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von Stebut J, Mallach M, Schneider-Burrus S, Heiland M, Rendenbach C, Preissner R, Preissner S. Rosacea is strongly associated with melanoma in Caucasians. Sci Rep 2024; 14:11949. [PMID: 38789467 PMCID: PMC11126582 DOI: 10.1038/s41598-024-62552-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
Rosacea is often considered a cosmetic problem but is known to be associated with a variety of comorbidities. To identify such risks, we generated two age- and sex-matched real-world cohorts of 122,444 patients each with and without rosacea. In contrast to earlier studies, we found significant associations with malignant melanoma (OR 6.02, 95% CI 5.76-6.32). This association does not exist for an Asian sub-cohort, which could explain previous inconclusive or conflicting reports. Several strongly associated comorbidities like visual disturbances (ICD-10: H53-H54; OR 4.80, 4.68-4.92), metabolic disorders (E73-E79; OR 3.17, 3.11-3.22), joint problems (M25; OR 4.16, 4.08-4.25) and type 2 diabetes (E11; OR 1.62, 1.58-1.65) should be watched as a risk for rosacea patients. Rosacea is associated with some comorbidities and ethnicity may be a risk factor in melanoma development. The retrospective nature of this study and the sole use of ICD-10 code based filtering calls for future validation of our findings. Additionally, confounding factors such as skin type and previous UV exposure should be included in future studies.
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Affiliation(s)
- Jennifer von Stebut
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
- Centre for Dermatosurgery, Havelklinik, Gatower Str. 191, 13595, Berlin, Germany
| | - Michael Mallach
- Structural Bioinformatics Group, Science-IT and Institute for Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Robert Preissner
- Structural Bioinformatics Group, Science-IT and Institute for Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.
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Whiting C, Abdel Azim S, Friedman A. The Skin Microbiome and its Significance for Dermatologists. Am J Clin Dermatol 2024; 25:169-177. [PMID: 38252188 DOI: 10.1007/s40257-023-00842-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2023] [Indexed: 01/23/2024]
Abstract
The skin is a physical and immunological barrier to the external environment. Its large surface area is colonized by diverse communities of microorganisms, including bacteria, viruses, fungi, and Demodex species mites. These microorganisms and their genetic material together create the skin microbiome. Physiologic and anatomic properties of skin sites create biogeographical habitats (dry, moist, and sebaceous) where distinct microbiota communities reside. Although, in general, the composition of these habitats is maintained from person to person, the skin microbiome of an individual also has unique microbial features. Dysbiosis occurs when the normal abundance, composition, or location of the microbiota is changed, most notably there is a decrease in flora diversity. Certain skin diseases, including atopic dermatitis, rosacea, and psoriasis are associated with cutaneous dysbiosis, and even disruption of the gut microbiota. Studies have shown that current treatments for these dermatologic conditions can alter/stabilize the skin microbiome, and there is emerging research detailing the impact of prebiotics, probiotics, and postbiotics on these conditions. Although clinical guidelines do not currently exist, clinical studies support the safety and possible benefits of using topical prebiotics and postbiotics and oral probiotics for a variety of skin conditions. Until such guidelines exist, utilizing carefully designed clinical studies to inform clinical practice is recommended.
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Affiliation(s)
- Cleo Whiting
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave. NW, Suite 2b-430, Washington, DC, 20037, USA
| | - Sara Abdel Azim
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave. NW, Suite 2b-430, Washington, DC, 20037, USA
- Georgetown University School of Medicine, Washington, DC, USA
| | - Adam Friedman
- Department of Dermatology, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave. NW, Suite 2b-430, Washington, DC, 20037, USA.
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3
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Nguyen C, Kuceki G, Birdsall M, Sahni DR, Sahni VN, Hull CM. Rosacea: Practical Guidance and Challenges for Clinical Management. Clin Cosmet Investig Dermatol 2024; 17:175-190. [PMID: 38283794 PMCID: PMC10821660 DOI: 10.2147/ccid.s391705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/02/2023] [Indexed: 01/30/2024]
Abstract
Rosacea is a common chronic dermatosis. Clinically, rosacea can present with flushing, erythema, papules, pustules, telangiectasias, phymatous changes, pruritus, burning, and stinging. In 2017, the National Rosacea Society Expert Committee recommended a phenotype-based classification for therapy. In this review, we identify monotherapies and multimodal treatment approaches for the clinical management of rosacea including topical, systemic, laser and light, alternative, and combination therapies.
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Affiliation(s)
- Cassidy Nguyen
- School of Medicine, University of Utah, Salt Lake City, UT, USA
| | | | | | - Dev Ram Sahni
- Department of Dermatology, University of Utah Health, Salt Lake City, UT, USA
- Department of Dermatology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Vikram Nath Sahni
- Department of Dermatology, University of Utah Health, Salt Lake City, UT, USA
| | - Christopher M Hull
- Department of Dermatology, University of Utah Health, Salt Lake City, UT, USA
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Sánchez-Pellicer P, Eguren-Michelena C, García-Gavín J, Llamas-Velasco M, Navarro-Moratalla L, Núñez-Delegido E, Agüera-Santos J, Navarro-López V. Rosacea, microbiome and probiotics: the gut-skin axis. Front Microbiol 2024; 14:1323644. [PMID: 38260914 PMCID: PMC10800857 DOI: 10.3389/fmicb.2023.1323644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
Rosacea is an inflammatory skin disease involving diverse symptoms with a variable clinical progress which can severely impact the patient's quality of life as well as their mental health. The pathophysiological model of rosacea involves an unbalanced immune system predisposed to excessive inflammation, in addition to vascular and nervous alterations, being certain cutaneous microorganisms' triggers of the symptoms onset. The gut-skin axis explains a bidirectional interaction between skin and gut microbiota in some inflammatory skin diseases such as atopic dermatitis, psoriasis, or rosacea. The introduction and consolidation of the next-generation sequencing in recent years has provided unprecedented information about the microbiome. However, the characterization of the gut and skin microbiota and the impact of the gut-skin axis in patients with rosacea has been little explored, in contrast to other inflammatory skin diseases such as atopic dermatitis or psoriasis. Furthermore, the clinical evolution of patients with rosacea is not always adequate and it is common for them to present a sustained symptomatology with frequent flare-ups. In this context, probiotic supplementation could improve the clinical evolution of these patients as happens in other pathologies. Through this review we aim to establish and compile the basics and directions of current knowledge to understand the mechanisms by which the microbiome influences the pathogenesis of rosacea, and how modulation of the skin and gut microbiota could benefit these patients.
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Affiliation(s)
- Pedro Sánchez-Pellicer
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | | | | | - Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de La Princesa, Madrid, Spain
| | - Laura Navarro-Moratalla
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Eva Núñez-Delegido
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Juan Agüera-Santos
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
| | - Vicente Navarro-López
- MiBioPath Research Group, Faculty of Medicine, Catholic University of Murcia (UCAM), Guadalupe, Spain
- Infectious Diseases Unit, Department of Internal Medicine, University Hospital of Vinalopó-Fisabio, Elche, Spain
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Park S, Jang H, Seong SH, Kim JY, Lee EJ, Bae YJ, Ahn YJ, Kim J, Oh SH. The effects of long-pulsed alexandrite laser therapy on facial redness and skin microbiota compositions in rosacea: A prospective, multicentre, single-arm clinical trial. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40. [PMID: 37890996 DOI: 10.1111/phpp.12921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/26/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Rosacea is a chronic skin disorder characterised by abnormal neurovasculature and inflammation in the central region of the face. The efficacy of pulsed-dye laser and intense pulsed light treatments for rosacea have been demonstrated in several clinical trials. However, there is currently no research on the efficacy of long-pulsed alexandrite laser (LPAL) therapy alone for rosacea-related facial redness and its effect on skin microbiota. AIM To evaluate the efficacy of LPAL therapy on facial redness in rosacea and assess changes in skin microbiota composition. METHODS Subjects with rosacea (n = 21, mean age: 39.2 ± 11.3 years) were recruited from two medical institutions and received monthly LPAL treatments (Clarity II™, Lutronic Corp.) for 3 months. At each visit, clinical photographs were taken, and erythema was measured using a spectrometer. At the initial and final visits, the Dermatology Life Quality Index (DLQI) and Skin Sensitivity Questionnaire (SSQ) were evaluated. Skin swabs were obtained at the initial and final visit, and facial microbiome composition was analysed using 16S rRNA amplicon sequencing. RESULTS After three LPAL treatment sessions, the average facial erythema index, measured using Mexameter® decreased significantly from 360.0 ± 96.7 at baseline to 312.0 ± 94.5 at the final visit (p < .05). The DLQI and SSQ showed significant improvement of symptoms. Skin microbiome diversity and relative abundance were altered significantly, particularly in the genera Clostridium, Lawsonella, Bacteroides, and Lactobacillus. CONCLUSIONS LPAL therapy alone showed favourable efficacy for the treatment of facial redness in rosacea, with some impacts on the skin microbiota composition.
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Affiliation(s)
- Sujin Park
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyunwoo Jang
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seol Hwa Seong
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Jung Lee
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yu Jeong Bae
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Ju Ahn
- HuNBiome Co., Ltd., R&D Center, Seoul, Korea
| | - Jihee Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Department of Dermatology, Yongin Severance Hospital, Yongin, Korea
| | - Sang Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Hofmeyer S, Weber F, Gerds S, Emmert S, Thiem A. A Prospective Randomized Controlled Pilot Study to Assess the Response and Tolerability of Cold Atmospheric Plasma for Rosacea. Skin Pharmacol Physiol 2023; 36:205-213. [PMID: 37490882 PMCID: PMC10652650 DOI: 10.1159/000533190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
INTRODUCTION Rosacea is a common, facial, chronic inflammatory skin disease. Due to its complex pathogenesis, adequate therapy of rosacea can be challenging. An innovative recent therapeutic tool is cold atmospheric plasma (CAP), which is already established in the treatment of chronic wounds and promising in different other skin diseases. METHODS In a split-face pilot study we investigated dielectric-barrier-discharged CAP in erythemato-telangiectatic (ETR) and/or papulopustular rosacea (PPR). CAP treatment was applied on lesional skin of a randomized side once daily (90 s/area) for 6 weeks. The other untreated side served as control. Co-primary endpoints were ≥1 improvement of the Investigator Global Assessment (IGA) score on the treated side compared to control and a decline of the Dermatology Life Quality Index (DLQI) after 6 weeks. Secondary endpoints included inflammatory lesion count (papules and pustules), skin redness intensity and erythema size. Adverse events (AEs) were recorded constantly. Additionally, participants were weekly assessed for symptoms, skin condition, trigger factors, skin care, treatment success, and local tolerance parameters. All p values were calculated using the Wilcoxon signed-rank test. RESULTS Twelve subjects (ETR, n = 3; ETR and PPR, n = 9) completed the study. DLQI was significantly improved after 6 weeks (p = 0.007). On the CAP-treated side, lesions (p = 0.007) and erythema size (p = 0.041) were significantly reduced compared to the control. IGA (p = 0.2) and skin redness intensity (p = 0.5) did not differ significantly between control and CAP-treated side. No serious AEs occurred and treatment was well tolerated. CONCLUSION CAP is a promising new treatment of rosacea, especially for PPR.
