Rosacea

J Exp Bot. 2009 May 21; Encinas-Villarejo S, Maldonado AM, Amil-Ruiz F, de Los Santos B, Romero F, Pliego-Alfaro F, Muñoz-Blanco J, Caballero JLKnowledge of the molecular basis of plant resistance to pathogens in species other than Arabidopsis is limited. The function of Fa WRKY1, the first WRKY gene isolated from strawberry (Fragariaxananassa), an important agronomical fruit crop, has been investigated here. Fa WRKY1 encodes a IIc WRKY transcription factor and is up-regulated in strawberry following Colletotrichum acutatum infection, treatments with elicitors, and wounding. Its Arabidopsis sequence homologue, At WRKY75, has been described as playing a role in regulating phosphate starvation responses. However, using T-DNA insertion mutants, a role for the At WRKY75 and Fa WRKY1 in the activation of basal and R-mediated resistance in Arabidopsis is demonstrated. At wrky75 mutants are more susceptible to virulent and avirulent isolates of Pseudomonas syringae. Overexpression of Fa WRK...

Curr Opin Otolaryngol Head Neck Surg. 2009 May 21; Brodsky JPURPOSE OF REVIEW: Patients commonly present to the otolaryngologist for management of benign facial lesions. It is important to be able to both recognize these lesions and offer patients the most effective therapies currently available. Advances in the understanding and management of three of the more common benign skin lesions affecting the face will be addressed in this review, with a particular emphasis on the most current therapeutic options for each lesion. RECENT FINDINGS: Actinic keratosis can now be treated with photodynamic therapy or with many topical agents, as alternatives to traditional surgical techniques. Seborrheic keratosis, as well as actinic keratosis and rosacea, are now often treated with laser therapy. In addition, rosacea management now includes nonantimicrobial topical agents, such as azelaic acid, and a wider armamentarium of systemic agents. SUMMARY: An understanding of these options will allow the ...

Int Ophthalmol. 2009 May 23; Jain V, Shome D, Sajnani M, Natarajan SIn order to report fungal keratitis in patients of ocular rosacea, a retrospective review of all cases of fungal keratitis was undertaken. Cases in which ocular rosacea coexisted were identified and included in the study. The clinical course of patients thus identified was studied from the medical records and outcomes were evaluated. A total of three cases of fungal keratitis with coexisting ocular rosacea were identified. All three patients were known cases of acne rosacea with an intermittent, irregular treatment for the same. Previous history of contact lens use, ocular surgery or trauma was not present in any of the cases. Microbiological evaluation revealed Aspergillus flavus as the causative organism in two patients and an unidentified hyaline fungus in the third. Patients received simultaneous therapy for fungal keratitis and ocular rosacea. The ocular surface completely stabilized and the infiltrate resolved i...

J Cosmet Laser Ther. 2009 May 22; 1-3Menezes N, Moreira A, Mota G, Baptista ABackground: Rosacea is a chronic inflammatory eruption of the face that may significantly impair patients' lives, leading to considerable emotional distress and behavioral withdrawal from normal social interactions. The pulsed dye laser is a device that selectively targets oxyhemoglobin with proved efficacy in the treatment of vascular lesions, especially at purpuric doses. Objective: We decided to evaluate the impact of the pulsed dye laser on rosacea patients' quality of life using the Dermatology Life Quality Index (DLQI) score. Methods: Twenty-two patients with erythematotelangiectatic rosacea were enrolled in the study. They were asked to complete a DLQI questionnaire before and after three treatments. Erythema improvement was subjectively evaluated by two investigators who ranked it as equal, better or worse after the three treatments. Results: A statistically significant improvement was observe...

Inflammations of the conjunctiva represent some of the most frequent eye diseases in general and ophthalmologic practice. Etiologically multiple diseases can be identified. A group of infectious conjunctivites contrasts with a very hereogeneous non-infectious group. Neoplastic processes such as low grade epithelial dysplasias and lymphomas may mascarade conjunctivitis. The differentiation of the various clinical pictures may be challenging for the practitioner. This article reviews the methodology of patient history and clinical work up as well as the symptomatology and treatment options for the most important conjunctivites in clinical practice. "Inflammation of the conjunctiva" Ther Umsch. 2009 Mar; 66(3): 153-61Meyer P, Messerli J (Hubmed.org) Highlight : Treatment Of Rosacea | Acne Rosacea Antibiotic

Rhinophyma is an irregular and progressive nasal hypertrophy, due to hyperplasia and fibrosis of the sebaceous glands and surrounding soft tissues. Its etiology is unknown. Its psychosocial, functional, and esthetic consequences may be severe. It is rare in the black African population. We present a case of glandular rhinophyma in a 70-year-old black male patient. OBSERVATION: A 70-year-old male patient consulted for nasal tumors. These lesions had appeared 11 years before, after rosacea acne . The patient had no specific history, no alcohol addiction nor any particular treatment. The nose was voluminous. The tumors were located on the left nostril ala, the tip of the nose, and the tip and right nostril ala junction. The size of the pediculated lesions was variable. They covered most of the nostril opening and upper lip. Pressure forced out whitish, pasty, and fetid sebum. The lesions were an obstacle to nasal ventilation and feeding. This glandular rhinophyma was responsible for a sev...

