit. PMID:39070463 | PMC:PMC11281938 | DOI:10.7759/cureus.63245 {url} = URL to article
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      PubMed RSS Feed - -Investigation of Thiol/Disulfide Homeostasis and Clinical Parameters in Rosacea Patients According to Skin Subtypes

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      J Clin Med. 2024 Jul 11;13(14):4052. doi: 10.3390/jcm13144052. ABSTRACT Background/Objective: The aim of this study was to compare thiol/disulfide homeostasis and clinical parameters of rosacea patients across skin subtypes of the disease and healthy controls. Methods: This prospective study included 90 rosacea patients with different skin subtypes (phymatous, erythematotelangiectatic and papulopustular) and ocular involvement and 30 healthy controls. Plasma native thiol (NT), total thiol (TT) and disulfide levels of the patients and controls were measured using an automated spectrophotometric method, and disulfide/native thiol ratio (DNTR), disulfide/total thiol ratio (DTTR) and native thiol/total thiol ratio (NTTR) were calculated. Tear breakup time (TBUT), meiboscore, Schirmer, ocular surface disease index (OSDI) and rosacea-specific quality of life scale (RosaQoL) were measured clinically. Results: Disulfide, DNTR and DTTR were significantly higher, and NT, TT and NTTR were significantly lower in the rosacea patients compared to the controls (p < 0.001). TBUT and Schirmer were significantly lower, and meiboscore and OSDI were significantly higher in the patients compared to the controls (p < 0.01). According to the skin subtypes, disulfide, DNTR and DTTR were significantly higher, and NTTR was significantly lower in the erythematotelangiectatic subtype compared to the other subtypes (p < 0.002). TBUT was significantly lower, and RosaQol was significantly higher in the erythematotelangiectatic subtype (p < 0.0083). Strong correlations were found between DNTR and TBUT and between DNTR and Meiboscore in all subtypes (p < 0.005), while there were strong correlations between DNTR and OSDI and between DNTR and RosaQol only in the erythematotelangiectatic and papulopustular subtypes (p < 0.05). Conclusions: The thiol/disulfide homeostasis shifted towards disulfides, an indicator of oxidative stress in rosacea, and this was more pronounced in the erythematotelangiectatic subtype. The impairment in TBUT and RosaQol was also more prominent in the erythematotelangiectatic subtype and strongly associated with the DNTR. PMID:39064093 | PMC:PMC11277807 | DOI:10.3390/jcm13144052 {url} = URL to article
    • rss
      PubMed RSS Feed - -Association between Air Quality Index and the risk of rosacea: A Nationwide population-based Cohort Study

      By rss · Posted

      Clin Exp Dermatol. 2024 Jul 27:llae291. doi: 10.1093/ced/llae291. Online ahead of print. ABSTRACT BACKGROUND: Air pollution is associated with several inflammatory skin disorders. However, the association between air quality and rosacea remains unclear. OBJECTIVE: To investigate the association between air quality index and incidence of rosacea. METHODS: Overall, 21,709,479 participants without rosacea before 2008 were recruited from the Taiwan National Health Insurance Research Database. The long-term average air quality index (AQI) value for each participant was acquired from the Taiwan Air Quality Monitoring System Network and calculated from 2008/1/1 until the diagnosis of rosacea, withdrawal from the National Health Insurance, or December 31, 2018. RESULTS: We observed a significant association between AQI and the incidence of rosacea, with each unit elevation in AQI increasing the risk of rosacea by 5 %. Compared with the Q1 group, the Q2, Q3, and Q4 cohorts exhibited 1.82-fold, 4.48-fold and 7.22-fold increased risk of rosacea, respectively. Additionally, exposure to PM2.5, SO2 and CO increased the risk of rosacea, whereas exposure to PM10 was associated with a lower risk. CONCLUSION: This study supported a significant dose-response relationship between AQI and the incidence of rosacea. PMID:39067059 | DOI:10.1093/ced/llae291 {url} = URL to article
    • rss
      PubMed RSS Feed - -Extrafacial Rosacea-A Diagnostic Challenge