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Affiliation(s)
- Stella Hofmeyer
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Frank Weber
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center Rostock, Rostock, Germany
| | - Sandra Gerds
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Steffen Emmert
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
| | - Alexander Thiem
- Clinic and Policlinic for Dermatology and Venereology, University Medical Center Rostock, Rostock, Germany
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7
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De Almeida CV, Antiga E, Lulli M. Oral and Topical Probiotics and Postbiotics in Skincare and Dermatological Therapy: A Concise Review. Microorganisms 2023; 11:1420. [PMID: 37374920 DOI: 10.3390/microorganisms11061420] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/25/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
The skin microbiota is a pivotal contributor to the maintenance of skin homeostasis by protecting it from harmful pathogens and regulating the immune system. An imbalance in the skin microbiota can lead to pathological conditions such as eczema, psoriasis, and acne. The balance of the skin microbiota components can be disrupted by different elements and dynamics such as changes in pH levels, exposure to environmental toxins, and the use of certain skincare products. Some research suggests that certain probiotic strains and their metabolites (postbiotics) may provide benefits such as improving the skin barrier function, reducing inflammation, and improving the appearance of acne-prone or eczema-prone skin. Consequently, in recent years probiotics and postbiotics have become a popular ingredient in skincare products. Moreover, it was demonstrated that skin health can be influenced by the skin-gut axis, and imbalances in the gut microbiome caused by poor diet, stress, or the use of antibiotics can lead to skin conditions. In this way, products that improve gut microbiota balance have been gaining attention from cosmetic and pharmaceutical companies. The present review will focus on the crosstalk between the SM and the host, and its effects on health and diseases.
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Affiliation(s)
| | - Emiliano Antiga
- Department of Health Sciences, Section of Dermatology, University of Florence, 50139 Florence, Italy
| | - Matteo Lulli
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, 50134 Florence, Italy
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8
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Chen Y, Knight R, Gallo RL. Evolving approaches to profiling the microbiome in skin disease. Front Immunol 2023; 14:1151527. [PMID: 37081873 PMCID: PMC10110978 DOI: 10.3389/fimmu.2023.1151527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/14/2023] [Indexed: 04/22/2023] Open
Abstract
Despite its harsh and dry environment, human skin is home to diverse microbes, including bacteria, fungi, viruses, and microscopic mites. These microbes form communities that may exist at the skin surface, deeper skin layers, and within microhabitats such as the hair follicle and sweat glands, allowing complex interactions with the host immune system. Imbalances in the skin microbiome, known as dysbiosis, have been linked to various inflammatory skin disorders, including atopic dermatitis, acne, and psoriasis. The roles of abundant commensal bacteria belonging to Staphylococcus and Cutibacterium taxa and the fungi Malassezia, where particular species or strains can benefit the host or cause disease, are increasingly appreciated in skin disorders. Furthermore, recent research suggests that the interactions between microorganisms and the host's immune system on the skin can have distant and systemic effects on the body, such as on the gut and brain, known as the "skin-gut" or "skin-brain" axes. Studies on the microbiome in skin disease have typically relied on 16S rRNA gene sequencing methods, which cannot provide accurate information about species or strains of microorganisms on the skin. However, advancing technologies, including metagenomics and other functional 'omic' approaches, have great potential to provide more comprehensive and detailed information about the skin microbiome in health and disease. Additionally, inter-species and multi-kingdom interactions can cause cascading shifts towards dysbiosis and are crucial but yet-to-be-explored aspects of many skin disorders. Better understanding these complex dynamics will require meta-omic studies complemented with experiments and clinical trials to confirm function. Evolving how we profile the skin microbiome alongside technological advances is essential to exploring such relationships. This review presents the current and emerging methods and their findings for profiling skin microbes to advance our understanding of the microbiome in skin disease.
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Affiliation(s)
- Yang Chen
- Department of Dermatology, University of California San Diego, La Jolla, CA, United States
- Department of Pediatrics, University of California San Diego, La Jolla, CA, United States
- Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, CA, United States
| | - Rob Knight
- Department of Pediatrics, University of California San Diego, La Jolla, CA, United States
- Department of Computer Science and Engineering, University of California San Diego, La Jolla, CA, United States
- Department of Bioengineering, University of California San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, United States
| | - Richard L. Gallo
- Department of Dermatology, University of California San Diego, La Jolla, CA, United States
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, United States
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Chudzicka-Strugała I, Gołębiewska I, Brudecki G, Elamin W, Zwoździak B. Demodicosis in Different Age Groups and Alternative Treatment Options-A Review. J Clin Med 2023; 12:jcm12041649. [PMID: 36836184 PMCID: PMC9961532 DOI: 10.3390/jcm12041649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/22/2023] Open
Abstract
Infestation with Demodex mites is a common occurrence, especially in adults and the elderly. More recent attention has been paid to the presence of Demodex spp. mites in children, even ones without comorbidities. It causes both dermatological and ophthalmological problems. The presence of Demodex spp. is often asymptomatic, thus it is suggested to include parasitological investigation tests in dermatological diagnostics, in addition to bacteriological analysis. Literature reports show that Demodex spp. are related to the pathogenesis of numerous dermatoses, including rosacea or demodicosis gravis, and common eye pathologies reported by patients such as dry eye syndrome or ocular surface inflammatory conditions, such as blepharitis, chalazia, Meibomian gland dysfunction, and keratitis. Treatment of patients is a challenge and is usually prolonged, therefore it is important to carefully diagnose and properly select the therapy regimen for the treatment to be successful, and with minimal side effects, especially for young patients. Apart from the use of essential oils, research is ongoing for new alternative preparations active against Demodex sp. Our review was focused on the analysis of the current literature data on the available agents in the treatment of demodicosis in adults and children.
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Affiliation(s)
- Izabela Chudzicka-Strugała
- Department of Medical Microbiology, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
| | - Iwona Gołębiewska
- Earth and Life Institute (ELI), Université Catholique de Louvain, Croix du Sud 2, 1348 Louvain-La-Neuve, Belgium
- Correspondence:
| | - Grzegorz Brudecki
- Group 42 (Healthcare), Masdar City, Abu Dhabi P.O. Box 112778, United Arab Emirates
| | - Wael Elamin
- Group 42 (Healthcare), Masdar City, Abu Dhabi P.O. Box 112778, United Arab Emirates
| | - Barbara Zwoździak
- Department of Medical Microbiology, Poznan University of Medical Sciences, Rokietnicka 10, 60-806 Poznan, Poland
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10
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Zhu W, Hamblin MR, Wen X. Role of the skin microbiota and intestinal microbiome in rosacea. Front Microbiol 2023; 14:1108661. [PMID: 36846769 PMCID: PMC9950749 DOI: 10.3389/fmicb.2023.1108661] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/09/2023] [Indexed: 02/12/2023] Open
Abstract
Rosacea is a chronic inflammatory cutaneous disorder of uncertain etiology that mainly affects the centrofacial region, including cheeks, nose, chin, forehead, and eyes. The pathogenesis of rosacea remains unclear because it involves several complex factors. Additionally, the potential treatment methods need to be explored. We reviewed the common bacterial species in the skin microbiota and gut microbiota of rosacea patients such as Demodex folliculorum, Staphylococcus epidermidis, Bacillus oleronius, Cutibacterium acnes, and Helicobacter pylori and identified their role in the pathogenesis. Besides, we summarized the influence factors such as temperature and age on rosacea patients. We also systematically reviewed the commonly used clinical treatment methods, including antibiotics, probiotics. as well as their treatment mechanism and application precautions.
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Affiliation(s)
- Weitao Zhu
- Clinical Medicine (Eight-Year Program), West China School of Medicine, Sichuan University, Chengdu, China
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China,*Correspondence: Xiang Wen, ✉
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11
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Staphylococcus epidermidis and its dual lifestyle in skin health and infection. Nat Rev Microbiol 2023; 21:97-111. [PMID: 36042296 PMCID: PMC9903335 DOI: 10.1038/s41579-022-00780-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 01/20/2023]
Abstract
The coagulase-negative bacterium Staphylococcus epidermidis is a member of the human skin microbiota. S. epidermidis is not merely a passive resident on skin but actively primes the cutaneous immune response, maintains skin homeostasis and prevents opportunistic pathogens from causing disease via colonization resistance. However, it is now appreciated that S. epidermidis and its interactions with the host exist on a spectrum of potential pathogenicity derived from its high strain-level heterogeneity. S. epidermidis is the most common cause of implant-associated infections and is a canonical opportunistic biofilm former. Additional emerging evidence suggests that some strains of S. epidermidis may contribute to the pathogenesis of common skin diseases. Here, we highlight new developments in our understanding of S. epidermidis strain diversity, skin colonization dynamics and its multifaceted interactions with the host and other members of the skin microbiota.
