1
|
Geng RSQ, Bourkas AN, Mufti A, Sibbald RG. Rosacea: Pathogenesis and Therapeutic Correlates. J Cutan Med Surg 2024; 28:178-189. [PMID: 38450615 PMCID: PMC11015710 DOI: 10.1177/12034754241229365] [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] [Indexed: 03/08/2024]
Abstract
Rosacea is a chronic inflammatory condition of which there is no cure. The pathogenesis of rosacea is likely multifactorial, involving genetic and environmental contributions. Current understanding suggests that pro-inflammatory pathways involving cathelicidins and inflammasome complexes are central to rosacea pathogenesis. Common rosacea triggers modulate these pathways in a complex manner, which may contribute to the varying severity and clinical presentations of rosacea. Established and emerging rosacea treatments may owe their efficacy to their ability to target different players in these pro-inflammatory pathways. Improving our molecular understanding of rosacea will guide the development of new therapies and the use of combination therapies.
Collapse
Affiliation(s)
- Ryan S. Q. Geng
- Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Asfandyar Mufti
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - R. Gary Sibbald
- Temerty School of Medicine, University of Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health and Division of Dermatology, Department of Medicine, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
2
|
Yan S, Du D, Liu X, Dai Y, Kim MK, Zhou X, Wang L, Zhang L, Jiang X. Assessment of the Reliability and Clinical Applicability of ChatGPT's Responses to Patients' Common Queries About Rosacea. Patient Prefer Adherence 2024; 18:249-253. [PMID: 38313827 PMCID: PMC10838492 DOI: 10.2147/ppa.s444928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/22/2024] [Indexed: 02/06/2024] Open
Abstract
Objective Artificial intelligence chatbot, particularly ChatGPT (Chat Generative Pre-trained Transformer), is capable of analyzing human input and generating human-like responses, which shows its potential application in healthcare. People with rosacea often have questions about alleviating symptoms and daily skin-care, which is suitable for ChatGPT to response. This study aims to assess the reliability and clinical applicability of ChatGPT 3.5 in responding to patients' common queries about rosacea and to evaluate the extent of ChatGPT's coverage in dermatology resources. Methods Based on a qualitative analysis of the literature on the queries from rosacea patients, we have extracted 20 questions of patients' greatest concerns, covering four main categories: treatment, triggers and diet, skincare, and special manifestations of rosacea. Each question was inputted into ChatGPT separately for three rounds of question-and-answer conversations. The generated answers will be evaluated by three experienced dermatologists with postgraduate degrees and over five years of clinical experience in dermatology, to assess their reliability and applicability for clinical practice. Results The analysis results indicate that the reviewers unanimously agreed that ChatGPT achieved a high reliability of 92.22% to 97.78% in responding to patients' common queries about rosacea. Additionally, almost all answers were applicable for supporting rosacea patient education, with a clinical applicability ranging from 98.61% to 100.00%. The consistency of the expert ratings was excellent (all significance levels were less than 0.05), with a consistency coefficient of 0.404 for content reliability and 0.456 for clinical practicality, indicating significant consistency in the results and a high level of agreement among the expert ratings. Conclusion ChatGPT 3.5 exhibits excellent reliability and clinical applicability in responding to patients' common queries about rosacea. This artificial intelligence tool is applicable for supporting rosacea patient education.
Collapse
Affiliation(s)
- Sihan Yan
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Dan Du
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xu Liu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Yingying Dai
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Min-Kyu Kim
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xinyu Zhou
- Department of Dermatology, Nanbu County People’s Hospital, Nanbu County, Nanchong, Sichuan, People’s Republic of China
| | - Lian Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Lu Zhang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| |
Collapse
|
3
|
Almeida LMC, Ianhez M, Dal'Forno T, Picosse FR, Ravelli F, Kamamoto C, Sarlos P, Gold LFS. Long-term maintenance treatment of rosacea: experts' opinion. Int J Dermatol 2024; 63:94-101. [PMID: 38013632 DOI: 10.1111/ijd.16920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Rosacea is a chronic inflammatory dermatosis characterized by remissions and flares. Although the rosacea active treatment phase is well established, the long-term maintenance phase is still challenging. OBJECTIVE To discuss and make recommendations on how to treat patients during the long-term maintenance phase for the main rosacea phenotypes. METHODS A panel of six board-certified Brazilian dermatologists and one American dermatologist gathered to compose a consensus based upon an initial statement on how to treat rosacea during the long-term maintenance phase based on the methodology Nominal Group Technique. The experts discussed each factor based upon an initial statement on how to treat rosacea patients in the long-term maintenance phase. A sequence of comprehensive narrative reviews was performed; a questionnaire preparation about the definition of the maintenance phase and its management was presented; an interpersonal discussion and ranking of the ideas were conducted. Recommendations were made if the specialists had 75% agreement. RESULTS The maintenance treatment phase, which starts by achieving IGA 0 or 1 grades at the active phase, should be considered at least during the 9-month period after remission. The recommendations of all treatments target this period. Daily skincare regimen and sunscreen are crucial. Active treatment phase should be recommended if signs or symptoms reappear or worsen. CONCLUSION Maintenance phase success depends on patient's adherence to daily skin care, appropriate treatments, continued follow-up with dermatologist, and self-assessment to identify new signs and symptoms indicating disease relapse.
Collapse
Affiliation(s)
- Luiz M C Almeida
- Department of Dermatology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - Mayra Ianhez
- Hospital of Tropical Diseases, Universidade Federal de Goiás Faculdade de Medicina, Goiânia, Brazil
| | - Taciana Dal'Forno
- Dermatology Residency Program, Pontificia Universidade Catolica do Rio Grande do Sul Porto Alegre, Private Practice, Porto Alegre, Brazil
| | - Fabíola R Picosse
- Department of Dermatology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | | | | | - Linda F S Gold
- Department of Dermatology, Henry Ford Medical Centre, Detroit, MI, USA
| |
Collapse
|
4
|
Fisher GW, Travers JB, Rohan CA. Rosacea pathogenesis and therapeutics: current treatments and a look at future targets. Front Med (Lausanne) 2023; 10:1292722. [PMID: 38193038 PMCID: PMC10773789 DOI: 10.3389/fmed.2023.1292722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024] Open
Abstract
Rosacea is a chronic inflammatory skin condition associated with a significant health and economic burden from costs and loss of productivity due to seeking medical treatment. The disease encompasses multiple phenotypic manifestations involving a complex and multi-variate pathogenesis. Although the pathophysiology of rosacea is not completely understood, ongoing research is continually elucidating its mechanisms. In this review, current concepts of rosacea pathogenesis will be addressed which involve skin barrier and permeability dysfunction, the innate and adaptive immune systems, and the neurovascular system. More specifically, the cathelicidin pathway, transient potential receptor channels, mast cells, and the NLRP3 inflammasome pathway are various targets of current pharmacologic regimens. Future therapies may seek different mechanisms to act on current treatment targets, like the potential use of JAK/STAT inhibitors in ameliorating skin barrier dysfunction or TLR antagonists in alleviating cathelicidin mediated inflammation. Other potential treatments aim for entirely different molecular targets such as microvesicle particle mediated local and systemic inflammation. Ultimately rosacea is associated with a significant health and economic burden which warrants deeper research into its pathogenesis and resultant new treatment discovery.
Collapse
Affiliation(s)
- Garrett W. Fisher
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
| | - Jeffrey B. Travers
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Department of Medicine (Dermatology), Dayton Veterans Administration Medical Center, Dayton, OH, United States
| | - Craig A. Rohan
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Department of Medicine (Dermatology), Dayton Veterans Administration Medical Center, Dayton, OH, United States
| |
Collapse
|
5
|
Thapa L, Xia J, Guo W, Usmani H, Miller D, Lozeau D. Rosacea and Its Association With Malignancy: Systematic Review. JMIR DERMATOLOGY 2023; 6:e47821. [PMID: 37938876 PMCID: PMC10666011 DOI: 10.2196/47821] [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: 04/03/2023] [Revised: 07/26/2023] [Accepted: 10/05/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Rosacea is a chronic inflammatory skin condition that predominantly manifests as facial flushing, irritation, and acne. Rosacea and cancer are thought to be linked by the commonality of inflammatory and immune response dysfunction. Studies that have looked into this possible association have reported mixed results. OBJECTIVE Given the conflicting literature on this topic, our study sought to evaluate the overall association between rosacea and several cancers commonly investigated in the literature. METHODS A systematic review was conducted using the Cochrane, PubMed, Embase, and Ovid databases. Studies were screened independently for inclusion of rosacea and glioma and breast, thyroid, hepatic, or skin cancers. Using information from the articles, rosacea and each cancer were categorized as having a positive, negative, or unclear association. RESULTS Our systematic review included 39 full-text studies that investigated the association between rosacea and various malignancies. Among the malignancies of concern, 41% (16/39) of the studies reported an association with basal cell carcinoma, with 2 cohorts revealing an adjusted risk ratio (RR) of 1.50 (95% CI 1.35-1.67) and 0.72 (95% CI 0.56-0.93). In total, 33% (13/39) of the studies reported an association with squamous cell carcinoma, with 2 cohorts revealing an adjusted RR of 1.4 (95% CI 1.02-1.93) and 1.30 (95% CI 0.90-1.88). A total of 8% (3/39) of the studies reported an association between breast cancer and melanoma, with breast cancer cohorts revealing an adjusted RR of 8.453 (95% CI 1.638-43.606), 1.03 (95% CI 0.89-1.20), and 1.36 (95% CI 1.18-1.58) and melanoma cohorts revealing an adjusted RR of 1.10 (95% CI 0.95-1.27), 0.63 (95% CI 0.47-0.85), and 0.96 (95% CI 0.57-1.62). A total of 5% (2/39) of the studies reported an association among nonmelanoma skin cancers, hepatic cancer, and thyroid carcinomas, with nonmelanoma skin cancer cohorts revealing an adjusted RR of 1.36 (95% CI 1.26-1.47) and 2.66 (95% CI 1.53-4.61), hepatic cancer cohorts revealing an adjusted RR of 1.42 (95% CI 1.06-1.90) and 1.32 (95% CI 0.89-1.95), and thyroid carcinoma cohorts revealing an adjusted RR of 1.06 (95% CI 0.68-1.65) and 1.59 (95% CI 1.07-2.36). Only 1 cohort reported an association with glioma, revealing an adjusted RR of 1.36 (95% CI 1.18-1.58). According to our review, patients with rosacea were statistically more likely to have nonmelanoma skin cancers, breast cancer, and glioma. Rosacea was not found to be substantially associated with melanoma. The associations between rosacea and hepatic and thyroid cancers were unclear because of conflicting results. CONCLUSIONS The current literature shows that rosacea is significantly associated with increased odds of nonmelanoma skin cancers, glioma, and breast cancer. Rosacea does not appear to be associated with melanoma. Further studies should be conducted to clarify the association between thyroid and hepatic cancers and rosacea.
