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Sharma N, Martin E, Pearce EI, Hagan S, Purslow C, Craig JP. Comparison of the Diagnosis and Management of Demodex Blepharitis Between Eye Care Practitioners in India and Australasia - A Survey-Based Comparison. CLINICAL OPTOMETRY 2024; 16:255-265. [PMID: 39359323 PMCID: PMC11446198 DOI: 10.2147/opto.s469599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/15/2024] [Indexed: 10/04/2024]
Abstract
Aim The primary aim of this study was to compare how eyecare professionals in disparate regions of the world diagnose and manage Demodex blepharitis. A secondary aim was to explore interprofessional differences in diagnostic and management practices. Methods Ophthalmologists and optometrists from India and Australia/New Zealand, were invited to complete an online survey on Demodex blepharitis. Clinical practice patterns relating to patients with Demodex blepharitis, with details of how they investigate and manage Demodex blepharitis in clinical practice, were collected along with clinician demographics and general perceptions on eyelid health. Mann-Whitney U, and Fisher's exact tests were used for statistical analysis. Results A total of 261 eyecare professionals completed the survey, comprising 207 from India (84% optometrists) and 54 from Australia and New Zealand (91% optometrists). Almost 70% of practitioners across the 3 countries recognized Demodex blepharitis as a cause of ocular discomfort, yet only 45% reported attempting to identify Demodex in their patients. There were significant differences noted in clinical practice between those in Australasia and India. Perceived prevalence of Demodex blepharitis also differed (60% in Australasia vs 27% in India; p<0.01), as well as, the choice of slit lamp magnification used to detect the mites (25x in Australasia vs 16x in India; p = 0.02), preferred treatment option to manage Demodex blepharitis (tea tree oil in Australasia vs Standard lid hygiene in India; p = 0.01), treatment duration (from 3-4 weeks to over 12 weeks in Australasia vs 3-4 weeks in India; p = 0.02) and treatment application frequency (once daily in Australasia vs twice daily in India; p = 0.01). Conclusions This study highlights differences in clinical evaluation and treatment practices between eyecare professionals in India and Australasia. Overall, practitioners in Australia and New Zealand were more evidence-based in their investigation and management. However, in both regions, interprofessional differences in perceived optimal treatment duration and frequency were reported.
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Affiliation(s)
- Nikhil Sharma
- Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Eilidh Martin
- Glasgow Caledonian University, Glasgow, Scotland, UK
| | | | - Suzanne Hagan
- Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Christine Purslow
- Christine Purslow – School of Optometry and Vision Sciences, Cardiff University, Cardiff, Wales, UK
| | - Jennifer P Craig
- Jennifer P Craig – Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
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2
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Koch W, Zagórska J, Michalak-Tomczyk M, Karav S, Wawruszak A. Plant Phenolics in the Prevention and Therapy of Acne: A Comprehensive Review. Molecules 2024; 29:4234. [PMID: 39275081 PMCID: PMC11397085 DOI: 10.3390/molecules29174234] [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: 08/13/2024] [Revised: 09/02/2024] [Accepted: 09/04/2024] [Indexed: 09/16/2024] Open
Abstract
Plants are a rich source of secondary metabolites, among which phenolics are the most abundant. To date, over 8000 various polyphenolic compounds have been identified in plant species, among which phenolic acids, flavonoids, coumarins, stilbenes and lignans are the most important ones. Acne is one of the most commonly treated dermatological diseases, among which acne vulgaris and rosacea are the most frequently diagnosed. In the scientific literature, there is a lack of a detailed scientific presentation and discussion on the importance of plant phenolics in the treatment of the most common specific skin diseases, e.g., acne. Therefore, the aim of this review is to gather, present and discuss the current state of knowledge on the activity of various plant phenolics towards the prevention and treatment of acne, including in vitro, in vivo and human studies. It was revealed that because of their significant antibacterial, anti-inflammatory and antioxidant activities, phenolic compounds may be used in the treatment of various types of acne, individually as well as in combination with commonly used drugs like clindamycin and benzoyl peroxide. Among the various phenolics that have been tested, EGCG, quercetin and nobiletin seem to be the most promising ones; however, more studies, especially clinical trials, are needed to fully evaluate their efficacy in treating acne.
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Affiliation(s)
- Wojciech Koch
- Department of Food and Nutrition, Medical University of Lublin, 4a Chodźki Str., 20-093 Lublin, Poland
| | - Justyna Zagórska
- Department of Food and Nutrition, Medical University of Lublin, 4a Chodźki Str., 20-093 Lublin, Poland
| | - Magdalena Michalak-Tomczyk
- Department of Animal Physiology and Toxicology, The John Paul II Catholic University of Lublin, Konstantynów 1I Street, 20-708 Lublin, Poland
| | - Sercan Karav
- Department of Molecular Biology and Genetics, Canakkale Onsekiz Mart University, Canakkale 17000, Türkiye
| | - Anna Wawruszak
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, 20-093 Lublin, Poland
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Pakdaman SF, Samadi A, Fattahi M, Naeimifar A, Ardehali FA, Ketabi Y, Nasrollahi SA, Firooz A. Fabrication and efficacy assessment of combination of brimonidine and ivermectin for treatment of papulopustular rosacea. J Cosmet Dermatol 2024; 23:2973-2981. [PMID: 38831548 DOI: 10.1111/jocd.16372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 04/22/2024] [Accepted: 05/03/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND & AIM Rosacea is a chronic inflammatory, multifactorial disease for which combination therapy could be an effective treatment. In this study, we evaluate the effect of the combination therapy of brimonidine 0.33% and ivermectin 1% as a single cream for the treatment of papulopustular rosacea. METHOD A stable and appropriate formulation was prepared by adding the aqueous phase to the lipid phase while being stirred. The stability and physicochemical properties of the formulation were evaluated under accelerated conditions. Twelve patients (36-60 years) with mild to moderate papulopustular rosacea and a Demodex count of five or more were treated with the combination of brimonidine 0.33% and ivermectin 1% cream. Clinician's Erythema Assessment (CEA), Patients Self-Assessment (PSA), skin erythema (ΔE) and lightness (ΔL), and skin biophysical parameters including transepidermal water loss (TEWL), skin hydration, pH, and sebum content, as well as erythema and melanin index and ultrasound parameters, were measured before treatment and 4 and 8 weeks after. Adverse drug reactions were also recorded. RESULTS CEA and PSA decreased significantly from 3 to 2 after 8 weeks, respectively (p-value = 0.014 for CEA and 0.010 for PSA). ΔE and ΔL, as well as skin erythema index and TEWL improved after 8 weeks of treatment (p < 0.05). Two patients withdrew from the study in the first week because of local adverse effects; one developed flushing following treatment and left the investigation after 4 weeks and another patient withdrew from the study after 4 weeks due to deciding to become pregnant. CONCLUSION Eight-week treatment with the combination of brimonidine 0.33% and ivermectin 1% was shown to be effective for improvement of erythema and inflammatory lesions in mild to moderate papulopustular rosacea.
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Affiliation(s)
| | - Aniseh Samadi
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Fattahi
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Naeimifar
- Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Amiri Ardehali
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Ketabi
- Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Saman Ahmad Nasrollahi
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Firooz
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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4
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Wang J, Zhang L. Correlation between cigarette smoking and alcohol consumption and Rosacea: A two-sample Mendelian randomization study. Skin Res Technol 2024; 30:e13765. [PMID: 38881049 PMCID: PMC11180680 DOI: 10.1111/srt.13765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Controversy persists regarding the causal relationship between Cigarette smoking, alcohol consumption, and Rosacea. This paper employs the Mendelian randomization (MR) method to elucidate the correlation between Cigarette smoking, alcohol consumption, and Rosacea. The aim is to contribute valuable insights to aid in the prevention and early treatment of Rosacea. METHOD Summary datasets for cigarette smoking parameters (Cigarettes smoked per day, Smoking status: Previous, smoking status: Current) and alcohol consumption (Alcoholic drinks per week) were selected alongside data for Rosacea from genome-wide association studies (GWAS). The Two-sample MR method was employed to analyze the correlation between cigarette smoking, alcohol consumption, and Rosacea. Various MR analysis methods, including inverse variance weighting (IVW), MR-Egger, Simple Mode, Weighted Mode, and Weighted Median, were chosen. IVW served as the primary analysis method. RESULTS The results indicate a significant negative association between Cigarettes smoked per day and Rosacea. Moreover, a significant positive correlation was observed between Smoking status: Previous and Rosacea. However, no significant associations were found between Smoking status: Current, Alcoholic drinks per week, and Rosacea. CONCLUSION This study provides further clarity on the association between cigarette smoking, drinking, and Rosacea through a two-sample MR analysis. Notably, the number of cigarettes smoked per day appears to be associated with a reduced incidence of Rosacea, while cigarette smoking cessation may increase the risk. Surprisingly, alcohol consumption does not emerge as a significant risk factor for Rosacea. These findings contribute to a nuanced understanding of the complex relationship between lifestyle factors and the occurrence of Rosacea, offering potential insights for preventive measures and early intervention.
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Affiliation(s)
- Juan Wang
- Department of OtorhinolaryngologyCentral Hospital Affiliated to Chongqing University of TechnologyChongqingChina
| | - Lingli Zhang
- Department of OtorhinolaryngologyCentral Hospital Affiliated to Chongqing University of TechnologyChongqingChina
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5
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Woo YR, Kim HS. Deciphering Childhood Rosacea: A Comprehensive Review. J Clin Med 2024; 13:1126. [PMID: 38398439 PMCID: PMC10889684 DOI: 10.3390/jcm13041126] [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: 12/25/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
Childhood rosacea is a lesser known, yet significant, skin condition presenting diagnostic and treatment challenges. Although often underdiagnosed due to unclear diagnostic criteria, it manifests similarly to adult rosacea, with features such as papulopustular, telangiectasia, granulomatous, idiopathic facial aseptic granuloma, and ocular rosacea. The complex pathophysiology involves genetic, immunological, and environmental factors. Distinguishing childhood rosacea from conditions like acne, steroid rosacea, sarcoidosis, and lupus vulgaris is crucial but complicated by the lack of established criteria. Treatment strategies, mainly extrapolated from adult management protocols, include topical therapies, systemic medications, and laser treatments, adapted for pediatric patients. Special attention is given to ocular rosacea, often preceding skin manifestations, necessitating multidisciplinary care. The review underscores the urgent need for clear diagnostic guidelines, increased awareness, and tailored pediatric treatment protocols to improve patient outcomes and mitigate the condition's evolution into adulthood.
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Affiliation(s)
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 21431, Republic of Korea;
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6
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Zhang XE, Zheng P, Ye SZ, Ma X, Liu E, Pang YB, He QY, Zhang YX, Li WQ, Zeng JH, Guo J. Microbiome: Role in Inflammatory Skin Diseases. J Inflamm Res 2024; 17:1057-1082. [PMID: 38375021 PMCID: PMC10876011 DOI: 10.2147/jir.s441100] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/23/2024] [Indexed: 02/21/2024] Open
Abstract
As the body's largest organ, the skin harbors a highly diverse microbiota, playing a crucial role in resisting foreign pathogens, nurturing the immune system, and metabolizing natural products. The dysregulation of human skin microbiota is implicated in immune dysregulation and inflammatory responses. This review delineates the microbial alterations and immune dysregulation features in common Inflammatory Skin Diseases (ISDs) such as psoriasis, rosacea, atopic dermatitis(AD), seborrheic dermatitis(SD), diaper dermatitis(DD), and Malassezia folliculitis(MF).The skin microbiota, a complex and evolving community, undergoes changes in composition and function that can compromise the skin microbial barrier. These alterations induce water loss and abnormal lipid metabolism, contributing to the onset of ISDs. Additionally, microorganisms release toxins, like Staphylococcus aureus secreted α toxins and proteases, which may dissolve the stratum corneum, impairing skin barrier function and allowing entry into the bloodstream. Microbes entering the bloodstream activate molecular signals, leading to immune disorders and subsequent skin inflammatory responses. For instance, Malassezia stimulates dendritic cells(DCs) to release IL-12 and IL-23, differentiating into a Th17 cell population and producing proinflammatory mediators such as IL-17, IL-22, TNF-α, and IFN-α.This review offers new insights into the role of the human skin microbiota in ISDs, paving the way for future skin microbiome-specific targeted therapies.