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12
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Skincare in Rosacea from the Cosmetologist's Perspective: A Narrative Review. J Clin Med 2022; 12:jcm12010115. [PMID: 36614915 PMCID: PMC9821000 DOI: 10.3390/jcm12010115] [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: 11/27/2022] [Revised: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Rosacea is a common skin disease that affects about 5% of the general population. Its symptoms include telangiectasia, persistent erythema, burning/stinging sensation, dry skin sensation, and pruritus. It is characterized by a chronic course with frequent exacerbation. It often coexists with anxiety and depression, reducing the quality of life of affected patients. The etiopathogenesis of rosacea is complex and not fully elucidated; hence, there is no causative effective treatment. In this review, we highlight the role of a cosmetologist in the treatment of rosacea and the maintenance of remission. As part of medical treatment, patients are advised to introduce lifestyle changes and use proper skin care; a cosmetologist can help educate patients affected with rosacea, create effective home care programs for skin care, and support them with treatments in beauty salons. Proper skin care is essential, including the use of dermocosmetics, cleansing of the skin, and frequent visits to beauty salons for tailored apparatus procedures. A cosmetologist is more accessible to patients and can help implement healthy daily habits, including skin care and eating habits, as well as support and mediate good communication between the patient and the patient's treating physician, thereby improving compliance and ensuring long-term satisfactory outcomes.
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13
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Sun H, Duan Y, Li R. Reflection confocal microscope characteristics of rose acne and some thoughts caused by it. Skin Res Technol 2022; 28:762-765. [PMID: 35788994 PMCID: PMC9907667 DOI: 10.1111/srt.13192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/19/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Hongyong Sun
- Department of DermatologyPeople's Hospital of Inner Mongolia Autonomous RegionHohhotChina
| | - Yan Duan
- Department of DermatologyPeople's Hospital of Inner Mongolia Autonomous RegionHohhotChina
| | - Ruiya Li
- Department of DermatologyPeople's Hospital of Inner Mongolia Autonomous RegionHohhotChina
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14
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Liu X, Zhuo Y, Zhou Y, Hu J, Wen H, Xiao C. Analysis of the Vulvar Skin Microbiota in Asymptomatic Women and Patients With Vulvar Lichen Sclerosus Based on 16S rRNA Sequencing. Front Cell Dev Biol 2022; 10:842031. [PMID: 35445011 PMCID: PMC9014084 DOI: 10.3389/fcell.2022.842031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/11/2022] [Indexed: 12/01/2022] Open
Abstract
Vulvar lichen sclerosus (VLS) is a chronic inflammatory skin disease that brings life-long and psychological distress to patients. It remains unclear whether this condition is related to changes in the skin microbial community. The aim of this study was to evaluate the compositional characteristics of the vulvar skin microbiota between VLS patients and asymptomatic postmenopausal women. We included 60 cases of postmenopausal patients in the outpatient vulvar clinic of Peking University First Hospital from August 2020 to October 2020. Thirty-one patients were diagnosed with VLS by vulvar skin biopsy (VLS group), while 29 women were asymptomatic volunteers (control group). DNA was extracted from vulvar skin swabs of the VLS and control groups. The V3-V4 fragments of 16S rRNA were targeted for high-throughput sequencing and gene sequence analysis. The sequencing results were analysed by α diversity, β diversity, species composition, LEfSe analysis to compare the compositional differences of the vulvar skin microbiota between the two groups. Our study revealed that at the phylum level, patients with VLS had a lower relative abundance of Firmicutes (p < 0.0001) and a higher relative abundance of Proteobacteria than the control group (p < 0.0001). At the genus level, Lactobacillus spp. accounted for the largest proportion of the microflora in the asymptomatic controls, while the proportion of Prevotella spp. in the VLS group was the highest. In the VLS group, the relative abundance of Finegoldia spp., Ralstonia spp., Peptoniphilus spp., Anaerococcus spp., Campylobacter spp., Providencia spp. Kelbsiella spp., Ezakiella spp., and Escherichia-Shigella spp. was significantly increased compared with the control group. Although there was no significant difference in the α diversity of the vulvar skin microbiota, the β diversity differed significantly between the two groups.
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Affiliation(s)
- Xiaoxiao Liu
- Obstetrics and Gynaecology Department, Peking University First Hospital, Peking University, Beijing, China
| | - Yingying Zhuo
- School of Basic Medical Sciences, Peking University, Ministry of Education, Beijing, China
| | - Yunlu Zhou
- School of Basic Medical Sciences, Peking University, Ministry of Education, Beijing, China
| | - Jun Hu
- Obstetrics and Gynaecology Department, Peking University First Hospital, Peking University, Beijing, China
- *Correspondence: Jun Hu,
| | - Hongwu Wen
- Obstetrics and Gynaecology Department, Peking University First Hospital, Peking University, Beijing, China
| | - Changji Xiao
- Obstetrics and Gynaecology Department, Peking University First Hospital, Peking University, Beijing, China
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15
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Li G, Tang X, Zhang S, Deng Z, Wang B, Shi W, Xie H, Liu B, Li J. Aging-conferred SIRT7 Decline Inhibits Rosacea-like Skin Inflammation via Modulating TLR2-NF-κB Signaling. J Invest Dermatol 2022; 142:2580-2590.e6. [DOI: 10.1016/j.jid.2022.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 11/24/2022]
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16
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Lee WJ, Kraitman N, Sarriera-Lazaro CJ, Greene J. Rosacea Granulomatosis in a Neutropenic Leukemic Patient. Cureus 2022; 14:e23308. [PMID: 35464516 PMCID: PMC9015070 DOI: 10.7759/cureus.23308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2022] [Indexed: 11/19/2022] Open
Abstract
Rosacea granulomatosis is a common, chronic skin disorder that primarily affects the central face, namely the cheek, nose, chin, and central forehead. Although rosacea is mainly a disorder of innate and adaptive immunity, a variety of endogenous and exogenous triggers such as Demodex may stimulate it. Often found as commensal organisms in human skin, Demodex can be parasitic if there is a change in the host’s cutaneous environment. This is especially relevant for immunosuppressed patients, who need prompt treatment to prevent further complications. We review the literature regarding rosacea granulomatosis in immunosuppression and present an acute myelogenous leukemia patient with severe neutropenia, which may have promoted the development of rosacea due to Demodex mite proliferation. This local proliferation of the ectoparasite on the face can cause an atypical skin rash that mimics severe infections in the setting of neutropenia.
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17
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Forton FM. Rosacea, an infectious disease: why rosacea with papulopustules should be considered a demodicosis. A narrative review. J Eur Acad Dermatol Venereol 2022; 36:987-1002. [DOI: 10.1111/jdv.18049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
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18
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Gürtler A, Schmitt L. Der Einfluss der Ernährung bei entzündlichen Gesichtsdermatosen. J Dtsch Dermatol Ges 2022; 20:185-204. [PMID: 35146875 DOI: 10.1111/ddg.14683_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/05/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Anne Gürtler
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU, München
| | - Laurenz Schmitt
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Aachen
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19
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Kim HJ, Oh HN, Park T, Kim H, Lee HG, An S, Sul WJ. Aged related human skin microbiome and mycobiome in Korean women. Sci Rep 2022; 12:2351. [PMID: 35149745 PMCID: PMC8837753 DOI: 10.1038/s41598-022-06189-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 01/14/2022] [Indexed: 01/04/2023] Open
Abstract
We examined differences in the skin microbiome of two separate age groups to find key microbial and skin physiological indicators associated with aging. We recruited healthy Korean women 19–28 years old (Y-group) and 60–63 years old (O-group) and evaluated their cheek and forehead skin microbiome, including bacteria and fungi. The microbiome was significantly different by age group, with bacterial and fungal communities displaying higher alpha-diversity in the O-group than in the Y-group. We identified amplicon sequence variants affiliated with Cutibacterium and Lactobacillus and fungi Malassezia restricta as microbial biomarkers showing significant differences between the Y and O-group. There are more microbial communities and metabolic processes related to skin health in the Y-group than in the O-group, and there are more microbial interactions to increase the stability of the network structure of the skin. Skin physical metadata, including transepidermal water loss and sebum content, differed by two age groups. The crucial skin microbes, skin physical parameters, and microbial network found through this research will be useful key indicators in associating skin aging and skin microbiome research.
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Affiliation(s)
- Hye-Jin Kim
- Department of Systems Biotechnology, Chung-Ang University, Anseong, South Korea
| | - Han Na Oh
- Department of Systems Biotechnology, Chung-Ang University, Anseong, South Korea
| | - Taehun Park
- Safety Research Team, Amorepacific R&D Center, Yongin, South Korea
| | - Hanbyul Kim
- Safety Research Team, Amorepacific R&D Center, Yongin, South Korea
| | - Hyun Gee Lee
- Safety Research Team, Amorepacific R&D Center, Yongin, South Korea
| | - Susun An
- Safety Research Team, Amorepacific R&D Center, Yongin, South Korea.
| | - Woo Jun Sul
- Department of Systems Biotechnology, Chung-Ang University, Anseong, South Korea.
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20
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Gürtler A, Laurenz S. The impact of clinical nutrition on inflammatory skin diseases. J Dtsch Dermatol Ges 2022; 20:185-202. [PMID: 35088524 DOI: 10.1111/ddg.14683] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022]
Abstract
The influence of nutrition on the pathophysiology and clinical severity of inflammatory facial dermatoses such as acne, rosacea, seborrheic dermatitis, and perioral dermatitis has been controversially discussed for years. As part of a modern treatment approach, clinicians should provide patients with information on how their choice of diet might impact their dermatologic diagnosis and could potentially enhance therapeutic outcome. Recently, the concept of a gut-skin axis has gained momentum in the understanding of inflammatory dermatoses, with nutrition considered a contributing factor in this context. For example, gastrointestinal symptoms in rosacea patients may indicate a dysbiosis of the gut microbiome, treatment of which may also improve severity of the skin disease. New research efforts were recently made for acne patients addressing the clinical effects of omega-3 fatty acids and probiotics. In contrast, due to the limited data available, no comparable specific dietary recommendations can yet be made for seborrheic or perioral dermatitis. However, there are promising signs that clinical nutrition and dermatology will be more extensively interlinked in the future, both clinically and scientifically.