Collapse
Affiliation(s)
- Luna Thapa
- West Virginia School of Osteopathic Medicine, Lewisburg, WV, United States
| | - Joyce Xia
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - William Guo
- Department of Dermatology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Hunya Usmani
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| | - Devin Miller
- Stony Brook Dermatology Associates, Stony Brook, NY, United States
| | - Daniel Lozeau
- Department of Dermatology, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States
| |
Collapse
|
6
|
Senemar S, Kuzma BA, Ramezanli T, Ghosh P, Raney SG, Rantou E, Stagni G. Bioequivalence Evaluation of Topical Metronidazole Products Using Dermal Microdialysis in New Zealand Rabbits. AAPS PharmSciTech 2023; 24:204. [PMID: 37789133 DOI: 10.1208/s12249-023-02660-2] [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: 05/05/2023] [Accepted: 09/15/2023] [Indexed: 10/05/2023] Open
Abstract
Comparative assessment of cutaneous pharmacokinetics (cPK) by dermal microdialysis (dMD) appears to be suitable to evaluate the bioequivalence (BE) of topical dermatological drug products applied to the skin (TDDPs). Although dMD studies in the literature have reported inconclusive BE assessments, we have addressed several methodological deficiencies to improve dMD's capability to assess BE between reference (R) and approved generic (referred to as test (T)) gel and cream products of metronidazole (MTZ). The 90% confidence interval (CI) of the geometric mean ratios for the Ln(AUC0-24) and Ln(Cmax) endpoints was centered within the BE limits of 80-125%. The CIs extended outside this range as the proof-of-principle study was not statistically powered to demonstrate BE (N = 7 rabbits). A power analysis suggests that, with the variability observed in this study, 21 rabbits for the cream and 11 rabbits for the gel would be sufficient to support an evaluation of BE with the 2 probe replicates we used, and only 10 and 5 rabbits would be sufficient to power the study for the cream and gel, respectively, if 4 probe replicates are used for each treatment per rabbit. These results indicate that dMD when properly controlling variables can be used to support BE assessments for TDDPs.
Collapse
Affiliation(s)
- Sharareh Senemar
- Division of Pharmaceutical Sciences, Arnold and Marie Schwartz College of Pharmacy, Long Island University, 75 DeKalb Ave., Brooklyn, New York, 11201, USA
| | - Benjamin A Kuzma
- Division of Pharmaceutical Sciences, Arnold and Marie Schwartz College of Pharmacy, Long Island University, 75 DeKalb Ave., Brooklyn, New York, 11201, USA
- Drug Metabolism and Pharmacokinetics, Vertex Pharmaceuticals, Boston, Massachusetts, USA
| | - Tannaz Ramezanli
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Priyanka Ghosh
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Sam G Raney
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Elena Rantou
- Division of Biometrics VIII, Office of Biostatistics, Office of Translational Sciences, Center for Drug Evaluation and Research, United States Food and Drug Administration, Silver Spring, Maryland, USA
| | - Grazia Stagni
- Division of Pharmaceutical Sciences, Arnold and Marie Schwartz College of Pharmacy, Long Island University, 75 DeKalb Ave., Brooklyn, New York, 11201, USA.
| |
Collapse
|
7
|
Kuna AC, Flaig MJ, Guertler A. [Rosacea-the updated S2k guideline]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:715-724. [PMID: 37594512 DOI: 10.1007/s00105-023-05197-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 08/19/2023]
Abstract
Rosacea is a common chronic inflammatory dermatosis of the face, clinically characterized by erythema, telangiectasia, papules, pustules, and rhinophyma. In January 2022, the updated guideline on rosacea was published. Groundbreaking innovations include the new clinical classification according to phenotypes, extended diagnostic and therapeutic recommendations for ocular rosacea and implications of the gut microbiome on rosacea. Furthermore, the guideline encompasses a new chapter on the psychosocial aspects of rosacea and detailed recommendations for approved and off-label therapies.
Collapse
Affiliation(s)
- Anne-Charlotte Kuna
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland.
| | - Michael J Flaig
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
| | - Anne Guertler
- Klinik und Poliklinik für Dermatologie und Allergologie, Klinikum der Universität München, LMU München, Frauenlobstr. 9-11, 80337, München, Deutschland
| |
Collapse
|
8
|
Ohanenye C, Taliaferro S, Callender VD. Diagnosing Disorders of Facial Erythema. Dermatol Clin 2023; 41:377-392. [PMID: 37236708 DOI: 10.1016/j.det.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Identification of specific patterns, shades, and intensity of erythema in the skin has always been critical and fundamental to diagnostic accuracy in dermatology. Erythema is often less noticeable in darker skin types. The interplay of inflammation and variance of skin tone contributes to appreciable differences in the clinical appearance of cutaneous disease in darker complexions. In this article, we discuss common disorders that present with facial erythema in skin of color and offer distinguishing features of each disorder to assist the clinician with diagnosing these conditions in the presence of deeply pigmented skin.
Collapse
Affiliation(s)
- Chiamaka Ohanenye
- Lewis Katz School of Medicine at Temple University, 3500 North Broad Street, Philadelphia, PA 19140, USA
| | - Sumayah Taliaferro
- Atlanta Dermatology & Aesthetics, PC, 232 19th Street Northwest, Atlanta, GA 30363, USA
| | - Valerie D Callender
- Callender Dermatology & Cosmetic Center, 12200 Annapolis Road, Suite 315, Glenn Dale, MD 20769, USA.
| |
Collapse
|
9
|
Shen S, Yan G, Cao Y, Zeng Q, Zhao J, Wang X, Wang P. Dietary supplementation of n-3 PUFAs ameliorates LL37-induced rosacea-like skin inflammation via inhibition of TLR2/MyD88/NF-κB pathway. Biomed Pharmacother 2023; 157:114091. [PMID: 36481403 DOI: 10.1016/j.biopha.2022.114091] [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: 08/22/2022] [Revised: 11/28/2022] [Accepted: 12/04/2022] [Indexed: 12/12/2022] Open
Abstract
Rosacea is a facial chronic inflammatory skin disease with dysfunction of immune and neurovascular system and treatments for rosacea are challenging. N-3 polyunsaturated fatty acids (PUFAs), one of essential fatty acids, are needed for health maintenance and exert anti-inflammation and immunomodulatory effects in a series of cutaneous diseases such as atopic dermatitis and photoaging through dietary supplementation. However, the role of n-3 PUFAs on rosacea remains to be elucidated. In this study, KEGG enrichment analysis and GO analysis indicated that the biological process and signaling pathways, including chemokine signaling pathway, regulated by n-3 PUFAs highly overlapped with those in the pathogenic biological process of rosacea, especially the erythema telangiectasia type. Next, mice were randomized to fed with a customized n-3 PUFAs diet. We showed that n-3 PUFAs ameliorated skin erythema, inhibited dermal inflammatory cell infiltration (mast cells, neutrophils, and CD4 +T cells) and suppressed elevated pro-inflammatory cytokines in LL37-induced rosacea-like mice. Besides, n-3 PUFAs were also verified to repress angiogenesis in LL37-induced mice skin. Further investigation revealed that n-3 PUFAs attenuated LL37-induced inflammation via TLR2/ MyD88/ NF-κB pathway both in mice and in keratinocytes. In conclusion, our findings underscore that dietary supplementation of n-3 PUFAs have the potential to become an efficient and safe clinical therapeutic candidate for rosacea.
Collapse
Affiliation(s)
- Shuzhan Shen
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Guorong Yan
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Yajing Cao
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Qingyu Zeng
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, PR China
| | - Jingjun Zhao
- Department of Dermatology, Tongji Hospital, School of Medicine, Tongji University, Shanghai 200092, PR China.
| | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, PR China.
| | - Peiru Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200092, PR China.
| |
Collapse
|
10
|
Li Y, Hua W, Tang J, Xiong L, Li L. An online course about cosmetics improves skin care practices and skin health. Front Public Health 2022; 10:951481. [PMID: 36159238 PMCID: PMC9507002 DOI: 10.3389/fpubh.2022.951481] [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: 05/24/2022] [Accepted: 08/22/2022] [Indexed: 01/24/2023] Open
Abstract
Background The incidence of cosmetics-associated dermatoses is on the rise recently while the awareness and knowledge about proper utilization of cosmetics are insufficient in both the public and specialists due to limited education about cosmetics. Methods Our aim was to build and enhance the public's ability to select appropriate cosmetics, manage possible dermatoses and improve skin-care practices and skin health by offering access to medical information via free online courses. Consequently, we launched a massive open online course (MOOC), Appreciation and Analysis of Cosmetics. An online questionnaire was also sent to evaluate the effectiveness of the course. Results Nearly 540,000 learners were enrolled in the course since 2014. In the discussion forum, there were 8,383 posts and 73,014 replies in total, where learners were mostly concerned about topics of sun protection, cleansing and proper utilization of cosmetics in some skin diseases. 645 learners answered the questionnaire with 88.84% of the them changed skin care practices and 50.39% reported improvement in skin health. Moreover, participants who completed the course reported better understanding and utilization of cosmetics-related knowledge (p values < 0.05). 72.09% of respondents were willing to recommend this course to others. Conclusions Free online public courses are feasible for conducting public health education campaigns related to cosmetics and associated dermatology to lower the incidence of cosmetics-associated dermatoses.