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Affiliation(s)
- Xue-Er Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Pai Zheng
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Sheng-Zhen Ye
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 6610072, People’s Republic of China
| | - Xiao Ma
- State Key Laboratory of Southwestern Chinese Medicine Resources, School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, 611137, People’s Republic of China
| | - E Liu
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Yao-Bin Pang
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Qing-Ying He
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Yu-Xiao Zhang
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Wen-Quan Li
- Chengdu University of Traditional Chinese Medicine, Chengdu, 6610075, People’s Republic of China
| | - Jin-Hao Zeng
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, People’s Republic of China
| | - Jing Guo
- Department of Dermatology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 6610072, People’s Republic of China
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7
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Del Rosso J, Baldwin H, Bhatia N, Chavda R, York JP, Harper J, Hougeir FG, Jackson JM, Noor O, Rodriguez DA, Schlesinger T, Weiss J. A Review of the Diagnostic and Therapeutic Gaps in Rosacea Management: Consensus Opinion. Dermatol Ther (Heidelb) 2024; 14:271-284. [PMID: 38194021 PMCID: PMC10891023 DOI: 10.1007/s13555-023-01087-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/12/2023] [Indexed: 01/10/2024] Open
Abstract
Rosacea is a common, chronic inflammatory disease characterized by both fluctuating and fixed heterogeneous signs such as facial erythema, papules/pustules, telangiectasia, acute vasodilation (flushing), and phymatous changes, and symptoms such as cutaneous stinging and burning. The shift to a phenotype-based approach to rosacea management has improved the consistency of recommendations across recent published guidelines. Consistent and thorough guidance for the classification, diagnosis, and management of the disease is difficult, as the mechanisms underlying the development of rosacea are still not completely understood nor universally accepted. Here, we provide a critical review of current published guidance, and gaps in the knowledge and management of rosacea. We present the recently approved microencapsulated benzoyl peroxide as an effective topical treatment option for papulopustular rosacea. Benzoyl peroxide (BPO) has been used in acne management for many years; however, many clinicians perceive treatment of rosacea with any BPO formulation to be counterintuitive because of concerns of potential skin irritation, while the lack of an accepted mechanism of action on rosacea pathophysiology means that others may be hesitant to use BPO as a treatment. Minocycline foam 1.5% is also an option for the treatment of inflammatory lesions in rosacea, with a decreased risk of systemic adverse events compared with oral minocycline.
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Affiliation(s)
- James Del Rosso
- Touro University Nevada, Henderson, NV, USA.
- JDR Dermatology Research, 9080 West Post Road, Suite 100, Las Vegas, NV, 89149, USA.
- Advanced Dermatology and Cosmetic Surgery, Maitland, FL, USA.
| | - Hilary Baldwin
- Robert Wood Johnson Medical Center, New Brunswick, NJ, USA
- The Acne Treatment and Research Center, Brooklyn, NY, USA
| | - Neal Bhatia
- Therapeutics Clinical Research, San Diego, CA, USA
| | | | | | - Julie Harper
- Dermatology and Skin Care Center of Birmingham, Birmingham, AL, USA
| | | | | | | | - David A Rodriguez
- Research Dadeland Dermatology Group, University of Miami, Coral Gables, FL, USA
| | | | - Jonathan Weiss
- Georgia Dermatology Partners, Snellville, GA, USA
- Gwinnett Clinical Research Center, Snellville, GA, USA
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8
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Chen A, Choi J, Balazic E, Zhu TR, Kobets K. Review of laser and energy-based devices to treat rosacea in skin of color. J COSMET LASER THER 2024; 26:43-53. [PMID: 39171934 DOI: 10.1080/14764172.2024.2376701] [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: 04/28/2023] [Revised: 09/06/2023] [Accepted: 07/02/2024] [Indexed: 08/23/2024]
Abstract
The prevalence of rosacea in skin of color (SOC) populations is estimated to be as high as 10% in some countries. Traditionally, intense pulsed light (IPL) and pulsed dye laser (PDL) have been the laser and energy-based devices (EBDs) used to treat rosacea. However, not all laser and EBDs are safe for SOC (Fitzpatrick skin types IV-VI) due to increased absorption of energy in pigmented skin and increased risk of post-inflammatory hyperpigmentation and scarring. This review summarizes the use of the top seven laser and EBDs for treating rosacea in SOC.
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Affiliation(s)
- Anna Chen
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Janet Choi
- Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Tian Ran Zhu
- Albert Einstein College of Medicine, Bronx, NY, USA
- Montefiore Medical Center, Department of Medicine, Division of Dermatology, Bronx, NY, USA
| | - Kseniya Kobets
- Montefiore Medical Center, Department of Medicine, Division of Dermatology, Bronx, NY, USA
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9
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Mylonas A, Hawerkamp HC, Wang Y, Chen J, Messina F, Demaria O, Meller S, Homey B, Di Domizio J, Mazzolai L, Hovnanian A, Gilliet M, Conrad C. Type I IFNs link skin-associated dysbiotic commensal bacteria to pathogenic inflammation and angiogenesis in rosacea. JCI Insight 2023; 8:151846. [PMID: 36633910 PMCID: PMC9977509 DOI: 10.1172/jci.insight.151846] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 01/11/2023] [Indexed: 01/13/2023] Open
Abstract
Rosacea is a common chronic inflammatory skin disease with a fluctuating course of excessive inflammation and apparent neovascularization. Microbial dysbiosis with a high density of Bacillus oleronius and increased activity of kallikrein 5, which cleaves cathelicidin antimicrobial peptide, are key pathogenic triggers in rosacea. However, how these events are linked to the disease remains unknown. Here, we show that type I IFNs produced by plasmacytoid DCs represent the pivotal link between dysbiosis, the aberrant immune response, and neovascularization. Compared with other commensal bacteria, B. oleronius is highly susceptible and preferentially killed by cathelicidin antimicrobial peptides, leading to enhanced generation of complexes with bacterial DNA. These bacterial DNA complexes but not DNA complexes derived from host cells are required for cathelicidin-induced activation of plasmacytoid DCs and type I IFN production. Moreover, kallikrein 5 cleaves cathelicidin into peptides with heightened DNA binding and type I IFN-inducing capacities. In turn, excessive type I IFN expression drives neoangiogenesis via IL-22 induction and upregulation of the IL-22 receptor on endothelial cells. These findings unravel a potentially novel pathomechanism that directly links hallmarks of rosacea to the killing of dysbiotic commensal bacteria with induction of a pathogenic type I IFN-driven and IL-22-mediated angiogenesis.
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Affiliation(s)
- Alessio Mylonas
- Department of Dermatology, University Hospital CHUV, Lausanne, Switzerland
| | - Heike C Hawerkamp
- Department of Dermatology, Dusseldorf University Hospital, Dusseldorf, Germany
| | - Yichen Wang
- INSERM UMR 1163, Institut IMAGINE, Necker Hospital for Sick Children, Paris, France
| | - Jiaqi Chen
- Department of Dermatology, University Hospital CHUV, Lausanne, Switzerland
| | - Francesco Messina
- Department of Dermatology, University Hospital CHUV, Lausanne, Switzerland
| | - Olivier Demaria
- Department of Dermatology, University Hospital CHUV, Lausanne, Switzerland
| | - Stephan Meller
- Department of Dermatology, Dusseldorf University Hospital, Dusseldorf, Germany
| | - Bernhard Homey
- Department of Dermatology, Dusseldorf University Hospital, Dusseldorf, Germany
| | - Jeremy Di Domizio
- Department of Dermatology, University Hospital CHUV, Lausanne, Switzerland
| | - Lucia Mazzolai
- Department of Angiology, University Hospital CHUV, Lausanne, Switzerland
| | - Alain Hovnanian
- INSERM UMR 1163, Institut IMAGINE, Necker Hospital for Sick Children, Paris, France
| | - Michel Gilliet
- Department of Dermatology, University Hospital CHUV, Lausanne, Switzerland
| | - Curdin Conrad
- Department of Dermatology, University Hospital CHUV, Lausanne, Switzerland
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10
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Ma L, Niu Y, Yuan C, Bai T, Yang S, Wang M, Li Y, Shao L. The Characteristics of the Skin Physiological Parameters and Facial Microbiome of "Ideal Skin" in Shanghai Women. CLINICAL, COSMETIC AND INVESTIGATIONAL DERMATOLOGY 2023; 16:325-337. [PMID: 36762256 PMCID: PMC9904309 DOI: 10.2147/ccid.s400321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
Purpose Everyone pursues perfect skin, but there exist significant differences between cultures, and no commonly accepted standards have been established. Therefore, our study attempted to define the "ideal skin" of oriental women and analyze the relationship between different skin physiological parameters and microbiomes. Patients and Methods Based on our customized grading standard, the VISIA CR photos of 111 young women aged from 18 to 25 in Shanghai were collected and scored by the severity of pores, acne, spots, and wrinkles. The volunteers were then divided into "ideal skin" (W1), "normal skin" (W2), and "undesirable skin" (W3) groups. The physiological parameters of facial skin were measured by non-invasive instrumental methods, and the skin microbiome was analyzed by 16S rRNA and ITS high-throughput sequencing. Results From "ideal skin" to "undesirable skin", the skin physiological parameters, α-diversity, and composition of the facial microbiome showed noticeable regular changes. Compared with the "normal skin" (W2) and "undesirable skin" (W3), the "ideal skin" (W1) group had lower sebum content, TEWL, melanin, hemoglobin, and roughness but higher hydration content and skin pH value. Furthermore, the Shannon index of skin bacteria was significantly increased in W1 (P = 0.004), suggesting that the ideal skin had higher species diversity. From W1 to W3, the species composition was changed significantly. The abundance of Actinobacteria was increased, while Proteobacteria and Bacteroidetes were decreased. Correspondingly, the abundances of lipophilic Propionibacterium and Malassezia were increased, while the abundances of Stenotrophomonas, Pseudomonas, Ralstonia, and Streptococcus, were significantly decreased. Additionally, Spearman correlation analysis revealed strong correlations between the physiological parameters and the microbiota. Notably, the Shannon index of skin bacteria was significantly positively correlated with skin hydration (P = 0.03) but negatively correlated with the abundance of Cutibacterium (P = 0.000), hemoglobin content (P = 0.025), and sebum content (P = 0.5). Therefore, the skin hydration content and the abundance of Cutibacterium played an important role in maintaining the α-diversity and skin homeostasis. Conclusion Ideal skin had better water-oil balance and barrier function, higher microbial diversity, and more reasonable species distribution. Therefore, daily skincare needs to control skin oil and maintain skin microecological balance to achieve ideal skin conditions for young women aged 18-25 years old.