Surv Ophthalmol. 2009 May-Jun; 54(3): 321-38Donnenfeld E, Pflugfelder SCCyclosporine has been used successfully as a systemic immunomodulator for more than two decades, and numerous studies have investigated its mechanisms of action. In 2003 an ophthalmic formulation, cyclosporine 0.05% ophthalmic emulsion, was approved by the FDA to treat dry eye disease. Topical cyclosporine emulsion has also been investigated for treatment of other ocular surface disorders that may have an immune-based inflammatory component. In these trials, cyclosporine 0.05% ophthalmic emulsion has shown efficacy for management of posterior blepharitis, ocular rosacea, post-LASIK dry eye, contact lens intolerance, atopic keratoconjunctivitis, graft-versus-host disease, and herpetic stromal keratitis. As these disorders are often refractory to other available treatments, ophthalmic cyclosporine is a welcome nontoxic adjunct or replacement to potentially toxic topical or systemic immunosuppressive therapies.

Skin Therapy Lett. 2009 Feb; 14(2): 1-3Gooderham MMany options exist for the treatment of rosacea, including topical and systemic therapies, laser and light-based therapies, and surgical procedures. A classification system for rosacea identifies 4 subtypes (i.e., erythematotelangiectatic, papulopustular, phymatous, and ocular), which may help guide therapeutic decision-making. The goals of therapy include reduction of papules, pustules, erythema, physical discomfort, and an improvement in quality of life. Standard topical treatment agents include metronidazole, azelaic acid, and sodium sulfacetamide-sulfur. Second line therapies include benzoyl peroxide, clindamycin, calcineurin inhibitors, and permethrin.

J Dermatolog Treat. 2009 Jan 1; 1-3Cravo M, Miguel Canelas M, Carlos Cardoso J, Vieira R, Figueiredo ARhinophyma is a progressive and disfiguring disorder of the nose characterized by hyperplasia of the sebaceous glands and dermal tissue, representing the end-stage of rosacea. Four male patients affected by a moderate-severe rhinophyma were treated using a combined therapy with carbon dioxide laser and bipolar electrocoagulation. All patients achieved marked cosmetic results with minimal scarring. Various surgical approaches have been described to treat this condition but as yet there is no agreement in the literature on the ideal treatment. This combined method provides a bloodless operative field which allows the sculpting of the hypertrophic areas, leading to a good cosmetic outcome and a pain-free postoperative recovery.

Cutis. 2008 Dec; 82(6 Suppl): 2-16Ditre C, Wu J, Baumann LS, Rigel DThe use of natural products for skin care has become more common in the past few years. Consumers are more aware of unnatural chemicals and other toxins and are searching for natural products to use on their skin. Fortunately, a large number of botanical antioxidants exist and are being marketed as either over-the-counter or prescription skin care products. Antioxidants can have profound effects on the intracellular signaling pathways involved in skin damage and thus may be protective against photodamage as well as may prevent wrinkles and inflammation. This supplement discusses the potent effect that botanical antioxidants may have in the management of a broad range of skin issues, from photoaging to inflammatory skin conditions.

Cutis. 2009 Mar; 83(3): 119-24Del Rosso JQ, Lehman PA, Raney SGThe medical management of rosacea increasingly has involved not only the appropriate selection of topical medication but also patient education and specific recommendations regarding appropriate skin care. The recognition that epidermal barrier dysfunction and transepidermal water loss (TEWL) play a pathophysiologic role in rosacea and that skin moisturization may help to mitigate signs and symptoms of the disease has led to a deeper appreciation of the importance of proper skin care in the treatment of rosacea. Data from a percutaneous penetration study performed using human skin suggest that any of the tested moisturizer lotions may be applied either before or after azelaic acid gel 15% without a major change in the percutaneous absorption profile of azelaic acid.

P R Health Sci J. 2009 Mar; 28(1): 80-2Morales-Burgos A, Alvarez Del Manzano G, Sánchez JL, Cruz CLPersistent facial swelling may occur as a rare complication of rosacea. This finding has been referred to as lymphedematous rosacea, Morbihan's disease or persistent solid facial edema. A literature review for cases of lymphedematous rosacea revealed that the chronic inflammatory process that accompanies the disease contributes to an increase in the permeability of blood vessels. With time, the lymphatic drainage system becomes permanently impaired, leading to fluid accumulation in the affected skin. Herein, we report the case of a 58-year-old female with history of rosacea who developed bilateral periorbital swelling with associated erythema of the conjunctiva (ocular rosacea) over a 4 month period that only responded to oral corticosteroids. Biopsy revealed changes of lymphedematous rosacea.