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Affiliation(s)
- Anne Gürtler
- Department for Dermatology and Allergy, University Hospital Munich, LMU, Munich, Germany
| | - Schmitt Laurenz
- Department of Dermatology and Allergology, University Hospital Aachen, Germany
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21
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Li Y, Wang R. Efficacy Comparison of Pulsed Dye Laser vs. Microsecond 1064-nm Neodymium:Yttrium-Aluminum-Garnet Laser in the Treatment of Rosacea: A Meta-Analysis. Front Med (Lausanne) 2022; 8:798294. [PMID: 35127754 PMCID: PMC8811442 DOI: 10.3389/fmed.2021.798294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/10/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose The advantage of pulsed dye laser (PDL) for the treatment of rosacea is not yet clear. This meta-analysis compared the curative effect of PDL to neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for the treatment of rosacea. Methods The PubMed, Embase, and Cochrane Library databases were searched for clinical studies on the efficacy of PDL for the treatment of rosacea through October 13, 2021, and heterogeneity tests among studies were evaluated. Meta-analysis was conducted to combine the effects of physicians' clinical assessments, patient global assessment, erythema index, and visual analog scale. Results A total of 326 articles were obtained from three databases and ten articles were finally included. The clinical improvements of >50% clearance of up to 68.6% in the PDL group and 71.4% in the control group, and the subjective satisfaction rate of patients in the PDL group of 88.6% compared to 91.4% in the Nd:YAG group, but there were no significant differences in the rates of patients with rosacea with clinical improvement (>50% clearance) (relative risk [RR] = 0.94, 95% confidence interval [CI]: 0.75–1.17, P = 0.578) or patient subjective satisfaction rate (RR = 0.96, 95% CI: 0.70–1.33, P = 0.808) between PDL and Nd:YAG groups for rosacea treatment. Also, the pain score for PDL and Nd:YAG were not significant (mean = 3.07, 95% CI: 1.82–4.32, P = 0.115). Conclusion Two treatments all showed clinical efficacy and patient satisfaction for the treatment of rosacea, with no significant differences observed between treatments. The pain scores for PDL and Nd:YAG were not significant.
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22
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Mahmud MR, Akter S, Tamanna SK, Mazumder L, Esti IZ, Banerjee S, Akter S, Hasan MR, Acharjee M, Hossain MS, Pirttilä AM. Impact of gut microbiome on skin health: gut-skin axis observed through the lenses of therapeutics and skin diseases. Gut Microbes 2022; 14:2096995. [PMID: 35866234 PMCID: PMC9311318 DOI: 10.1080/19490976.2022.2096995] [Citation(s) in RCA: 77] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/10/2022] [Accepted: 06/27/2022] [Indexed: 02/08/2023] Open
Abstract
The human intestine hosts diverse microbial communities that play a significant role in maintaining gut-skin homeostasis. When the relationship between gut microbiome and the immune system is impaired, subsequent effects can be triggered on the skin, potentially promoting the development of skin diseases. The mechanisms through which the gut microbiome affects skin health are still unclear. Enhancing our understanding on the connection between skin and gut microbiome is needed to find novel ways to treat human skin disorders. In this review, we systematically evaluate current data regarding microbial ecology of healthy skin and gut, diet, pre- and probiotics, and antibiotics, on gut microbiome and their effects on skin health. We discuss potential mechanisms of the gut-skin axis and the link between the gut and skin-associated diseases, such as psoriasis, atopic dermatitis, acne vulgaris, rosacea, alopecia areata, and hidradenitis suppurativa. This review will increase our understanding of the impacts of gut microbiome on skin conditions to aid in finding new medications for skin-associated diseases.
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Affiliation(s)
- Md. Rayhan Mahmud
- Department of Production Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Sharmin Akter
- Department of Microbiology, Jagannath University, Dhaka, Bangladesh
| | | | - Lincon Mazumder
- Department of Microbiology, Jagannath University, Dhaka, Bangladesh
| | - Israt Zahan Esti
- Department of Microbiology, Jagannath University, Dhaka, Bangladesh
| | | | - Sumona Akter
- Department of Microbiology, Jagannath University, Dhaka, Bangladesh
| | | | - Mrityunjoy Acharjee
- Department of Bioscience, Graduate School of Science and Technology, Shizuoka University, Shizuoka, Japan
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23
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Niehues H, van der Krieken DA, Ederveen THA, Jansen PAM, van Niftrik L, Mesman R, Netea MG, Smits JPH, Schalkwijk J, van den Bogaard EH, Zeeuwen PLJM. Antimicrobial late cornified envelope (LCE) proteins: the psoriasis risk factor LCE3B/C-del affects microbiota composition. J Invest Dermatol 2021; 142:1947-1955.e6. [PMID: 34942199 DOI: 10.1016/j.jid.2021.11.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 11/03/2021] [Accepted: 11/22/2021] [Indexed: 12/20/2022]
Abstract
Late cornified envelope (LCE) proteins are predominantly expressed in the skin and other cornified epithelia. Based on sequence similarity, this eighteen-member homologous gene family has been subdivided into six groups. The LCE3 proteins have been the focus of dermatological research, as the combined deletion of LCE3B and LCE3C genes (LCE3B/C-del) is a risk factor for psoriasis. We previously reported that LCE3B/C-del increases expression of the LCE3A gene and that LCE3 proteins exert antibacterial activity. In the current study we analyzed the antimicrobial properties of other family members and the role of LCE3B/C-del in modulation of microbiota composition of the skin and oral cavity. Differences in killing efficiency and specificity between the LCE proteins and their target microbes were found, and the amino acid content, rather than the order, of the well-conserved central domain of the LCE3A protein was found responsible for its antibacterial activity. In vivo, LCE3B/C-del correlated with a higher beta-diversity in the skin and oral microbiota. From these results we conclude that all LCE proteins possess antimicrobial activity. Tissue-specific and genotype-dependent antimicrobial protein profiles impact skin and oral microbiota composition, which could direct towards LCE3B/C-del associated dysbiosis and a possible role for microbiota in the pathophysiology of psoriasis.
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Affiliation(s)
- Hanna Niehues
- Department of Dermatology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Nijmegen Medical Center (Radboudumc), Nijmegen, The Netherlands
| | - Danique A van der Krieken
- Department of Dermatology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Nijmegen Medical Center (Radboudumc), Nijmegen, The Netherlands
| | - Thomas H A Ederveen
- Center for Molecular and Biomolecular Informatics, RIMLS, Radboudumc, Nijmegen, The Netherlands
| | - Patrick A M Jansen
- Department of Dermatology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Nijmegen Medical Center (Radboudumc), Nijmegen, The Netherlands
| | - Laura van Niftrik
- Department of Microbiology, Institute for Water and Wetland Research, Faculty of Science, Radboud University, Nijmegen, The Netherlands
| | - Rob Mesman
- Department of Microbiology, Institute for Water and Wetland Research, Faculty of Science, Radboud University, Nijmegen, The Netherlands
| | - Mihai G Netea
- Department of Internal Medicine, RIMLS, Radboudumc, Nijmegen, The Netherlands; Department of Immunology and Metabolism, Life and Medical Sciences Institute, University of Bonn, Bonn, Germany
| | - Jos P H Smits
- Department of Dermatology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Nijmegen Medical Center (Radboudumc), Nijmegen, The Netherlands
| | - Joost Schalkwijk
- Department of Dermatology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Nijmegen Medical Center (Radboudumc), Nijmegen, The Netherlands
| | - Ellen H van den Bogaard
- Department of Dermatology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Nijmegen Medical Center (Radboudumc), Nijmegen, The Netherlands
| | - Patrick L J M Zeeuwen
- Department of Dermatology, Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Nijmegen Medical Center (Radboudumc), Nijmegen, The Netherlands.
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24
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Alia E, Feng H. Rosacea pathogenesis, common triggers, and dietary role: The cause, the trigger, and the positive effects of different foods. Clin Dermatol 2021; 40:122-127. [PMID: 34819228 DOI: 10.1016/j.clindermatol.2021.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Rosacea is a common chronic inflammatory cutaneous disorder, primarily manifesting on the cheeks, nose, chin, and forehead with a classic relapsing-remitting course that affects mostly fair skin types (Fitzpatrick I and II). The pathogenesis remains unclear, but the complex interplay between environmental and genetic factors may augment the innate immune response and neurovascular dysregulation. Different nutrients may play a role in the pathogenesis of rosacea. Many dietary triggers, including hot beverages, alcohol, spicy foods, caffeine, vanilla, cinnamon, niacin, marinated meats, and dairy products, have been postulated for this disease; however, there is a lack of well-designed and controlled studies evaluating the causal relationship between rosacea and dietary factors. We have explored the available evidence and hypotheses based on trigger-food categories of rosacea, the role of the skin-gut microbiome axis, and potentially benefiting dietary factors such as probiotics, prebiotics, and high-fiber diets.
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Affiliation(s)
- Erisa Alia
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Hao Feng
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut, USA.
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25
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Evaluation of demodicosis, nailfold capillaroscopy, and oxidative stress in rosacea: a case-control study. Postepy Dermatol Alergol 2021; 38:590-596. [PMID: 34658699 PMCID: PMC8501418 DOI: 10.5114/ada.2021.108917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/03/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction Inflammation, immune system disorders, Demodex infestation, neurovascular dysregulation and oxidative stress are thought to be contributory factors in the pathogenesis of rosacea. Aim To evaluate the presence of Demodex mites, the morphologic features of the nailfold capillaries, and the systemic oxidative stress status in patients with rosacea. Material and methods Thirty-one patients diagnosed with rosacea and 37 healthy age- and gender-matched subjects were included in this prospective case-control study. The presence of Demodex infestation, the findings of nailfold capillaroscopy (NFC), and the status of systemic oxidative stress measured by total oxidant capacity (TOC), total antioxidant capacity (TAC) and oxidative stress index (OSI) were evaluated. Results Demodex infestation rates were significantly higher in rosacea patients than in controls (p = 0.001). Increases in the diameters of the capillaries and the presence of avascular areas and crossing and abnormal structures were significantly more common in rosacea patients than in the healthy controls (p < 0.01, p = 0.016, p = 0.02, p < 0.001, respectively), and hairpin structures were significantly less common in rosacea patients than in the controls (p < 0.001). The presence of crossing capillaries was positively correlated with higher TOC levels (p = 0.05), while abnormal structures were found to be correlated with lower levels of TAC (p = 0.045). Conclusions Oxidative status and NFC may play diagnostic and prognostic roles in rosacea, which should be confirmed by studies with larger sample sizes.