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Affiliation(s)
- Laiji Ma
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People’s Republic of China,The Oriental Beauty Valley Research Institute, Shanghai Institute of Technology, Shanghai, People’s Republic of China
| | - Yujie Niu
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People’s Republic of China,The Oriental Beauty Valley Research Institute, Shanghai Institute of Technology, Shanghai, People’s Republic of China
| | - Chunying Yuan
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, Shandong, People’s Republic of China
| | - Tianming Bai
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, Shandong, People’s Republic of China
| | - Suzhen Yang
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, Shandong, People’s Republic of China
| | - Man Wang
- Department of Nutrition, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital South Campus, Shanghai, People’s Republic of China
| | - Yan Li
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd., Jinan, Shandong, People’s Republic of China,Yan Li, R&D Innovation Center, Shandong Freda Biotech Co., Ltd, No. 888, Xinluo Street, Lixia District, Jinan, Shandong, 250101, People’s Republic of China, Email
| | - Li Shao
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People’s Republic of China,Correspondence: Li Shao, School of Perfume and Aroma Technology, Shanghai Institute of Technology, No. 100, Haiquan Road, Fengxian District, Shanghai, 201418, People’s Republic of China, Email
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11
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The Acari Hypothesis, III: Atopic Dermatitis. Pathogens 2022; 11:pathogens11101083. [DOI: 10.3390/pathogens11101083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/12/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Atopic dermatitis is a chronic relapsing dermatopathology involving IgE against allergenic materials present on mammalian epithelial surfaces. Allergens are as diverse as pet danders, and polypeptides expressed by microbes of the mammalian microbiome, e.g., Malassezia spp. The Acari Hypothesis posits that the mammalian innate immune system utilizes pathogen-bound acarian immune effectors to protect against the vectorial threat posed by mites and ticks. Per The Hypothesis, IgE-mediated allergic disease is a specious consequence of the pairing of acarian gastrointestinal materials, e.g., allergenic foodstuffs, with acarian innate immune effectors that have interspecies operability. In keeping with The Hypothesis, the IgE profile of atopic patients should include both anti-acarian antibodies and specious antibodies responsible for specific allergy. Further, the profile should inform on the diet and/or environment of the acarian vector. In this regard, the prevalence of Demodex and Dermatophagoides on the skin of persons suffering from atopic dermatitis is increased. Importantly, the diets of these mites correspond well with the allergens of affected patients. In this report, roles for these specific acarians in the pathogenesis of atopic dermatitis are proposed and elaborated.
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Yang Y, Qu L, Mijakovic I, Wei Y. Advances in the human skin microbiota and its roles in cutaneous diseases. Microb Cell Fact 2022; 21:176. [PMID: 36038876 PMCID: PMC9422115 DOI: 10.1186/s12934-022-01901-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/18/2022] [Indexed: 11/23/2022] Open
Abstract
Skin is the largest organ in the human body, and the interplay between the environment factors and human skin leads to some skin diseases, such as acne, psoriasis, and atopic dermatitis. As the first line of human immune defense, skin plays significant roles in human health via preventing the invasion of pathogens that is heavily influenced by the skin microbiota. Despite being a challenging niche for microbes, human skin is colonized by diverse commensal microorganisms that shape the skin environment. The skin microbiota can affect human health, and its imbalance and dysbiosis contribute to the skin diseases. This review focuses on the advances in our understanding of skin microbiota and its interaction with human skin. Moreover, the potential roles of microbiota in skin health and diseases are described, and some key species are highlighted. The prevention, diagnosis and treatment strategies for microbe-related skin diseases, such as healthy diets, lifestyles, probiotics and prebiotics, are discussed. Strategies for modulation of skin microbiota using synthetic biology are discussed as an interesting venue for optimization of the skin-microbiota interactions. In summary, this review provides insights into human skin microbiota recovery, the interactions between human skin microbiota and diseases, and the strategies for engineering/rebuilding human skin microbiota.
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Affiliation(s)
- Yudie Yang
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450051, China
- Laboratory of Synthetic Biology, Zhengzhou University, Zhengzhou, 450051, China
| | - Lingbo Qu
- Laboratory of Synthetic Biology, Zhengzhou University, Zhengzhou, 450051, China
- College of Chemistry, Zhengzhou University, Zhengzhou, China
| | - Ivan Mijakovic
- Department of Biology and Biological Engineering, Chalmers University of Technology, Göteborg, Sweden
- The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, Lyngby, Denmark
| | - Yongjun Wei
- School of Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, 450051, China.
- Laboratory of Synthetic Biology, Zhengzhou University, Zhengzhou, 450051, China.
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Antiparasitic Activity of Tea Tree Oil (TTO) and Its Components against Medically Important Ectoparasites: A Systematic Review. Pharmaceutics 2022; 14:pharmaceutics14081587. [PMID: 36015213 PMCID: PMC9416580 DOI: 10.3390/pharmaceutics14081587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 12/04/2022] Open
Abstract
Ectoparasites are pathogens that can infect the skin and cause immense pain, discomfort, and disease. They are typically managed with insecticides. However, the fast-emerging antimicrobial resistance and the slow rate of development of new bio-actives combined with environmental and health concerns over the continued use of neurotoxic insecticides warrant newer and alternative methods of control. Tea tree oil (TTO), as an alternative agent, has shown remarkable promise against ectoparasites in recent studies. To our knowledge, this is the first systematic review to assess preclinical and clinical studies exploring the antiparasitic activity of TTO and its components against clinically significant ectoparasites, such as Demodex mites, scabies mites, house dust mites, lice, fleas, chiggers, and bed bugs. We systematically searched databases, including PubMed, MEDLINE (EBSCOhost), Embase (Scopus), CENTRAL, Cochrane Library, CINAHL, ScienceDirect, Web of Science, SciELO, and LILACS in any language from inception to 4 April 2022. Studies exploring the therapeutic activity of TTO and its components against the ectoparasites were eligible. We used the ToxRTool (Toxicological data reliability assessment) tool, the Joanna Briggs Institute (JBI) critical appraisal tools, and the Jadad scale to assess the methodological qualities of preclinical (in vitro and in vivo) studies, non-randomised controlled trials (including cohort, case series, and case studies), and randomised controlled trials, respectively. Of 497 identified records, 71 studies were included in this systematic review, and most (66%) had high methodological quality. The findings of this review revealed the promising efficacy of TTO and its components against ectoparasites of medical importance. Most importantly, the compelling in vitro activity of TTO against ectoparasites noted in this review seems to have translated well into the clinical environment. The promising outcomes observed in clinical studies provide enough evidence to justify the use of TTO in the pharmacotherapy of ectoparasitic infections.
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Relationships of Serum Homocysteine, Vitamin B12, and Folic Acid Levels with Papulopustular Rosacea Severity: A Case-Control Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5479626. [PMID: 35832851 PMCID: PMC9273444 DOI: 10.1155/2022/5479626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/18/2022] [Indexed: 02/07/2023]
Abstract
Background Rosacea is a chronic inflammatory skin disease with a multifactorial etiology. Recently, associations between serum homocysteine (Hcy) levels and inflammatory skin diseases, such as psoriasis and hidradenitis suppurativa, have been reported. However, no study has explored the levels of serum Hcy, folic acid, and vitamin B12 in patients with rosacea. Objective To investigate serum Hcy, vitamin B12, and folic acid levels in patients with papulopustular rosacea (PPR), we characterized the association of these levels with PPR severity. Methods This case-control study included 138 PPR patients and 58 healthy controls. The serum levels of Hcy, vitamin B12, and folic acid were measured. A correlation was assessed between disease severity and serum levels of Hcy, vitamin B12, and folic acid. Results Serum vitamin B12 and folic acid levels were significantly lower in PPR patients than in the healthy controls (p = 0.011 and p = 0.0173, respectively). Although serum Hcy levels did not significantly differ between PPR patients and healthy controls, PPR severity was positively correlated with serum Hcy levels (p < 0.001). Conclusions Our results suggest a possible association between hyperhomocysteinemia and vitamin B12 deficiency in patients with PPR.
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Shao L, Jiang S, Li Y, Shi Y, Wang M, Liu T, Yang S, Ma L. Regular Late Bedtime Significantly Affects the Skin Physiological Characteristics and Skin Bacterial Microbiome. Clin Cosmet Investig Dermatol 2022; 15:1051-1063. [PMID: 35698548 PMCID: PMC9188400 DOI: 10.2147/ccid.s364542] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022]
Abstract
Background Late bedtime is a common form of unhealthy sleep pattern in adulthood, which influences circadian rhythm, and negatively affects health. However, little is known about the effect of regular late bedtime on skin characteristics, particularly on skin microbiome. Objective To investigate the changes and effects of the regular late bedtime on skin physiological parameters and facial bacterial microbiome of 219 cases of Chinese women aged 18-38 years living in Shanghai. Methods Based on the Self-Evaluation Questionnaire, bedtime was categorized as 11:00 PM; thus, the volunteers were divided into early bedtime group (S0) and late bedtime group (S1). The physiological parameters of facial skin were measured by non-invasive instrumental methods, and the skin microbiome was analyzed by 16S rRNA high-throughput sequencing. Results The skin physiological parameters of the late bedtime group exhibited significant decrease in skin hydration content, skin firmness (F4) and elasticity (R2), while TEWL, sebum and wrinkle significantly increased. The result indicated that late bedtime significantly impaired the integrity of skin barrier, damaged skin structure, and disrupted water-oil balance. Furthermore, the analysis of α-diversity, Sobs, Ace and Chao index were found to significantly decrease (P < 0.05) in the late bedtime group, suggesting that late bedtime reduced both the abundance and the diversity of facial bacterial microbiota. Moreover, the abundance of Pseudomonas increased significantly, while Streptococcus, Stenotrophomonas, Acinetobacter, Haemophilus, Actinomyces and Neisseria decreased significantly. In addition, Spearman correlation analysis revealed strong correlations between the microbiota and the physiological parameters. Notably, the abundance of Pseudomonas significantly positively correlated with skin firmness and elasticity, but significantly negatively correlated with skin hemoglobin content, melanin content and skin hydration. Conclusion Bedtime is an important factor in maintaining skin health. Regular late bedtime not only damages the skin barrier and skin structure but also reduces the diversity and composition of facial bacterial microbiome.
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Affiliation(s)
- Li Shao
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People's Republic of China
| | - Sujing Jiang
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People's Republic of China
| | - Yan Li
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd, Jinan, Shandong, People's Republic of China
| | - Yanqin Shi
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People's Republic of China.,The Oriental Beauty Valley Research Institute, Shanghai Institute of Technology, Shanghai, People's Republic of China
| | - Man Wang
- Department of Nutrition, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, People's Republic of China
| | - Ting Liu
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People's Republic of China
| | - Suzhen Yang
- R&D Innovation Center, Shandong Freda Biotech Co., Ltd, Jinan, Shandong, People's Republic of China
| | - Laiji Ma
- School of Perfume and Aroma Technology, Shanghai Institute of Technology, Shanghai, People's Republic of China.,The Oriental Beauty Valley Research Institute, Shanghai Institute of Technology, Shanghai, People's Republic of China
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Paichitrojjana A. Demodex: the worst enemies are the ones that used to be friends. Dermatol Reports 2022; 14:9339. [PMID: 36199896 PMCID: PMC9527693 DOI: 10.4081/dr.2022.9339] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 08/23/2021] [Indexed: 12/02/2022] Open
Abstract
Demodex mites are common ectoparasites of the human pilosebaceous units. Most adults are infested with Demodex mites without clinical symptoms. Demodex mite will only become a pathogenic organism when there is an abnormal increase in the number of Demodex mite density. This situation happens when the equilibrium between Demodex mites, skin microenvironment and human immunity system changes. Demodex infestation can cause multiple skin disorders, which are grouped under the term demodicosis or demodicidosis. Clinical manifestations of demodicosis can mimic other known skin diseases such as folliculitis, rosacea, perioral dermatitis, which is why it is often misdiagnosed. Diagnosis criteria consists of relevant correlation of suspected clinical skin lesions, confirmed by the presence of abnormal proliferation of Demodex mites and by clinical cure after acaricidal treatment together with normalization of Demodex mite density. Dermatologists should be aware that demodicosis is not an uncommon skin disease, and there are still many unknowns about it that should be researched further.
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Ijardar SP, Singh V, Gardas RL. Revisiting the Physicochemical Properties and Applications of Deep Eutectic Solvents. Molecules 2022; 27:1368. [PMID: 35209161 PMCID: PMC8877072 DOI: 10.3390/molecules27041368] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 01/31/2023] Open
Abstract
Recently, deep eutectic solvent (DES) or ionic liquid (IL) analogues have been considered as the newest green solvent, demonstrating the potential to replace harsh volatile organic solvents. DESs are mainly a combination of two compounds: hydrogen bond acceptor (HBA) and hydrogen bond donor (HBD), which have the ability to interact through extensive hydrogen bonds. A thorough understanding of their physicochemical properties is essential, given their successful applications on an industrial scale. The appropriate blend of HBA to HBD can easily fine-tune DES properties for desired applications. In this context, we have reviewed the basic information related to DESs, the two most studied physicochemical properties (density and viscosity), and their performance as a solvent in (i) drug delivery and (ii) extraction of biomolecules. A broader approach of various factors affecting their performance has been considered, giving a detailed picture of the current status of DESs in research and development.
