Rosacea

J Eur Acad Dermatol Venereol. 2009 Sep 8; Lazaridou E, Apalla Z, Sotiraki S, Ziakas NG, Fotiadou C, Ioannides DAbstract Background Numerous factors have been implicated in the pathogenesis of rosacea, which remains obscure. Objectives To examine the epidemiological characteristics of rosacea patients, the histopathological alterations, the prevalence of gastric Helicobacter pylori infection and the role of ultraviolet radiation, to detect the presence of Demodex folliculorum on affected skin and to elucidate the immunological nature of this disorder. Methods The study included 100 patients with rosacea. Each patient was assessed with a clinical, haematological, biochemical and histological examination; serology test for the detection of antibodies against H. pylori; direct immunofluorescence on perilesional, sun exposed skin and indirect immunofluorescence with monkey oesophagus as a substrate; antinuclear antibody titre and a skin surface biopsy to search for Demodex folliculorum. Re...

Acta Derm Venereol. 2009 Sep; 89(5): 488-491Abram K, Silm H, Maaroos HI, Oona M

Acta Derm Venereol. 2009 Sep; 89(5): 522-523Kosmidou M, Gaitanis G, Nomikos K, Zioga A, Katsanos K, Bassukas ID, Tsianos E

Am Fam Physician. 2009 Sep 1; 80(5): 461-8Goldgar C, Keahey DJ, Houchins JRosacea is a common chronic, and sometimes progressive, dermatosis. It is characterized, alone or in combination, by central facial erythema,symmetric flushing, stinging sensation, inflammatory lesions (papules and pustules), telangiectasias, and phymatous changes (tissue hyperplasia and nodules). Rosacea can occur in adults of any ethnicity,and adversely affects patients' quality of life. The condition can be effectively controlled with therapy tailored to the specific subtype of rosacea that is affecting the patient. Topical metronidazole, sulfacetamide/sulfur, and azelaic acid are generally effective for patients with mild rosacea. For moderate papulopustular rosacea, combination therapy with oral tetracyclines and topical agents is the first-line choice. Treatment with a topical agent, such as metronidazole, may help maintain remission. Patients with ocular involvement may benefit from long-term oral ant...

J Allergy Clin Immunol. 2009 Sep; 124(3S2): R13-R18Schauber J, Gallo RLOur skin is constantly challenged by microbes but is rarely infected. Cutaneous production of antimicrobial peptides (AMPs) is a primary system for protection, and expression of some AMPs further increases in response to microbial invasion. Cathelicidins are unique AMPs that protect the skin through 2 distinct pathways: (1) direct antimicrobial activity and (2) initiation of a host response resulting in cytokine release, inflammation, angiogenesis, and reepithelialization. Cathelicidin dysfunction emerges as a central factor in the pathogenesis of several cutaneous diseases, including atopic dermatitis, in which cathelicidin is suppressed; rosacea, in which cathelicidin peptides are abnormally processed to forms that induce inflammation; and psoriasis, in which cathelicidin peptide converts self-DNA to a potent stimulus in an autoinflammatory cascade. Recent work identified vitamin D3 as a major factor involved in ...

Dermatology. 2009; 219(2): 179-81Oberholzer PA, Nobbe S, Kolm I, Kerl K, Kamarachev J, Trüeb RM

Arch Immunol Ther Exp (Warsz). 2009 Aug 18; Meyer-Hoffert UThe skin protects us from water loss and mechanical damage. The surface-exposed epidermis, a self-renewing stratified squamous epithelium composed of several layers of keratinocytes, is most important in the barrier defense against these challenges. Endogenous and exogenous proteases such as kallikreins, matriptase, caspases, cathepsins, and proteases derived from microorganisms are important in the desquamation process of the stratum corneum and are able to activate and inactivate defense molecules in human epidermis. Protease inhibitors such as like LEKTI, elafin, SLPI, SERPINs, and cystatins regulate their proteolytic activity and contribute to the integrity and protective barrier function of the skin. Changes in the proteolytic balance of the skin can result in inflammation, which leads to the typical clinical signs of redness, scaling, and itching. This review summarizes the current knowledge of how proteases, their inhib...