Rosacea

Laryngoscope. 2009 Jun; 119(6): 1082-4Hetherington HE

Reactive oxygen species (ROS) play a vital role in the pathophysiology of the skin disease rosacea, a chronic, genetically-determined and UV-triggered disease, leading to facial redness and blemishes and exhibiting a deep impact on a patient's self-esteem and quality of life. ROS can cause oxidative damage to nucleic acids, sugars, proteins and lipids, thereby contributing to adverse effects on the skin. Metronidazole has been the first-line topical agent therapy for many years; nevertheless the mechanism of action is still not well understood. The therapeutic efficacy of metronidazole has been attributed to its antioxidant effects, which can involve two pathways: decreased generation of ROS within tissues or scavenging and inactivation of existing ROS. Previous investigations have shown that metronidazole reduces ROS by decreasing ROS production in cellular in-vitro systems. The aim of the following study was to demonstrate that metronidazole additionally exhibits antioxidative pr...

No rosacea-specific quality-of-life (QOL) instrument exists. OBJECTIVE: We sought to develop a validated, reliable rosacea-specific instrument. METHODS: From 6 in-depth interviews, we composed 21 rosacea-specific items. These items and Skindex-29 were administered in a validation cohort (n = 59). Internal consistency reliability and reproducibility were measured with Cronbach's coefficient alpha and intraclass correlation coefficient, respectively. Responsiveness was assessed comparing baseline with 4- to 6-month responses. Construct validity was assessed with principal axes factor analyses. Discriminant validity was examined with an additional 38 patients comparing differences in responsiveness between the rosacea-specific QOL instrument and Skindex. RESULTS: Reliability was high (Cronbach's alpha: 0.82-0.97, intraclass correlation coefficient: 0.70-0.95). The rosacea-specific QOL instrument showed preliminary responsiveness for patients with improved disease "A pilot qu...

Until recently, with the exception of oral isotretinoin for the treatment of severe recalcitrant nodular acne , systemic therapy for acne vulgaris and rosacea has been based on anecdotal support, clinical experience, and small clinical trials. Tetracycline derivatives are the predominant systemic agents that have been used for both disease states, prescribed in dose ranges that produce antibiotic activity. Anti-inflammatory dose doxycycline, a controlled-release (CR) 40-mg capsule formulation of doxycycline that is devoid of antibiotic activity when administered once daily, was US Food and Drug Administration (FDA)-approved for the treatment of inflammatory lesions (papules and pustules) of rosacea , based on large-scale phase 3 pivotal trials and long-term microbiologic and safety data. Also, an extended-release (ER) tablet formulation of minocycline was approved by the FDA for the treatment of inflammatory lesions of moderate to severe acne vulgaris in patients 12 years and older ba...

A 68-year-old healthy man presented with papulopustular rosacea (PPR) recalcitrant to multiple therapies, including permethrin cream 5%. Histologic examination detected the presence of chronic folliculitis and numerous Demodex organisms. A diagnosis of rosacealike demodicidosis was rendered, and the patient was treated with oral ivermectin and permethrin cream 5%, resulting in resolution of the folliculitis. Demodex infestation should be considered in any patient with rosacea like dermatitis resistant to conventional rosacea therapies . If infestation is demonstrated in these patients, oral ivermectin in combination with topical permethrin is a safe and effective therapeutic option. "Recalcitrant papulopustular rosacea in an immunocompetent patient responding to combination therapy with oral ivermectin and topical permethrin" Allen KJ, Davis CL, Billings SD, Mousdicas N Cutis. 2007 Aug ; 80(2): 149-51 (Hubmed.org) Highlight : Treatment Of Rosacea | Acne Rosacea Antibio...