101
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Sukakul T, Dahlin J, Svedman C. Primum non nocere; the importance of evaluating the effect of treatment and considering side effects. Contact Dermatitis 2020; 84:121-122. [PMID: 32713000 PMCID: PMC7891437 DOI: 10.1111/cod.13675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Thanisorn Sukakul
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden.,Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jakob Dahlin
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Cecilia Svedman
- Department of Occupational and Environmental Dermatology, Skåne University Hospital, Lund University, Malmö, Sweden
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102
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Chauhan R, Loewenstein SN, Hassanein AH. Rhinophyma: Prevalence, Severity, Impact and Management. Clin Cosmet Investig Dermatol 2020; 13:537-551. [PMID: 32848439 PMCID: PMC7429105 DOI: 10.2147/ccid.s201290] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 07/21/2020] [Indexed: 12/29/2022]
Abstract
Rhinophyma is an advanced stage of rosacea affecting the nasal soft tissues and resulting in disruption of the nasal architecture, airway obstruction, and disfigurement of the nasal aesthetic units. Rhinophyma presents with hypertrophy of the nasal soft tissues, erythema, telangiectasias, nodules, and lobules with a bulbous appearance. Significant psychosocial morbidity is associated with the disease. Understanding of this disease has improved and multiple treatment options exist. The article is a review of the literature to evaluate the pathophysiology, clinical presentation, and epidemiology of keywords “rhinophyma” and “rosacea” using an OVID Medline and PubMed search along with a systematic review of outcomes pertaining to treatment of rhinophyma with laser therapy, scalpel excision, and the subunit method using an OVID Medline search. The subunit method has the highest complication and revision rates followed by carbon dioxide laser therapy. Outcomes between carbon dioxide laser and scalpel therapy and electrocautery are equivalent. Scalpel excision is a more cost-effective treatment modality with less post-operative complications; however, it risks poor hemostasis intraoperatively. Patient satisfaction is common post-therapy regardless of the treatment method. Over 89% of patients would recommend undergoing treatment for rhinophyma irrespective of treatment type. Treatment options vary, and choice of treatment can be dependent on practitioner and patients’ treatment goals.
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Affiliation(s)
- Ruvi Chauhan
- Indiana University School of Medicine, Department of Surgery, Division of Plastic Surgery, Indianapolis, IN, USA
| | - Scott N Loewenstein
- Indiana University School of Medicine, Department of Surgery, Division of Plastic Surgery, Indianapolis, IN, USA
| | - Aladdin H Hassanein
- Indiana University School of Medicine, Department of Surgery, Division of Plastic Surgery, Indianapolis, IN, USA
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103
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Searle T, Al‐Niaimi F, Ali FR. Rosacea and the cardiovascular system. J Cosmet Dermatol 2020; 19:2182-2187. [DOI: 10.1111/jocd.13587] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Tamara Searle
- University of Birmingham Medical School Birmingham UK
| | - Firas Al‐Niaimi
- Department of Dermatology Aalborg University Hospital Aalborg Denmark
| | - Faisal R. Ali
- Vernova Healthcare CIC Macclesfield UK
- Dermatological Surgery & Laser Unit Guy's Hospital Cancer Centre St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation Trust London UK
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104
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Zhang AC, Muntz A, Wang MTM, Craig JP, Downie LE. Ocular Demodex: a systematic review of the clinical literature. Ophthalmic Physiol Opt 2020; 40:389-432. [PMID: 32691894 DOI: 10.1111/opo.12691] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE There is increasing clinical and research interest in the potential contribution of Demodex to ocular surface disease. The aim of this systematic review was to summarise and synthesise current clinical evidence relating to the aetiology, diagnosis and treatment of ocular Demodex. RECENT FINDINGS A comprehensive literature search was performed in OVID Medline, OVID Embase, and clinical trial registries, for studies published between 1990 and August 2019, examining Demodex on the ocular surface. The review included primary clinical research studies and systematic reviews of primary clinical research studies, where Demodex was considered in the context of the ocular surface and/or adnexa. Studies were categorised using the National Health and Medical Research Council evidence hierarchy. Risk of bias assessment was performed using validated tools for studies categorised as providing Level I or II evidence. A total of 87 studies were eligible for inclusion, including two systematic reviews. Most studies (60%) were observational, describing the prevalence of ocular Demodex in different clinical populations. There was a high degree of variability in the epidemiological data derived from cross-sectional aetiology studies. There was mostly consistent evidence to support an association between ocular Demodex and chronic blepharitis. Seven diagnostic test-accuracy studies were identified, which considered a range of techniques, including slit lamp examination for cylindrical eyelash collarettes and/or eyelash manipulation techniques, light microscopic evaluation of epilated eyelashes and in vivo confocal microscopy. There is currently no accepted gold-standard diagnostic method for ocular Demodex. For intervention studies, there was one systematic review, 11 published randomised trials, six trial registry entries, and nine case series. Despite a number of recent trials, the appropriate treatment regimen for ocular Demodex (including the optimal criteria and timing of an intervention) is not clearly established. CONCLUSIONS This comprehensive narrative synthesis has captured the landscape of clinical evidence relating to the prevalence, aetiology, diagnosis and treatment of ocular Demodex. There remain opportunities to enhance understanding of its role in ocular surface disease, best diagnostic approaches and optimal treatment protocols.
