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Intestinal alkaline phosphatase: The molecular link between rosacea and gastrointestinal disease?

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...

The metabolism and pharmacokinetics of isotretinoin in patients with acne and rosacea are not influenced by ethanol.

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...

Azelaic acid in the treatment of papulopustular rosacea

To evaluate the clinical efficacy of topical 20% azelaic acid cream and 15% azelaic acid gel compared with their respective vehicles and metronidazole gel in the treatment of papulopustular rosacea . DATA SOURCES: Electronic searches of MEDLINE, EMBASE, BIOSIS, and SciSearch through July or August 2004 and the Cochrane Central Register of Controlled Trials through 2004 (issue 3). We performed hand searches of reference lists, conference proceedings, and clinical trial databases. Experts in rosacea and azelaic acid were contacted. STUDY SELECTION: Randomized controlled trials involving topical azelaic acid (cream or gel) for the treatment of rosacea compared with placebo or other topical treatments. Two authors independently examined the studies identified by the searches. Ten studies were identified, of which 5 were included (873 patients). DATA EXTRACTION: Two authors independently extracted data from the included studies, then jointly assessed methodological quality using a quality a...

Iron status with particular consideration of soluble transferrin receptors in children

Role of Helicobacter pylori infection in chronic gastritis and gastric and/or duodenal ulcers is well known. Simultaneously there are some articles in literature considering H. pylori as a cause of extra-gastrointestinal illnesses such as atopic dermatitis, chronic urticaria or acne rosacea , hypotrophy, Schoenlein-Henoch disease, atherosclerosis or hypochromic anaemia. The aim of the study. was to asses iron status in aspect of plasmatic transferrin receptors concentration among children and youth with chronic gastritis with or without Helicobacter pylori infection. MATERIALS AND METHODS: Forty one patients were included as a study group. Range of age was 9-18 years. All patients were diagnosed due to chronic abdominal pains. There were 13 males and 28 females. Blood was collected from every patient for blood cell count, iron, transferrin and transferrin receptors concentration (sTfR) assessment before endoscopy of upper gastrointestinal tract. RESULTS: Concentration of sTfR was highe...

Rosacea: A Review.

P T. 2009 Jan; 34(1): 38-45Culp B, Scheinfeld NRosacea is a chronic inflammatory condition of the facial skin affecting the blood vessels and pilosebaceous units. Rosacea is more common in persons of northern and western European descent with a fair complexion, but it can affect skin of any color. Although symptoms may wax and wane during the short term, rosacea can progress with time. Patients usually present with complaints of flushing and blushing and sensitive skin, and their skin may be especially irritated by topical preparations. Rosacea has a variety of triggers; however, they may be unnoticed by the patient.Standard treatments approved by the FDA include azelaic acid, topical metronidazole, and oral tetracyclines, in particular minocycline and doxycycline. Other topical treatments include topical clindamycin, subantimicrobial-dose doxycycline, and sulfur products. Azithromycin and controlled-release minocycline are possible options for treating rosacea, but the FDA has not ap...

Tinea incognito in Italy

Tinea incognito or steroid modified tinea is a dermatophytic infection in which topical or systemic steroids, administered as a result of dermatological misdiagnosis or preexisting pathologies, have modified the clinical appearance of the fungal infection, transforming the typical ringworm and mimicking other skin diseases . This is a retrospective study of the agents, clinical aspects, sources of infection of 200 cases (98 males, 102 females, mean age 42 years) of tinea incognito, observed in Siena and Milan, Italy, in the period 1987-2002. In order of decreasing frequency, Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum, Microsporum canis, Microsporum gypseum, Trichophyton violaceum and Trichophyton erinacei were isolated. The clinical appearance of the infection was lupus erythematosus discoid-like, eczema-like, rosacea-like, especially on the face, impetigo-like and eczema-like on trunk and limbs. Less often the dermatophytosis resembled psoriasis, purpur...