J Drugs Dermatol. 2009 Feb; 8(2): 120-3Elewski BEA survey of people with rosacea was conducted in 2006 to gain insight into experiences with rosacea therapies and relationships with health care providers. The survey was completed by 2946 participants, of whom 2847 had been diagnosed with rosacea. Participants ranged in age from 20 to 81 years (mean age 50 years). Among those diagnosed with rosacea, 80% agreed that medication prevented their rosacea from worsening. Most respondents currently using prescription medication (82%) did not plan to discontinue its use. Among current users of medication, 46% had switched from a prior agent, usually due to the lack of improvement. Among respondents who previously switched therapies, 84% reported using some formulation of topical metronidazole. Of those respondents who discussed rosacea with their physician, 83% agreed that their physician influences their use of medication; 61% viewed their physician-in most cases a dermatologist-as a partner ...

J Biophotonics. 2008 May; 1(2): 140-53Tfayli A, Piot O, Manfait MConfocal Raman microspectroscopy represents the advantage of giving structural and conformational information on samples without any destructive treatment. Recently, several studies were achieved to study the skin hydration, endogenous and exogenous molecules repartition in the skin using the confocal feature of this technique. Meanwhile, when working through a material boundary with a different refractive index, the main limitation remains the spatial precision, especially the distortion in the depth and the depth resolution. Recently, several authors described mathematical models to correct the depth and the resolution values. In this study, we combined theoretical approaches, proposed by different authors with experimental measurements to try to find out the most appropriate approach for correction. We then applied the corrections on in-depth profiles tracking the penetration of Metronidazole, a drug produced by Galde...

J Eur Acad Dermatol Venereol. 2009 May; 23(5): 544-9Bakar O, Demircay Z, Toker E, Cakir SBACKGROUND: Tetracycline derivatives provide moderate benefit in the treatment of ocular rosacea. Recently, azithromycin has been found to be an effective alternative in the treatment of cutaneous papulopustular rosacea. OBJECTIVE: We planned a study to evaluate the effects of azithromycin on ocular symptoms, signs and tear function tests of papulopustular rosacea patients. METHODS: An open-labelled study was performed in a population of 20 papulopustular rosacea patients. RESULTS: Eighteen subjects completed the trial. Significant improvement was seen in ocular symptoms, eyelid findings and conjunctival hyperaemia scores (P = 0.002, P

J Drugs Dermatol. 2009 Mar; 8(3): 299-304Trumbore MW, Goldstein JA, Gurge RMAcne rosacea is a chronic cutaneous disorder affecting as many as 14 million Americans. Papulopustular rosacea is the classic form of rosacea characterized by papules, pustules, and erythema. The skin barrier deficiency and vascular hyperactivity characteristic of papulopustular rosacea increase skin dryness and irritation, which can be further exacerbated by medications commonly used to treat rosacea. Sodium sulfacetamide 10%/sulfur 5% emollient foam (SSSE foam) is formulated for topical administration and is fragrance free and alcohol free. This nonrandomized, noncontrolled, open-label, prospective case series was designed to evaluate the efficacy and safety of a SSSE foam for the treatment of papulopustular rosacea in 8 patients. Patients experienced clinically significant improvements in the severity of rosacea with a favorable safety profile, and reported of an improved quality of life. The high patient s...

J Drugs Dermatol. 2009 Feb; 8(2): 125-33Bikowski JSeborrheic dermatitis, characterized by erythema and/or flaking or scaling in areas of high sebaceous activity, affects up to 5% of the US population and often appears in conjunction with other common skin disorders, such as rosacea and acne. Despite ongoing research, its etiology is puzzling. Increased sebaceous and hormonal (androgenic) activity is thought to play a part. Recent evidence suggests an important role for individual susceptibility to irritant metabolites of the skin commensal Malassezia, most probably M globosa. Current approaches thus include agents with antifungal as well as antikeratinizing, and anti-inflammatory activity. Azelaic acid, which has all 3 properties, may be a useful addition to first-line management, which now comprises of topical steroids, the immunosuppressant agents tacrolimus and pimecrolimus, azoles and other antifungals, and keratolytic agents. A recent exploratory study supports the efficacy and s...