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Affiliation(s)
- Alexis Ceecee Zhang
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Michael T M Wang
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
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105
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Jabbehdari S, Memar OM, Caughlin B, Djalilian AR. Update on the pathogenesis and management of ocular rosacea: an interdisciplinary review. Eur J Ophthalmol 2020; 31:22-33. [PMID: 32586107 DOI: 10.1177/1120672120937252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Rosacea is one of the most common conditions affecting the ocular surface. The purpose of this review is to provide an update on the pathogenesis and treatment of rosacea based on the dermatology and ophthalmology literatures. METHODS Literature searches were conducted for rosacea and ocular rosacea. Preference was given to systematic reviews, meta-analysis, case-controlled studies, and documented case reports while excluding poorly documented case studies and commentaries. The data were examined and independently analyzed by more than two of the authors. RESULTS Rosacea is a complex inflammatory condition involving the pilosebaceous unit. Its underlying mechanism involves an interplay of the microbiome, innate immunity, adaptive immunity, environmental triggers, and neurovascular sensitivity. The latest classification of rosacea includes three dermatologic subgroups and a fourth subgroup, ocular rosacea. Ocular rosacea clinically displays many features that are analogous to the cutaneous disease, such as lid margin telangiectasia and phlyctenulosis. The role of environmental triggers in the exacerbation of ocular rosacea appears to be understudied. While lid hygiene and systemic treatment with tetracycline drugs remain the mainstay of treatment for ocular rosacea, newer dermatologic targets and therapies may have potential application for the eye disease. CONCLUSIONS Ocular rosacea appears to embody many of the manifestation of the dermatologic disease. Hence, the basic pathophysiologic mechanisms of the ocular and cutaneous disease are likely to be shared. Better understanding of the ocular surface microbiome and the immunologic mechanisms, may lead to novel approaches in the management of ocular rosacea.
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Affiliation(s)
- Sayena Jabbehdari
- Department of Ophthalmology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Benjamin Caughlin
- Department of Surgery/Division of Otolaryngology, Jr. Hospital of Cook County, Chicago, IL, USA.,Hospital of Cook County, Chicago, IL, USA.,Division of Facial Plastic and Reconstructive Surgery, Jesse Brown VA Medical Center, Chicago, IL, USA.,Division of Facial Plastic and Reconstructive Surgery, University of Illinois Health Hospital System, Chicago, IL, USA
| | - Ali R Djalilian
- Department of Ophthalmology, University of Illinois at Chicago, Chicago, IL, USA
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106
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Thompson KG, Rainer BM, Antonescu C, Florea L, Mongodin EF, Kang S, Chien AL. Comparison of the skin microbiota in acne and rosacea. Exp Dermatol 2020; 30:1375-1380. [PMID: 32278334 DOI: 10.1111/exd.14098] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/26/2020] [Accepted: 03/26/2020] [Indexed: 12/20/2022]
Abstract
Acne and rosacea, despite their similar clinical presentations, follow distinct clinical courses, suggesting that fundamental differences exist in their pathophysiology. We performed a case-control study profiling the skin microbiota in rosacea and acne patients compared to matched controls. Nineteen rosacea and eight acne patients were matched to controls by age ± 5 years, sex and race. DNA was extracted from facial skin swabs. The V3V4 region of the bacterial 16S rRNA gene was sequenced using Illumina MiSeq and analysed using QIIME/Metastats 2.0 software. The mean relative abundance of Cutibacterium acnes in rosacea with inflammatory papules and pustules (20.454% ±16.943%) was more similar to that of acne (19.055% ±15.469%) than that of rosacea without inflammatory papules and pustules (30.419% ±21.862%). C acnes (P = .048) and Serratia marcescens (P = .038) were significantly enriched in individuals with rosacea compared to acne. Investigating the differences between the skin microbiota in acne and rosacea can provide important clues towards understanding the disease progression in each condition.