      By rss · Posted

      Indian Dermatol Online J. 2024 May 20;15(4):695-697. doi: 10.4103/idoj.idoj_571_23. eCollection 2024 Jul-Aug. NO ABSTRACT PMID:39050077 | PMC:PMC11265765 | DOI:10.4103/idoj.idoj_571_23 {url} = URL to article
    • rss
      PubMed RSS Feed - -Investigation of Choroidal Thickness and Choroidal Vascularity Index in Ocular Rosacea Patients According to Skin Subtypes

      By rss · Posted

      Photodiagnosis Photodyn Ther. 2024 Jul 23:104288. doi: 10.1016/j.pdpdt.2024.104288. Online ahead of print. ABSTRACT BACKGROUND: To compare the choroidal thickness (CT) and choroidal vascularity index (CVI) values in ocular rosacea (OR) patients across skin subtypes of the disease and healthy controls. METHODS: This prospective study included 90 eyes of 90 mild-moderate OR patients with different skin subtypes (30 phymatous, 30 papulopustular and 30 erythematotelangiectatic) and 30 eyes of 30 age-gender matched healthy volunteers. After obtaining the enhanced depth imaging optical coherence tomography images, the CT was measured at subfoveal, 1500μm nasal and 1500μm temporal to the fovea, and the CVI was calculated using Image J software in the subfoveal, nasal and temporal areas. RESULTS: There was no CT significant difference between OR patients and healthy controls in all regions (p>0.05). CVI values of OR patients were found to be significantly lower in the subfoveal, nasal and temporal regions compared to healthy controls (p=0.02, p=0.01, p=0.01, respectively). No CT difference was detected between the subtypes and healthy controls in all regions (p>0.05). Subfoveal-CVI was significantly lower in the phymatous subtype than the other subtypes and controls (p<0.05), while nasal and temporal-CVI were significantly lower in the phymatous and papulopustular subtypes than the erythematotelangiectatic subtype and controls. CONCLUSION: Our study demonstrated no difference between rosacea skin types and healthy controls in terms of CT. Phymatous and papulopustular subtypes were more likely to be affected by chronic inflammation with having lower CVI in most of the regions. Further studies are needed to investigate the association of inflammatory factors with CVI in OR. PMID:39053790 | DOI:10.1016/j.pdpdt.2024.104288 {url} = URL to article
    • rss
      PubMed RSS Feed - -Beyond the classic players: Mas-related G protein-coupled receptor member X2 role in pruritus and skin diseases

      By rss · Posted

      J Eur Acad Dermatol Venereol. 2024 Jul 23. doi: 10.1111/jdv.20249. Online ahead of print. ABSTRACT Chronic spontaneous urticaria (CSU), atopic dermatitis (AD), psoriasis and rosacea are highly prevalent inflammatory skin conditions which impose a significant burden on patients' quality of life. Their pathophysiology is likely multifactorial, involving genetic, immune and environmental factors. Recent advancements in the field have demonstrated the key role of mast cells (MC) in the pathophysiology of these conditions. The Mas-related G protein-coupled receptor X2 (MRGPRX2) has emerged as a promising non-IgE-mediated MC activation receptor. MRGPRX2 is predominately expressed on MC and activated by endogenous and exogenous ligands, leading to MC degranulation and release of various pro-inflammatory mediators. Mounting evidence on the presence of endogenous MRGPRX2 agonists (substance P, cortistatin-14, LL37, PAMP-12 and VIP) and its high expression among patients with CSU, AD, rosacea, psoriasis and chronic pruritus emphasizes the pathogenic role of MRGPRX2 in these conditions. Despite the currently available treatments, there remains a pressing need for novel drug targets and treatment options for these chronic inflammatory skin conditions. Here, we reviewed the pathogenic role of MRGPRX2 and its potential as a novel therapeutic target and provided an update on future research directions. PMID:39044547 | DOI:10.1111/jdv.20249 {url} = URL to article
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      PubMed RSS Feed - -Treatment of rosacea with upadacitinib and abrocitinib: case report and review of evidence for Janus kinase inhibition in rosacea