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26
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Naik PP. Utilities of Botulinum Toxins in Dermatology and Cosmetology. Clin Cosmet Investig Dermatol 2021; 14:1319-1330. [PMID: 34584436 PMCID: PMC8464334 DOI: 10.2147/ccid.s332247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 09/04/2021] [Indexed: 12/22/2022]
Abstract
Botulinum toxin (BoNT) is a neurotoxin produced by the Clostridium botulinum bacterium with a well-known efficacy and safety profile in the focal idiopathic hyperhidrosis treatment. BoNT comprises seven different neurotoxins; however, only toxins A and B are clinically employed. BoNT is lately practiced in off-label therapies for a variety of skin diseases. Scar prevention, hyperhidrosis, rhytides, eccrine nevus, alopecia, psoriasis, Darier disease, bullous skin disease, pompholyx and Raynaud's phenomenon are some of the novel indications for BoNT in cosmetic and notably non-cosmetic aspects of dermatology. To employ BoNT correctly in clinical practice, we must have a thorough understanding of the functional anatomy of the mimetic muscles. An intensive literature search was conducted to update all dermatology-oriented experiments and clinical trials on the described element of BoNT for this general overview of BoNT use in dermatology. This review aims to analyse the role of BoNT in dermatology and cosmetology.
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Affiliation(s)
- Piyu Parth Naik
- Department of Dermatology, Saudi German Hospital and Clinic, Dubai, United Arab Emirates
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27
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Chinnappan M, Harris-Tryon TA. Novel mechanisms of microbial crosstalk with skin innate immunity. Exp Dermatol 2021; 30:1484-1495. [PMID: 34252227 DOI: 10.1111/exd.14429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/28/2021] [Accepted: 07/06/2021] [Indexed: 12/12/2022]
Abstract
Skin is an organ with a dynamic ecosystem that harbours pathogenic and commensal microbes, which constantly communicate amongst each other and with the host immune system. Evolutionarily, skin and its microbiota have evolved to remain in homeostasis. However, frequently this homeostatic relationship is disturbed by a variety of factors such as environmental stress, diet, genetic mutations, and the microbiome itself. Commensal microbes also play a major role in the maintenance of microbial homeostasis. In addition to their ability to limit pathogens, many skin commensals such as Staphylococcus epidermidis and Cutibacterium acnes have recently been implicated in disease pathogenesis either by directly modulating the host immune components or by supporting the expansion of other pathogenic microbes. Likewise, opportunistic skin pathogens such as Staphylococcus aureus and Staphylococcus lugdunensis are able to breach the skin and cause disease. Though much has been established about the microbiota's function in skin immunity, we are in a time where newer mechanistic insights rapidly redefine our understanding of the host/microbial interface in the skin. In this review, we provide a concise summary of recent advances in our understanding of the interplay between host defense strategies and the skin microbiota.
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Affiliation(s)
- Mahendran Chinnappan
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Tamia A Harris-Tryon
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX, USA.,Department of Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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28
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van Zuuren EJ, Arents BWM, van der Linden MMD, Vermeulen S, Fedorowicz Z, Tan J. Rosacea: New Concepts in Classification and Treatment. Am J Clin Dermatol 2021; 22:457-465. [PMID: 33759078 PMCID: PMC8200341 DOI: 10.1007/s40257-021-00595-7] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2021] [Indexed: 12/16/2022]
Abstract
Rosacea is a chronic inflammatory dermatosis mainly affecting the cheeks, nose, chin, and forehead. Rosacea is characterized by recurrent episodes of flushing or transient erythema, persistent erythema, phymatous changes, papules, pustules, and telangiectasia. The eyes may also be involved. Due to rosacea affecting the face, it has a profound negative impact on quality of life, self-esteem, and well-being. In addition to general skin care, there are several approved treatment options available for addressing these features, both topical and systemic. For some features, intense pulse light, laser, and surgery are of value. Recent advances in fundamental scientific research have underscored the roles of the innate and adaptive immune systems as well as neurovascular dysregulation underlying the spectrum of clinical features of rosacea. Endogenous and exogenous stimuli may initiate and aggravate several pathways in patients with rosacea. This review covers the new phenotype-based diagnosis and classification system reflecting pathophysiology, and new and emerging treatment options and approaches. We address new topical and systemic formulations, as well as recent evidence on treatment combinations. In addition, ongoing studies investigating novel therapeutic interventions will be summarized.
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Affiliation(s)
- Esther J van Zuuren
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands.
| | - Bernd W M Arents
- Skin Patients Netherlands, Nieuwerkerk a/d IJssel, The Netherlands
| | | | - Sofieke Vermeulen
- Department of Dermatology, Reinier de Graaf Hospital, Delft, The Netherlands
| | | | - Jerry Tan
- Department of Medicine, Western University, Windsor Campus, Windsor, ON, Canada
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29
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Wang L, Yang M, Wang X, Cheng B, Ju Q, Eichenfield DZ, Sun BK. Glucocorticoids Promote CCL20 Expression in Keratinocytes. Br J Dermatol 2021; 185:1200-1208. [PMID: 34157145 PMCID: PMC9290737 DOI: 10.1111/bjd.20594] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
Glucocorticoids (GC) are generally envisioned as immunosuppressive, but in conditions such as rosacea and perioral dermatitis they can lead to increased skin inflammation. In lung epithelia, GC promote expression of the pro-inflammatory cytokine CCL20, which contributes to steroid-resistant asthma. In the skin, CCL20 stimulates inflammation by recruiting Th17 T-lymphocytes and dendritic cells and is elevated in papulopustular rosacea. The objective of this study was to understand if and how glucocorticoids affect CCL20 expression in human keratinocytes. CCL20 expression was assessed by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) and ELISA. Selective inhibition of candidate genes and signaling pathways was performed using RNA interference and chemical inhibitors. The binding of activated glucocorticoid receptor to genomic DNA was determined by chromatin immunoprecipitation, and enhancer activity of genomic sequences was measured with a reporter assay. We found that GC treatment increased CCL20 expression in human keratinocytes and murine skin, both in the undisturbed state and with tumor necrosis factor-α (TNFα) stimulation. GC repressed pro-inflammatory signaling pathways including NFκB and p38/MAPK, but these inhibitory effects were opposed by the direct binding of activated glucocorticoid receptor to the CCL20 enhancer, promoting CCL20 expression. Viewed together, these findings demonstrate a mechanism by which GC induce expression of CCL20 in keratinocytes, which may contribute to the inflammation seen in steroid-exacerbated skin conditions.
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Affiliation(s)
- L Wang
- Department of Dermatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, China.,Department of Dermatology, University of California San Diego, La Jolla, California, 92093, USA
| | - M Yang
- State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - X Wang
- Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, China
| | - B Cheng
- Department of Dermatology, University of California San Diego, La Jolla, California, 92093, USA
| | - Q Ju
- Department of Dermatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, China
| | - D Z Eichenfield
- Department of Dermatology, University of California San Diego, La Jolla, California, 92093, USA
| | - B K Sun
- Department of Dermatology, University of California San Diego, La Jolla, California, 92093, USA
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Ko J, Mandal A, Dhawan S, Shevachman M, Mitragotri S, Joshi N. Clinical translation of choline and geranic acid deep eutectic solvent. Bioeng Transl Med 2021; 6:e10191. [PMID: 34027084 PMCID: PMC8126811 DOI: 10.1002/btm2.10191] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/08/2020] [Accepted: 10/14/2020] [Indexed: 01/03/2023] Open
Abstract
Choline geranate deep eutectic solvent/ionic liquid (CAGE) has shown several desirable therapeutic properties including antimicrobial activity and ability to deliver drugs transdermally in research laboratories. Here, we describe the first report of clinical translation of CAGE from the lab into the clinic for the treatment of rosacea, a common chronic inflammatory skin disorder that affects the face. We describe the seven steps of clinical translation including (a) scale-up, (b) characterization, (c) stability analysis, (d) mechanism of action, (e) dose determination, (f) GLP toxicity study, and (g) human clinical study. We describe the challenges and outcomes in these steps, especially those that uniquely arise from the deep eutectic nature of CAGE. Our translational efforts led to a 12-week open-label phase 1b cosmetic study with CAGE1:2 gel (CGB400) in mild-moderate facial rosacea in 26 patients where CGB400 exhibited a marked reduction in the number of inflammatory lesions. These results demonstrate the therapeutic potential of CGB400 for treating rosacea as well as it provides insights into the translational journey of deep eutectic solvents, in particular CAGE, for dermatological applications.
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Affiliation(s)
- Justin Ko
- Department of DermatologyStanford University School of MedicineRedwood CityCaliforniaUSA
| | | | - Sunil Dhawan
- Center for Dermatology Clinical Research, Inc.FremontCaliforniaUSA
| | | | - Samir Mitragotri
- John A. Paulson School of Engineering and Applied SciencesHarvard UniversityCambridgeMassachusettsUSA
- Wyss Institute of Biologically Inspired Engineering at Harvard UniversityBostonMassachusettsUSA
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Chang J, Wang Y, Sun D, Zhang L, Man MQ, Tu Y, Jiang X, He L, Gu H. Characterization of rosacea in Chinese: An analysis of 254 cases. J Cosmet Dermatol 2021; 20:3666-3671. [PMID: 33655687 DOI: 10.1111/jocd.14039] [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: 01/24/2021] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rosacea is a common chronic inflammatory dermatosis with uncertainty of etiology. Although clinical features and risk factors of the disease in Caucasians have been reported, this information in Chinese is largely unavailable. AIMS To analyze the clinical features and associated risk factors of rosacea in Chinese. METHODS A questionnaire was given to outpatients with rosacea who visited the dermatology department of the first affiliated hospital of Kunming Medical University from June 2018 to March 2019. Analyses included demographic characteristics of subjects, clinical characteristics, and risk factors of rosacea. RESULTS A total of 254 outpatients completed the questionnaire. The ratio of female to male was 5.68:1.00. The mean age at onset was 31.18 ± 10.23 years. Erythematotelangiectatic subtype accounted for 51.60%, while 39% of the subjects were of papulopustular subtype. The rest were phymatous type (9.40%). Subjects with flushing, persistent facial erythema, and telangiectasia accounted for 91.73%, 90.55%, and 83.07%, respectively. One hundred and thirteen subjects (44.49%) had papules or pustules, and 24 subjects (9.40%) were with phymatous changes. The most commonly involved sites were the cheeks (93.31%), followed by the nose (82.68%), the perioral area (61.42%), and the forehead (51.97%). The clinical symptoms included burning (93.70%), dryness (90.55%), and itching (75.59%). The main risk factors were sun exposure (90.94%), temperature change (87.40%), etc. Fifty-one (20.08%) patients had comorbidities. CONCLUSIONS Rosacea mainly affects young females. The common signs and symptoms include flushing, persistent facial erythema, and burning. Sun exposure and temperature changes are the common risk factors. Patients can have comorbidities of systemic disorders.