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Affiliation(s)
| | - Barbara M Rainer
- Department of Dermatology, Johns Hopkins University, Baltimore, MD, USA.,Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Corina Antonescu
- Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Liliana Florea
- Institute of Genetic Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Emmanuel F Mongodin
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins University, Baltimore, MD, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins University, Baltimore, MD, USA
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107
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Identification of Long Noncoding RNA Associated ceRNA Networks in Rosacea. BIOMED RESEARCH INTERNATIONAL 2020; 2020:9705950. [PMID: 32185228 PMCID: PMC7060422 DOI: 10.1155/2020/9705950] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 01/24/2020] [Accepted: 01/27/2020] [Indexed: 02/05/2023]
Abstract
Rosacea is a chronic and relapsing inflammatory cutaneous disorder with highly variable prevalence worldwide that adversely affects the health of patients and their quality of life. However, the molecular characterization of each rosacea subtype is still unclear. Furthermore, little is known about the role of long noncoding RNAs (lncRNAs) in the pathogenesis or regulatory processes of this disorder. In the current study, we established lncRNA-mRNA coexpression networks for three rosacea subtypes (erythematotelangiectatic, papulopustular, and phymatous) and performed their functional enrichment analyses using Gene Onotology, KEGG, GSEA, and WGCNA. Compared to the control group, 13 differentially expressed lncRNAs and 525 differentially expressed mRNAs were identified in the three rosacea subtypes. The differentially expressed genes identified were enriched in four signaling pathways and the GO terms found were associated with leukocyte migration. In addition, we found nine differentially expressed lncRNAs in all three rosacea subtype-related networks, including NEAT1 and HOTAIR, which may play important roles in the pathology of rosacea. Our study provided novel insights into lncRNA-mRNA coexpression networks to discover the molecular mechanisms involved in rosacea development that can be used as future targets of rosacea diagnosis, prevention, and treatment.
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108
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van Zuuren EJ, van der Linden MMD, Arents BWM. Rosacea treatment guideline for the Netherlands. Br J Dermatol 2020; 182:1504-1506. [PMID: 31970753 PMCID: PMC7317907 DOI: 10.1111/bjd.18882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Linked Editorial:van Zuuren et al. Br J Dermatol 2020; 182:1319–1320. Plain language summary available online
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Affiliation(s)
- E J van Zuuren
- Dermatology Department, Leiden University Medical Centre, Leiden, the Netherlands
| | - M M D van der Linden
- Department of Dermatology, Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - B W M Arents
- Skin Patients Netherlands, Nieuwegein, the Netherlands
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109
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Thiboutot D, Anderson R, Cook-Bolden F, Draelos Z, Gallo RL, Granstein RD, Kang S, Macsai M, Gold LS, Tan J. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2020; 82:1501-1510. [PMID: 32035944 DOI: 10.1016/j.jaad.2020.01.077] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 10/24/2019] [Accepted: 01/31/2020] [Indexed: 12/19/2022]
Abstract
In 2017, a National Rosacea Society Expert Committee developed and published an updated classification of rosacea to reflect current insights into rosacea pathogenesis, pathophysiology, and management. These developments suggest that a multivariate disease process underlies the various clinical manifestations of the disorder. The new system is consequently based on phenotypes that link to this process, providing clear parameters for research and diagnosis as well as encouraging clinicians to assess and treat the disorder as it may occur in each individual. Meanwhile, a range of therapies has become available for rosacea, and their roles have been increasingly defined in clinical practice as the disorder has become more widely recognized. This update is intended to provide a comprehensive summary of management options, including expert evaluations, to serve as a guide for tailoring treatment and care on an individual basis to achieve optimal patient outcomes.
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Affiliation(s)
- Diane Thiboutot
- Department of Dermatology, Pennsylvania State University, Hershey, Pennsylvania.
| | - Rox Anderson
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Fran Cook-Bolden
- Skin of Color Center, Department of Dermatology, St Luke's-Roosevelt Hospital, New York, New York
| | - Zoe Draelos
- Department of Dermatology, Duke University, Durham, North Carolina
| | - Richard L Gallo
- Department of Dermatology, University of California-San Diego, San Diego, California
| | - Richard D Granstein
- Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Marian Macsai
- Department of Ophthalmology, University of Chicago, Chicago, Illinois
| | - Linda Stein Gold
- Department of Dermatology, Henry Ford Health System, West Bloomfield, Michigan
| | - Jerry Tan
- Department of Medicine, University of Western Ontario, Windsor, Ontario, Canada
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110
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111
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Tizek L, Schielein M, Seifert F, Biedermann T, Böhner A, Zink A. Response to ‘Letter to the editor’ by Wienholtz et al. entitled ‘The many faces of rosacea: liberal diagnostic criteria have ramifications on disease prevalence and accuracy’. J Eur Acad Dermatol Venereol 2019; 33:e428. [DOI: 10.1111/jdv.15747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/24/2019] [Indexed: 11/29/2022]
Affiliation(s)
- L. Tizek
- Department of Dermatology and Allergy, School of Medicine Technical University of Munich Munich Germany
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE) LMU Munich Munich Germany
| | - M.C. Schielein
- Department of Dermatology and Allergy, School of Medicine Technical University of Munich Munich Germany
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE) LMU Munich Munich Germany