      By rss · Posted

      Front Immunol. 2024 Jul 9;15:1416004. doi: 10.3389/fimmu.2024.1416004. eCollection 2024. ABSTRACT INTRODUCTION: Conventional rosacea treatments are not uniformly pervasive, and the adverse reactions can potentially constrain their utility. The clinical use of JAK1 inhibitors upadacitinib and abrocitinib in the treatment of refractory rosacea has rarely been explored. CASE REPORT: We presented two cases of patients who received the JAK1 inhibitor upadacitinib and four cases of patients who received the JAK1 inhibitor abrocitinib for the treatment of refractory rosacea. DISCUSSION: The JAK1 inhibitors upadacitinib and abrocitinib may be promising medical options for patients with refractory rosacea. However, the long-term safety and efficacy of upadacitinib and abrocitinib require prospective controlled studies to assess them more comprehensively. PMID:39044833 | PMC:PMC11263021 | DOI:10.3389/fimmu.2024.1416004 {url} = URL to article
    • rss
      PubMed RSS Feed - -Symptomatic bradycardia associated with topical brimonidine gel (Mirvaso) administration: a case report

      By rss · Posted

      Eur Heart J Case Rep. 2024 Jul 10;8(7):ytae329. doi: 10.1093/ehjcr/ytae329. eCollection 2024 Jul. ABSTRACT BACKGROUND: Bradycardia can have a number of different aetiologies, including as a side effect of medications. Brimonidine is a rare, but recognized, cause of bradycardia. Brimonidine is indicated in the treatment of facial erythema in rosacea when given as topical brimonidine gel (Mirvaso). It may also be administered as eye drops for raised intraocular pressure in open-angle glaucoma and ocular hypertension. Brimonidine is an alpha-2 agonist, which if systemically absorbed can present with bradycardia, hypotension, and dizziness. The authors are unaware of any other case reports regarding topical administration of Mirvaso in an adult and symptomatic bradycardia. CASE SUMMARY: We present the case of a 78-year-old man with a background of rosacea, benign prostatic hyperplasia, and hypertension who had two separate admissions with symptomatic bradycardia. Electrocardiograms showed sinus bradycardia with AV block first degree, with rate recorded as low as 31 b.p.m. during a syncopal episode. These episodes of symptomatic bradycardia were intermittent and had a temporal association with topical administration of Mirvaso. He had no further episodes of bradycardia on discontinuation of Mirvaso and has remained symptom free for over 6 months. DISCUSSION: The topical administration of Mirvaso should be avoided to broken or inflamed skin. This is owing to the increased risk of systemic absorption, which as in this case report, may present with bradycardia. This case reiterates the importance of completing a full medication history including all topical and parenteral medications in patients with arrhythmia. PMID:39045525 | PMC:PMC11263871 | DOI:10.1093/ehjcr/ytae329 {url} = URL to article
    • rss
      PubMed RSS Feed - -Comparative transcriptome analysis of acne vulgaris, rosacea, and hidradenitis suppurativa supports high-dose dietary zinc as a therapeutic agent

      By rss · Posted

      Exp Dermatol. 2024 Jul;33(7):e15145. doi: 10.1111/exd.15145. ABSTRACT Acne vulgaris, rosacea, and hidradenitis suppurativa are enduring inflammatory skin conditions that frequently manifest with akin clinical attributes, posing a considerable challenge for their distinctive diagnosis. While these conditions do exhibit certain resemblances, they also demonstrate distinct underlying pathophysiological mechanisms and treatment modalities. Delving into both the molecular parallels and disparities among these three disorders can yield invaluable insights for refined diagnostics, effective management, and targeted therapeutic interventions. In this report, we present a comparative analysis of transcriptomic data across these three diseases, elucidating differentially expressed genes and enriched pathways specific to each ailment, as well as those shared among them. Specifically, we identified multiple zinc-binding proteins (SERPINA1, S100A7, S100A8, S100A9 and KRT16) as consistently highly upregulated genes across all three diseases. Our hypothesis suggests that these proteins could bind and sequester zinc, potentially leading to localized zinc deficiency and heightened inflammation. We identified high-dose dietary zinc as a promising therapeutic approach and confirmed its effectiveness through validation in an acne mouse model. PMID:39046322 | DOI:10.1111/exd.15145 {url} = URL to article
    • rss
      PubMed RSS Feed - -Detection of demodex mites in papulopustular rosacea using microscopic examination and polymerase chain reaction: a comparative case-control study