Collapse
Affiliation(s)
- Yu Li
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, China,Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China,NMPA Key Laboratory for Human Evaluation and Big Data of Cosmetics, Chengdu, China,Sichuan Engineering Technology Research Center of Cosmetic, Chengdu, China
| | - Wei Hua
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, China,Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China,NMPA Key Laboratory for Human Evaluation and Big Data of Cosmetics, Chengdu, China,Sichuan Engineering Technology Research Center of Cosmetic, Chengdu, China
| | - Jie Tang
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, China,NMPA Key Laboratory for Human Evaluation and Big Data of Cosmetics, Chengdu, China,Sichuan Engineering Technology Research Center of Cosmetic, Chengdu, China
| | - Lidan Xiong
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, China,NMPA Key Laboratory for Human Evaluation and Big Data of Cosmetics, Chengdu, China,Sichuan Engineering Technology Research Center of Cosmetic, Chengdu, China,Lidan Xiong
| | - Li Li
- Center of Cosmetics Evaluation, West China Hospital, Sichuan University, Chengdu, China,Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China,NMPA Key Laboratory for Human Evaluation and Big Data of Cosmetics, Chengdu, China,Sichuan Engineering Technology Research Center of Cosmetic, Chengdu, China,*Correspondence: Li Li
| |
Collapse
|
11
|
Zhang Y, Li Y, Zhou L, Yuan X, Wang Y, Deng Q, Deng Z, Xu S, Wang Q, Xie H, Li J. Nav1.8 in keratinocytes contributes to ROS-mediated inflammation in inflammatory skin diseases. Redox Biol 2022; 55:102427. [PMID: 35952475 PMCID: PMC9372634 DOI: 10.1016/j.redox.2022.102427] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/21/2022] [Accepted: 07/30/2022] [Indexed: 11/22/2022] Open
Abstract
Reactive oxygen species (ROS)-activated proinflammatory signals in keratinocytes play a crucial role in the immunoregulation of inflammatory skin diseases, including rosacea and psoriasis. Nav1.8 is a voltage-gated sodium ion channel, and its abnormal expression in the epidermal layer contributes to pain hypersensitivity in the skin. However, whether and how epidermal Nav1.8 is involved in skin immunoregulation remains unclear. This study was performed to identify the therapeutic role of Nav1.8 in inflammatory skin disorders. We found that Nav1.8 expression was significantly upregulated in the epidermis of rosacea and psoriasis skin lesions. Nav1.8 knockdown ameliorated skin inflammation in LL37-and imiquimod-induced inflammation mouse models. Transcriptome sequencing results indicated that Nav1.8 regulated the expression of pro-inflammatory mediators (IL1β and IL6) in keratinocytes, thereby contributing to immune infiltration in inflammatory skin disorders. In vitro, tumor necrosis factor alpha (TNFα), a cytokine that drives the development of various inflammatory skin disorders, increased Nav1.8 expression in keratinocytes. Knockdown of Nav1.8 eliminated excess ROS production, thereby attenuating the TNFα-induced production of inflammatory mediators; however, a Nav1.8 blocker did not have the same effect. Mechanistically, Nav1.8 reduced superoxide dismutase 2 (SOD2) activity by directly binding to SOD2 to prevent its deacetylation and mitochondrial localization, subsequently inducing ROS accumulation. Collectively, our study describes a central role for Nav1.8 in regulating pro-inflammatory responses in the skin and indicates a novel therapeutic strategy for rosacea and psoriasis.
Collapse
Affiliation(s)
- Yiya Zhang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Yangfan Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - Lei Zhou
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - Xin Yuan
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - Yaling Wang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - Qing Deng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - Zhili Deng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
| | - San Xu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Qian Wang
- Hunan Binsis Biotechnology Co., Ltd, Changsha, China
| | - Hongfu Xie
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China; Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, China.
| |
Collapse
|
12
|
Fabbrocini G, Monteil CB, Carballido F. A cream containing the sap of oat plantlets and mandarin extract soothes the symptoms of rosacea and improves the quality of life of patients. J Eur Acad Dermatol Venereol 2022; 36 Suppl 8:3-11. [PMID: 35796500 DOI: 10.1111/jdv.18201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/05/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rosacea is a chronic inflammatory disease of the facial skin that affects all skin types and occurs mostly in adults. The main clinical sign of rosacea is a characteristic and persistent form of centro-facial erythema that is prone to exacerbation and can impair quality of life (QoL). The current therapeutic approach for rosacea is to combine various treatments, use appropriate skincare products and avoid flare-up triggers. OBJECTIVE To evaluate the use of a facial skincare product containing protein-free sap extruded from Rhealba® oat plantlets and mandarin extract in subjects with rosacea. METHODS Three clinical studies were conducted in adult subjects with various rosacea phenotypes (erythematotelangiectatic or papulopustular) and treatment histories to assess the dermatological and ophthalmological tolerance of the study product, as well as its clinical effectiveness, after a twice-daily application on the whole face and neck for up to 4 weeks. RESULTS Tolerance of the product was rated as good to very good by dermatologists across the three studies, which involved a total of 105 evaluable subjects. Subjects with untreated erythematotelangiectatic rosacea reported fewer functional signs and symptoms of the disease and an improved QoL. The evaluation of skin biometric parameters revealed a reduction in transepidermal water loss, indicating that the study product helped to restore skin barrier integrity after 4 weeks, and a higher skin pH, indicating that the cutaneous microbiote was respected. Most subjects (93%) who had either undergone a superficial dermatological procedure for erythematotelangiectatic rosacea or were taking oral/topical treatments for papulopustular rosacea, rated the study product as very good (8/10) and felt it further relieved their symptoms. CONCLUSION Overall, the study product was very well tolerated and may be beneficial for subjects with rosacea as an adjunct to superficial dermatological procedures or oral/topical therapies, in line with the current recommendations for rosacea management.
Collapse
Affiliation(s)
- G Fabbrocini
- Section of Dermatology and Venereology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Napoli, Italy
| | - C Beziat Monteil
- Pierre Fabre Dermo-Cosmétique Research & Development, Clinical Division, Toulouse, France
| | - F Carballido
- Laboratoires A-Derma, Pierre Fabre Dermo-Cosmétique, Lavaur, France
| |
Collapse
|
13
|
Hung CT, Chen YH, Hung TL, Chiang CP, Chen CY, Wang WM. Clinician-created educational video for shared decision-making in the outpatient management of acne. PLoS One 2022; 17:e0271100. [PMID: 35802643 PMCID: PMC9269380 DOI: 10.1371/journal.pone.0271100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 06/23/2022] [Indexed: 12/02/2022] Open
Abstract
Shared decision-making (SDM) provides patient-centered care. However, the limited consultation time was the main factor hindering the application. Patient education is crucial in the process of SDM. The use of visual aids as health education materials is an effective way to improve patients’ health literacy and medication adherence. This study aimed to determine the effectiveness of the clinician-created educational video of acne, accessed by patients during the waiting time, including knowledge level and satisfaction. This study was conducted in dermatology outpatient clinics and collected patient responses through electronic devices. During the waiting time, patients with acne would read educational pamphlets and complete the test first. Then, a clinician-created 8-minute educational video, as a patient decision aid (PDA), was accessed by patients using their own mobile smart devices, followed by a test and questionnaire about the satisfaction of the pamphlet and video. We enrolled 50 patients with acne, including 33 males and 17 females. The mean age is 25.55 ± 6.27 years old, ranging from 15 to 47 years old. About the patients’ knowledge, the test score improved significantly after watching the video (P < .001). The same findings were observed in the subgroup analysis of gender and different age groups. A higher proportion of patients preferred the educational video over the pamphlet in both genders and different age groups. All patients agreed with the video helped them to understand the educational information and impressed them more than reading pamphlets. The application of clinician-created educational videos in patient education seems to be an efficient solution to implement SDM in the daily clinical work. Besides, we could remind patients to watch the video anytime when they were not sure about the treatment choices, side effects, or the precautions of medications.
Collapse
Affiliation(s)
- Chih-Tsung Hung
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Department of General Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Yi-Hsien Chen
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of General Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Tzu-Ling Hung
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chien-Ping Chiang
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Yu Chen
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Wei-Ming Wang
- Department of Dermatology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
- Vice Chairman, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
| |
Collapse
|
14
|
Choi D, Choi S, Choi S, Park SM, Yoon HS. Association of Rosacea With Cardiovascular Disease: A Retrospective Cohort Study. J Am Heart Assoc 2021; 10:e020671. [PMID: 34558290 PMCID: PMC8649155 DOI: 10.1161/jaha.120.020671] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background There is emerging evidence that rosacea, a chronic cutaneous inflammatory disease, is associated with various systemic diseases. However, its association with cardiovascular disease (CVD) remains controversial. We aimed to investigate whether patients with rosacea are at increased risk of developing CVD. Methods and Results This retrospective cohort study from the Korean National Health Insurance Service-Health Screening Cohort included patients with newly diagnosed rosacea (n=2681) and age-, sex-, and index year-matched reference populations without rosacea (n=26 810) between 2003 and 2014. The primary outcome was subsequent CVD including coronary heart disease and stroke. Multivariable Cox regression analyses were used to evaluate adjusted hazard ratios for subsequent CVD adjusted for major risk factors of CVD. Compared with the reference population (13 410 women; mean [SD] age, 57.7 [9.2] years), patients with rosacea (1341 women; mean [SD] age, 57.7 [9.2] years) displayed an increased risk for CVD (adjusted hazard ratios, 1.20; 95% CI, 1.03-1.40) and coronary heart disease (adjusted hazard ratios, 1.29; 95% CI, 1.05-1.60). The risk for stroke was not significantly elevated (adjusted hazard ratios, 1.12; 95% CI, 0.91-1.37). Conclusions This study suggests that patients with rosacea are more likely to develop subsequent CVD. Proper education for patients with rosacea to manage other modifiable risk factors of CVD along with rosacea is needed.