| | | | - T. Biedermann
- Department of Dermatology and Allergy, School of Medicine Technical University of Munich Munich Germany
| | - A. Böhner
- Department of Dermatology and Allergy, School of Medicine Technical University of Munich Munich Germany
| | - A. Zink
- Department of Dermatology and Allergy, School of Medicine Technical University of Munich Munich Germany
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112
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Trave I, Merlo G, Cozzani E, Parodi A. Real-life experience on effectiveness and tolerability of topical ivermectin in papulopustular rosacea and antiparasitic effect on Demodex mites. Dermatol Ther 2019; 32:e13093. [PMID: 31579993 DOI: 10.1111/dth.13093] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 09/11/2019] [Accepted: 09/20/2019] [Indexed: 12/15/2022]
Abstract
Ivermectin is a drug approved for the treatment of papulopustular rosacea (PPR). Although clinical guidelines recommend the use of ivermectin as the first-line treatment in patients with almost clear and mild rosacea, studies concerning its use on them are lacking. This study investigated the effectiveness and the tolerability of ivermectin in almost clear to severe rosacea and assessed the antiparasitic effect on Demodex mites. This is a retrospective study based on 50 patients affected by PPR and treated with topical ivermectin 1% once daily over 16 weeks. The disease severity, the patient-examined improvement, and the safety assessment of patients were evaluated. Demodex mites were studied with the standardized skin surface biopsy. PPR to all severity achieved a therapeutic success. The number of inflammatory lesions was significantly decreased in almost clear (p < .0001), mild, moderate, and severe (p < .001) forms. A complete remission of inflammatory lesions was achieved by almost clear (p < .001) and mild (p = .005) with 82% with none-to-mild cutaneous adverse events. Thirty-two percent were positive for Demodex mites, and all of them turned negative after 16 weeks. Ivermectin is an effective treatment not only in moderate to severe PPR but also in almost clear/mild rosacea.
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Affiliation(s)
- Ilaria Trave
- Section of Dermatology, Department of Health Science, University of Genoa, Genoa, Italy
| | - Giulia Merlo
- Section of Dermatology, Department of Health Science, University of Genoa, Genoa, Italy
| | - Emanuele Cozzani
- Section of Dermatology, Department of Health Science, University of Genoa, Genoa, Italy
| | - Aurora Parodi
- Section of Dermatology, Department of Health Science, University of Genoa, Genoa, Italy
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113
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Abenavoli L, Dastoli S, Bennardo L, Boccuto L, Passante M, Silvestri M, Proietti I, Potenza C, Luzza F, Nisticò SP. The Skin in Celiac Disease Patients: The Other Side of the Coin. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E578. [PMID: 31505858 PMCID: PMC6780714 DOI: 10.3390/medicina55090578] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/13/2019] [Accepted: 09/05/2019] [Indexed: 02/07/2023]
Abstract
Celiac disease (CD) is an autoimmune enteropathy that primarily affects the small intestine and is characterized by atrophy of intestinal villi. The manifestations of the disease improve following a gluten-free diet (GFD). CD is associated with various extra-intestinal diseases. Several skin manifestations are described in CD patients. The present paper reviews all CD-associated skin diseases reported in the literature and tries to analyze the pathogenic mechanisms possibly involved in these associations. Different hypotheses have been proposed to explain the possible mechanisms involved in every association between CD and cutaneous manifestations. An abnormal small intestinal permeability seems to be implicated in various dermatological manifestations. However, most of the associations between CD and cutaneous diseases is based on case reports and case series and a few controlled studies. To better assess the real involvement of the cutaneous district in CD patients, large multicentric controlled clinical trials are required.
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Affiliation(s)
- Ludovico Abenavoli
- Digestive Physiopathology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
| | - Stefano Dastoli
- Dermatology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
| | - Luigi Bennardo
- Dermatology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
| | - Luigi Boccuto
- JC Self Research Institute, Greenwood Genetic Center, Greenwood, SC 29646, USA.
- Clemson University School of Health Research, Clemson University, Clemson, SC 29634, USA.
| | - Maria Passante
- Dermatology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
| | - Martina Silvestri
- Dermatology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
| | - Ilaria Proietti
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, 04110 Terracina, Italy.
| | - Concetta Potenza
- Dermatology Unit "Daniele Innocenzi", Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Polo Pontino, 04110 Terracina, Italy.
| | - Francesco Luzza
- Digestive Physiopathology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
| | - Steven Paul Nisticò
- Dermatology Unit, Department of Health Sciences, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy.
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114
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Aşiran Serdar Z, Aktaş Karabay E. A case of fractional microneedling radiofrequency induced rosacea. J COSMET LASER THER 2019; 21:349-351. [PMID: 31476963 DOI: 10.1080/14764172.2019.1661487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Fractional microneedling radiofrequency (FMR) has been reported to improve cutaneous wrinkles due to its effects of inducing neoelastogenesis and neocollagenosis. Furthermore, FMR has shown to be effective in acne scars, acne lesions, hyperhidrosis, acne-related postinflammatory erythema and recently in rosacea. FMR treatment has been suggested to improve rosacea by reducing inflammation and abnormal vessel proliferation. Here we present a 61-year-old female who developed rosacea symptoms after the treatment of FMR for cutaneous wrinkles. Since the case shows conflictory findings with the previous data, it was found worthy presentation.
