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Peng Y, Wang B, Mao M, Li J, Shi W, Zhao H, Huang Z, Zhao Z, Huang C, Jian D. Clinical characteristics of the well-defined upper eyelid vascular network pattern in patients with rosacea. Int J Dermatol 2024; 63:337-344. [PMID: 38197322 DOI: 10.1111/ijd.16946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/03/2023] [Accepted: 11/18/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Rosacea is a chronic inflammatory skin disease. The diagnosis is based on the symptoms and physical signs, which still lacks objective laboratory tests or imaging tests. OBJECTIVES To propose and evaluate the upper eyelid network pattern in rosacea. METHODS Participants included patients diagnosed with rosacea, other facial erythematous skin diseases, and normal controls, all of whom underwent full-face imaging utilizing the VISIA® system software. According to these images, researchers evaluated the condition of the upper eyelid vascular network, developed the grading scale and then compared the difference of distribution in the three groups. RESULTS The occurrence rate of upper eyelid vascular network in rosacea was significantly higher than that in other facial erythematous skin diseases (84.3 vs. 32.0%, P < 0.001) and normal controls (84.3 vs. 28.0%, P < 0.001). The upper eyelid vascular network pattern was proposed (none [no clearly reticular vessels], mild [10-50% area of reticular vessels], moderate-to-severe [>50% area of reticular vessels]). Moderate-to-severe grade was defined as well-defined upper eyelid vascular network pattern, which was specific to patients with rosacea (rosacea vs. other facial erythematous skin diseases, adjusted odds ratio [aOR] = 5.814, 95% confidence interval [CI]: 3.899-8.670) (rosacea vs. heathy controls, aOR = 12.628, 95% CI: 8.334-19.112). The severity of the well-defined pattern had no significant association with age, duration, and phenotypes of rosacea (P > 0.05). CONCLUSION The well-defined upper eyelid vascular network pattern specifically appeared in patients with rosacea, which could be a possible clue to the diagnosis of rosacea.
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Affiliation(s)
- Yiran Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ben Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, China
| | - Mengping Mao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, China
| | - Wei Shi
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Huimin Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ziyang Huang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhixiang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, Hunan, China
| | - Chuchu Huang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Dan Jian
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Lee D, Kim MJ, Park HJ, Rah GC, Choi H, Anh S, Ji GH, Kim MS, Kim G, Shin DW, Oh SM. Current practices and perceived effectiveness of polynucleotides for treatment of facial erythema by cosmetic physicians. Skin Res Technol 2023; 29:e13466. [PMID: 37753681 PMCID: PMC10485387 DOI: 10.1111/srt.13466] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND Polynucleotides (PN) are increasingly used for the treatment of facial erythema in the Republic of Korea. However, there are limited pre-clinical and clinical data on the efficacy of polynucleotides for facial erythema. In this study, we investigated the current practice and perceived effectiveness of polynucleotide treatment for facial erythema among cosmetic physicians. METHODS By conducting a survey among clinicians who use PN in clinical practice, we explored the current practices and assessed the perceived effectiveness of polynucleotides in treating facial erythema. RESULTS A total of 557 physicians who used polynucleotides for facial erythema participated in the survey. Polynucleotides were used by 84.4%, 66.4%, and 47.4% of physicians for facial erythema caused by inflammatory facial dermatosis, repeated laser/microneedle radiofrequency, and steroid overuse, respectively. Among those users, 88.1%, 90%, and 83.7% respectively in those same categories answered that polynucleotides were "highly effective" or "effective." Furthermore, they agreed that polynucleotides have the following properties: wound healing/regeneration (95.8%), protection of skin barrier (92.2%), hydration (90.5%), vascular stabilization (81.0%), and anti-inflammation (79.5%). CONCLUSION Our findings showed that cosmetic physicians in the Republic of Korea have used PN as a part of combination treatment for facial erythema resulting from inflammatory facial dermatosis and repeated laser/ microneedle radiofrequency, rather than from steroid overuse. Also, most clinicians agreed that PN was effective for treatment of facial erythema. Given the lack of pre-clinical and clinical trial evidence, the empirical responses of practicing physicians provide useful information to guide clinical practice and further research.