Collapse
Affiliation(s)
- Daein Choi
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea.,Department of Medicine Mount Sinai Beth IsraelIcahn School of Medicine at Mount Sinai New York NY
| | - Sungjun Choi
- Department of Dermatology Seoul National University Hospital Seoul South Korea
| | - Seulggie Choi
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea
| | - Sang Min Park
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea.,Department of Family Medicine Seoul National University Hospital Seoul South Korea
| | - Hyun-Sun Yoon
- Department of Dermatology SMG-SNU Boramae Medical Center Seoul South Korea
| |
Collapse
|
15
|
Marchitto MC, Chien AL. Mast Cell Stabilizers in the Treatment of Rosacea: A Review of Existing and Emerging Therapies. Dermatol Ther (Heidelb) 2021; 11:1541-1549. [PMID: 34476755 PMCID: PMC8484408 DOI: 10.1007/s13555-021-00597-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Indexed: 12/11/2022] Open
Abstract
Rosacea is a chronic inflammatory skin disease characterized by centrofacial erythema, papules, pustules, and telangiectasias. The onset of rosacea typically occurs after 30 years of age. It is estimated that approximately 2–5% of adults worldwide are affected. While the exact etiology of rosacea remains unknown, its pathogenesis is thought to be multifactorial with both environmental and genetic factors implicated. Ultraviolet radiation, heat, steam, ingested agents, including spicy foods and alcohol, host vasculature, dermal matrix degeneration, genetic susceptibility, and microbial organisms, including Demodex mites and Heliobacter pylori, have been implicated in the development of rosacea. Recently, mast cells (MCs) have emerged as key players in the pathogenesis of rosacea through the release of pro-inflammatory cytokines, chemokines, proteases, and antimicrobial peptides leading to cutaneous vasodilation, angiogenesis, and tissue fibrosis. Several existing and emerging topical, oral, and injectable therapeutics have been associated with improvement of rosacea symptoms based on their ability to stabilize and downregulate activated MCs. Herein, we review the data implicating MCs in the pathogenesis of rosacea and discuss interventions that may stabilize this pathway.
Collapse
Affiliation(s)
- Mark C Marchitto
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
| |
Collapse
|
16
|
Demirbaş A, Yümer Y, Elmas ÖF, Ulutaş Demirbaş G, Atasoy M, Türsen Ü, Dursun R, Lotti T. Relationship between rosacea and chronic obstructive pulmonary disease: Rosacea and comorbidities. J Cosmet Dermatol 2021; 21:2255-2262. [PMID: 34411396 DOI: 10.1111/jocd.14389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/01/2021] [Accepted: 08/05/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Rosacea is a chronic inflammatory skin disease that has been reported to be associated with many systemic disorders including respiratory diseases. AIMS This study aims to investigate respiratory function in patients with rosacea. PATIENTS/METHODS Patients with rosacea and age- and gender-matched healthy volunteers were included in this cross-sectional study. Spirometric pulmonary function tests including the percentage of forced vital capacity (FVC%), percentage of forced expiratory volume in one second (FEV 1%), forced expiratory flow at 25-75% of FVC (FEF 25-75%), and FEV 1/FVC ratio was assessed in both patient and controls. The potential relationship between rosacea severity and pulmonary functions was assessed. RESULTS A total of 120 patients with rosacea and 120 healthy controls were enrolled in the study. Compared to the controls, FEV 1%, FEV 1/FVC%, and FEF 25-75% values were significantly lower in patients with rosacea. Lower FEV 1/FVC% values were found to be associated with disease severity. FEV 1%, FEV 1/FVC%, and FEF 25-75% values were found to be more useful in differentiating the patients from healthy subjects. CONCLUSIONS This study showed that patients with rosacea may have abnormal respiratory function compared to healthy subjects. Besides, disease severity was associated with worse respiratory functions. We believe that patients with rosacea, particularly those with additional risk factors, should be screened for respiratory disorders.
Collapse
Affiliation(s)
- Abdullah Demirbaş
- Department of Dermatology, Evliya Çelebi Training and Research Hospital, Kütahya Health Sciences University, Kütahya, Turkey
| | - Yusuf Yümer
- Department of Pulmonary Diseases, Konya Numune Hospital, Konya, Turkey
| | - Ömer Faruk Elmas
- Department of Dermatology, Kırıkkale University, Kırıkkale, Turkey
| | - Gözde Ulutaş Demirbaş
- Department of Dermatology, Evliya Çelebi Training and Research Hospital, Kütahya Health Sciences University, Kütahya, Turkey
| | - Mustafa Atasoy
- Department of Dermatology, Kayseri City Hospital, Health Science University, Kayseri, Turkey
| | - Ümit Türsen
- Department of Dermatology, Mersin University, Mersin, Turkey
| | - Recep Dursun
- Department of Dermatology, Necmettin Erbakan University, Konya, Turkey
| | - Torello Lotti
- Department of Dermatology, Guglielmo Marconi University, Rome, Italy
| |
Collapse
|
17
|
Shemer A, Gupta AK, Kassem R, Sharon N, Quinlan EM, Galili E. Low-dose isotretinoin versus minocycline in the treatment of rosacea. Dermatol Ther 2021; 34:e14986. [PMID: 33993601 DOI: 10.1111/dth.14986] [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: 02/18/2021] [Accepted: 05/12/2021] [Indexed: 11/28/2022]
Abstract
Rosacea is a common inflammatory facial skin condition affecting the adult population. Its papulopustular subtype is mainly treated pharmacologically by topical and oral antibiotics. For severe or antibiotics-recalcitrant disease, daily low-dose isotretinoin has also been reported to be effective. However, no previous study has assessed the efficacy of once-weekly administered isotretinoin for papulopustular rosacea. For this purpose, a retrospective comparative study was conducted. For severe rosacea, 40 mg/week isotretinoin (24 patients) was administered. For mild to moderate rosacea, once-weekly 20 mg/week isotretinoin (28 patients) was compared with 100 mg/day minocycline (24 patients). Treatment courses lasted 4 to 7 months. Forty milligrams per week isotretinoin was highly effective for severe rosacea, achieving complete response (over 90% improvement) in 62.5% of patients and partial response (50%-90% improvement) in additional 29.2% of patients. Twenty milligrams per week isotretinoin and hundred milligrams per day minocycline showed comparable efficacy for mild to moderate rosacea (complete response of 10.7% vs 8.3% and partial response of 28.6% vs 33.3%, respectively). This study demonstrates that that the use of a weekly low-dose isotretinoin is an effective treatment for papulopustular rosacea, including among patients with severe disease.
Collapse
Affiliation(s)
- Avner Shemer
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Tel Aviv University, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aditya K Gupta
- Mediprobe Research Inc., London, Ontario, Canada.,Division of Dermatology, Department of Medicine, University of Toronto School of Medicine, Toronto, Canada
| | - Riad Kassem
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Tel Aviv University, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nechama Sharon
- Pediatric Hemato-oncology Department, Laniado Hospital, Netanya, Israel.,Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | | | - Eran Galili
- Department of Dermatology, Sheba Medical Center, Tel-Hashomer, Tel Aviv University, Ramat-Gan, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
18
|
Kuzma BA, Senemar S, Ramezanli T, Ghosh P, Raney SG, Stagni G. Evaluation of local bioavailability of metronidazole from topical formulations using dermal microdialysis: Preliminary study in a Yucatan mini-pig model. Eur J Pharm Sci 2021; 159:105741. [PMID: 33540039 DOI: 10.1016/j.ejps.2021.105741] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/31/2022]
Abstract
Dermal microdialysis (dMD) can measure the rate and extent to which a topically administered active pharmaceutical ingredient (API) becomes available in the dermis. Using multiple test-sites on the same subject, and replicate probes at each test-site, it is feasible to compare the cutaneous pharmacokinetics of an API from different topical dermatological drug products in parallel on the same subject with this technique. This study design would help to reduce variability. However, there are technical considerations related to the dMD experimental methods that must be characterized and optimized to ensure that an in vivo dMD study is selective, sensitive, discriminating, and reproducible. The goals of this study were to assess: the minimum distance required between test-sites to prevent cross-talk between probes due to potential lateral-diffusion; the sensitivity of the dMD method to detect differences in the local concentration of metronidazole (MTZ) among single escalating doses; the ability to discriminate between the two different formulations; and the stability of the dMD-probes over 48 h. Results indicate that lateral-diffusion and systemic redistribution of the API following topical application of the drug product were negligible, thus MTZ measured by dMD can be selectively attributed to the dermal bioavailability of the API from the applied topical dose. The dMD methodology was able to detect differences in the bioavailability of MTZ from the cream compared to the gel when applied at the same dose, as well as among different doses of the same formulation over a 48-hour sampling duration; therefore, the method is sensitive. The percentage loss of D3-MTZ from the probe compared to its original concentration in the perfusate indicates that the probe performance was stable over the 48 h.
Collapse
Affiliation(s)
- Benjamin A Kuzma
- Division of Pharmaceutical Sciences, Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, NY, USA
| | - Sharareh Senemar
- Division of Pharmaceutical Sciences, Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, NY, USA
| | - Tannaz Ramezanli
- Division of Therapeutic Performance, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Priyanka Ghosh
- Division of Therapeutic Performance, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Sam G Raney
- Division of Therapeutic Performance, Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Grazia Stagni
- Division of Pharmaceutical Sciences, Arnold and Marie Schwartz College of Pharmacy, Long Island University, Brooklyn, NY, USA.
| |
Collapse
|
19
|
Hakobyan G, Evsyukova Z, Ribakova E, Haruthyunyan A, Hovsepyan N. Evaluation of the effectiveness of neodymium laser therapies for Rosacea of the face. MGM JOURNAL OF MEDICAL SCIENCES 2021. [DOI: 10.4103/mgmj.mgmj_89_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
20
|
Thiboutot D, Anderson R, Cook-Bolden F, Draelos Z, Gallo RL, Granstein RD, Kang S, Macsai M, Gold LS, Tan J. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2020; 82:1501-1510. [PMID: 32035944 DOI: 10.1016/j.jaad.2020.01.077] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 10/24/2019] [Accepted: 01/31/2020] [Indexed: 12/19/2022]
Abstract
In 2017, a National Rosacea Society Expert Committee developed and published an updated classification of rosacea to reflect current insights into rosacea pathogenesis, pathophysiology, and management. These developments suggest that a multivariate disease process underlies the various clinical manifestations of the disorder. The new system is consequently based on phenotypes that link to this process, providing clear parameters for research and diagnosis as well as encouraging clinicians to assess and treat the disorder as it may occur in each individual. Meanwhile, a range of therapies has become available for rosacea, and their roles have been increasingly defined in clinical practice as the disorder has become more widely recognized. This update is intended to provide a comprehensive summary of management options, including expert evaluations, to serve as a guide for tailoring treatment and care on an individual basis to achieve optimal patient outcomes.