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Affiliation(s)
- Zehra Aşiran Serdar
- Faculty of Medicine, Department of Dermatology and Venereology, Bahçeşehir University , Istanbul , Turkey
| | - Ezgi Aktaş Karabay
- Faculty of Medicine, Department of Dermatology and Venereology, Bahçeşehir University , Istanbul , Turkey
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115
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Artemisinin, a potential option to inhibit inflammation and angiogenesis in rosacea. Biomed Pharmacother 2019; 117:109181. [DOI: 10.1016/j.biopha.2019.109181] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/26/2019] [Accepted: 06/26/2019] [Indexed: 01/17/2023] Open
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116
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Chen M, Xie H, Chen Z, Xu S, Wang B, Peng Q, Sha K, Xiao W, Liu T, Zhang Y, Li J, Deng Z. Thalidomide ameliorates rosacea-like skin inflammation and suppresses NF-κB activation in keratinocytes. Biomed Pharmacother 2019; 116:109011. [DOI: 10.1016/j.biopha.2019.109011] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/19/2019] [Accepted: 05/21/2019] [Indexed: 12/30/2022] Open
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117
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Abstract
Rosacea is a chronic inflammatory facial disease occurring world-wide. The incidence of rosacea is increasing with age, with the clinical course being characterized by relapses. The pathogenesis of rosacea is not completely understood, but neurovascular and immunologic mechanisms are involved. Rosacea has a number of known extrinsic triggers that should be avoided, such as sun exposure, heat and cold, alcoholic beverages, and spicy food. Of greater importance is the observation that rosacea may develop as a manifestation of systemic diseases with a significant morbidity and even mortality. Obesity, Helicobacter pylori infection, smoking, and inflammatory bowel disease bear a significant risk for the development of rosacea. Metabolic, psychiatric, and neurologic disorders and certain types of cancer show a significant association with rosacea. The possible link to cardiovascular events is debatable. There are extrafacial and extracutaneous manifestations of rosacea, such as the red scalp syndrome, ocular rosacea, and migraine. Rosacea should be considered a systemic disease.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.
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118
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van Zuuren E, Fedorowicz Z, Tan J, van der Linden M, Arents B, Carter B, Charland L. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol 2019; 181:65-79. [PMID: 30585305 PMCID: PMC6850438 DOI: 10.1111/bjd.17590] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Rosacea is a common chronic facial dermatosis. Classification of rosacea has evolved from subtyping to phenotyping. OBJECTIVES To update our systematic review on interventions for rosacea. METHODS We searched CENTRAL, MEDLINE, Embase, LILACS, Science Citation Index and ongoing trials registers (March 2018) for randomized controlled trials. Study selection, data extraction, risk-of-bias assessment and analyses were carried out independently by two authors. Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to assess certainty of evidence. RESULTS We included 152 studies (46 were new), comprising 20 944 participants. Topical interventions included brimonidine, oxymetazoline, metronidazole, azelaic acid, ivermectin and other topical treatments. Systemic interventions included oral antibiotics, combinations with topical treatments or other systemic treatments. Several studies evaluated laser or light-based treatment. We present the most current evidence for rosacea management based on a phenotype-led approach. CONCLUSIONS For reducing temporarily persistent erythema there was high-certainty evidence for topical brimonidine and moderate certainty for topical oxymetazoline; for erythema and mainly telangiectasia there was low-to-moderate-certainty evidence for laser and intense pulsed light therapy. For reducing papules/pustules there was high-certainty evidence for topical azelaic acid and topical ivermectin; moderate-to-high-certainty evidence for doxycycline 40 mg modified release (MR) and isotretinoin; and moderate-certainty evidence for topical metronidazole, and topical minocycline and oral minocycline being equally effective as doxycycline 40 mg MR. There was low-certainty evidence for tetracycline and low-dose minocycline. For ocular rosacea, there was moderate-certainty evidence that oral omega-3 fatty acids were effective and low-certainty evidence for ciclosporin ophthalmic emulsion and doxycycline.