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Affiliation(s)
- Jinxiu Chang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yulan Wang
- Department of Dermatology, Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Dongjie Sun
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liyuan Zhang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mao-Qiang Man
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Ying Tu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xin Jiang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua Gu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
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Daou H, Paradiso M, Hennessy K, Seminario-Vidal L. Rosacea and the Microbiome: A Systematic Review. Dermatol Ther (Heidelb) 2021; 11:1-12. [PMID: 33170492 PMCID: PMC7859152 DOI: 10.1007/s13555-020-00460-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
Rosacea, a chronic inflammatory skin disease characterized by recurrent episodes of facial flushing, erythema, pustules, and telangiectasia, largely affects fair-skinned women over 30 years of age. Although a long-recognized entity, the exact pathophysiology of this disease is still debated. Current theories highlight the role of the cutaneous microbiome and its associated inflammatory effects in rosacea's pathogenesis. However, microbiological reverberations are not limited to the skin, as recent studies have described the potential cutaneous effects of alterations in the gastrointestinal (GI) microbiome. Associations with additional GI pathologies, including small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD), have been investigated, as well as Helicobacter pylori infection. In an attempt to better understand and characterize these relationships, as well as current treatment options, we conducted a systematic review of the literature in PubMed, Cochrane, and Embase from their inception to August 6, 2020. We have synthesized the literature findings within three sections of this manuscript: the cutaneous microbiome, the gut microbiome, and therapeutic strategies. Future studies should focus on specific mechanisms linking GI pathology with rosacea manifestations and the role of enteral drugs in mitigating cutaneous symptoms.
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Affiliation(s)
- Hala Daou
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | | | - Kerry Hennessy
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL, USA
| | - Lucia Seminario-Vidal
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL, USA.
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33
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Updates on the Risk of Neuropsychiatric and Gastrointestinal Comorbidities in Rosacea and Its Possible Relationship with the Gut-Brain-Skin Axis. Int J Mol Sci 2020; 21:ijms21228427. [PMID: 33182618 PMCID: PMC7696644 DOI: 10.3390/ijms21228427] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 02/07/2023] Open
Abstract
Rosacea is a common chronic cutaneous inflammatory disorder. Recently, patients with rosacea were identified as having a higher risk of developing various comorbidities such as cardiovascular disease, psychiatric disorders, neurologic disorders, and gastrointestinal disorders. However, the risks of some comorbidities in patients with rosacea are somewhat contradictory, depending upon the study design. Moreover, pathomechanisms associated with the comorbidities of patients with rosacea remain poorly elucidated. The purpose of this review was to provide the most up-to-date evidence on the risks of neuropsychiatric and gastrointestinal comorbidities in patients with rosacea. Moreover, the molecular pathomechanisms associated with neuropsychiatric and gastrointestinal comorbidities in patients with rosacea were evaluated based on recent studies. This review was also intended to focus more on the role of the gut–brain–skin axis in the association of neuropsychiatric and gastrointestinal comorbidities in rosacea.
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34
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The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea? Dermatol Ther (Heidelb) 2020; 10:1229-1253. [PMID: 33095403 PMCID: PMC7649190 DOI: 10.1007/s13555-020-00458-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Indexed: 12/15/2022] Open
Abstract
Rosacea is a common facial dermatosis but its definition and classification are still unclear, especially in terms of its links with demodicosis. Triggers of rosacea (ultraviolet light, heat, spicy foods, alcohol, stress, microbes) are currently considered to induce a cascading innate and then adaptive immune response that gets out of control. Recent histological and biochemical studies support the concept that this inflammatory response is a continuum, already present from the onset of the disease, even when no clinical signs of inflammation are visible. The Demodex mite is beginning to be accepted as one of the triggers of this inflammatory cascade, and its proliferation as a marker of rosacea; moreover, the papulopustules of rosacea can be effectively treated with topical acaricidal agents. Demodex proliferation appears to be a continuum process in rosacea, and may not be clinically visible at the onset of the disease. Molecular studies suggest that Demodex may induce tolerogenic dendritic cells and collaborate with vascular endothelial growth factor (VEGF) to induce T cell exhaustion and favor its own proliferation. These interactions among VEGF, Demodex, and immunity need to be explored further and the nosology of rosacea adapted accordingly. However, treating early rosacea, with only clinically visible vascular symptoms, with an acaricide may decrease early inflammation, limit potential flare-ups following laser treatment, and prevent the ultimate development of the papulopustules of rosacea. The effectiveness of this approach needs to be confirmed by prospective controlled clinical trials with long-term follow-up. Currently, the evidence suggests that patients with only vascular symptoms of rosacea should be carefully examined for the presence of follicular scales as signs of Demodex overgrowth or pityriasis folliculorum so that these patients, at least, can be treated early with an acaricidal cream.
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35
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Abstract
Rosacea is a complex facial skin condition associated with abnormal inflammation and vascular dysfunction. Next to the known trigger factors, the role of microbiota in the development and aggravation of rosacea continues to raise interest. Demodex folliculorum mites, Helicobacter pylori, Staphylococcus epidermidis, Chlamydia pneumoniae, and the Demodex-associated bacterium, Bacillus oleronius are microbes that have been linked with rosacea. However, the results of studies which assessed their involvement in the disease have been inconsistent and inconclusive. Microbiological research in many different disciplines exploded in recent years as methods to analyze complex microbial communities at the taxonomic and phylogenetic levels became available. Here, we provide an update on the microorganisms implicated in rosacea and review the potential pathogenic role of microbes in the development of rosacea.
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Affiliation(s)
- Hei Sung Kim
- Department of Dermatology and Cutaneous Surgery, Miami Itch Center, Miller School of Medicine, University of Miami, Miami, FL, USA.
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, 06591, Korea.
- Department of Biomedicine and Health Sciences, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea.
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36
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Ederveen THA, Smits JPH, Boekhorst J, Schalkwijk J, van den Bogaard EH, Zeeuwen PLJM. Skin microbiota in health and disease: From sequencing to biology. J Dermatol 2020; 47:1110-1118. [PMID: 32804417 PMCID: PMC7589227 DOI: 10.1111/1346-8138.15536] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/06/2020] [Indexed: 01/24/2023]
Abstract
Microbiota live in a closely regulated interaction with their environment, and vice versa. The presence and absence of microbial entities is greatly influenced by features of the niche in which they thrive. Characteristic of this phenomenon is that different human skin sites harbor niche‐specific communities of microbes. Microbial diversity is considerable, and the current challenge lies in determining which microbes and (corresponding) functionality are of importance to a given ecological niche. Furthermore, as there is increasing evidence of microbial involvement in health and disease, the need arises to fundamentally understand microbiome processes for application in health care, nutrition and personal care products (e.g. diet, cosmetics, probiotics). This review provides a current overview of state‐of‐the‐art sequencing‐based techniques and corresponding data analysis methodology for profiling of complex microbial communities. Furthermore, we also summarize the existing knowledge regarding cutaneous microbiota and their human host for a wide range of skin diseases.
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Affiliation(s)
- Thomas H A Ederveen
- Center for Molecular and Biomolecular Informatics (CMBI), Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center (Radboudumc), Nijmegen, The Netherlands.,Department of Dermatology, RIMLS, Radboudumc, Nijmegen, The Netherlands
| | - Jos P H Smits
- Department of Dermatology, RIMLS, Radboudumc, Nijmegen, The Netherlands
| | - Jos Boekhorst
- Center for Molecular and Biomolecular Informatics (CMBI), Radboud Institute for Molecular Life Sciences (RIMLS), Radboud University Medical Center (Radboudumc), Nijmegen, The Netherlands.,NIZO, Ede, The Netherlands
| | - Joost Schalkwijk
- Department of Dermatology, RIMLS, Radboudumc, Nijmegen, The Netherlands
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Comparison of the efficacy of tea tree ( Melaleuca alternifolia) oil with other current pharmacological management in human demodicosis: A Systematic Review. Parasitology 2020; 147:1587-1613. [PMID: 32772960 DOI: 10.1017/s003118202000150x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Various treatments are found to be moderately effective in managing Demodex-related diseases except tea tree oil (TTO) and terpinen-4-ol (T4O), which showed superior miticidal and anti-inflammatory effects in numerous clinical studies. Their possible effects include lowering mite counts, relieving Demodex-related symptoms, and modulating the immune system. This review summarizes the current clinical topical and oral treatments in human demodicosis, their possible mechanisms of action, side-effects and resistance in treating this condition. TTO (especially T4O) is found to be the most effective followed by metronidazole, ivermectin and permethrin in managing the disease. This is because TTO has anti-parasitic, anti-bacterial, anti-fungal, anti-inflammatory and wound-healing effects. Furthermore, nanoTTO can even release its contents into fungus and Pseudomonas biofilms. Combinations of different treatments are occasionally needed for refractory cases, especially for individuals with underlying genetic predisposal or are immuno-compromised. Although the current treatments show efficacy in controlling the Demodex mite population and the related symptoms, further research needs to be focused on the efficacy and drug delivery technology in order to develop alternative treatments with better side-effects profiles, less toxicity, lower risk of resistance and are more cost-effective.