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Affiliation(s)
- Sushma P. Ijardar
- Department of Chemistry, Veer Narmad South Gujarat University, Surat 395007, India;
| | - Vickramjeet Singh
- Department of Chemistry, Dr. B. R. Ambedkar National Institute of Technology, Jalandhar 144011, India;
| | - Ramesh L. Gardas
- Department of Chemistry, Indian Institute of Technology Madras, Chennai 600036, India
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Badawi Yousif A, Abdel-Aal AA, El-Tawab Sabry AEHA, Hashem El-Naggar AA, Masoud M, Mohamed S, M Shaapan R, M M Mohamed FA. Demodex Mites in Relation to the Degree of Acne Vulgaris among Egyptian Patients. Pak J Biol Sci 2022; 25:406-414. [PMID: 35638511 DOI: 10.3923/pjbs.2022.406.414] [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: 06/15/2023]
Abstract
<b>Background and Objective:</b> <i>Demodex</i> mites are considered to play a pathogenic role in facial dermatoses as <i>Acne vulgaris</i>. In this study the association between <i>Acne vulgaris</i> and <i>Demodex</i> spp. intensity, kind and activity were investigated. <b>Materials and Methods:</b> Two degrees of acne was included, mild acne (30 cases) and moderate to severe acne (30 cases), besides 30 healthy subjects as a control. Deep skin scraping followed by direct microscopic detection was applied to diagnose demodicosis. <b>Results:</b> All the detected mites in moderate to severe acne were <i>D. folliculorum</i> which was observed in a highly dynamic status with their entire life cycle stages with intensity >5 mites per cm<sup><a href="2246157_ja">2</a></sup>. While very few inactive <i>D. brevis</i> mites were detected in the 2 subjects related to the control group<i>. </i>Despite that females comprised the majority of acne cases, males encompassed a statistically higher number than females among positive demodicosis cases. Itching and hair loss were the significant clinical signs within positive cases. Regarding risk factors, oily skins, repeated exposure to the sun, stressful lifestyle plus defective use of facial cleansers were found to be statistically significant. <b>Conclusion:</b> These results attained an association between moderate to severe acne and energetic <i>D. folliculorum</i> entire population. Thus, this study recommended lifestyle's modification for those cases suffering from <i>Acne vulgaris</i> with deep facial cleaning to avoid such infestation that worsens acne condition. Accordingly, once acne treatments are ineffective, consideration of <i>Demodex</i> mites with the needed acaricidal therapy is necessary.
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Garbutcheon-Singh KB, Smith SD. Cannabinoids interaction with transient receptor potential family and implications in the treatment of rosacea. Dermatol Ther 2021; 34:e15162. [PMID: 34664381 DOI: 10.1111/dth.15162] [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: 03/19/2021] [Accepted: 10/11/2021] [Indexed: 11/29/2022]
Abstract
With the recent interest in medical marijuana, research into cannabinoids is regaining wider attention. Cannabinoids are collectively a group of active compounds that can be produced by animals (endocannabinoids), plants (phytocannabinoids), or synthetically. By acting on a number of different receptors like cannabinoids receptors and transient receptor potential ion channel family, cannabinoids are known to modulate cutaneous inflammation, pain, and itch. Rosacea is a highly prevalent disease and can be associated with a significant degree of morbidity associated with its symptom. Transient receptor potential ion channels are known to be triggered in rosacea and may underlie a portion of rosacea's pathophysiology. This article aims to detail the transient receptor potential channel pathways in rosacea and the known effects of cannabinoids on these pathways and further discussing the potential role of cannabinoids in treating rosacea.
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Affiliation(s)
| | - Saxon D Smith
- The Dermatology and Skin Cancer Centre, St Leonards, New South Wales, Australia.,Discipline of Dermatology, School of Medicine, University of Sydney, Sydney, New South Wales, Australia
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Pistone D, Meroni G, Panelli S, D’Auria E, Acunzo M, Pasala AR, Zuccotti GV, Bandi C, Drago L. A Journey on the Skin Microbiome: Pitfalls and Opportunities. Int J Mol Sci 2021; 22:9846. [PMID: 34576010 PMCID: PMC8469928 DOI: 10.3390/ijms22189846] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 12/22/2022] Open
Abstract
The human skin microbiota is essential for maintaining homeostasis and ensuring barrier functions. Over the years, the characterization of its composition and taxonomic diversity has reached outstanding goals, with more than 10 million bacterial genes collected and cataloged. Nevertheless, the study of the skin microbiota presents specific challenges that need to be addressed in study design. Benchmarking procedures and reproducible and robust analysis workflows for increasing comparability among studies are required. For various reasons and because of specific technical problems, these issues have been investigated in gut microbiota studies, but they have been largely overlooked for skin microbiota. After a short description of the skin microbiota, the review tackles methodological aspects and their pitfalls, covering NGS approaches and high throughput culture-based techniques. Recent insights into the "core" and "transient" types of skin microbiota and how the manipulation of these communities can prevent or combat skin diseases are also covered. Finally, this review includes an overview of the main dermatological diseases, the changes in the microbiota composition associated with them, and the recommended skin sampling procedures. The last section focuses on topical and oral probiotics to improve and maintain skin health, considering their possible applications for skin diseases.
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Affiliation(s)
- Dario Pistone
- Pediatric Clinical Research Center “Invernizzi”, Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, 20157 Milan, Italy; (S.P.); (A.R.P.); (G.V.Z.)
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
| | - Gabriele Meroni
- Department of Biomedical Surgical and Dental Sciences-One Health Unit, University of Milan, 20133 Milan, Italy;
| | - Simona Panelli
- Pediatric Clinical Research Center “Invernizzi”, Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, 20157 Milan, Italy; (S.P.); (A.R.P.); (G.V.Z.)
| | - Enza D’Auria
- Department of Pediatrics, Children’s Hospital Vittore Buzzi, University of Milan, 20154 Milan, Italy; (E.D.); (M.A.)
| | - Miriam Acunzo
- Department of Pediatrics, Children’s Hospital Vittore Buzzi, University of Milan, 20154 Milan, Italy; (E.D.); (M.A.)
| | - Ajay Ratan Pasala
- Pediatric Clinical Research Center “Invernizzi”, Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, 20157 Milan, Italy; (S.P.); (A.R.P.); (G.V.Z.)
| | - Gian Vincenzo Zuccotti
- Pediatric Clinical Research Center “Invernizzi”, Department of Biomedical and Clinical Sciences “L. Sacco”, University of Milan, 20157 Milan, Italy; (S.P.); (A.R.P.); (G.V.Z.)
- Department of Pediatrics, Children’s Hospital Vittore Buzzi, University of Milan, 20154 Milan, Italy; (E.D.); (M.A.)
| | - Claudio Bandi
- Pediatric Clinical Research Center “Invernizzi”, Department of Biosciences, University of Milan, 20133 Milan, Italy;
| | - Lorenzo Drago
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milan, Italy;
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Demodex Infection Changes Ocular Surface Microbial Communities, in Which Meibomian Gland Dysfunction May Play a Role. Ophthalmol Ther 2021; 10:601-617. [PMID: 34159561 PMCID: PMC8319250 DOI: 10.1007/s40123-021-00356-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/27/2021] [Indexed: 10/28/2022] Open
Abstract
INTRODUCTION Demodex and bacteria are both components of the ocular surface micro-ecology, constituting a complex interaction. This study aims to explore how ocular surface Demodex infestation (DI) affects ocular surface microbial communities and diversity. METHODS We recruited 255 subjects, and examined the correlation between ocular surface mite infestation and clinical indicators such as age, blood glucose level, dry eye symptoms, and blood pressure. 16S rRNA sequencing was performed on the conjunctival swab samples of 14 patients with ocular DI (P group) and 17 healthy people (N group). For further analysis, the subjects were divided into four subgroups, i.e. N-NMGD (n = 11), N-MGD (n = 6), P-NMGD (n = 6), and P-MGD (n = 8), according to meibomian gland dysfunction (MGD) or no MGD (NMGD). RESULTS There was no difference in the α-diversity of ocular surface microbial communities between the DI and healthy control groups. In linear discriminant analysis effect size (LEfSe), there were more Acinetobacter, Novosphingobium, and Anoxybacillus in the DI group and fewer Novosphingobium, Lactobacillus, and Candidatus Microthrix in the healthy control group. P-NMGD had more Thermaceae and fewer Pseudomonas than P-MGD. There were more Bacteroidetes in N-NMGD than in N-MGD. The α-diversity of P-NMGD was lower than that of N-NMGD (Shannon index, P = 0.027). At the same time, the α-diversity of N-MGD was lower than that of N-NMGD (Shannon, Simpson, and dominance index, P = 0.048). There was no significant difference in β-diversity or in the primary flora at the phylum and genus levels between groups and subgroups. CONCLUSION DI had no significant effect on the diversity of ocular surface microbial communities. DI primarily changed the dominant flora and relative abundance of ocular surface microbial communities. MGD may play an important role in this process.
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22
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Yasak Guner R, Tosun M, Akyol M, Hayta SB. Demodex infestation as a cause of sensitive skin in a dermatology outpatient clinic. J Cosmet Dermatol 2021; 21:1610-1615. [PMID: 34021963 DOI: 10.1111/jocd.14246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/21/2021] [Accepted: 05/10/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sensitive skin is subjective cutaneous hyperreactivity to environmental factors. Demodicosis is a skin disorder caused by Demodex mites. There may be a link between demodicosis and sensitive skin. AIM This study aimed to examine facial Demodex mites density and other factors associated with sensitive skin in patients. METHODS AND METHODS A total of 349 randomly selected patients presented to the dermatology department. The research data were collected using a questionnaire form that included the participants' sociodemographic and lifestyle characteristics, a sensitive skin questionnaire, the Dermatology Life Quality Index (DLQI), and European Health Interview Survey (EHIS). Patients underwent standardized superficial skin surface biopsy of 4 areas of the face. D. folliculorum count greater than 5 mites/cm2 was considered positive. RESULTS In relation to Demodex, there was an increase in skin sensitivity with higher Demodex density (p = 0.04). There was a statistically significant, weak positive correlation between skin sensitivity and DLQI score (r = 0.33, p = 0.00), and there was also a significant but very weak negative correlation between skin sensitivity and EUROHIS (r = -0.164, p = 0.002). Skin sensitivity was more common in patients with a concomitant dermatological disease (p = 0.01) and increased with more frequent cosmetic use (p = 0.00). CONCLUSION Alongside other risk factors, for the patients presenting with complaints of sensitive skin, investigating Demodex population density may help alleviate sensitive skin symptoms with appropriate therapies and preventive measures.
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Affiliation(s)
- Rukiye Yasak Guner
- Dermatology Department, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Mustafa Tosun
- Dermatology Department, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Melih Akyol
- Dermatology Department, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Sibel Berksoy Hayta
- Dermatology Department, Cumhuriyet University School of Medicine, Sivas, Turkey
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Ko J, Mandal A, Dhawan S, Shevachman M, Mitragotri S, Joshi N. Clinical translation of choline and geranic acid deep eutectic solvent. Bioeng Transl Med 2021; 6:e10191. [PMID: 34027084 PMCID: PMC8126811 DOI: 10.1002/btm2.10191] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/08/2020] [Accepted: 10/14/2020] [Indexed: 01/03/2023] Open
Abstract
Choline geranate deep eutectic solvent/ionic liquid (CAGE) has shown several desirable therapeutic properties including antimicrobial activity and ability to deliver drugs transdermally in research laboratories. Here, we describe the first report of clinical translation of CAGE from the lab into the clinic for the treatment of rosacea, a common chronic inflammatory skin disorder that affects the face. We describe the seven steps of clinical translation including (a) scale-up, (b) characterization, (c) stability analysis, (d) mechanism of action, (e) dose determination, (f) GLP toxicity study, and (g) human clinical study. We describe the challenges and outcomes in these steps, especially those that uniquely arise from the deep eutectic nature of CAGE. Our translational efforts led to a 12-week open-label phase 1b cosmetic study with CAGE1:2 gel (CGB400) in mild-moderate facial rosacea in 26 patients where CGB400 exhibited a marked reduction in the number of inflammatory lesions. These results demonstrate the therapeutic potential of CGB400 for treating rosacea as well as it provides insights into the translational journey of deep eutectic solvents, in particular CAGE, for dermatological applications.