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Affiliation(s)
- E.J. van Zuuren
- Dermatology DepartmentLeiden University Medical CentreLeiden2333 ZAthe Netherlands
| | - Z. Fedorowicz
- DynaMed PlusEBSCO Health10 Estes StreetIpswichMA01938U.S.A.
| | - J. Tan
- Department of MedicineUniversity of Western OntarioLondonCanada
| | - M.M.D. van der Linden
- Department of DermatologyAmsterdam University Medical CentreAmsterdamthe Netherlands
| | - B.W.M. Arents
- Skin Patients Netherlands (Huidpatiënten Nederland)Nieuwegeinthe Netherlands
| | - B. Carter
- Biostatistics and Health InformaticsKing's College LondonLondonU.K
- Institute of Psychiatry, Psychology and NeuroscienceLondonU.K
| | - L. Charland
- Independent Researcher and Consumer RefereeQuebecCanada
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Emerging Roles of Redox-Mediated Angiogenesis and Oxidative Stress in Dermatoses. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:2304018. [PMID: 31178954 PMCID: PMC6501144 DOI: 10.1155/2019/2304018] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/14/2019] [Accepted: 03/14/2019] [Indexed: 12/24/2022]
Abstract
Angiogenesis is the process of new vessel formation, which sprouts from preexisting vessels. This process is highly complex and primarily involves several key steps, including stimulation of endothelial cells by growth factors, degradation of the extracellular matrix by proteolytic enzymes, migration and proliferation of endothelial cells, and capillary tube formation. Currently, it is considered that multiple cytokines play a vital role in this process, which consist of proangiogenic factors (e.g., vascular endothelial growth factor, fibroblast growth factors, and angiopoietins) and antiangiogenic factors (e.g., endostatin, thrombospondin, and angiostatin). Angiogenesis is essential for most physiological events, such as body growth and development, tissue repair, and wound healing. However, uncontrolled neovascularization may contribute to angiogenic disorders. In physiological conditions, the above promoters and inhibitors function in a coordinated way to induce and sustain angiogenesis within a limited period of time. Conversely, the imbalance between proangiogenic and antiangiogenic factors could cause pathological angiogenesis and trigger several diseases. With insights into the molecular mechanisms of angiogenesis, increasing reports have shown that a close relationship exists between angiogenesis and oxidative stress (OS) in both physiological and pathological conditions. OS, an imbalance between prooxidant and antioxidant systems, is a cause and consequence of many vascular complains and serves as one of the biomarkers for these diseases. Furthermore, emerging evidence supports that OS and angiogenesis play vital roles in many dermatoses, such as psoriasis, atopic dermatitis, and skin tumor. This review summarizes recent findings on the role of OS as a trigger of angiogenesis in skin disorders, highlights newly identified mechanisms, and introduces the antiangiogenic and antioxidant therapeutic strategies.
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Paci KM, Wink R, Blatt J, Morrell DS, Googe PB, McShane DB. Erythematous Crusted Papules on Face Arising in an Immunocompromised Child With Chemotherapy-Induced Acral Erythema. Clin Pediatr (Phila) 2019; 58:478-481. [PMID: 30674201 DOI: 10.1177/0009922818825148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Karina M Paci
- 1 University of North Carolina, Chapel Hill, NC, USA
| | - Randall Wink
- 1 University of North Carolina, Chapel Hill, NC, USA
| | - Julie Blatt
- 1 University of North Carolina, Chapel Hill, NC, USA
| | | | - Paul B Googe
- 1 University of North Carolina, Chapel Hill, NC, USA
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Tizek L, Schielein M, Seifert F, Biedermann T, Böhner A, Zink A. Skin diseases are more common than we think: screening results of an unreferred population at the Munich Oktoberfest. J Eur Acad Dermatol Venereol 2019; 33:1421-1428. [DOI: 10.1111/jdv.15494] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 01/18/2019] [Indexed: 02/06/2023]
Affiliation(s)
- L. Tizek
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE) LMU Munich Munich Germany
| | - M.C. Schielein
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE) LMU Munich Munich Germany
| | | | - T. Biedermann
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - A. Böhner
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - A. Zink
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
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122
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Morbihan Disease Treatment: Two Case Reports and a Systematic Literature Review. Ophthalmic Plast Reconstr Surg 2019; 35:126-132. [DOI: 10.1097/iop.0000000000001229] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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123
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Zhang Y, Jiang S, Lu Y, Yan W, Yan H, Xu Y, Xu T, Li Y, Geng L, Gao X, Chen H. A decade retrospective study of light/laser devices in treating nasal rosacea. J DERMATOL TREAT 2019; 31:84-90. [PMID: 30732485 DOI: 10.1080/09546634.2019.1580669] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Yanping Zhang
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Shibin Jiang
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Yansong Lu
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Wu Yan
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Hongwei Yan
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Yuanyuan Xu
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Tianhua Xu
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Yuanhong Li
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Long Geng
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Xinghua Gao
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
| | - Hongduo Chen
- Department of Dermatology, The First Hospital of China Medical University, Shenyang, China
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Dall'Oglio F, Lacarrubba F, Luca M, Boscaglia S, Micali G. Clinical and erythema-directed imaging evaluation of papulo-pustular rosacea with topical ivermectin: a 32 weeks duration study. J DERMATOL TREAT 2019; 30:703-707. [PMID: 30663445 DOI: 10.1080/09546634.2019.1572860] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Ivermectin (IVM) 1% cream represents an emerging therapy for papulo-pustular rosacea (PPR) and erythema-directed photography is a useful tool for evaluation of patient's erythema. Objective: The aim of our study was to assess the efficacy of IVM in PPR in achieving clear status at 8 weeks or at 20 weeks followed by respectively 24 and 12 weeks follow-up, using clinical/instrumental evaluation. Methods: Twenty patients with PPR were instructed to apply IVM for 8 weeks. At week 8, in case of complete response the therapy was stopped and a follow-up period up to 24 weeks was carried out, whereas in case of improvement the treatment was extended for additional 12 weeks followed by a 12 weeks follow-up. Instrumental evaluation was performed by erythema-directed digital photography (VISIA-CRTM- RBXTM). Results: At week 8, complete response was observed in 31.6% of cases along with a significant decrease of erythema degree. During treatment extension, additional improvement in terms of complete response, respectively at 12 (42%), 16 (47%) and 20 (58%) weeks, and reduction of erythema degree was observed. Conclusions: IVM is a valuable therapeutic option in mild/moderate PPR. Erythema-directed digital photography enhances erythema changes visualization compared to clinical observation alone.