Collapse
Affiliation(s)
- Diane Thiboutot
- Department of Dermatology, Pennsylvania State University, Hershey, Pennsylvania.
| | - Rox Anderson
- Department of Dermatology and Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Fran Cook-Bolden
- Skin of Color Center, Department of Dermatology, St Luke's-Roosevelt Hospital, New York, New York
| | - Zoe Draelos
- Department of Dermatology, Duke University, Durham, North Carolina
| | - Richard L Gallo
- Department of Dermatology, University of California-San Diego, San Diego, California
| | - Richard D Granstein
- Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Marian Macsai
- Department of Ophthalmology, University of Chicago, Chicago, Illinois
| | - Linda Stein Gold
- Department of Dermatology, Henry Ford Health System, West Bloomfield, Michigan
| | - Jerry Tan
- Department of Medicine, University of Western Ontario, Windsor, Ontario, Canada
| |
Collapse
|
21
|
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.
Collapse
|
22
|
Wang GJ, Gao XY, Wu Y, He HQ, Yu Y, Qin HH, Shen WT. Evaluation of the efficacy and tolerance of artemether emulsion for the treatment of papulopustular rosacea: a randomized pilot study. J DERMATOL TREAT 2019; 30:809-812. [PMID: 31017492 DOI: 10.1080/09546634.2019.1610549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Guo-Jiang Wang
- Department of Zhoupu Hospital, Shanghai University of Medicine&Health Sciences, Pudong New Area, Shanghai, China
| | - Xiao-Yan Gao
- Department of Science and Economic Commission, Pudong New Area, Shanghai, China
| | - Yun Wu
- Department of Zhoupu Hospital, Shanghai University of Medicine&Health Sciences, Pudong New Area, Shanghai, China
| | - Hui-Qiong He
- Department of Zhoupu Hospital, Shanghai University of Medicine&Health Sciences, Pudong New Area, Shanghai, China
| | - Yue Yu
- Department of Zhoupu Hospital, Shanghai University of Medicine&Health Sciences, Pudong New Area, Shanghai, China
| | - Hai-Hong Qin
- Department of Zhoupu Hospital, Shanghai University of Medicine&Health Sciences, Pudong New Area, Shanghai, China
| | - Wen-Tong Shen
- Department of Zhoupu Hospital, Shanghai University of Medicine&Health Sciences, Pudong New Area, Shanghai, China
| |
Collapse
|
23
|
Logger J, Vries F, Erp PJ, Jong E, Peppelman M, Driessen R. Noninvasive objective skin measurement methods for rosacea assessment: a systematic review. Br J Dermatol 2019; 182:55-66. [DOI: 10.1111/bjd.18151] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/19/2019] [Indexed: 12/11/2022]
Affiliation(s)
- J.G.M. Logger
- Department of Dermatology Radboud University Medical Center Nijmegen the Netherlands
| | - F.M.C. Vries
- HU University of Applied Sciences Utrecht the Netherlands
| | - P.E J. Erp
- Department of Dermatology Radboud University Medical Center Nijmegen the Netherlands
| | - E.M.G.J. Jong
- Department of Dermatology Radboud University Medical Center Nijmegen the Netherlands
| | - M. Peppelman
- Department of Dermatology Radboud University Medical Center Nijmegen the Netherlands
| | - R.J.B. Driessen
- Department of Dermatology Radboud University Medical Center Nijmegen the Netherlands
| |
Collapse
|
24
|
A Cheek Nodule in a Child: Be Aware of Idiopathic Facial Aseptic Granuloma and Its Differential Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142471. [PMID: 31336722 PMCID: PMC6679178 DOI: 10.3390/ijerph16142471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/07/2019] [Accepted: 07/10/2019] [Indexed: 12/03/2022]
Abstract
Background: Idiopathic facial aseptic granuloma (IFAG) is a rare skin disease that typically presents in children with one or more nontender, erythematous to violaceous nodules located on the cheeks or eyelids. Lesions are not accompanied by other skin abnormalities. IFAG remains a diagnostic challenge in pediatric dermatology, because several diseases may present with similar signs. Case presentation: A three-year-old girl with a previous negative clinical history was referred to our hospital for the evaluation of some asymptomatic nodules on the convexity of the left cheek. The nodules had appeared two months before, and had gradually increased in size. Her mother denied any association with trauma or insect bites. The nodules had a hard-elastic consistency, were moderately firm, and were not fluctuant. No associated lymphadenopathy was observed. The girl was afebrile and in good general condition. A histologic evaluation of a biopsy specimen revealed an inflammatory, granulomatous-diffuse infiltrate in the superficial and deep dermis consisting of giant cells, histiocytes, lymphocytes, neutrophils, eosinophils, and plasma cells. The Ziehl–Neelsen stains, Gram-stains, and cultures were negative. Suspecting an IFAG, treatment with topical fusidic acid and oral clarithromycin for 14 days was started. After two months, the lesion resolved and did not recur. Conclusion: This case shows how to differentiate IFAG from other dermatologic diseases associated with a negative evolution. Treatment with oral clarithromycin was effective in our patient. However, more scientific evidence is needed to evaluate the most suitable antibiotic therapy. Further studies are also needed to establish whether antibiotics actually impact IFAG prognosis.
Collapse
|
25
|
Emerging Roles of Redox-Mediated Angiogenesis and Oxidative Stress in Dermatoses. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2019; 2019:2304018. [PMID: 31178954 PMCID: PMC6501144 DOI: 10.1155/2019/2304018] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/14/2019] [Accepted: 03/14/2019] [Indexed: 12/24/2022]
Abstract
Angiogenesis is the process of new vessel formation, which sprouts from preexisting vessels. This process is highly complex and primarily involves several key steps, including stimulation of endothelial cells by growth factors, degradation of the extracellular matrix by proteolytic enzymes, migration and proliferation of endothelial cells, and capillary tube formation. Currently, it is considered that multiple cytokines play a vital role in this process, which consist of proangiogenic factors (e.g., vascular endothelial growth factor, fibroblast growth factors, and angiopoietins) and antiangiogenic factors (e.g., endostatin, thrombospondin, and angiostatin). Angiogenesis is essential for most physiological events, such as body growth and development, tissue repair, and wound healing. However, uncontrolled neovascularization may contribute to angiogenic disorders. In physiological conditions, the above promoters and inhibitors function in a coordinated way to induce and sustain angiogenesis within a limited period of time. Conversely, the imbalance between proangiogenic and antiangiogenic factors could cause pathological angiogenesis and trigger several diseases. With insights into the molecular mechanisms of angiogenesis, increasing reports have shown that a close relationship exists between angiogenesis and oxidative stress (OS) in both physiological and pathological conditions. OS, an imbalance between prooxidant and antioxidant systems, is a cause and consequence of many vascular complains and serves as one of the biomarkers for these diseases. Furthermore, emerging evidence supports that OS and angiogenesis play vital roles in many dermatoses, such as psoriasis, atopic dermatitis, and skin tumor. This review summarizes recent findings on the role of OS as a trigger of angiogenesis in skin disorders, highlights newly identified mechanisms, and introduces the antiangiogenic and antioxidant therapeutic strategies.
Collapse
|
26
|
di Cerbo A, Pezzuto F, Guidetti G, Canello S, Corsi L. Tetracyclines: Insights and Updates of their Use in Human and Animal Pathology and their Potential Toxicity. Open Biochem J 2019. [DOI: 10.2174/1874091x01913010001] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
27
|
Choi JE, Werbel T, Wang Z, Wu CC, Yaksh TL, Di Nardo A. Botulinum toxin blocks mast cells and prevents rosacea like inflammation. J Dermatol Sci 2018; 93:58-64. [PMID: 30658871 DOI: 10.1016/j.jdermsci.2018.12.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 12/11/2018] [Accepted: 12/25/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Rosacea is a chronic inflammatory skin condition whose etiology has been linked to mast cells and the antimicrobial peptide cathelicidin LL-37. Individuals with refractory disease have demonstrated clinical benefit with periodic injections of onabotulinum toxin, but the mechanism of action is unknown. OBJECTIVES To investigate the molecular mechanism by which botulinum toxin improves rosacea lesions. METHODS Primary human and murine mast cells were pretreated with onabotulinum toxin A or B or control. Mast cell degranulation was evaluated by β-hexosaminidase activity. Expression of botulinum toxin receptor Sv2 was measured by qPCR. The presence of SNAP-25 and VAMP2 was established by immunofluorescence. In vivo rosacea model was established by intradermally injecting LL-37 with or without onabotulinum toxin A pretreatment. Mast cell degranulation was assessed in vivo by histologic counts. Rosacea biomarkers were analyzed by qPCR of mouse skin sections. RESULTS Onabotulinum toxin A and B inhibited compound 48/80-induced degranulation of both human and murine mast cells. Expression of Sv2 was established in mouse mast cells. Onabotulinum toxin A and B increased cleaved SNAP-25 and decreased VAMP2 staining in mast cells respectively. In mice, injection of onabotulinum toxin A significantly reduced LL-37-induced skin erythema, mast cell degranulation, and mRNA expression of rosacea biomarkers. CONCLUSIONS These findings suggest that onabotulinum toxin reduces rosacea-associated skin inflammation by directly inhibiting mast cell degranulation. Periodic applications of onabotulinum toxin may be an effective therapy for refractory rosacea and deserves further study.