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38
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Searle T, Ali FR, Carolides S, Al‐Niaimi F. Rosacea and the gastrointestinal system. Australas J Dermatol 2020; 61:307-311. [DOI: 10.1111/ajd.13401] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Tamara Searle
- University of Birmingham Medical School Birmingham UK
| | - Faisal R. Ali
- Dermatological Surgery & Laser Unit St John’s Institute of Dermatology Guy’s Hospital Cancer Centre Guy’s and St Thomas’ NHS Foundation Trust Great Maze Pond London UK
- Vernova Healthcare CIC Macclesfield Cheshire UK
| | | | - Firas Al‐Niaimi
- Department of Dermatology Aalborg University Hospital Aalborg Denmark
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39
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Yuan C, Ma Y, Wang Y, Wang X, Qian C, Hocquet D, Zheng S, Mac-Mary S, Humbert P. Rosacea is associated with conjoined interactions between physical barrier of the skin and microorganisms: A pilot study. J Clin Lab Anal 2020; 34:e23363. [PMID: 32419294 PMCID: PMC7521319 DOI: 10.1002/jcla.23363] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/08/2020] [Accepted: 04/16/2020] [Indexed: 12/19/2022] Open
Abstract
Background Rosacea is a common condition characterized by transient or persistent central facial erythema, and often papules and pustules. Currently, the role of bacterium in the development and progression of rosacea remains controversial. This study aimed to investigate the difference in the physiological conditions and microorganisms between the lesional and non‐lesional areas of papulopustular rosacea. Methods Twenty‐five French patients with papulopustular rosacea were enrolled in this pilot study. Each patient was subjected to clinical assessment, and the skin barrier function was tested in lesional and non‐lesional areas. In addition, samples from the lesional and non‐lesional areas were collected for bacterial culturing. Results Of all subjects included in the study, a lower skin conductivity was measured in lesional areas than in non‐lesional areas (43.5 ± 12.4 vs. 57.2 ± 11.6 U, P < .05), and a higher transepidermal water loss (TEWL) value was found in lesional areas than in non‐lesional areas (17.2 ± 5.9 vs. 14.2 ± 4.1 g/(m2 h), P < .05). We found a lower TEWL in lesions in rosacea patients with bacterial dysbiosis than in those with bacterial balance (P < .05). In addition, there were significant differences in the skin conductivity and TEWL between lesional and non‐lesional areas in patients with bacterial dysbiosis (P < .001), and no significant differences were seen in patients with bacterial balance (P < .05). Conclusion The results of the present study demonstrate that the physiological features of rosacea are closely associated with the interactions between the host and the microorganisms.
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Affiliation(s)
- Chao Yuan
- Skin & Cosmetic Research Department, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yafeng Ma
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, China
| | | | - Xiuli Wang
- Department of Phototherapy, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chunyan Qian
- Yuhang Branch of the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Didier Hocquet
- Department of Infection Control, University Hospital of Besançon, France
| | - Shuli Zheng
- Skin & Cosmetic Research Department, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | | | - Philippe Humbert
- Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC INSERM 1431), University Hospital of Besançon, Besançon, France.,INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France.,FONDATION Cheikh Khalifa Mohammed VI Casablanca, Casablanca, Morocco
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40
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41
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Coupled blue and red light-emitting diodes therapy efficacy in patients with rosacea: two case reports. J Med Case Rep 2020; 14:22. [PMID: 31992343 PMCID: PMC6988247 DOI: 10.1186/s13256-019-2339-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/22/2019] [Indexed: 01/17/2023] Open
Abstract
Background Rosacea is a common inflammatory skin condition affecting approximately 5% of the world population. Therapeutic approaches to rosacea are focused on symptom suppression by means of anti-inflammatory agents. More recently, photodynamic therapy, especially light-emitting diodes, has been introduced as a valid alternative to conventional therapy. Case presentation In the present work, we reported the efficacy and safety of light-emitting diodes therapy combining blue (480 nm) and red (650 nm) light for the treatment of two patients with papulopustular rosacea: a 22-year-old Caucasian woman and a 68-year-old Caucasian man. Conclusions This kind of treatment could represent an effective, safer, and well-tolerated approach for the treatment of such conditions.
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Characterization and Analysis of the Skin Microbiota in Rosacea: Impact of Systemic Antibiotics. J Clin Med 2020; 9:jcm9010185. [PMID: 31936625 PMCID: PMC7019287 DOI: 10.3390/jcm9010185] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/06/2020] [Accepted: 01/07/2020] [Indexed: 02/06/2023] Open
Abstract
Systemic antibiotics are extensively used to control the papules and pustules of rosacea. Hence, it is crucial to understand their impact on the rosacea skin microbiota which is thought to be perturbed. The purpose of this study was to compare the makeup and diversity of the skin microbiota in rosacea before and after taking oral antibiotics. We also compared the skin microbiota at baseline according to age and rosacea severity. A longitudinal cohort study was performed on 12 rosacea patients with papules/pustules and no recent use of oral and topical antimicrobials/retinoids. Patients were prescribed oral doxycycline, 100 mg, twice daily for six weeks. Skin areas on the cheek and nose were sampled for 16S ribosomal RNA gene sequencing at baseline, and after six weeks of doxycycline treatment. Eleven females and one male aged 20–79 (median 51) with a median Investigator’s Global Assessment score of 3 (moderate) were enrolled. At baseline, Staphylococcus epidermidis was the most dominant species followed by Cutibacterium acnes (formerly Propionibacterium acnes). In the 60 Over-age group, the prevalence of Cutibacterium acnes was lower than that of the 60 & Under-age group. Rosacea severity increased with age and was associated with a decrease in the relative abundance of Cutibacterium acnes and an increase of Snodgrassella alvi. Across all subjects, antibiotic treatment reduced clinical rosacea grades and was associated with an increase in the relative abundance of Weissella confusa (P = 0.008, 95% CI 0.13% to 0.61%). Bacterial diversity (alpha diversity) was not significantly altered by antibiotics treatment. Principal coordinates analysis showed mild clustering of samples by patient (ANOSIM, Analysis of Similarity, R = 0.119, P = 0.16) and scant clustering with treatment (ANOSIM, R = 0.002; P = 0.5). In conclusion, we believe that rosacea has a unique age-dependent characteristic (i.e., severity). Although we were not able to pinpoint a causative microbiota, our study provides a glimpse into the skin microbiota in rosacea and its modulation by systemic antibiotics.
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43
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Marson JW, Baldwin HE. Rosacea: a wholistic review and update from pathogenesis to diagnosis and therapy. Int J Dermatol 2019; 59:e175-e182. [PMID: 31880327 DOI: 10.1111/ijd.14757] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/23/2019] [Accepted: 11/25/2019] [Indexed: 12/15/2022]
Abstract
Rosacea is a chronic inflammatory disorder of the central face with multiple overlapping presentations. Recent advancements are reshaping our understanding of rosacea from both a pathophysiologic perspective and clinical approach to therapy, introducing novel agents that have improved patient outcomes and reduced morbidity. In this article, we aim to outline the advancements in understanding, diagnosing, and managing rosacea and to familiarize physicians with the literature, thereby allowing us to better practice safe and effective medicine.
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Affiliation(s)
- Justin W Marson
- Department of Medicine, University of California at Irvine, Orange, CA, USA
| | - Hilary E Baldwin
- Medical Director, The Acne Treatment and Research Center, Morristown, NJ, USA.,Clinical Associate Professor of Dermatology, Rutgers Robert Wood Johnson Medical Center, Piscataway, NJ, USA
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44
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Ellis SR, Nguyen M, Vaughn AR, Notay M, Burney WA, Sandhu S, Sivamani RK. The Skin and Gut Microbiome and Its Role in Common Dermatologic Conditions. Microorganisms 2019; 7:microorganisms7110550. [PMID: 31717915 PMCID: PMC6920876 DOI: 10.3390/microorganisms7110550] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 10/27/2019] [Accepted: 11/06/2019] [Indexed: 02/08/2023] Open
Abstract
Microorganisms inhabit various areas of the body, including the gut and skin, and are important in maintaining homeostasis. Changes to the normal microflora due to genetic or environmental factors can contribute to the development of various disease states. In this review, we will discuss the relationship between the gut and skin microbiome and various dermatological diseases including acne, psoriasis, rosacea, and atopic dermatitis. In addition, we will discuss the impact of treatment on the microbiome and the role of probiotics.
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Affiliation(s)
- Samantha R. Ellis
- PotozkinMD Skincare Center, Danville, CA 94526, USA;
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
| | - Mimi Nguyen
- School of Medicine, University of California-Davis, Sacramento, CA 95817, USA; (M.N.); (S.S.)
| | - Alexandra R. Vaughn
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
| | - Manisha Notay
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
| | - Waqas A. Burney
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
- Department of Biological Sciences, California State University, Sacramento, CA 95819, USA
| | - Simran Sandhu
- School of Medicine, University of California-Davis, Sacramento, CA 95817, USA; (M.N.); (S.S.)
| | - Raja K. Sivamani
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
- Department of Biological Sciences, California State University, Sacramento, CA 95819, USA
- College of Medicine, California Northstate University, Elk Grove, CA 95757, USA
- Pacific Skin Institute, Sacramento, CA 95815, USA
- Zen Dermatology, Sacramento, CA 95819, USA
- Correspondence:
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Liu T, Deng Z, Xie H, Chen M, Xu S, Peng Q, Sha K, Xiao W, Zhao Z, Li J. ADAMDEC1 promotes skin inflammation in rosacea via modulating the polarization of M1 macrophages. Biochem Biophys Res Commun 2019; 521:64-71. [PMID: 31627897 DOI: 10.1016/j.bbrc.2019.10.073] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 10/09/2019] [Indexed: 12/16/2022]
Abstract
Rosacea is a chronic inflammatory cutaneous disease which mainly affects central face, leading to cosmetic disfigurement and compromised social psychology in billions of rosacea patients. Though the exact etiology of rosacea remains elusive, accumulating evidence has highlighted the dysfunction of innate immunity and inflammation in rosacea pathogenesis. Disintegrin Metalloprotease ADAM-like Decysin-1 (ADAMDEC1) is an orphan ADAM-like metalloprotease which is believed to be closely related to inflammation. Here for the first time, we reported that Adamdec1 expression was significantly increased in the skin lesions of rosacea patients and LL37-induced rosacea-like mouse models. Immunofluorescence analysis revealed co-localization of ADAMDEC1 and macrophages in patient and mouse biopsies. In cellular experiment, the expression of ADAMDEC1 was prominently elevated in M1 but not M2 macrophages. Knocking down of ADAMDEC1 significantly blunted M1 polarization in macrophages induced from human monocytes and THP-1 cell lines. Furthermore, silencing of Adamdec1 in LL-37-induced mouse model also suppressed the expression of M1 signature genes such as IL-6, iNOS and TNF-α, resulting in attenuated rosacea-like phenotype and inflammation. Taken together, our results demonstrate that ADAMDEC1 plays a pro-inflammatory role in rosacea via modulating the M1 polarization of macrophages.