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Affiliation(s)
| | | | - Maria Luca
- a Dermatology Clinic, University of Catania , Catania , Italy
| | | | - Giuseppe Micali
- a Dermatology Clinic, University of Catania , Catania , Italy
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Marchitto M, Chien A. Rosacea and Associated Comorbidities: A Google Search Trends Analysis (Preprint). JMIR Public Health Surveill 2019. [DOI: 10.2196/13603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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Akdogan N, Alli N, Incel Uysal P, Candar T. Role of serum 25-hydroxyvitamin D levels and vitamin D receptor gene polymorphisms in patients with rosacea: a case-control study. Clin Exp Dermatol 2018; 44:397-403. [PMID: 30246390 DOI: 10.1111/ced.13769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Vitamin D has significant effects on the immune system and thereby on the pathogenesis of rosacea. However, there is a lack of information on the vitamin D status and vitamin D receptors (VDRs) of patients with rosacea. AIM To evaluate the role of vitamin D in rosacea susceptibility. METHODS A case-control study was conducted, enrolling patients with rosacea and healthy controls (HCs). Five VDR gene single nucleotide polymorphisms (SNPs) (Cdx2, FokI, ApaI, BsmI and TaqI) and serum 25-hydroxyvitamin D3 [25(OH)D3 ] levels were compared between patients and HCs. RESULTS The study enrolled 60 patients (M/F: 14/46) and 60 age- and sex-matched HCs (M/F: 14/46). Age (mean ± SD) was 48 ± 11 years for both groups. The serum 25(OH)D3 levels (median ± interquartile range) were higher in patients with rosacea (12.9 ± 6.8 ng/mL) than in HCs (10.5 ± 3.7 ng/mL) (P < 0.001). Subjects with high serum 25(OH)D3 levels had a 1.36-fold increased risk of rosacea (95% CI 1.17-1.58). Heterozygous and mutant ApaI polymorphisms increased rosacea risk by 5.26-fold (95% CI 1.51-18.35) and 3.69-fold (95% CI 1.19-11.48), respectively, whereas mutant TaqI polymorphisms decreased the risk by 4.69 times (95% CI 1.37-16.67). Heterozygosity for Cdx2 alleles increased rosacea risk, whereas wildtype ApaI and mutant TaqI alleles decreased it. CONCLUSIONS The present study suggests that an increase in vitamin D levels may contribute to the development of rosacea. ApaI and TaqI polymorphisms, and heterozygous Cdx2, wildtype ApaI and mutant TaqI alleles were significantly associated with rosacea. These results indicate a possible role of vitamin D and VDR pathways in the pathogenesis of rosacea, although causality could not be assessed.
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Affiliation(s)
- N Akdogan
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - N Alli
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - P Incel Uysal
- Department of Dermatology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - T Candar
- Department of Medical Biochemistry, Ufuk University Faculty of Medicine, Ankara, Turkey
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Tan J, Berg M, Gallo RL, Del Rosso JQ. Applying the phenotype approach for rosacea to practice and research. Br J Dermatol 2018; 179:741-746. [PMID: 29799114 DOI: 10.1111/bjd.16815] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Rosacea diagnosis and classification have evolved since the 2002 National Rosacea Society expert panel subtype approach. Several working groups are now aligned to a more patient-centric phenotype approach, based on an individual's presenting signs and symptoms. However, subtyping is still commonplace across the field and an integrated strategy is required to ensure widespread progression to the phenotype approach. OBJECTIVES To provide practical recommendations that facilitate adoption of a phenotype approach across the rosacea field. METHODS A review of the literature and consolidation of rosacea expert experience. RESULTS We identify challenges to implementing a phenotype approach in rosacea and offer practical recommendations to overcome them across clinical practice, interventional research, epidemiological research and basic science. CONCLUSIONS These practical recommendations are intended to indicate the next steps in the progression from subtyping to a phenotype approach in rosacea, with the goals of improving our understanding of the disease, facilitating treatment developments and ultimately improving care for patients with rosacea.