Collapse
Affiliation(s)
- Jae Eun Choi
- Department of Dermatology, University of California, San Diego, CA, USA
| | - Tyler Werbel
- School of Medicine, University of California, San Diego, CA, USA
| | - Zhenping Wang
- Department of Dermatology, University of California, San Diego, CA, USA
| | - Chia Chi Wu
- Department of Dermatology, University of California, San Diego, CA, USA
| | - Tony L Yaksh
- Department of Anesthesiology and Pharmacology, University of California, San Diego, CA, USA
| | - Anna Di Nardo
- Department of Dermatology, University of California, San Diego, CA, USA.
| |
Collapse
|
28
|
Gao Y, Lin W, Zhou S, Shi G, He J, Chen Y. Treatment of Rosacea using acupuncture for improving the local skin microcirculation: A case report. Medicine (Baltimore) 2018; 97:e11931. [PMID: 30142810 PMCID: PMC6113042 DOI: 10.1097/md.0000000000011931] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
RATIONALE Rosacea is an irritating disease that affects patients' health and life quality. The current treatments for rosacea have limited efficacy and are generally not satisfying most patients. This report presents a patient diagnosed with rosacea who was treated with acupuncture to a satisfactory effect. Laser Doppler was used to measure the local blood perfusion of the nose before, during, and after acupuncture treatment. The Dermatology Life Quality Index (DLQI) was used to measure the impact of rosacea on the quality of the patient's life. PATIENT CONCERNS A 52-year-old woman had been diagnosed with rosacea 18 months before this study. She had tried medical treatments in other hospitals with metronidazole cream, antifungal drugs, and steroidal ointments, but the effect was poor and limited. DIAGNOSES In this study, the diagnosis of rosacea (stage I, subtype Erythematotelangiectatic) was made by a dermatologist according to physical examination). INTERVENTIONS The patient's treatment included a half-hour of acupuncture 3 times per week. OUTCOMES The patient experienced significant improvements in the region around the nose after 3 sessions of acupuncture treatment within the first week and reported that there was no relapse for 6 months after acupuncture treatment. The perfusion of blood flow was redistributed during and after acupuncture treatment according to laser Doppler measurements. The patient's DLQI score substantially improved. The patient was generally satisfied with the acupuncture treatment. LESSONS The results suggested that acupuncture might be an alternative therapy for facial localized rosacea. As well, acupuncture may be effective in treating rosacea through redistributing micro-circulation of blood at the localized area of effect. The overall costs of the rosacea treatment may be reduced, provided that this therapy is demonstrated to be effective in future controlled studies.
Collapse
Affiliation(s)
- Yacen Gao
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine
| | - Weipeng Lin
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine
| | - Sisi Zhou
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine
| | - Guoqi Shi
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine
| | - Jun He
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine
- Rehabilitation Center, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yongjun Chen
- South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine
| |
Collapse
|
29
|
Sahni DR, Feldman SR, Taylor SL. Ivermectin 1% (CD5024) for the treatment of rosacea. Expert Opin Pharmacother 2018; 19:511-516. [PMID: 29544355 DOI: 10.1080/14656566.2018.1447562] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Rosacea is a chronic and recurrent disease with a variety of cutaneous manifestations. The disorder is a centrofacial inflammatory dermatosis with significant financial, physical and psychological impacts. There are a number of topical, oral and systemic treatments available. Yet, treatment for rosacea remains difficult. The multifactorial nature of the disease combined with an incomplete understanding of the pathophysiology is challenging for providers and patients. Areas covered: This article provides an in-depth review of rosacea treatment and emerging use of ivermectin 1% cream for papulopustular rosacea based on multiple clinical trials. The PubMed database was searched using the combination of keywords "ivermectin, rosacea, and papulopustular." Expert opinion: Topical ivermectin 1% cream has emerged as a novel agent for treatment of papulopustular rosacea. The drug targets the Demodex mite which is increased in patients with rosacea. Though ivermectin 1% is a clinically efficacious medication, poor adherence continues to remain an issue due to topical application. Ultimately, the agent has the potential to be an effective drug when used as a single or combination agent. With the move to limit chronic antibiotic use, topical agents such as ivermectin 1% will continue to thrive as a specialized niche in the rosacea market.
Collapse
Affiliation(s)
- Dev R Sahni
- a School of Medicine , Virginia Commonwealth University , Richmond , VA , USA
| | - Steven R Feldman
- b Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,c Department of Pathology , Wake Forest School of Medicine , Winston-Salem , NC , USA.,d Department of Social Sciences & Health Policy , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Sarah L Taylor
- b Center for Dermatology Research, Department of Dermatology , Wake Forest School of Medicine , Winston-Salem , NC , USA
| |
Collapse
|
30
|
|
31
|
Hernández-Martín Á. Reply To: The Possible Combined Action of Different Trigger Agents in Rosacea. ACTAS DERMO-SIFILIOGRAFICAS 2018. [DOI: 10.1016/j.adengl.2017.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
32
|
Reply To: The Possible Combined Action of Different Trigger Agents in Rosacea. ACTAS DERMO-SIFILIOGRAFICAS 2018; 109:92-93. [DOI: 10.1016/j.ad.2017.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 08/03/2017] [Indexed: 11/24/2022] Open
|
33
|
Grobel H, Murphy SA. Acne Vulgaris and Acne Rosacea. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00077-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
34
|
McGregor SP, Alinia H, Snyder A, Tuchayi SM, Fleischer A, Feldman SR. A Review of the Current Modalities for the Treatment of Papulopustular Rosacea. Dermatol Clin 2017; 36:135-150. [PMID: 29499797 DOI: 10.1016/j.det.2017.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Papulopustular rosacea is characterized by papules and pustules in the central facial region. We review the literature surrounding the treatment of papulopustular rosacea. PubMed, EMBASE, and Cochrane (Central) databases searches of articles published from 1980 to 2015 were performed using the MeSH terms or keywords "rosacea" and "clinical trial." Additional searches were performed to include rosacea and each treatment modality used. Topical metronidazole, azelaic acid, ivermectin, and oral doxycycline have the most robust data to support their use. Variation in assessment tools and a lack of clinical trial standardization makes comparison of therapeutic options difficult.
Collapse
Affiliation(s)
- Sean P McGregor
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
| | - Hossein Alinia
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA.
| | - Alyson Snyder
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
| | - Sara Moradi Tuchayi
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
| | - Alan Fleischer
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
| | - Steven R Feldman
- Department of Dermatology, Center for Dermatology Research, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA; Department of Pathology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA; Department of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1071, USA
| |
Collapse
|
35
|
Soualmia F, El Amri C. Serine protease inhibitors to treat inflammation: a patent review (2011-2016). Expert Opin Ther Pat 2017; 28:93-110. [PMID: 29171765 DOI: 10.1080/13543776.2018.1406478] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Inflammation is a physiological part of the complex biological response of tissues to counteract various harmful signals. This process involves diverse actors such as immune cells, blood vessels, and nerves as sources of mediators for inflammation control. Among them serine proteases are key elements in both physiological and pathological inflammation. AREAS COVERED Serine protease inhibitors to treat inflammatory diseases are being actively investigated by various industrial and academic institutions. The present review covers patent literature on serine protease inhibitors for the therapy of inflammatory diseases patented between 2011 and 2016. EXPERT OPINION Serine proteases regulating inflammation are versatile enzymes, usually involved in proinflammatory cytokine production and activation of immune cells. Their dysregulation during inflammation can have devastating consequences, promoting various diseases including skin and lung inflammation, neuroinflammation, and inflammatory arthritis. Several serine proteases were selected for their contribution to inflammatory diseases and significant efforts that are spread to develop inhibitors. Strategies developed for inhibitor identification consist on either peptide-based inhibitor derived from endogenous protein inhibitors or small-organic molecules. It is also worth noting that among the recent patents on serine protease inhibitors related to inflammation a significant number are related to retinal vascular dysfunction and skin diseases.
Collapse
Affiliation(s)
- Feryel Soualmia
- a B2A, Biological Adaptation and Ageing, Integrated Cellular Ageing and Inflammation, Molecular & Functional Enzymology , Sorbonne Universités , UPMC Univ Paris 06, UMR 8256 , Paris , France
| | - Chahrazade El Amri
- a B2A, Biological Adaptation and Ageing, Integrated Cellular Ageing and Inflammation, Molecular & Functional Enzymology , Sorbonne Universités , UPMC Univ Paris 06, UMR 8256 , Paris , France
| |
Collapse
|
36
|
Human Skin Permeation Studies with PPARγ Agonist to Improve Its Permeability and Efficacy in Inflammatory Processes. Int J Mol Sci 2017; 18:ijms18122548. [PMID: 29182532 PMCID: PMC5751151 DOI: 10.3390/ijms18122548] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 11/17/2017] [Accepted: 11/21/2017] [Indexed: 01/09/2023] Open
Abstract
Rosacea is the most common inflammatory skin disease. It is characterized by erythema, inflammatory papules and pustules, visible blood vessels, and telangiectasia. The current treatment has limitations and unsatisfactory results. Pioglitazone (PGZ) is an agonist of peroxisome proliferator-activated receptors (PPARs), a nuclear receptor that regulates important cellular functions, including inflammatory responses. The purpose of this study was to evaluate the permeation of PGZ with a selection of penetration enhancers and to analyze its effectiveness for treating rosacea. The high-performance liquid chromatography (HPLC) method was validated for the quantitative determination of PGZ. Ex vivo permeation experiments were realized in Franz diffusion cells using human skin, in which PGZ with different penetration enhancers were assayed. The results showed that the limonene was the most effective penetration enhancer that promotes the permeation of PGZ through the skin. The cytotoxicity studies and the Draize test detected cell viability and the absence of skin irritation, respectively. The determination of the skin color using a skin colorimetric probe and the results of histopathological studies confirmed the ability of PGZ-limonene to reduce erythema and vasodilation. This study suggests new pharmacological indications of PGZ and its possible application in the treatment of skin diseases, namely rosacea.