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Affiliation(s)
- Dagyeong Lee
- Department of Family Medicine/Supportive Care CenterSamsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
| | | | | | | | | | | | | | | | - Geebum Kim
- Misogain Dermatology ClinicGimpoRepublic of Korea
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care CenterSamsung Medical CenterSungkyunkwan University School of MedicineSeoulRepublic of Korea
- Department of Clinical Research Design & EvaluationSamsung Advanced Institute for Health Science & Technology (SAIHST)Sungkyunkwan UniversitySeoulRepublic of Korea
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Metzler-Wilson K, Wilson TE, Ausmus SM, Sventeckis AM. Effect of sensory blockade and rate of sensory stimulation on local heating induced axon reflex response in facial skin. Auton Neurosci 2021; 233:102809. [PMID: 33862476 DOI: 10.1016/j.autneu.2021.102809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/12/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
Local neuronal circuits in non-glabrous skin drive the initial increase of the biphasic cutaneous vasodilation response to fast non-noxious heating. Voltage-sensitive Na+ (NaV) channel inhibition blocks the afferent limb of the non-glabrous forearm cutaneous axon reflex. Slow local heating does not engage this response. These mechanisms have not been adequately investigated or extended into areas associated with flushing pathology. We hypothesized that despite regional differences in sensory afferents, both sensory blockade and slowing the heating rate would abate the cutaneous axon reflex-mediated vasodilator responses in facial skin. We measured skin blood flow responses (laser-Doppler flowmetry) of 6 healthy subjects (5 female) to non-noxious forearm, cheek, and forehead local heating, expressed as a percentage of cutaneous vascular conductance at plateau (CVC = flux/mean arterial pressure). We assessed CVC during fast (1 °C/30s) and slow (1 °C/10 min) local heating to 43 °C in both NaV inhibition (topical 2.5% lidocaine/prilocaine) and control conditions. NaV inhibition decreased forearm (control: 84 ± 4, block: 34 ± 9%plateau, p < 0.001) and trended toward decreased forehead (control: 90 ± 3, block: 68 ± 3%plateau, p = 0.057) initial CVC peaks but did not alter cheek responses (control: 90 ± 3, block: 92 ± 13%plateau, p = 0.862) to fast heating. Slow heating eliminated the initial CVC peak incidence for all locations, and we observed similar results with combined slow heating and NaV inhibition. Slower sensory afferent activation rate eliminated the axon reflex response in facial and non-glabrous skin, but topical sensory blockade did not block axon reflex responses in flushing-prone cheek skin. Thus, slower heating protocols are needed to abate facial, particularly cheek, axon reflex responses.
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Affiliation(s)
- Kristen Metzler-Wilson
- Department of Physical Therapy, School of Health & Human Sciences; and (2)Departments of Dermatology and Anatomy, Cell Biology, & Physiology, School of Medicine, Indiana University, Indianapolis, IN, USA; Departments of Dermatology and Anatomy, Cell Biology & Physiology, School of Medicine, Indiana University, Indianapolis, IN, USA.
| | - Thad E Wilson
- Division of Biomedical Sciences, College of Osteopathic Medicine, Marian University, Indianapolis, IN, USA; Department of Physiology and Saha Cardiovascular Research Center, College of Medicine, University of Kentucky, Lexington, KY, USA.
| | - Samantha M Ausmus
- Department of Physical Therapy, School of Health & Human Sciences; and (2)Departments of Dermatology and Anatomy, Cell Biology, & Physiology, School of Medicine, Indiana University, Indianapolis, IN, USA.
| | - Austin M Sventeckis
- Department of Physical Therapy, School of Health & Human Sciences; and (2)Departments of Dermatology and Anatomy, Cell Biology, & Physiology, School of Medicine, Indiana University, Indianapolis, IN, USA.