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Affiliation(s)
- J Tan
- Department of Medicine, Western University, Windsor, ON, Canada
| | - M Berg
- Department of Dermatology, Uppsala University, Uppsala, Sweden
| | - R L Gallo
- Department of Dermatology, University of California San Diego, La Jolla, CA, U.S.A
| | - J Q Del Rosso
- Department of Dermatology, Touro University Nevada, Henderson, NV, U.S.A
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Affiliation(s)
| | - Bruce H Gray
- Greenville Health System, Greenville, SC, USA
- University of South Carolina School of Medicine, Greenville, SC, USA
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129
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Schaller M, Pietschke K. Successful therapy of ocular rosacea with topical ivermectin. Br J Dermatol 2018. [PMID: 29527668 DOI: 10.1111/bjd.16534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M Schaller
- Department of Dermatology, Eberhard Karls University Tünalebingen, Tüebingen, Germany
| | - K Pietschke
- Department of Dermatology, Eberhard Karls University Tünalebingen, Tüebingen, Germany
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Shatkin S, Shatkin M, Smith K, Beland LE, Oppenheimer AJ. Diffuse Large B-cell Lymphoma Occurring with Rhinophyma: A Case Report. Cureus 2018; 10:e2536. [PMID: 29946504 PMCID: PMC6017160 DOI: 10.7759/cureus.2536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Rhinophyma is the final stage in the evolution of acne rosacea, a common vasoactive dermatosis. Individuals with rhinophyma present with a typical, disfiguring nasal appearance consisting of bulbous enlargement, erythema, and telangiectasia with a sebaceous, oily skin surface. This classic appearance permits a facile diagnosis but may also lead the physician to overlook a coexistent malignancy. We report the occurrence of a diffuse large B-cell lymphoma (DLBCL) arising synchronously with a marked rhinophyma. A wide local excision of the malignancy was performed, and the defect was reconstructed with forehead flaps. The rhinophyma was treated with a skin graft and cheek flaps. Following surgery, chemotherapy was used to manage the systemic disease. This case demonstrates the necessity for clinical scrutiny in the diagnosis and treatment of rhinophyma. It is imperative to entertain a high degree of suspicion when non-typical changes are observed within a rhinophymatous lesion or in adjacent areas of the nose.
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Affiliation(s)
- Samuel Shatkin
- Department of Plastic Surgery, Aesthetic Associates Centre, Buffalo, USA
| | - Michael Shatkin
- Department of Plastic & Reconstructive Surgery, Aesthetic Associates Centre, Buffalo, USA
| | - Katherine Smith
- Medical Education, University of Central Florida College of Medicine, Orlando, USA
| | - Leah E Beland
- Medical Education, University of Central Florida College of Medicine, Orlando, USA
| | - Adam J Oppenheimer
- Department of Plastic & Reconstructive Surgery, Oppenheimer Plastic Surgery, Orlando, USA
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Sahni DR, Feldman SR, Taylor SL. Ivermectin 1% (CD5024) for the treatment of rosacea. Expert Opin Pharmacother 2018; 19:511-516. [PMID: 29544355 DOI: 10.1080/14656566.2018.1447562] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Rosacea is a chronic and recurrent disease with a variety of cutaneous manifestations. The disorder is a centrofacial inflammatory dermatosis with significant financial, physical and psychological impacts. There are a number of topical, oral and systemic treatments available. Yet, treatment for rosacea remains difficult. The multifactorial nature of the disease combined with an incomplete understanding of the pathophysiology is challenging for providers and patients. Areas covered: This article provides an in-depth review of rosacea treatment and emerging use of ivermectin 1% cream for papulopustular rosacea based on multiple clinical trials. The PubMed database was searched using the combination of keywords "ivermectin, rosacea, and papulopustular." Expert opinion: Topical ivermectin 1% cream has emerged as a novel agent for treatment of papulopustular rosacea. The drug targets the Demodex mite which is increased in patients with rosacea. Though ivermectin 1% is a clinically efficacious medication, poor adherence continues to remain an issue due to topical application. Ultimately, the agent has the potential to be an effective drug when used as a single or combination agent. With the move to limit chronic antibiotic use, topical agents such as ivermectin 1% will continue to thrive as a specialized niche in the rosacea market.
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Affiliation(s)
- Dev R Sahni
- a School of Medicine , Virginia Commonwealth University , Richmond , VA , USA
| | - Steven R Feldman
- b Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,c Department of Pathology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,d Department of Social Sciences & Health Policy , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Sarah L Taylor
- b Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA
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Chosidow O. Correspondance à propos de l’article : « L’absence de preuve n’est pas la preuve de l’absence. Du mésusage de “l’evidence based medicine” ». Ann Dermatol Venereol 2018; 145:188-191. [DOI: 10.1016/j.annder.2017.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022]
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