Collapse
|
37
|
Affiliation(s)
- Esther J van Zuuren
- From the Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| |
Collapse
|
38
|
Rainer BM, Kang S, Chien AL. Rosacea: Epidemiology, pathogenesis, and treatment. DERMATO-ENDOCRINOLOGY 2017; 9:e1361574. [PMID: 29484096 PMCID: PMC5821167 DOI: 10.1080/19381980.2017.1361574] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 07/26/2017] [Indexed: 02/08/2023]
Abstract
Rosacea is a chronic relapsing inflammatory skin disease with a high prevalence among adults of Northern European heritage with fair skin. Symptoms present in various combinations and severity, often fluctuating between periods of exacerbation and remission. Based on morphological characteristics, rosacea is generally classified into four major subtypes: erythematotelangiectatic, papulopustular, phymatous, and ocular. Diverse environmental and endogenous factors have been shown to stimulate an augmented innate immune response and neurovascular dysregulation; however, rosacea's exact pathogenesis is still unclear. An evidence-based approach is essential in delineating differences between the many available treatments. Because of the diverse presentations of rosacea, approaches to treatment must be individualized based on the disease severity, quality-of-life implications, comorbidities, trigger factors, and the patient's commitment to therapy.
Collapse
Affiliation(s)
- Barbara M Rainer
- Department of Dermatology, Medical University of Graz, Graz, Austria.,Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sewon Kang
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| |
Collapse
|
39
|
Christensen CE, Andersen FS, Wienholtz N, Egeberg A, Thyssen JP, Ashina M. The relationship between migraine and rosacea: Systematic review and meta-analysis. Cephalalgia 2017; 38:1387-1398. [DOI: 10.1177/0333102417731777] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective To systematically review the association between migraine and rosacea. Background Migraine is a complex disorder with episodes of headache, nausea, photo- and phonophobia. Rosacea is an inflammatory skin condition with flushing, erythema, telangiectasia, papules, and pustules. Both are chronic disorders with exacerbations of symptoms almost exclusively in areas innervated by the trigeminal nerve. Previous studies found an association between these disorders. We review these findings, provide a meta-analysis, and discuss possible pathophysiological commonalities. Methods A search through PubMed and EMBASE was undertaken for studies investigating the association between all forms of migraine and rosacea published until November 2016, and meta-analysis of eligible studies. Results Nine studies on eight populations were identified. Studies differed in methodology and diagnostic process, but all investigated co-occurrence of migraine and rosacea. Four studies were eligible for meta-analysis, resulting in a pooled odds ratio of 1.96 (95% confidence interval 1.41–2.72) for migraine in a rosacea population compared to a non-rosacea population. Conclusion Our meta-analysis confirmed an association in occurrence of migraine and rosacea. Future studies should specifically investigate possible shared pathophysiological mechanisms between the two disorders.
Collapse
Affiliation(s)
- Casper Emil Christensen
- Danish Headache Centre and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Frederikke Schelde Andersen
- Danish Headache Centre and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Nita Wienholtz
- Danish Headache Centre and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Denmark
| | - Messoud Ashina
- Danish Headache Centre and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| |
Collapse
|
40
|
Etiologies and management of cutaneous flushing. J Am Acad Dermatol 2017; 77:391-402. [DOI: 10.1016/j.jaad.2016.12.031] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/07/2016] [Accepted: 12/18/2016] [Indexed: 12/12/2022]
|
41
|
Ko HS, Suh YJ, Byun JW, Choi GS, Shin J. Pulsed Dye Laser Treatment Combined with Oral Minocycline Reduces Recurrence Rate of Rosacea. Ann Dermatol 2017; 29:543-547. [PMID: 28966509 PMCID: PMC5597646 DOI: 10.5021/ad.2017.29.5.543] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 11/03/2016] [Accepted: 11/04/2016] [Indexed: 11/16/2022] Open
Abstract
Background The recurrence rate of rosacea was not known very well, but has been reported as 60% in 6 months after withdrawal of the drug. It is not known which treatment can reduce relapses of rosacea effectively. Objective The objective was to identify whether 595 nm-pulsed dye laser (PDL) treatment reduced recurrence rate among rosacea patients who were treated with oral minocycline. Methods One hundred and seven Korean patients with rosacea who started treatment with oral minocycline (100 mg/d) with or without PDL (2∼4 sessions) were evaluated retrospectively. The recurrence rate was estimated using the Kaplan-Meier method, and difference was evaluated using the log-rank test. Cox proportional hazards model was used to estimate hazard ratios and 95% confidence intervals (CIs) of risk factors for the recurrence of rosacea. Results The recurrence-free survival analysis revealed that the group with oral minocycline plus PDL was significantly different compared with the group with oral minocycline alone (p=0.011). Cox proportional hazards model showed that the combined use of PDL with oral minocycline appeared to be a significant protective factor for the hazard of recurrence of rosacea (hazard ratio, 0.492; 95% CI, 0.257∼0.941; p=0.032). Conclusion PDL can be used added to oral minocycline to reduce relapses among rosacea patients who are undergoing oral minocycline treatment.
Collapse
Affiliation(s)
- Hye Soo Ko
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Young Ju Suh
- Department of Biomedical Sciences, Inha University School of Medicine, Incheon, Korea
| | - Ji Won Byun
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Gwang Seong Choi
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| | - Jeonghyun Shin
- Department of Dermatology, Inha University School of Medicine, Incheon, Korea
| |
Collapse
|
42
|
Kim M, Kim J, Jeong SW, Jo H, Woo YR, Park HJ. Inhibition of mast cell infiltration in an LL-37-induced rosacea mouse model using topical brimonidine tartrate 0.33% gel. Exp Dermatol 2017; 26:1143-1145. [PMID: 28500634 DOI: 10.1111/exd.13381] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2017] [Indexed: 01/03/2023]
Abstract
Brimonidine is a highly selective α2-adrenergic receptor agonist approved by the FDA for the treatment of rosacea. Rosacea is a major clinical disease with vasodilatation and rash on the centre of the face, and that brimonidine as a vasoconstrictor can act as a remedy for rosacea. However, there is no study of how brimonidine has an effect on rosacea-related immune cells or mechanisms in the skin to improve rosacea. In this study, we observed that clinical features of rosacea induced by LL-37 in Balb/c mice were improved after the application of brimonidine gel, and we also showed a marked decrease in the number of inflammatory cells, especially mast cells (MCs) histologically. Furthermore, we confirmed that mRNA levels of MC enzymes increased by LL-37 were reduced by brimonidine gel. To our knowledge, we first found that brimonidine has a mechanism of treating rosacea by reducing the number and mRNA levels of MC-specific enzymes, an important immune cell in the pathogenesis of rosacea.
Collapse
Affiliation(s)
- Miri Kim
- Department of Dermatology, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Jongsic Kim
- Department of Dermatology, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Seo-Won Jeong
- Department of Dermatology, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Hyunmu Jo
- Department of Dermatology, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Yu Ri Woo
- Department of Dermatology, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Hyun Jeong Park
- Department of Dermatology, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
43
|
Ali H. Emerging Roles for MAS-Related G Protein-Coupled Receptor-X2 in Host Defense Peptide, Opioid, and Neuropeptide-Mediated Inflammatory Reactions. Adv Immunol 2017; 136:123-162. [PMID: 28950944 DOI: 10.1016/bs.ai.2017.06.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Mast cells (MCs) are tissue-resident immune cells that contribute to host defense but are best known for their roles in allergic and inflammatory diseases. In humans, MCs are divided into two subtypes based on the protease content of their secretory granules. Thus, human lung MCs contain only tryptase and are known as MCT, whereas skin MCs contain both tryptase and chymase and are known as MCTC. Patients with severe asthma display elevated MCs in the lung, which undergo phenotypic change from MCT to MCTC. Although the human genome contains four Mas related G protein coupled receptor X (MRGPRX) genes, an important feature of MCTC is that they selectively express MRGPRX2. It is activated by antimicrobial host defense peptides such as human β-defensins and the cathelicidin LL-37 and likely contributes to host defense. MRGPRX2 is also a receptor for the neuropeptide substance P, major basic protein, eosinophil peroxidase, opioids, and many FDA-approved cationic drugs. Increased expression of MRGPRX2 or enhanced downstream signaling likely contributes to chronic inflammatory diseases such as rosacea, atopic dermatitis, chronic urticaria, and severe asthma. In this chapter, I will discuss the expression profile and function of MRGPRX1-4 and review the emerging roles of MRGPRX2 on host defense, chronic inflammatory diseases, and drug-induced pseudoallergic reactions. I will also examine the novel aspects of MRGPRX2 signaling in MCs as it related to degranulation and review the mechanisms of its regulation.
Collapse
Affiliation(s)
- Hydar Ali
- University of Pennsylvania School of Dental Medicine, Philadelphia, PA, United States.
| |
Collapse
|
44
|
Schaller M, Schöfer H, Homey B, Hofmann M, Gieler U, Lehmann P, Luger TA, Ruzicka T, Steinhoff M. Rosacea Management: Update on general measures and topical treatment options. J Dtsch Dermatol Ges 2017; 14 Suppl 6:17-27. [PMID: 27869379 DOI: 10.1111/ddg.13143] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2016] [Indexed: 02/02/2023]
Abstract
Although there is presently no cure for rosacea, there are several recommended treatment options available to control many of the symptoms and to prevent them from getting worse. In addition to self-help measures like avoidance of trigger factors and proper skin care, rosacea management should include topical medications as one of the first-line choices for patients with erythematous and mild to severe papulopustular rosacea. Since mixed forms of characteristic rosacea symptoms are more common, medical treatment must be symptom-tailored for each individual case and will often involve a combination therapy. Approved topical agents for the major symptoms of rosacea encompass brimonidine for erythema and ivermectin, metronidazole or azelaic acid for inflammatory lesions, all of which have shown their efficacy in numerous valid, well-controlled trials. In addition, there are several other, not approved topical treatments which are possible options that require further validation in larger well-controlled studies.