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Affiliation(s)
- Justin Ko
- Department of DermatologyStanford University School of MedicineRedwood CityCaliforniaUSA
| | | | - Sunil Dhawan
- Center for Dermatology Clinical Research, Inc.FremontCaliforniaUSA
| | | | - Samir Mitragotri
- John A. Paulson School of Engineering and Applied SciencesHarvard UniversityCambridgeMassachusettsUSA
- Wyss Institute of Biologically Inspired Engineering at Harvard UniversityBostonMassachusettsUSA
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Neves RDCDSM, Barros LA, Mendes SMC, Amorim TIDSWDAD, Ferraz VP, Mateus LADF, Leite JDS, Ferreira AMR. The sensitivity of Demodex canis (Acari: Demodicidae) to the essential oil of Melaleuca alternifolia - an in vitro study. REVISTA BRASILEIRA DE PARASITOLOGIA VETERINARIA 2020; 29:e005220. [PMID: 32935769 DOI: 10.1590/s1984-29612020059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 06/08/2020] [Indexed: 11/21/2022]
Abstract
The essential oil of the Melaleuca alternifolia (Maiden & Betche) (tea tree oil) has been effective in previous studies, in the treatment of infestation by Demodex mites in humans. The present study aimed at evaluating the in vitro acaricidal effect of this herbal medicine on Demodex canis. For the parasitological examination, samples were collected from a dog's skin and examined using optical microscopy. Only samples with intact mites and with evident movement of chelicerae and tarsi were selected. Twenty-one samples were tested with the oil, in seven different concentrations: 100%; 50%; 25%; 12.5%; 6.25%; 5.0% and 3.13%. Three samples were tested with the positive control amitraz, and three with the negative control neutral shampoo. The interval between the time the solution was added and the moment the movement of the last mite ceased defined the survival time in the sample. By comparing the times at different concentrations and controls, the results showed that the higher the concentration of the oil, the more quickly its lethal effect occurred, and that the survival times in the controls were longer than in the different concentrations of melaleuca oil.
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Affiliation(s)
- Rita de Cássia da Silva Machado Neves
- Área de Concentração em Clínica e Reprodução Animal, Programa de Pós-graduação em Medicina Veterinária, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil.,Hospital Veterinário Professor Firmino Marsico Filho, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil
| | - Luciano Antunes Barros
- Área de Concentração em Clínica e Reprodução Animal, Programa de Pós-graduação em Medicina Veterinária, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil.,Departamento de Saúde Coletiva e Saúde Pública Veterinária, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil
| | - Shihane Mohamad Costa Mendes
- Departamento de Saúde Coletiva e Saúde Pública Veterinária, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil
| | | | - Vany Perpétua Ferraz
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brasil
| | | | - Juliana da Silva Leite
- Área de Concentração em Clínica e Reprodução Animal, Programa de Pós-graduação em Medicina Veterinária, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil.,Hospital Veterinário Professor Firmino Marsico Filho, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil.,Departamento de Patologia e Clínica Veterinária, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil
| | - Ana Maria Reis Ferreira
- Área de Concentração em Clínica e Reprodução Animal, Programa de Pós-graduação em Medicina Veterinária, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil.,Hospital Veterinário Professor Firmino Marsico Filho, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil.,Departamento de Patologia e Clínica Veterinária, Faculdade de Veterinária, Universidade Federal Fluminense - UFF, Niterói, RJ, Brasil
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25
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Abstract
Demodex is the most common parasite living on humans and yet little is understood about its pathogenicity with respect to the ocular surface. An increasing interest in Demodex over the past 20-years has increased our understanding of this mite and its pathogenetic role. This article begins with a review of the anatomy, life cycle, mode of transmission and advances in genetics that can distinguish between Demodex folliculorum and Demodex brevis, the only two Demodex species in humans. Additionally, a review of diagnostic procedures and existing and emerging ocular and systemic management options are presented. Despite the increasing interest in Demodex in the literature, there remains numerous obstacles for future studies, hence a section of this review is dedicated to the identification and proposal for future considerations. The lack of uniformity with respect to terminology, diagnostic technique and management approach for Demodex remain as obstacles for future study comparisons. This review summarised the current knowledge on Demodex and hopes to offer some recommendations for future directions in the study of Demodex in humans.
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Affiliation(s)
- Etty Bitton
- École d'optométrie, Université de Montréal, Montreal, Québec, Canada
| | - Sarah Aumond
- École d'optométrie, Université de Montréal, Montreal, Québec, Canada
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26
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Zhang AC, Muntz A, Wang MTM, Craig JP, Downie LE. Ocular Demodex: a systematic review of the clinical literature. Ophthalmic Physiol Opt 2020; 40:389-432. [PMID: 32691894 DOI: 10.1111/opo.12691] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 04/06/2020] [Accepted: 04/14/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE There is increasing clinical and research interest in the potential contribution of Demodex to ocular surface disease. The aim of this systematic review was to summarise and synthesise current clinical evidence relating to the aetiology, diagnosis and treatment of ocular Demodex. RECENT FINDINGS A comprehensive literature search was performed in OVID Medline, OVID Embase, and clinical trial registries, for studies published between 1990 and August 2019, examining Demodex on the ocular surface. The review included primary clinical research studies and systematic reviews of primary clinical research studies, where Demodex was considered in the context of the ocular surface and/or adnexa. Studies were categorised using the National Health and Medical Research Council evidence hierarchy. Risk of bias assessment was performed using validated tools for studies categorised as providing Level I or II evidence. A total of 87 studies were eligible for inclusion, including two systematic reviews. Most studies (60%) were observational, describing the prevalence of ocular Demodex in different clinical populations. There was a high degree of variability in the epidemiological data derived from cross-sectional aetiology studies. There was mostly consistent evidence to support an association between ocular Demodex and chronic blepharitis. Seven diagnostic test-accuracy studies were identified, which considered a range of techniques, including slit lamp examination for cylindrical eyelash collarettes and/or eyelash manipulation techniques, light microscopic evaluation of epilated eyelashes and in vivo confocal microscopy. There is currently no accepted gold-standard diagnostic method for ocular Demodex. For intervention studies, there was one systematic review, 11 published randomised trials, six trial registry entries, and nine case series. Despite a number of recent trials, the appropriate treatment regimen for ocular Demodex (including the optimal criteria and timing of an intervention) is not clearly established. CONCLUSIONS This comprehensive narrative synthesis has captured the landscape of clinical evidence relating to the prevalence, aetiology, diagnosis and treatment of ocular Demodex. There remain opportunities to enhance understanding of its role in ocular surface disease, best diagnostic approaches and optimal treatment protocols.
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Affiliation(s)
- Alexis Ceecee Zhang
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - Alex Muntz
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Michael T M Wang
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Jennifer P Craig
- Department of Ophthalmology, New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
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27
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Guo Y, Wang R, Zhao Y, Niu D, Gong X, Hu L. Study on the Relationship Between Microbial Composition and Living Environment in Important Medical Mites Based on Illumina MiSeq Sequencing Technology. JOURNAL OF MEDICAL ENTOMOLOGY 2020; 57:1049-1056. [PMID: 32215556 DOI: 10.1093/jme/tjaa034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Indexed: 06/10/2023]
Abstract
The microbiota of mites is closely related to their growth, development, and pathogenicity. Therefore, it is necessary to study the bacteria in mites. Here, for the first time, based on 16s rRNA V3-V4 region, the microbiota of 45 samples of nine species in six families of medically important mites were analyzed using Illumina MiSeq sequencing technique. The results showed that, at the phylum level, Proteobacteria (56.20-86.40%) were the dominant, followed by Firmicutes (6.41-19.43%), Bacteroidetes (5.56-13.38%) and Actinobacteria (1.93-28.07%). But at the genera the microbiota of mites are different, showing four characteristics: 1) The microbiota is related to the parasitic host. Demodex folliculorum (Acariforms: Demodicidae) and D. brevis (Acariforms: Demodicidae), both parasitizing humans, showed similar microbial composition, as did D. canis (Acariforms: Demodicidae) and Sarcoptes scabiei canis (Acariforms: Sarcoptidae) parasitizing dogs, but D. caprae (Acariforms: Demodicidae) parasitizing sheep showed unique microbial community; 2) The microbiota is related to mite's species. Dermatophagoides farinae and Cheyletus malaccensis (Acariforms: Cheyletidae), both collecting from flour, show respective microbial composition; 3) The microbiota is related to the life stage. There were differences in microbiota between adults and larvae of D. farinae, but no differences observed in Psoroptes cuniculi (Acariforms: Psoroptidae); and 4) The microbiota is related to the blood-feeding state. The microbiota of blood-fed Ornithonyssus bacoti (Parasitiformes: Macronyssidae) adults was significantly higher than that of unfed adults. This indicates that the microbiota of mites is affected by mite species, parasitic host, growth stage and habitat. Therefore, understanding these influencing factors will have a very important guiding significance for the prevention and control of mite-borne diseases.
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Affiliation(s)
- Yijie Guo
- Department of Pathogen Biology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Ruiling Wang
- Department of Pathogen Biology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
- Assisted Reproduction Center, Northwest Women's & Children's Hospital, Xi'an, China
| | - Yae Zhao
- Department of Pathogen Biology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Dongling Niu
- Department of Pathogen Biology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Xiaojuan Gong
- Department of Pathogen Biology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Li Hu
- Department of Pathogen Biology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China
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28
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Yuan C, Ma Y, Wang Y, Wang X, Qian C, Hocquet D, Zheng S, Mac-Mary S, Humbert P. Rosacea is associated with conjoined interactions between physical barrier of the skin and microorganisms: A pilot study. J Clin Lab Anal 2020; 34:e23363. [PMID: 32419294 PMCID: PMC7521319 DOI: 10.1002/jcla.23363] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/08/2020] [Accepted: 04/16/2020] [Indexed: 12/19/2022] Open
Abstract
Background Rosacea is a common condition characterized by transient or persistent central facial erythema, and often papules and pustules. Currently, the role of bacterium in the development and progression of rosacea remains controversial. This study aimed to investigate the difference in the physiological conditions and microorganisms between the lesional and non‐lesional areas of papulopustular rosacea. Methods Twenty‐five French patients with papulopustular rosacea were enrolled in this pilot study. Each patient was subjected to clinical assessment, and the skin barrier function was tested in lesional and non‐lesional areas. In addition, samples from the lesional and non‐lesional areas were collected for bacterial culturing. Results Of all subjects included in the study, a lower skin conductivity was measured in lesional areas than in non‐lesional areas (43.5 ± 12.4 vs. 57.2 ± 11.6 U, P < .05), and a higher transepidermal water loss (TEWL) value was found in lesional areas than in non‐lesional areas (17.2 ± 5.9 vs. 14.2 ± 4.1 g/(m2 h), P < .05). We found a lower TEWL in lesions in rosacea patients with bacterial dysbiosis than in those with bacterial balance (P < .05). In addition, there were significant differences in the skin conductivity and TEWL between lesional and non‐lesional areas in patients with bacterial dysbiosis (P < .001), and no significant differences were seen in patients with bacterial balance (P < .05). Conclusion The results of the present study demonstrate that the physiological features of rosacea are closely associated with the interactions between the host and the microorganisms.