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Przydatek-Tyrajska R, Sędzikowska A, Bartosik K. Primary facial demodicosis as a health problem and aesthetic challenge: A case report. J Cosmet Dermatol 2020; 20:420-424. [PMID: 32533738 PMCID: PMC7891371 DOI: 10.1111/jocd.13542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/13/2020] [Accepted: 06/01/2020] [Indexed: 12/15/2022]
Abstract
Colonization of skin by Demodex mites developing as a single facial lesion with a limited range is diagnosed relatively rarely. The presence of this type of skin lesions may hinder and thus delay the diagnostic process and application of appropriate treatment. The persistent cosmetic defect on the face is extremely onerous/embarrassing to the patient and impedes normal functioning. Describe a case of atypical presentation of primary facial demodicosis and its successful treatment. We present a case of a 38-year-old patient who consulted an aesthetic medicine doctor about a skin lesion, that is, erythematous-papular lesion with single pustules persisting for more than half a year around the right eye corner and below the lower eyelid. Previous topical antibiotic treatment has proved ineffective. Diagnosis was targeted at detection of Demodex spp. invasion, which yielded a positive result. Targeted therapy with 1% topical ivermectin was implemented. Complete resolution of the skin lesions was observed after 8.5 weeks of the treatment with no further recurrence. In the case of limited scaly erythematous-papular skin lesions with single pustules, Demodex mites should be considered as an etiological factor or one of the factors in the case of a mixed-etiology lesion. A delayed diagnosis of visible lesions on facial skin has a negative impact on patient's well-being and normal functioning. As diagnosis of primary demodicosis is underestimated, knowledge about this dermatosis and its clinical manifestations should be disseminated among cosmetologists and doctors of various specialties.
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Affiliation(s)
- Renata Przydatek-Tyrajska
- Reno-Med, Non-Public Health Care Centre, Warsaw, Poland.,Chair and Department of Biology and Parasitology, Medical University of Lublin, Lublin, Poland
| | - Aleksandra Sędzikowska
- Department of General Biology and Parasitology, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Bartosik
- Chair and Department of Biology and Parasitology, Medical University of Lublin, Lublin, Poland
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Chen Y, Hua W, Li A, He H, Xie L, Li L. Analysis of facial redness by comparing VISIA ® from Canfield and CSKIN ® from Yanyun Technology. Skin Res Technol 2020; 26:696-701. [PMID: 32196761 DOI: 10.1111/srt.12856] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/03/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Redness is the most common symptom among many facial dermatoses. With the rapid development of optical instruments, spectral imaging, and image processing technology, there appear varieties of skin color analysis methods and instruments. The aim of this study is to reveal the differences and correlations in measuring the facial redness between CSKIN® and VISIA® , as well as the relevance between the instrument parameters and clinical evaluation. MATERIALS & METHODS Forty-three Chinese patients were enrolled. Images were taken and analyzed by VISIA® from Canfield and CSKIN® from Yanyun Technology, and the facial erythema was graded by the dermatologists. RESULTS Feature counts within the red areas measured by VISIA® were found to have significantly positive correlations with red pixels and percent which were measured by CSKIN® on both sides of the face (r = .45 ~ .566, P < .01). The parameters analyzed by CSKIN® and VISIA® feature counts were correlated with visual scores graded by the dermatologists, VISIA® presented with a weak correlation (r = .213, P < .05), while CSKIN® had a moderate correlation with the visual scores (r = .472 ~ .492, P < .001). CONCLUSION CSKIN® may be another alternative option when encountering with measurement and follow-up of facial erythema.
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Affiliation(s)
- Yanjing Chen
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Hua
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, China
| | - Anqi Li
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, China
| | - Hailun He
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Xie
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Li
- Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, China
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Abstract
A red swollen face can be a skin sign of a potentially life-threatening condition. We present in detail the main clinical presentations, diagnostic tests, and management of some of the most severe conditions that can frequently present as a red and swollen face: acute or recurrent angioedema, mast cell-driven or bradykinin-mediated angioedema, nonhereditary and hereditary angioedema, allergic or photoallergic facial contact dermatitis, contact urticaria, severe adverse drug reactions (particularly drug reaction with eosinophilia and systemic symptoms [DRESS]), skin infections (erysipelas, cellulitis, necrotizing fasciitis), and autoimmune diseases (dermatomyositis). There are many other conditions that also have to be considered in the differential diagnosis of a red swollen face.
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Affiliation(s)
- Mariana Batista
- Dermatology Department, Coimbra University Hospital, Coimbra, Portugal
| | - Margarida Gonçalo
- Dermatology Department, Coimbra University Hospital, Coimbra, Portugal; Clinic of Dermatology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
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