Collapse
Affiliation(s)
- M Schaller
- Department of Dermatology, Tübingen University Hospital, Tübingen, Germany
| | - H Schöfer
- Department of Dermatology, Venereology, and Allergology, University Hospital, Goethe-University, Frankfurt/M, Germany
| | - B Homey
- Department of Dermatology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - M Hofmann
- Department of Dermatology and Allergology, Charité - Universitätsmedizin, Berlin, Germany
| | - U Gieler
- Clinics for Dermatology and Allergology, Justus-Liebig-University, Giessen, Germany
| | - P Lehmann
- Department of Dermatology and Allergology, HELIOS Hospital Wuppertal, Witten/Herdecke University, Germany
| | - T A Luger
- Department of Dermatology, University Hospital Münster, Germany
| | - T Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - M Steinhoff
- Department of Dermatology and, UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
| |
Collapse
|
45
|
Schaller M, Schöfer H, Homey B, Gieler U, Lehmann P, Luger TA, Ruzicka T, Steinhoff M. State of the art: systemic rosacea management. J Dtsch Dermatol Ges 2017; 14 Suppl 6:29-37. [PMID: 27869374 DOI: 10.1111/ddg.13141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2016] [Indexed: 12/30/2022]
Abstract
Based on numerous trials, oral tetracyclines and most commonly their second-generation derivative doxycycline have become the main pillar in systemic rosacea treatment. However, the only preparation that has been approved so far in this setting is 40 mg doxycycline in an anti-inflammatory dosage and with a modified release formulation. With the introduction of this once-daily, non-antibiotic dosing of doxycycline, oral therapy is more commonly prescribed as first-line treatment in moderate to severe papulopustular rosacea. In addition, topical and oral strategies are often used in combination due to the more substantial improvements compared to monotherapy. Although several other non-approved oral agents like macrolides, isotretinoin, and carvedilol have been evaluated for systemic treatment and showed promising results, yet the experience with these drugs in rosacea is limited, and thus they should be reserved for special situations.
Collapse
Affiliation(s)
- M Schaller
- Department of Dermatology, Tübingen University Hospital, Tübingen, Germany
| | - H Schöfer
- Department of Dermatology, Venereology, and Allergology, University Hospital, Goethe-University, Frankfurt/M, Germany
| | - B Homey
- Department of Dermatology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - U Gieler
- Clinics for Dermatology and Allergology, Justus-Liebig-University, Giessen, Germany
| | - P Lehmann
- Department of Dermatology and Allergology, HELIOS Hospital Wuppertal, Witten/Herdecke University, Germany
| | - T A Luger
- Department of Dermatology, University Hospital Münster, Germany
| | - T Ruzicka
- Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich, Germany
| | - M Steinhoff
- Department of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland
| |
Collapse
|
46
|
Lee CN, Lee JYY. Severe erythematotelangiectatic rosacea with cold wave-induced epidermal necrosis treated with carvedilol combined with brimonidine gel. Dermatol Ther 2017; 30. [DOI: 10.1111/dth.12501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 05/02/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Chaw-Ning Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Julia Yu-Yun Lee
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
47
|
Abstract
Acne, one of the most common skin diseases, affects approximately 85% of the adolescent population, and occurs most prominently at skin sites with a high density of sebaceous glands such as the face, back, and chest. Although often considered a disease of teenagers, acne is occurring at an increasingly early age. Rosacea is a chronic facial inflammatory dermatosis characterized by flushing (or transient facial erythema), persistent central facial erythema, inflammatory papules/pustules, and telangiectasia. Both acne and rosacea have a multifactorial pathology that is incompletely understood. Increased sebum production, keratinocyte hyper-proliferation, inflammation, and altered bacterial colonization with Propionibacterium acnes are considered to be the underlying disease mechanisms in acne, while the multifactorial pathology of rosacea is thought to involve both vasoactive and neurocutaneous mechanisms. Several advances have taken place in the past decade in the research field of acne and rosacea, encompassing pathogenesis and epidemiology, as well as the development of new therapeutic interventions. In this article, we provide an overview of current perspectives on the pathogenesis and treatment of acne and rosacea, including a summary of findings from recent landmark pathophysiology studies considered to have important implications for future clinical practice. The advancement of our knowledge of the different pathways and regulatory mechanisms underlying acne and rosacea is thought to lead to further advances in the therapeutic pipeline for both conditions, ultimately providing a greater array of treatments to address gaps in current management practices.
Collapse
Affiliation(s)
| | | | - Jerry Tan
- University of Western Ontario, Windsor, ON, Canada
| |
Collapse
|
48
|
Schaller M, Schöfer H, Homey B, Gieler U, Lehmann P, Luger TA, Ruzicka T, Steinhoff M. Aktueller Stand der systemischen Rosazea-Therapie. J Dtsch Dermatol Ges 2016; 14 Suppl 6:29-37. [DOI: 10.1111/ddg.13141_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2016] [Indexed: 11/29/2022]
Affiliation(s)
- M Schaller
- Universitäts-Hautklinik; Klinikum der Universität Tübingen; Deutschland
| | - H Schöfer
- Klinik für Dermatologie, Venerologie und Allergologie; Johann Wolfgang Goethe-Universität; Frankfurt/Main Deutschland
| | - B Homey
- Klinik für Dermatologie; Universitätsklinikum Düsseldorf; Deutschland
| | - U Gieler
- Zentrum für Psychosomatische Medizin, Psychosomatische Dermatologie; Universitätsklinikum Gießen; Deutschland
| | - P Lehmann
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie; Helios Kliniken Wuppertal, Universität Witten/Herdecke; Deutschland
| | - TA Luger
- Klinik für Hautkrankheiten, Allgemeine Dermatologie und Venerologie; Universitätsklinikum Münster; Deutschland
| | - T Ruzicka
- Klinik und Poliklinik für Dermatologie und Allergologie; Ludwig-Maximilians-Universität München
| | - M Steinhoff
- Department of Dermatology and UCD Charles Institute for Translational Dermatology; University Collge Dublin; Dublin Irland
| |
Collapse
|
49
|
Schaller M, Schöfer H, Homey B, Hofmann M, Gieler U, Lehmann P, Luger TA, Ruzicka T, Steinhoff M. Rosazea-Management: Update über allgemeine Maßnahmen und topische Therapieoptionen. J Dtsch Dermatol Ges 2016; 14 Suppl 6:17-28. [PMID: 27869373 DOI: 10.1111/ddg.13143_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2016] [Indexed: 11/29/2022]
Abstract
Obwohl bislang für die Rosazea keine kurative Therapie besteht, können verschiedene Optionen zur Behandlung der Symptome und zur Vorbeugung von Exazerbationen empfohlen werden. Neben Selbsthilfemaßnahme wie der Vermeidung von Triggerfaktoren und einer geeigneten Hautpflege sollte das Rosazea-Management bei Patienten mit erythematöser und leichter bis schwerer papulopustulöser Rosazea die Anwendung topischer Präparate als First-Line-Therapie umfassen. Da Überlappungen der charakteristischen Rosazea-Symptome im klinischen Alltag die Regel sind, sollte die medikamentöse Therapie auf die individuellen Symptome zugeschnitten werden; auch eine Kombinationstherapie kann erforderlich sein. Zu den für die Behandlung der Hauptsymptome der Rosazea zugelassenen Wirkstoffen gehören Brimonidin gegen das Erythem sowie Ivermectin, Metronidazol oder Azelainsäure gegen entzündliche Läsionen. Ihre Wirksamkeit wurde in zahlreichen validen, gut kontrollierten Studien belegt. Darüber hinaus existieren verschiedene nicht zugelassene topische Behandlungsmöglichkeiten, deren Wirksamkeit und Sicherheit noch in größeren, kontrollierten Studien zu untersuchen ist.
Collapse
Affiliation(s)
- M Schaller
- Universitäts-Hautklinik, Klinikum der Universität Tübingen, Deutschland
| | - H Schöfer
- Klinik für Dermatologie, Venerologie und Allergologie, Johann Wolfgang Goethe-Universität, Frankfurt/Main, Deutschland
| | - B Homey
- Klinik für Dermatologie, Universitätsklinikum Düsseldorf, Deutschland
| | - M Hofmann
- Klinik für Dermatologie und Allergologie, Charité - Universitätsmedizin Berlin, Deutschland
| | - U Gieler
- Zentrum für Psychosomatische Medizin, Psychosomatische Dermatologie, Universitätsklinikum Gießen, Deutschland
| | - P Lehmann
- Zentrum für Dermatologie, Allergologie und Dermatochirurgie, Helios Kliniken Wuppertal, Universität Witten/Herdecke, Deutschland
| | - T A Luger
- Klinik für Hautkrankheiten, Allgemeine Dermatologie und Venerologie, Universitätsklinikum Münster, Deutschland
| | - T Ruzicka
- Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität München
| | - M Steinhoff
- Department of Dermatology and UCD Charles Institute for Translational Dermatology, University Collge Dublin, Dublin, Irland
| |
Collapse
|
50
|
Woo YR, Lim JH, Cho DH, Park HJ. Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition. Int J Mol Sci 2016; 17:ijms17091562. [PMID: 27649161 PMCID: PMC5037831 DOI: 10.3390/ijms17091562] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 08/23/2016] [Accepted: 09/07/2016] [Indexed: 01/21/2023] Open
Abstract
Rosacea is a chronic cutaneous inflammatory disease that affects the facial skin. Clinically, rosacea can be categorized into papulopustular, erythematotelangiectatic, ocular, and phymatous rosacea. However, the phenotypic presentations of rosacea are more heterogeneous. Although the pathophysiology of rosacea remains to be elucidated, immunologic alterations and neurovascular dysregulation are thought to have important roles in initiating and strengthening the clinical manifestations of rosacea. In this article, we present the possible molecular mechanisms of rosacea based on recent laboratory and clinical studies. We describe the genetic predisposition for rosacea along with its associated diseases, triggering factors, and suggested management options in detail based on the underlying molecular biology. Understanding the molecular pathomechanisms of rosacea will likely aid toward better comprehending its complex pathogenesis.
Collapse
Affiliation(s)
- Yu Ri Woo
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
| | - Ji Hong Lim
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
| | - Dae Ho Cho
- Department of Life Science, Sookmyung Women's University, Seoul 04310, Korea.
| | - Hyun Jeong Park
- Department of Dermatology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea.
| |
Collapse
|