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Affiliation(s)
- Chao Yuan
- Skin & Cosmetic Research Department, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yafeng Ma
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, China
| | | | - Xiuli Wang
- Department of Phototherapy, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chunyan Qian
- Yuhang Branch of the Second Affiliated Hospital of Zhejiang University, Hangzhou, China
| | - Didier Hocquet
- Department of Infection Control, University Hospital of Besançon, France
| | - Shuli Zheng
- Skin & Cosmetic Research Department, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China
| | | | - Philippe Humbert
- Research and Studies Center on the Integument (CERT), Department of Dermatology, Clinical Investigation Center (CIC INSERM 1431), University Hospital of Besançon, Besançon, France.,INSERM UMR1098, FED4234 IBCT, University of Franche-Comté, Besançon, France.,FONDATION Cheikh Khalifa Mohammed VI Casablanca, Casablanca, Morocco
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29
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Trager MH, Queen D, Chen D, Hodak E, Geskin LJ. Demodex-induced follicular mucinosis of the head and neck mimicking folliculotropic mycosis fungoides. JAAD Case Rep 2020; 6:266-272. [PMID: 32258294 PMCID: PMC7109359 DOI: 10.1016/j.jdcr.2020.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Megan H Trager
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Dawn Queen
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Diane Chen
- Columbia University, Department of Dermatopathology, New York, New York
| | - Emmilia Hodak
- Rabin Medical Center, Beilinson Hospital, Tel Aviv University, Tel Aviv, Israel
| | - Larisa J Geskin
- Columbia University Irving Medical Center, Department of Dermatology, New York, New York
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30
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Logger JGM, Peppelman M, van Erp PEJ, de Jong EMGJ, Nguyen KP, Driessen RJB. Value of reflectance confocal microscopy for the monitoring of rosacea during treatment with topical ivermectin. J DERMATOL TREAT 2020; 33:195-203. [PMID: 32189533 DOI: 10.1080/09546634.2020.1741501] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background: Reflectance confocal microscopy (RCM) enables noninvasive Demodex mite detection in rosacea. Objective scoring of rosacea severity is currently lacking.Objectives: To determine the value of RCM for monitoring Demodex, inflammation and vascular parameters in rosacea during treatment.Methods: In 20 rosacea patients, clinical and RCM examination were performed before, during, and 12 weeks after a 16-week treatment course with topical ivermectin. Using RCM, number of mites and inflammatory cells, epidermal thickness, and vascular density and diameter were measured. RCM features were correlated with clinical assessment.Results: Treatment resulted in clinical reduction of inflammatory lesions. Mites were detected in 80% of patients at baseline, 30% at week 16, and 63% at week 28. The number of mites reduced significantly during treatment, but no changes in inflammatory cells, epidermal thickness or vascular parameters were observed. Correlation between number of inflammatory lesions and mites was low. None of the RCM variables were significant predictors for clinical success.Conclusions: RCM enables anti-inflammatory effect monitoring of topical ivermectin by determining mite presence. Quantifying exact mite number, and inflammatory and vascular characteristics is challenging due to device limitations. In its current form, RCM seems of limited value for noninvasive follow-up of rosacea in clinical practice.
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Affiliation(s)
- Jade G M Logger
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Malou Peppelman
- Healthcare Policy, Santiz Hospitals, Doetinchem and Winterswijk, The Netherlands
| | - Piet E J van Erp
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Elke M G J de Jong
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Kim P Nguyen
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rieke J B Driessen
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
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31
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Marson JW, Baldwin HE. Rosacea: a wholistic review and update from pathogenesis to diagnosis and therapy. Int J Dermatol 2019; 59:e175-e182. [PMID: 31880327 DOI: 10.1111/ijd.14757] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/23/2019] [Accepted: 11/25/2019] [Indexed: 12/15/2022]
Abstract
Rosacea is a chronic inflammatory disorder of the central face with multiple overlapping presentations. Recent advancements are reshaping our understanding of rosacea from both a pathophysiologic perspective and clinical approach to therapy, introducing novel agents that have improved patient outcomes and reduced morbidity. In this article, we aim to outline the advancements in understanding, diagnosing, and managing rosacea and to familiarize physicians with the literature, thereby allowing us to better practice safe and effective medicine.
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Affiliation(s)
- Justin W Marson
- Department of Medicine, University of California at Irvine, Orange, CA, USA
| | - Hilary E Baldwin
- Medical Director, The Acne Treatment and Research Center, Morristown, NJ, USA.,Clinical Associate Professor of Dermatology, Rutgers Robert Wood Johnson Medical Center, Piscataway, NJ, USA
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32
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Ellis SR, Nguyen M, Vaughn AR, Notay M, Burney WA, Sandhu S, Sivamani RK. The Skin and Gut Microbiome and Its Role in Common Dermatologic Conditions. Microorganisms 2019; 7:microorganisms7110550. [PMID: 31717915 PMCID: PMC6920876 DOI: 10.3390/microorganisms7110550] [Citation(s) in RCA: 80] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 10/27/2019] [Accepted: 11/06/2019] [Indexed: 02/08/2023] Open
Abstract
Microorganisms inhabit various areas of the body, including the gut and skin, and are important in maintaining homeostasis. Changes to the normal microflora due to genetic or environmental factors can contribute to the development of various disease states. In this review, we will discuss the relationship between the gut and skin microbiome and various dermatological diseases including acne, psoriasis, rosacea, and atopic dermatitis. In addition, we will discuss the impact of treatment on the microbiome and the role of probiotics.
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Affiliation(s)
- Samantha R. Ellis
- PotozkinMD Skincare Center, Danville, CA 94526, USA;
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
| | - Mimi Nguyen
- School of Medicine, University of California-Davis, Sacramento, CA 95817, USA; (M.N.); (S.S.)
| | - Alexandra R. Vaughn
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
| | - Manisha Notay
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
| | - Waqas A. Burney
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
- Department of Biological Sciences, California State University, Sacramento, CA 95819, USA
| | - Simran Sandhu
- School of Medicine, University of California-Davis, Sacramento, CA 95817, USA; (M.N.); (S.S.)
| | - Raja K. Sivamani
- Department of Dermatology, University of California-Davis, Sacramento, CA 95816, USA; (A.R.V.); (M.N.); (W.A.B.)
- Department of Biological Sciences, California State University, Sacramento, CA 95819, USA
- College of Medicine, California Northstate University, Elk Grove, CA 95757, USA
- Pacific Skin Institute, Sacramento, CA 95815, USA
- Zen Dermatology, Sacramento, CA 95819, USA
- Correspondence:
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33
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Gazi U, Taylan-Ozkan A, Mumcuoglu KY. Immune mechanisms in human and canine demodicosis: A review. Parasite Immunol 2019; 41:e12673. [PMID: 31557333 DOI: 10.1111/pim.12673] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/11/2019] [Accepted: 09/23/2019] [Indexed: 12/11/2022]
Abstract
Demodex mites are saprophytic parasites of the mammalian skin, mostly found in or near pilosebaceous units of hairy regions. While they can be found in healthy humans and animals without causing any clinical manifestations, they were suggested to create pathogenic symptoms when they appear in high densities under favourable conditions (ie, demodicosis). Nevertheless, their role as the primary causative agent of the pathogenic conditions in humans is debated today. Canine demodicosis, which is highly prevalent in certain dog breeds, provides a valuable tool for studying the pathogenesis of human demodicosis. Canine and human demodicosis are caused by different Demodex species, and the clinical manifestations in former could be life-threatening. Nevertheless, current literature suggests similar immune responses and immune evasion mechanisms in human and canine demodicosis; cellular immunity appeared to have a central role in protection against demodicosis, and Demodex mites were shown to influence both innate and adaptive immune response to escape immune attack. The aim of this review is to summarize the relevant literature on demodicosis obtained from studies conducted on both organisms, and draw the attention to the effect of mite-associated factors (eg, microbiota) on the different clinical manifestations displayed during human and canine demodicosis.
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Affiliation(s)
- Umut Gazi
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Aysegul Taylan-Ozkan
- Department of Medical Microbiology and Clinical Microbiology, Faculty of Medicine, Near East University, Nicosia, Cyprus.,Department of Medical Microbiology, Faculty of Medicine, Hitit University, Corum, Turkey
| | - Kosta Y Mumcuoglu
- Parasitology Unit, Department of Microbiology and Molecular Genetics, The Kuvin Center for the Study of Infectious and Tropical Diseases, Hebrew University-Hadassah Medical School, Jerusalem, Israel
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34
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Moris García V, Valenzuela Vargas G, Marín Cornuy M, Aguila Torres P. Ocular demodicosis: A review. ACTA ACUST UNITED AC 2019; 94:316-322. [PMID: 31151686 DOI: 10.1016/j.oftal.2019.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 11/24/2022]
Abstract
Demodex folliculorum and Demodex brevis are ectoparasites that inhabit the skin of humans. They have been related to alterations in the ocular surface, such as, dysfunction of Meibomian glands, blepharitis, chalazion, etc. Ocular demodicosis is characterised by the pathognomonic presence of cylindrical dandruff at the base of the eyelashes, and various symptoms including, among others, itching, lacrimation, and hyperaemia. A bibliographic review was carried out on the role of Demodex spp. in ocular disease, including publications made by the scientific society between 2005 and 2018. A significant relationship was found between prevalence and incidence of Demodex spp. in eye diseases. D. folliculorum is usually found more frequently than D. brevis in ocular infestation, with the prevalence or incidence of infestation by both species increasing with the age of the patient. In patients with blepharitis or other infectious diseases of the ocular surface, unresolved with antibacterial treatment, the search for Demodex spp. should be considered.
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Affiliation(s)
- V Moris García
- Laboratorio de Microbiología Molecular, Escuela de Tecnología Médica, Universidad Austral de Chile, Puerto Montt, Chile
| | - G Valenzuela Vargas
- Laboratorio de Microbiología Molecular, Escuela de Tecnología Médica, Universidad Austral de Chile, Puerto Montt, Chile
| | - M Marín Cornuy
- Laboratorio de Microbiología Molecular, Escuela de Tecnología Médica, Universidad Austral de Chile, Puerto Montt, Chile
| | - P Aguila Torres
- Laboratorio de Microbiología Molecular, Escuela de Tecnología Médica, Universidad Austral de Chile, Puerto Montt, Chile.
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35
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Wladis EJ, Lau KW, Adam AP. Nuclear Factor Kappa-B Is Enriched in Eyelid Specimens of Rosacea: Implications for Pathogenesis and Therapy. Am J Ophthalmol 2019; 201:72-81. [PMID: 30703356 DOI: 10.1016/j.ajo.2019.01.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess the role of nuclear factor kappa-B (NFKB) in cutaneous specimens of rosacea and unaffected tissue. METHODS Immunohistochemical staining was performed for the activated, phosphorylated variant of NFKB (pNFKB) in eyelid specimens of rosacea (n = 12) and normal, healthy tissue (n = 12). The numbers of positively staining cells/40× microscopic field were counted across 5 consecutive fields. Additionally, quantitative Western blotting was carried out for pNFKB and NFKB in specimens of rosacea (n = 15) and normal controls (n = 14). Statistical comparisons were performed via a dedicated software package. RESULTS The mean number of cells/40× microscopic field that stained positively for pNFKB was 18.4 (standard deviation = 15.3) for control patients and 39.3 (standard deviation = 16.9) for rosacea patients, and the difference between the 2 groups was statistically significant (P = .0024). On Western blotting, the mean ratios of pNFKB:NFKB for control and rosacea patients measured 0.58 (standard deviation = 0.81) and 3.11 (standard deviation = 3.53), respectively. The 2 groups were statistically significantly different (P = .0002). CONCLUSIONS The activated form of NFKB is enriched in rosacea, indicating a role for this pathway in the pathogenesis of this disease. Interference with NFKB signaling may represent a novel therapy for rosacea as clinical agents become available. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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36
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Molecular Characterization of Chitin Synthase Gene of Demodex canis from Mizoram, India. Acta Parasitol 2019; 64:57-62. [PMID: 30645735 DOI: 10.2478/s11686-018-00008-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 10/23/2018] [Indexed: 11/21/2022]
Abstract
AIMS Canine demodicosis is a parasitic condition affecting the skin of dogs. The present study was designed to characterize chitin synthase gene of Demodex canis. The molecular technique was used for better understanding of this gene. METHODS A total of 75 dogs which are reared as pets with or without showing any skin lesions were examined during the study period. Skin scrapings were examined by indirect method using 10% potassium hydroxide solution under 10 × microscope. DNA samples were extracted from positive skin samples and were subjected to PCR for molecular identification. RESULTS A total of 25 dogs irrespective of age, sex, breed or coat showed positive result for D. canis. The PCR revealed a single amplified product of 339 bp length which exactly matched with D. canis. The chitin synthase gene was amplified by PCR, subsequently cloned, sequenced, and compared with available data in GenBank for the particular gene of D. canis. Only one single nucleotide polymorphism (SNP) was noticed at 231 position of the chitin synthase gene sequence when compared to other isolates. CONCLUSION The molecular technique confirms with the morphological identity of D. canis. This report signifies the value of peculiar tool to identify 'follicular mite' even from apparently healthy skin.