      By rss · Posted

      Arch Dermatol Res. 2024 Jul 23;316(7):485. doi: 10.1007/s00403-024-03228-1. ABSTRACT Demodex mite proliferation is frequently involved in the pathogenesis of rosacea. The gold standard for Demodex identification is microscopic examination on a standardized skin surface biopsy. However, this method of sampling can be distressing and painful, especially when performed on hairy sites. In this case-control study, we compared the sensitivity of PCR and microscopic examination in diagnosing a Demodex infestation. Moreover, we investigated the possible correlations between the presence of Demodex mites and clinical characteristics. In total, 20 patients affected by papulopustular rosacea and 10 controls were included. At both microscopic examination and PCR, patients with rosacea presented a greater prevalence of positive samples than controls at the scalp and at the face. Microscopy had sensitivity of 50% at the face and of 46.7% at the scalp. PCR had sensitivity of 93.75% at the face and of 86.7% at the scalp. The positivity of PCR was associated to a higher frequency of facial papules and pustules. Patients with positivity at the face had a more frequent positivity at the scalp. The scalp could represent a reservoir for the Demodex mites, and should be investigated by sensitive and painless methods. PCR performed on painlessly collected samples should be further investigated. PMID:39042262 | PMC:PMC11266235 | DOI:10.1007/s00403-024-03228-1 {url} = URL to article
    • rss
      PubMed RSS Feed - -JAAD Game Changers: "Clustering of autoimmune diseases in patients with rosacea"

      By rss · Posted

      J Am Acad Dermatol. 2024 Jul 19:S0190-9622(24)02499-X. doi: 10.1016/j.jaad.2024.07.1448. Online ahead of print. NO ABSTRACT PMID:39033980 | DOI:10.1016/j.jaad.2024.07.1448 {url} = URL to article
    • rss
      PubMed RSS Feed - -Five-blade scratcher for treating severe rhinophyma: A retrospective study

      By rss · Posted

      World J Clin Cases. 2024 Jul 16;12(20):4180-4190. doi: 10.12998/wjcc.v12.i20.4180. ABSTRACT BACKGROUND: Rhinophyma, a late-stage subtype of rosacea, is characterized by excessive sebaceous glands and connective tissue proliferation. Patients may experience respiratory disturbances and psychological distress that significantly affect their quality of life when excessive nasal hyperplasia obstructs the external nasal valves. Surgery is the treatment of choice for rhinophyma. However, excessive bleeding, scarring, pigmentation, and high recurrence rates frequently characterize current surgical methods. AIM: To evaluate the clinical effectiveness and recurrence rates after treating severe rhinophyma with the five-blade scratcher. METHODS: This study retrospectively analyzed the clinical records of 28 patients with severe rhinophyma rosacea. The Global Flushing Severity Score (GFSS), Clinician Erythema Assessment (CEA), Rhinophyma Severity Index (RHISI), Glasgow Benefit Inventory (GBI), and satisfaction scores were used to assess the recovery of patients at 6 months and 5 years, with the recurrence rate calculated at 5 years postoperatively. In addition, the levels of pro-inflammatory factors (TNF-α, IL-1β, and IL-6) in the serum of patients before and after surgery were detected by ELISA. RESULTS: The GFSS, CEA, and RHISI scores at 6 months and 5 years postoperatively were significantly lower than those preoperatively (P < 0.001 for both periods). Five-blade scratcher treatment greatly benefits patients as demonstrated by the GBI and patient satisfaction. A small number of patients (7/28, 25%) reported recurrence after surgical treatment for rhinophyma in our department that was not more serious than before treatment. The expression of pro-inflammatory factors (TNF-α, IL-1β, and IL-6) in the patient's serum was significantly reduced after surgery of five-blade scratcher. CONCLUSION: The five-blade scratcher treatment demonstrates notable advantages, including simplicity, safety, efficacy, and cost-effectiveness, coupled with reduced bleeding, minimized scarring, lower recurrence rates, reduced the level of pro-inflammatory factors and improved patient satisfaction. Consequently, this therapeutic modality exhibits a viable option for individuals afflicted with severe rhinophyma. PMID:39015915 | PMC:PMC11235531 | DOI:10.12998/wjcc.v12.i20.4180 {url} = URL to article

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