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Affiliation(s)
- Tangxiele Liu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Zhili Deng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Central South University, Changsha, Hunan, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Hongfu Xie
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Mengting Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - San Xu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Qinqin Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Ke Sha
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Wenqin Xiao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Zhixiang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, China; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Central South University, Changsha, Hunan, 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; Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Central South University, Changsha, Hunan, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Abstract
Rosacea is a common chronic inflammatory skin disease of the central facial skin and is of unknown origin. Currently, two classifications of rosacea exist that are based on either "preformed" clinical subtypes (erythematotelangiectatic, papulopustular, phymatous, and ocular) or patient-tailored analysis of the presented rosacea phenotype. Rosacea etiology and pathophysiology are poorly understood. However, recent findings indicate that genetic and environmental components can trigger rosacea initiation and aggravation by dysregulation of the innate and adaptive immune system. Trigger factors also lead to the release of various mediators such as keratinocytes (for example, cathelicidin, vascular endothelial growth factor, and endothelin-1), endothelial cells (nitric oxide), mast cells (cathelicidin and matrix metalloproteinases), macrophages (interferon-gamma, tumor necrosis factor, matrix metalloproteinases, and interleukin-26), and T helper type 1 (T H1) and T H17 cells. Additionally, trigger factors can directly communicate to the cutaneous nervous system and, by neurovascular and neuro-immune active neuropeptides, lead to the manifestation of rosacea lesions. Here, we aim to summarize the recent advances that preceded the new rosacea classification and address a symptom-based approach in the management of patients with rosacea.
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Affiliation(s)
- Joerg Buddenkotte
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Martin Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medicine-Qatar, Doha, Qatar.,Medical School, Qatar University, Doha, Qatar.,Weill Cornell Medicine, New York, NY, USA
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Falay Gur T, Erdemir AV, Gurel MS, Kocyigit A, Guler EM, Erdil D. The investigation of the relationships of demodex density with inflammatory response and oxidative stress in rosacea. Arch Dermatol Res 2018; 310:759-767. [PMID: 30151656 DOI: 10.1007/s00403-018-1857-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/05/2018] [Accepted: 08/21/2018] [Indexed: 01/11/2023]
Abstract
The relationships of demodex density with systemic oxidative stress, inflammatory response, and clinical severity in rosacea are not clear. This study aimed to (a) analyze the levels of systemic oxidative stress, antioxidant capacity, inflammatory parameters, and matrix metalloproteinases (MMPs) in systemic circulation in patients with rosacea, (b) identify the relationship between mite density and both oxidative stress and inflammation, and (c) investigate the role of photoaging and sebum secretion in etiopathogenesis. Forty patients with rosacea and 40 age-, sex-, and skin phenotype-matched healthy volunteers were included in the study. Clinical disease severity of the patients was determined. Sebum levels were measured in both the groups, and photoaging was evaluated. Reflectance confocal microscopy was used to calculate demodex density. Serum total antioxidant capacity (TAC), total oxidant capacity (TOC), myeloperoxidase (MPO), MMP-1, MMP-9, arylesterase (ARES), interleukin-1β (IL-1β), paraoxonase-1 (PON-1), and tumor necrosis factor-α (TNF-α) levels were also analyzed. The patients with rosacea had significantly higher serum TOC and lower TAC levels (p < 0.001). The serum ARES and PON-1 levels were significantly lower (p = 0.045 and p < 0.001, respectively); however, the serum levels of MMP-1, MMP-9, IL-1β and MPO were higher in the patient group. Demodex parameters were higher in the patient group compared to the control group. There was no significant correlation between the number of mites and disease severity. In addition, the number of mites was not correlated with the serum levels of TAC, TOC, OSI, MPO, MMP-1, MMP-9, ARES, PON-1, TNF-α, and IL-1β. However, sebum levels were directly proportional to the number of mites. Photoaging severity was similar between the patients and control subjects. The changing sebaceous microenvironment in rosacea leads to an increase in the number of demodex mites. However, increased demodex density does not alter disease severity, level of oxidative stress, or inflammation. Although none of the patients with rosacea had any underlying systemic disease, patients' systemic oxidative stress and inflammation parameters were found high in systemic circulation. It is assumed that the patients with rosacea are more prone to systemic diseases.
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Affiliation(s)
- Tuğba Falay Gur
- Department of Dermatology, Sultan Abdulhamid Han Training and Research Hospital, Health Science University, Usküdar, Istanbul, Turkey.
| | - Aslı Vefa Erdemir
- Department of Dermatology, Göztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mehmet Salih Gurel
- Department of Dermatology, Göztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Abdurrahim Kocyigit
- Department of Biochemistry, Bezmialem Vakif University Medical School, Istanbul, Turkey
| | - Eray Metin Guler
- Department of Biochemistry, Bezmialem Vakif University Medical School, Istanbul, Turkey
| | - Duygu Erdil
- Department of Dermatology, Ağrı State Hospital, Ağrı, Turkey
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Maher A, Staunton K, Kavanagh K. Analysis of the effect of temperature on protein abundance in Demodex-associated Bacillus oleronius. Pathog Dis 2018; 76:4966982. [PMID: 29648591 DOI: 10.1093/femspd/fty032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 04/09/2018] [Indexed: 01/10/2023] Open
Abstract
A potential role for bacteria in the induction of rosacea has been suggested. The aim of this work was to characterise the effect of temperature on the production of immunostimulatory proteins by Bacillus oleronius-a bacterium to which rosacea patients show sera reactivity and which was originally isolated from a Demodex mite from a rosacea patient. The affected skin of rosacea patients is at a higher temperature than unaffected skin, and it was postulated that this might alter the protein expression pattern of B. oleronius. B. oleronius growth was reduced at 37°C compared to 30°C but resulted in increased expression of the immune-reactive 62kDa protein (1.65 fold [P < 0.05]). Proteomic analysis revealed increased abundance of a wide range of proteins involved in the stress response (e.g. stress proteins [21.7-fold increase], phosphocarrier protein HPr [438.5-fold increase], 60 kDa chaperonin [12.6-fold increase]). Proteins decreased in abundance after growth at 37°C included ferredoxin (325-fold decrease) and peptidase (244-fold decrease). This work indicates that the increased skin temperature of rosacea patients may alter the growth and protein production pattern of B. oleronius and lead to the greater production of immuo-stimulatory proteins.
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Affiliation(s)
- Amie Maher
- Department of Biology, Maynooth University, Co. Kildare, Ireland
| | - Kara Staunton
- Department of Biology, Maynooth University, Co. Kildare, Ireland
| | - Kevin Kavanagh
- Department of Biology, Maynooth University, Co. Kildare, Ireland
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Yuan C, Zheng SL, Ma YF, Philippe J, Philippe H. Cleanser use could decrease numbers of Demodex Folliculorum in mild to moderate acne patients. DERMATO-ENDOCRINOLOGY 2018; 9:e1348444. [PMID: 29485142 PMCID: PMC5821153 DOI: 10.1080/19381980.2017.1348444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 06/04/2017] [Accepted: 06/26/2017] [Indexed: 11/03/2022]
Abstract
Objective: This study was to verify if the skin cleanser could help decrease the infection ratio of Demodex Folliculorum in acne patients. Methods: 132 participants with mild to moderate vulgaris acne participated in this monocentric, prospective, double-blind study. Dermatologists grading and Standardized Skin Surface Biopsy were performed in baseline and after using cleanser only 7 d later. Results: There was no significant difference between the 2 times for each type of acne, but the number of Demodex Folliculorum was significantly decreased compared with baseline. There was no relationship between the number of Demodex Folliculorum and the total number of acne lesions. Limitations: Short follow-up time in 7 d. Conclusion: Using the cleanser could decrease the average number of Demodex Folliculorum in only 7 d in mild to moderate acne patients. There is no relationship between Demodex and acne lesions number.
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Affiliation(s)
- Chao Yuan
- Department of Skin & Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - Shu-Li Zheng
- Department of Skin & Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - Ya Feng Ma
- Department of Skin & Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - Juliandri Philippe
- Department of Skin & Cosmetic Research, Shanghai Skin Disease Hospital, Shanghai, China
| | - Humbert Philippe
- Department of Dermatology, Research and Studies Center on the Integument (CERT), Clinical Investigation Center (CIC INSERM 1431), Besançon University Hospital; INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France
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50
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Vaughn AR, Notay M, Clark AK, Sivamani RK. Skin-gut axis: The relationship between intestinal bacteria and skin health. World J Dermatol 2017; 6:52-58. [DOI: 10.5314/wjd.v6.i4.52] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 09/07/2017] [Accepted: 11/03/2017] [Indexed: 02/06/2023] Open
Abstract
The gut microbiome is an emerging area of interest in medicine. Imbalances in the gut microbiome have been linked to a number of disease states such as obesity and type 2 diabetes. The relationship between normally residing intestinal bacteria (the gut microbiota) and their potential role in the pathogenesis of skin diseases is an area of research for which we are only beginning to understand. Small studies have demonstrated underlying changes in the gut microbiome of patients with certain dermatological diseases. Interestingly, studies suggest that probiotics may have a role in the treatment of atopic dermatitis. However, the concept of the “skin-gut axis” is a newly emerging and important avenue of investigation, still lacking in pathobiological explanations. This review will introduce and describe the intestinal microbiome as it relates to skin health in a complex communication network between the immune system, endocrine system, metabolic system, and nervous system.
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Affiliation(s)
- Alexandra R Vaughn
- Drexel University College of Medicine, Philadelphia, PA 19129, United States
- UC Davis Department of Dermatology, Sacramento, CA 95816, United States
| | - Manisha Notay
- UC Davis Department of Dermatology, Sacramento, CA 95816, United States
| | - Ashley K Clark
- UC Davis Department of Dermatology, Sacramento, CA 95816, United States
| | - Raja K Sivamani
- UC Davis Department of Dermatology, Sacramento, CA 95816, United States
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