Rosacea

Curr Gastroenterol Rep. 2009 Aug; 11(4): 253-4Coyle WJ

Can J Ophthalmol. 2009 Aug; 44(4): 385-94Jackson WBDry eye complaints are common, have a diverse etiology, and result from disruption of the normal tear film; hence, the term "dysfunctional tear syndrome." Recent research has shown that ocular surface disorders have an inflammatory origin, that inflammation of the ocular surface does not always manifest as "red eye," and that a patient does not have to have a systemic autoimmune disease to experience a local, ocular autoimmune event. A panel of Canadian cornea and external disease subspecialists met and developed a questionnaire and treatment algorithm to aid the comprehensive ophthalmologist. Management of ocular surface disorders begins with a review of the patient's medical history, with particular attention to medication use, and a thorough ophthalmological examination. Use of a simple questionnaire can aid in the diagnosis. A variety of treatment modalities are available, the most effective of which are th...

Clin Exp Dermatol. 2009 Jul 6; Koca R, Altinyazar HC, Ankarali H, Muhtar S, Tekin NS, Cinar SSummary Background. There are various treatment options available for rosacea, depending on the subtype, but treatment is still generally unsatisfactory. Some reports have indicated beneficial effects of topical pimecrolimus. Aim. To compare the efficacy and safety of pimecrolimus 1% cream and metronidazole 1% cream in the treatment of patients with papulopustular rosacea (PR). Methods. A group of 49 patients with PR was investigated in this single-centre, randomized, open-label study. Patients were randomly assigned treatment with either pimecrolimus 1% cream or metronidazole 1% cream for 12 weeks. Response was evaluated by the inflammatory lesion count, the severity of facial erythema and telangiectasia, Physician's Global Assessment (PGA), and safety and tolerability at baseline and at weeks 3, 6, 9 and 12. Results. In total, 48 patients completed the study. Both treatments were very ef...

Dermatology. 2009 Jul 8; Oberholzer PA, Nobbe S, Kolm I, Kerl K, Kamarachev J, Trüeb RM

J Drugs Dermatol. 2009 Jul; 8(7): 664-8Del Rosso JQAnti-inflammatory dose doxycycline (ADD), which is the administration of doxycycline 40 mg extended-release capsule once daily, is the only oral therapy approved by the United States Food and Drug Administration (FDA) for treatment of rosacea. ADD once daily has been shown to exhibit anti-inflammatory activity while not demonstrating evidence of antibiotic effects, including with chronic administration. This article summarizes the clinical studies to date on the use of ADD once daily in papulopustular rosacea, including both monotherapy and combination therapy studies. The combination therapy approach of ADD once daily and metronidazole gel 1% once daily has been shown to exhibit a more rapid onset of therapeutic effect than topical therapy alone. ADD once daily has been demonstrated to be effective in adult subjects with moderate to severe rosacea, and exhibits a favorable safety profile coupled with absence of antibiotic selection p...

J Drugs Dermatol. 2009 Jul; 8(7): 639-48Thiboutot DM, Fleischer AB, Del Rosso JQ, Rich PThis two-phase, multicenter study was undertaken to examine the safety and efficacy of combination therapy with oral doxycycline and topical azelaic acid (AzA) 15% gel in moderate-to-severe papulopustular rosacea and to determine the effect of subsequent maintenance monotherapy with AzA 15% gel alone. In the initial open-label, non-randomized phase of the study, subjects (n=172) received topical AzA 15% gel and oral doxycycline (100 mg), both twice daily, for or = 75% inflammatory lesion count reduction (n=136) were randomized to receive either AzA 15% gel or its vehicle twice daily for an additional 24 weeks. Assessments of efficacy were obtained at four-week intervals throughout both phases of the study and included change in inflammatory lesion count, investigator global assessment (IGA) of rosacea severity, and separate assessments of erythema and telangiectasia severity. At the last visit for...

Indian J Dermatol Venereol Leprol. 2009 Jul-Aug; 75(4): 405-6Keshtcar-Jafari A, Akhyani M, Ehsani AH, Ghiasi M, Lajevardi V, Baradran O, Toosi S

Ann R Coll Surg Engl. 2009 Mar; 91(2): 167Fishman JM, Kundu S, Draper M

Med Hypotheses. 2009 Jun 30; Whitehead JRosacea is a common inflammatory condition of the facial skin of unknown etiology, which frequently occurs in combination with gastrointestinal disorders. Many dietary and hormonal factors are known to affect the severity of rosacea symptoms, several of which also modulate the activity of the enzyme intestinal alkaline phosphatase (IAP). The role of IAP in inhibiting an inflammatory response to intestinal bacteria suggests a mechanism by which intestinal pathologies may be linked to the skin inflammation characteristic of rosacea. Analysis of alkaline phosphatase activity is routinely performed on blood samples, and methods to quantify enzyme activity of the intestinal isoform specifically have been described. Correlations between IAP activity and rosacea symptoms in patients and controls can thus be screened by noninvasive and inexpensive means. If IAP activity is found to be low in rosacea patients, acute symptoms could be treated with oral IA...

Br J Dermatol. 2009 May 21; Grønhøj Larsen F, Jakobsen P, Grønhøj Larsen C, Heidenheim M, Held E, Nielsen-Kudsk FSummary Background Isotretinoin is effective in the treatment of severe acne and rosacea. Both parent drug and its main metabolite 4-oxo-isotretinoin are potentially teratogenic compounds and contain a carboxylic acid moiety. In the presence of ethanol, naturally occurring as well as synthetic retinoids also containing a carboxylic acid moiety are capable of undergoing an ethyl esterification with the metabolic formation of more lipophilic compounds with a much longer terminal half-life. Objectives To determine if isotretinoin (13-cis-RA), its main metabolite 4-oxo-isotretinoin (4-oxo-13-cis-RA), and other possible metabolites in the presence or absence of ethanol are converted to their corresponding ethyl derivatives in patients with severe acne or rosacea after multiple isotretinoin dosing. In addition, pharmacokinetic parameters of the parent drug and its 4-oxo metab...