Rosacea

Persistent 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 "Persistent eyelid swelling in a patient with rosacea" Morales-Burgos A, Alvarez Del Manzano G, Sánchez JL, Cruz CL P R Health Sci J. 2009 Mar ; 28(1): 80-2 (Hubmed.org) High...

A patient, 64-year-old, is referred for the treatment of a giant rhinophyma. He refused any treatment during eight years. The interest of this case report is the size and the weight of the rhinophyma, the obstruction of the nasal airways and the resulting social disturbance. This exceptional clinical rhinophyma was associated with an otophyma, a zygophyma and ophthalmic disease. To our knowledge, this clinical presentation has never been reported before. The management of the rhinophyma and the otophyma was surgical excision, secondary healing followed by a full thickness skin graft associated to a fullface mechanical dermabrasion "Otophyma, zygophyma and giant rhinophyma: a rare association" Blairvacq JS, Yachouh J, Calteux N, Schmit S, Goudot P Ann Chir Plast Esthet. 2008 Oct ; 53(5): 441-7 (Hubmed.org) Highlight : Treatment Of Rosacea | Acne Rosacea Antibiotic

The widespread use of long-term antibiotics to treat acne and rosacea has resulted in increased Propionibacterium acnes resistance to antibiotics. Although resistance may decrease treatment effectiveness in some cases, it also is clear that antimicrobial activity is not the only role antibiotics play in acne management. The anti-inflammatory activity of antibiotics contributes to antipropionibacterial efficacy. In addition, the use of benzoyl peroxide (BPO) in combination with antibiotics to reduce resistant populations of propionibacteria is widely advocated, as P acnes has not developed resistance to it. P acnes now is known to form biofilms, which are bacterial communities that live encased in a glycocalyx polymer that aids in adherence to surfaces, thereby delaying antibiotic penetration. In addition to drug resistance, patient compliance with acne treatment is an important issue. Because compliance is a function of tolerability and convenience, new moisturizing noncomedogenic veh...

Here we propose to quantify local temperature variations using thermal imaging to assess the effect of dermatological lasers. OBJECTIVES: To quantify the temperature raise induced by laser application and to differentiate the effects of a potassium titanyl phosphate (KTP) laser and an intense pulsed light (IPL). METHODS: A randomized comparative study was performed on 10 adult volunteers with symmetrical rosacea treated by KTP laser or IPL. Skin temperature measurements were performed on inclusion, immediately after laser treatment and 3 min after thermal water application, using a high-resolution (0.08 degrees C) infrared thermal video camera. RESULTS: KTP laser treatment induced a significant rise in local skin temperature whereas no significant change was revealed by the IPL treatment. The infrared camera is a reliable and reproducible technique that allows a follow-up of skin temperature without skin contact. CONCLUSION: Thermography using an infrared camera could potentially be a...

The maintenance of normal hydration is an important function of the skin. The stratum corneum provides an antimicrobial, antioxidant, and UV barrier and plays an integral role in maintaining skin hydration. Environmental factors and disease states may compromise the barrier function of the stratum corneum, leading to excessively dry skin. Evidence supports the use of moisturizers in the treatment of various skin conditions, and a wide variety of these products are currently available. The presence of moisturizing agents in a compound, however, may not guarantee optimal moisturization effects. Pharmacologic and physiologic (eg, concentration, bioavailability, and proper determination of moisturization effects), as well as patient-based considerations, can potentially influence the effects of moisturizer ingredients. While moisturizers as adjunctive therapy have proven benefits in enhancing the management of certain dermatologic conditions, the incorporation of moisturizing ingredients i...

Morbihan disease is a rare complication of rosacea, characterized by persistent lymphoedema on the upper half of the face, occurring during the chronic clinical course of rosacea. This refractory condition has been also designated as 'rosacea lymphoedema' and 'solid persistent facial oedema of rosacea '. We report a patient with Morbihan disease showing persistent lymphoedema on the upper half of the face accompanied by unique histological findings of striking dermal dilated lymphatics and damage of the lymphatics at the site of the adjacent epithelioid cell granulomas, with histiocytes bulging into the lymphatic lumen. The marked epithelioid cell granulomas forming around dermal lymphatic vessels with subsequent lymphatic damage and luminal obstruction by histiocytic infiltration may account for the development of lymphoedema in this patient. "Persistent lymphoedema in Morbihan disease: formation of perilymphatic epithelioid cell granulomas as a possible pathogen...

Antibiotics are commonly prescribed in dermatology practice for a variety of disorders, including acne vulgaris and rosacea . Importantly, they often are used long-term for these inflammatory dermatoses. Changes in bacterial ecology related to antibiotic prescribing have led to the decreased sensitivity of some bacterial organisms, such as Propionibacterium acnes, to antibiotics commonly prescribed by dermatologists. The potential clinical outcomes of altered bacterial sensitivities may vary among specific disease states and include decreased therapeutic response and the need to alter approaches in disease management. Additionally, changing patterns of antibiotic sensitivity and the emergence of more virulent pathogens, such as community-acquired methicillin-resistant Staphylococcus aureus, macrolide-resistant staphylococci and streptococci, and mupirocin-resistant S aureus, have led to marked changes in how clinicians use antibiotics in clinical practice. This article reviews antibiot...