J Cutan Med Surg. 2009 Mar-Apr; 13(2): 115-8Lucas CR, Korman NJ, Gilliam ACBACKGROUND:We report a case of granulomatous periorificial dermatitis (GPD). A 13-year-old Jamaican boy presented with pink to flesh-colored perioral and periocular papules that erupted during a summer visit to Jamaica. The child was initially diagnosed with sarcoidosis and treated with oral corticosteroids, but the eruption recurred 2 years later. He was referred to Dermatology. Biopsy of one of the facial papules revealed a dense granulomatous infiltrate with surrounding prominent lymphocytes. A diagnosis of GPD was made.OBJECTIVE AND CONCLUSION:Also known as facial Afro-Caribbean childhood eruption (FACE), GPD occurs in prepubertal children. It can be confused with sarcoidosis, infection, and granulomatous rosacea but contains lymphocytes around the granulomas and lacks the systemic involvement seen in sarcoidosis. Cultures are invariably negative. The histologic features of GPD and granulomatous rosacea can...

J Cosmet Dermatol. 2009 Mar; 8(1): 52-5Abdel-Hafez HZ, Mahran AM, Hofny ER, Attallah DA, Sayed DS, Rashed HABACKGROUND: Alopecia areata (AA) is an immune-mediated form of hair loss that occurs in all ethnic groups, ages, and both sexes. Helicobacter pylori has been associated with certain extra-digestive dermatological conditions, including chronic urticaria, rosacea, Schönlein-Henoch purpura, Sweet syndrome, systemic sclerosis, and atopic dermatitis. OBJECTIVE: The causal relation between alopecia areata and H. pylori is discussed. We have screened for the presence of H. pylori in patients with AA in order to determine any potential role in its pathophysiology. PATIENTS AND METHODS: We have prospectively studied 31 patients with AA and 24 healthy volunteers of similar gender for the presence of H. pylori surface antigen (HpSag) in stool. RESULTS: Optical density values for H. pylori infection were positive in 18 of all 31 patients evaluated (58.1%), while in 13 patients, values did ...

Dermatol Surg. 2009 Apr 6; Neuhaus IM, Zane LT, Tope WDBACKGROUND Erythematotelangiectatic (ET) rosacea is commonly treated with a variety of laser and light-based systems. Although many have been used successfully, there are a limited number of comparative efficacy studies. OBJECTIVE To compare nonpurpuragenic pulsed dye laser (PDL) with intense pulsed light (IPL) treatment in the ability to reduce erythema, telangiectasia, and symptoms in patients with moderate facial ET rosacea. METHODS Twenty-nine patients were enrolled in a randomized, controlled, single-blind, split-face trial with nonpurpuragenic treatment with PDL and IPL and untreated control. Three monthly treatment sessions were performed with initial PDL settings of 10-mm spot size, 7 J/cm(2), 6-ms pulse duration and cryogen cooling, and initial IPL settings of 560-nm filter, a pulse train of 2.4 and 6.0 ms in duration separated by a 15-ms delay, and a starting fluence of 25 J/cm(2). Evaluation measures included spectropho...

J Am Acad Dermatol. 2009 Mar; 60(3): 453-62Hsu CK, Hsu MM, Lee JYBACKGROUND: Demodex mites are common commensal organisms of the pilosebaceous unit in human beings and have been implicated in pityriasis folliculorum, rosacea-like demodicosis, and demodicosis gravis. OBJECTIVE: We sought to describe the spectrum of clinicopathological findings and therapeutic responses of demodicosis in Taiwanese patients. METHODS: We conducted a retrospective study to review clinicopathologic findings and therapeutic responses of 34 cases of diagnosed demodicosis. RESULTS: Fifteen cases with positive results of potassium hydroxide examination, standardized skin surface biopsy specimen, and/or skin biopsy specimen, and resolution of skin lesions after anti-Demodex treatment were included for final analysis. Nineteen cases were excluded because of insufficient positive data to make a definite diagnosis. There were 4 male and 11 female patients (age 1-64 years, mean age 38.7 years). The disease was recur...

Eur J Intern Med. 2009 Mar; 20(2): 158-61Artantaş S, Gül U, Kiliç A, Güler SBACKGROUND: In cases of thyroid diseases, many of the symptoms arise on the skin. In this study, we aimed to detect and compare the skin findings and accompanying dermatoses of patients with thyroid diseases. MATERIALS AND METHODS: 220 patients with thyroid diseases, who did not have any medical cure, and 90 healthy individuals as a control group attended our study. All of the cases were examined, and the skin findings and/or dermatoses were recorded. The skin findings in the patients and the control group were compared statistically. RESULTS: Among 220 cases, in 125 (56.8%) skin findings were detected. The most frequently observed skin findings were chronic urticaria (6.8%), vitiligo (6.8%), diffuse alopecia (6%), acne vulgaris (5%) and acne rosacea (3.6%). No significant difference was detected statistically between the patients and control group in terms of skin findings. When compared for the presence ...