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Tranexamic acid ameliorates rosacea symptoms through regulating immune response and angiogenesis. Int Immunopharmacol 2019; 67:326-334. [DOI: 10.1016/j.intimp.2018.12.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/05/2018] [Accepted: 12/13/2018] [Indexed: 02/06/2023]
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Abstract
Rosacea is a common chronic inflammatory skin disease of the central facial skin and is of unknown origin. Currently, two classifications of rosacea exist that are based on either "preformed" clinical subtypes (erythematotelangiectatic, papulopustular, phymatous, and ocular) or patient-tailored analysis of the presented rosacea phenotype. Rosacea etiology and pathophysiology are poorly understood. However, recent findings indicate that genetic and environmental components can trigger rosacea initiation and aggravation by dysregulation of the innate and adaptive immune system. Trigger factors also lead to the release of various mediators such as keratinocytes (for example, cathelicidin, vascular endothelial growth factor, and endothelin-1), endothelial cells (nitric oxide), mast cells (cathelicidin and matrix metalloproteinases), macrophages (interferon-gamma, tumor necrosis factor, matrix metalloproteinases, and interleukin-26), and T helper type 1 (T H1) and T H17 cells. Additionally, trigger factors can directly communicate to the cutaneous nervous system and, by neurovascular and neuro-immune active neuropeptides, lead to the manifestation of rosacea lesions. Here, we aim to summarize the recent advances that preceded the new rosacea classification and address a symptom-based approach in the management of patients with rosacea.
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Affiliation(s)
- Joerg Buddenkotte
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Hamad Medical Corporation, Doha, Qatar
| | - Martin Steinhoff
- Department of Dermatology and Venereology, Hamad Medical Corporation, Doha, Qatar.,Translational Research Institute, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medicine-Qatar, Doha, Qatar.,Medical School, Qatar University, Doha, Qatar.,Weill Cornell Medicine, New York, NY, USA
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Vollmer DL, West VA, Lephart ED. Enhancing Skin Health: By Oral Administration of Natural Compounds and Minerals with Implications to the Dermal Microbiome. Int J Mol Sci 2018; 19:E3059. [PMID: 30301271 PMCID: PMC6213755 DOI: 10.3390/ijms19103059] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/30/2018] [Accepted: 10/01/2018] [Indexed: 12/21/2022] Open
Abstract
The history of cosmetics goes back to early Egyptian times for hygiene and health benefits while the history of topical applications that provide a medicinal treatment to combat dermal aging is relatively new. For example, the term cosmeceutical was first coined by Albert Kligman in 1984 to describe topical products that afford both cosmetic and therapeutic benefits. However, beauty comes from the inside. Therefore, for some time scientists have considered how nutrition reflects healthy skin and the aging process. The more recent link between nutrition and skin aging began in earnest around the year 2000 with the demonstrated increase in peer-reviewed scientific journal reports on this topic that included biochemical and molecular mechanisms of action. Thus, the application of: (a) topical administration from outside into the skin and (b) inside by oral consumption of nutritionals to the outer skin layers is now common place and many journal reports exhibit significant improvement for both on a variety of dermal parameters. Therefore, this review covers, where applicable, the history, chemical structure, and sources such as biological and biomedical properties in the skin along with animal and clinical data on the oral applications of: (a) collagen, (b) ceramide, (c) β-carotene, (d) astaxanthin, (e) coenzyme Q10, (f) colostrum, (g) zinc, and (h) selenium in their mode of action or function in improving dermal health by various quantified endpoints. Lastly, the importance of the human skin microbiome is briefly discussed in reference to the genomics, measurement, and factors influencing its expression and how it may alter the immune system, various dermal disorders, and potentially be involved in chemoprevention.
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Affiliation(s)
- David L Vollmer
- 4Life Research, Scientific Research Division, Sandy, UT 84070, USA.
| | - Virginia A West
- 4Life Research, Scientific Research Division, Sandy, UT 84070, USA.
| | - Edwin D Lephart
- Department of Physiology, Developmental Biology and The Neuroscience Center, Brigham Young University, Provo, UT 84602, USA.
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Nashat MA, Ricart Arbona RJ, Lepherd ML, Santagostino SF, Livingston RS, Riedel ER, Lipman NS. Ivermectin-compounded Feed Compared with Topical Moxidectin-Imidacloprid for Eradication of Demodex musculi in Laboratory Mice. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE 2018; 57:483-497. [PMID: 30185284 DOI: 10.30802/aalas-jaalas-18-000003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Demodex musculi is a prostigmatid follicular mite that has rarely been reported in laboratory mice. Although prevalence of this species has not been assessed formally, we have found that many imported mouse strains from noncommercial sources harbor Demodex mites. To assess whether an acaricide can be used to eradicate this mite, infested immunocompromised mice were provided ivermectin-compounded (12 ppm) feed without restriction for 8 wk (n = 10), were treated topically with moxidectin and imidacloprid (MI; 3 and 13 mg/kg, respectively) weekly for 8 wk (n = 10), or remained untreated (n = 10). Mice were confirmed to be mite-infested before treatment and were tested after treatment by using fur plucks (FP), deep skin scrapes (DSS), and PCR analysis of fur swabs. In addition, the presence of mites was confirmed through skin biopsies at 2 study endpoints (1 wk [n = 5] and 12 wk [ n = 5] after treatment). Samples collected before treatment and from untreated mice were positive for D. musculi at all time points and by all test modalities. After treatment, all ivermectin-treated animals remained infested, whereas mice treated with MI were repeatedly negative by all test modalities. An additional shortened treatment trial revealed that 4 wk of MI (n = 7) was insufficient to eradicate mites. Neither treatment produced any evidence of adverse effects according to hematology, serum chemistry parameters, behavior, body weight, and histopathology. Of the 70 PCR assays performed in treated mice, 14 were positive when FP+DSS was negative. In 6 cases where PCR results were negative, 5 were positive by FP+DSS and a single sample was positive on skin biopsy. Although PCR analysis has a high detection rate for D. musculi, FP+DSS can further enhance the detection rate. In conclusion, topical MI administered for 8 consecutive weeks can safely eradicate D. musculi from an immunocompromised mouse strain.
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Affiliation(s)
- Melissa A Nashat
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York
| | - Rodolfo J Ricart Arbona
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York, Center for Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York
| | - Michelle L Lepherd
- Center for Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York, Gribbles Veterinary, Christchurch, New Zealand
| | - Sara F Santagostino
- Center for Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York, Department of Safety Assessment, Genentech, Inc., South San Francisco, California
| | - Robert S Livingston
- IDEXX BioResearch, Columbia, Missouri, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elyn R Riedel
- Epidemiology and Biostatistics Department, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Neil S Lipman
- Tri-Institutional Training Program in Laboratory Animal Medicine and Science, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York, Center for Comparative Medicine and Pathology, Memorial Sloan Kettering Cancer Center, Weill Cornell Medicine, and The Rockefeller University, New York, New York;,
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Falay Gur T, Erdemir AV, Gurel MS, Kocyigit A, Guler EM, Erdil D. The investigation of the relationships of demodex density with inflammatory response and oxidative stress in rosacea. Arch Dermatol Res 2018; 310:759-767. [PMID: 30151656 DOI: 10.1007/s00403-018-1857-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 08/05/2018] [Accepted: 08/21/2018] [Indexed: 01/11/2023]
Abstract
The relationships of demodex density with systemic oxidative stress, inflammatory response, and clinical severity in rosacea are not clear. This study aimed to (a) analyze the levels of systemic oxidative stress, antioxidant capacity, inflammatory parameters, and matrix metalloproteinases (MMPs) in systemic circulation in patients with rosacea, (b) identify the relationship between mite density and both oxidative stress and inflammation, and (c) investigate the role of photoaging and sebum secretion in etiopathogenesis. Forty patients with rosacea and 40 age-, sex-, and skin phenotype-matched healthy volunteers were included in the study. Clinical disease severity of the patients was determined. Sebum levels were measured in both the groups, and photoaging was evaluated. Reflectance confocal microscopy was used to calculate demodex density. Serum total antioxidant capacity (TAC), total oxidant capacity (TOC), myeloperoxidase (MPO), MMP-1, MMP-9, arylesterase (ARES), interleukin-1β (IL-1β), paraoxonase-1 (PON-1), and tumor necrosis factor-α (TNF-α) levels were also analyzed. The patients with rosacea had significantly higher serum TOC and lower TAC levels (p < 0.001). The serum ARES and PON-1 levels were significantly lower (p = 0.045 and p < 0.001, respectively); however, the serum levels of MMP-1, MMP-9, IL-1β and MPO were higher in the patient group. Demodex parameters were higher in the patient group compared to the control group. There was no significant correlation between the number of mites and disease severity. In addition, the number of mites was not correlated with the serum levels of TAC, TOC, OSI, MPO, MMP-1, MMP-9, ARES, PON-1, TNF-α, and IL-1β. However, sebum levels were directly proportional to the number of mites. Photoaging severity was similar between the patients and control subjects. The changing sebaceous microenvironment in rosacea leads to an increase in the number of demodex mites. However, increased demodex density does not alter disease severity, level of oxidative stress, or inflammation. Although none of the patients with rosacea had any underlying systemic disease, patients' systemic oxidative stress and inflammation parameters were found high in systemic circulation. It is assumed that the patients with rosacea are more prone to systemic diseases.
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Affiliation(s)
- Tuğba Falay Gur
- Department of Dermatology, Sultan Abdulhamid Han Training and Research Hospital, Health Science University, Usküdar, Istanbul, Turkey.
| | - Aslı Vefa Erdemir
- Department of Dermatology, Göztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mehmet Salih Gurel
- Department of Dermatology, Göztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Abdurrahim Kocyigit
- Department of Biochemistry, Bezmialem Vakif University Medical School, Istanbul, Turkey
| | - Eray Metin Guler
- Department of Biochemistry, Bezmialem Vakif University Medical School, Istanbul, Turkey
| | - Duygu Erdil
- Department of Dermatology, Ağrı State Hospital, Ağrı, Turkey
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Maher A, Staunton K, Kavanagh K. Analysis of the effect of temperature on protein abundance in Demodex-associated Bacillus oleronius. Pathog Dis 2018; 76:4966982. [PMID: 29648591 DOI: 10.1093/femspd/fty032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 04/09/2018] [Indexed: 01/10/2023] Open
Abstract
A potential role for bacteria in the induction of rosacea has been suggested. The aim of this work was to characterise the effect of temperature on the production of immunostimulatory proteins by Bacillus oleronius-a bacterium to which rosacea patients show sera reactivity and which was originally isolated from a Demodex mite from a rosacea patient. The affected skin of rosacea patients is at a higher temperature than unaffected skin, and it was postulated that this might alter the protein expression pattern of B. oleronius. B. oleronius growth was reduced at 37°C compared to 30°C but resulted in increased expression of the immune-reactive 62kDa protein (1.65 fold [P < 0.05]). Proteomic analysis revealed increased abundance of a wide range of proteins involved in the stress response (e.g. stress proteins [21.7-fold increase], phosphocarrier protein HPr [438.5-fold increase], 60 kDa chaperonin [12.6-fold increase]). Proteins decreased in abundance after growth at 37°C included ferredoxin (325-fold decrease) and peptidase (244-fold decrease). This work indicates that the increased skin temperature of rosacea patients may alter the growth and protein production pattern of B. oleronius and lead to the greater production of immuo-stimulatory proteins.
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Affiliation(s)
- Amie Maher
- Department of Biology, Maynooth University, Co. Kildare, Ireland
| | - Kara Staunton
- Department of Biology, Maynooth University, Co. Kildare, Ireland
| | - Kevin Kavanagh
- Department of Biology, Maynooth University, Co. Kildare, Ireland
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Demodex spp. as a possible aetiopathogenic factor of acne and relation with acne severity and type. Postepy Dermatol Alergol 2018; 35:174-181. [PMID: 29760618 PMCID: PMC5949547 DOI: 10.5114/ada.2018.75239] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 12/18/2016] [Indexed: 01/09/2023] Open
Abstract
Introduction Acne is a very common skin disease in adolescents and young adults, but it also affects adults. However, its aetiology is not yet fully understood. Demodex appears to be associated with multiple skin disorders, but controversy persists. Some reports indicate a connection between acne vulgaris and demodicosis. Aim To confirm the association between Demodex infestation and acne vulgaris. Material and methods A total of 108 patients were enrolled in the acne group. Acne severity was calculated as GASS and acne type (adolescent and post adolescent) was recorded. An age-sex matched healthy control group comprising 65 individuals were included in the study. Dermatological examinations were performed and an SSSB was used to determine the presence of Demodex. Results In our study, Demodex positivity was seen in 46 (42.6%) patients in the acne group and 8 (12.3%) in the control group; this difference was statistically significant (p < 0.001). A multivariate Backward Step-By-Step Logistic Regression analysis identified the most effective factors for acne development such as Demodex positivity (OR = 5.565, 95% CI: 2.384–12.99 and p < 0.001) and age under 25 years (OR = 2.3 and 95% CI: 1.183–4.473 and p = 0.014). Alcohol consumption was related to Demodex positivity (p = 0.019) in post adolescent acne. Conclusions Our study is the first one to evaluate acne severity, acne type and the relationship to Demodex prevalence. We suggest that Demodex infestation should be considered when the classical therapies are ineffective especially in cases of post adolescent acne.
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Abstract
The skin supports a delicate ecosystem of microbial elements. Although the skin typically acts as a barrier, these microbes interact with the internal body environment and imbalances from the "healthy" state that have been linked to several dermatologic diseases. Understanding the changes in microbial flora in disease states allows for the potential to treat by restoring equilibrium. With the rising popularity of holistic and natural consumerism, prebiotics, probiotics, symbiotic, and other therapies are under study to find alternative treatments to these skin disorders through manipulation or supplementation of the microbiome.
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Affiliation(s)
- Shenara Musthaq
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY
| | - Anna Mazuy
- Early Clinical Evaluation Department, Galderma-Nestlé Skin Health R&D, Les Templiers, Sophia Antipolis, France
| | - Jeannette Jakus
- Department of Dermatology, SUNY Downstate Medical Center, Brooklyn, NY.
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Ocular Demodex folliculorum: prevalence and associated symptoms in an Irish population. Int Ophthalmol 2018; 39:405-417. [PMID: 29380184 DOI: 10.1007/s10792-018-0826-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 01/19/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the prevalence of ocular Demodex folliculorum (DF) in an Irish population. To validate a modified Ocular Surface Disease Index questionnaire and employ it to evaluate the relationship between dry eye symptoms and the presence of DF. METHODS One hundred and fifty-six subjects were enrolled in an epidemiological cross-sectional prevalence study. Each subject completed a novel questionnaire on ocular symptoms and was assessed for the presence of DF. Data was analysed to assess prevalence and to search for significant links between each symptom and DF. RESULTS An overall prevalence of 68% was found. Total mean number of DF found on microscopic examination was 3.83 mites per subject (range 0-25). The presence of symptoms was higher among individuals with DF (P = 0.04). Itch was found to be the symptom most significantly associated with the presence and number of DF (P = 0.025 and P = 0.035, respectively). The questionnaire showed good internal consistency (Cronbach's alpha; α > 0.7) and good reliability (Intra-class Correlation Co-efficient; ICC > 0.7). The sensitivity and specificity of a positive symptom result using the questionnaire were 70.8% and 46.9%, respectively. CONCLUSION There is a strong association between the prevalence of DF and symptoms, in particular itchy eyes. However, not all patients with DF will be symptomatic. The newly developed questionnaire is a reliable instrument for measuring change in symptoms over a period of time and suitable for observing patient reported outcomes in interventional treatment studies.
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Kumari P, Nigam R, Choudhury S, Singh SK, Yadav B, Kumar D, Garg SK. Demodex canis targets TLRs to evade host immunity and induce canine demodicosis. Parasite Immunol 2018; 40. [PMID: 29253318 DOI: 10.1111/pim.12509] [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] [Received: 10/22/2017] [Accepted: 12/13/2017] [Indexed: 12/31/2022]
Abstract
Widespread incidence of Demodex mites throughout the mammalian class and occasional serious and fatal outcomes in dogs warrant an insight into the host-parasite interface especially. Therefore, this study was aimed to unravel the interplay between innate immune response and canine demodicosis. The dogs diagnosed to have natural clinical demodicosis were allocated into two groups; dogs with localized demodicosis (LD) and with generalized demodicosis (GD). The expression of toll-like receptors (TLRs) 2, 4 and 6 genes in peripheral blood mononuclear cells of these dogs was quantified by real-time PCR. Significantly increased TLR2 gene expression, while significantly diminished TLR4 and TLR6 gene expressions were observed in demodicosed dogs (LD and GD) as compared with the healthy ones. Even the expression of TLR2 gene was found to differ significantly between the dogs with LD and GD. Therefore, it can be inferred that clinical demodicosis in dogs is coupled with an up-regulation of TLR2 and down-regulation of TLR4 and TLR6 gene expressions. Overexpression of TLR2 gene might be responsible for Demodex-induced clinical manifestations, while TLR4 and TLR6 gene down-regulations could be the paramount strategy of Demodex mites to elude the host-immune interface.
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Affiliation(s)
- P Kumari
- College of Biotechnology, U.P. Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - R Nigam
- College of Biotechnology, U.P. Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - S Choudhury
- Department of Pharmacology and Toxicology, College of Veterinary Science and Animal Husbandry, U.P. Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - S K Singh
- Department of Veterinary Medicine, College of Veterinary Science and Animal Husbandry, U.P. Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - B Yadav
- Department of Veterinary Physiology, College of Veterinary Science and Animal Husbandry, U.P. Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - D Kumar
- College of Biotechnology, U.P. Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
| | - S K Garg
- Department of Pharmacology and Toxicology, College of Veterinary Science and Animal Husbandry, U.P. Pandit Deen Dayal Upadhyaya Pashu Chikitsa Vigyan Vishwavidyalaya Evam Go Anusandhan Sansthan (DUVASU), Mathura, India
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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]
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Murphy O, O'Dwyer V, Lloyd-McKernan A. The efficacy of tea tree face wash, 1, 2-Octanediol and microblepharoexfoliation in treating Demodex folliculorum blepharitis. Cont Lens Anterior Eye 2017; 41:77-82. [PMID: 29074306 DOI: 10.1016/j.clae.2017.10.012] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 10/12/2017] [Accepted: 10/13/2017] [Indexed: 01/08/2023]
Abstract
PURPOSE To compare the efficacy of Dr Organic Tea Tree Face Wash, OcuSoft Lids Scrub Plus and the BlephEx™ device at treating of Demodex folliculorum blepharitis. METHODS Eighty-six subjects (33 males/36 females) were enrolled in a randomised controlled interventional treatment study. Subjects completed a dry eye symptom questionnaire and were assessed for presence of Demodex folliculorum. Subjects were divided into three groups according to treatment: Dr Organic Tea Tree Face Wash (A) (n=28), OcuSoft Lid Scrub Plus (B) (n=30), or in-house lid scrub with the BlephEx™ device before nightly lid scrubs with OcuSoft Lid Scrub Plus (C) (n=28). Subjects were advised to clean their eyelids nightly for four weeks. Each subject was re-assessed for symptoms and Demodex folliculorum blepharitis after two weeks and four weeks of treatment. RESULTS The quantity of Demodex folliculorum was significantly reduced after four weeks of treatment in all three groups (p<0.05). Overall, there was no difference in efficacy between the three treatments (p>0.1). Symptoms reported by subjects were significantly improved after two and four weeks of treatment (p<0.05). Overall, there was no difference in efficacy between the three treatments to reduce symptoms after two or four weeks (p= 0.813 and p=0.646 respectively). CONCLUSION All three methods tested have shown good ability to reduce Demodex folliculorum quantity, improve subjective symptoms and help treat Demodex folliculorum blepharitis.
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Augustin M, Goepel L, Jacobi A, Bosse B, Mueller S, Hopp M. Efficacy and tolerability of liposomal polyvinylpyrrolidone-iodine hydrogel for the localized treatment of chronic infective, inflammatory, dermatoses: an uncontrolled pilot study. Clin Cosmet Investig Dermatol 2017; 10:373-384. [PMID: 28989281 PMCID: PMC5624600 DOI: 10.2147/ccid.s141887] [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] [Indexed: 12/27/2022]
Abstract
Infection is common in many chronic, inflammatory skin conditions but is often difficult to treat, in part due to growing bacterial resistance to antibiotics. Liposomal polyvinyl-pyrrolidone (PVP)-iodine hydrogel has a unique mode of action, combining the antiseptic and anti-inflammatory actions of PVP-iodine with the drug delivery and moisturizing properties of liposomes. We investigated the utility of liposomal PVP-iodine to treat infective dermatoses. In this prospective, single-arm (uncontrolled), open-label Phase II pilot study, patients with acne vulgaris (n=30), atopic dermatitis (n=20), impetigo contagiosa (n=10), and rosacea (n=10) received PVP-iodine (3%) hydrogel for ≤4 weeks. Global Clinical Severity score improved for all dermatoses (range: 0.5 for acne vulgaris [p<0.001] to 1.0 for impetigo contagiosa [p=0.011]). Improvements in pain, quality of life, (Freiburg Life Quality Assessment), and Eczema Area and Severity Index scores were also seen. Treatment was well tolerated; most frequent adverse events were burning (14%) or itching (9%) sensations. Thus, liposomal PVP-iodine hydrogel has potential utility as an effective treatment for inflammatory skin conditions associated with bacterial colonization.
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Affiliation(s)
| | - Lisa Goepel
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg
| | - Arnd Jacobi
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, University of Hamburg, Hamburg
| | - Bjoern Bosse
- Mundipharma Research GmbH & Co.KG, Limburg (Lahn), Germany
| | - Stefan Mueller
- Mundipharma Research GmbH & Co.KG, Limburg (Lahn), Germany
| | - Michael Hopp
- Mundipharma Research GmbH & Co.KG, Limburg (Lahn), Germany
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Jones L, Downie LE, Korb D, Benitez-del-Castillo JM, Dana R, Deng SX, Dong PN, Geerling G, Hida RY, Liu Y, Seo KY, Tauber J, Wakamatsu TH, Xu J, Wolffsohn JS, Craig JP. TFOS DEWS II Management and Therapy Report. Ocul Surf 2017; 15:575-628. [DOI: 10.1016/j.jtos.2017.05.006] [Citation(s) in RCA: 578] [Impact Index Per Article: 82.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 02/06/2023]
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