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Alevizou A, Gregoriou S, Tsimpidakis A, Pappa G, Rigopoulos D, Katoulis A. Evaluation of Delayed Contact Hypersensitivity in Patients with Rosacea. Skin Appendage Disord 2024; 10:207-214. [PMID: 38835717 PMCID: PMC11147521 DOI: 10.1159/000536246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/22/2023] [Indexed: 06/06/2024] Open
Abstract
Introduction Rosacea is a common chronic inflammatory dermatosis characterized by erythema, telangiectasia, papules, and pustules on the central face. The frequency of contact sensitization complicating rosacea and its therapy is unknown, with only few studies published in the literature. In the present study, we aimed to evaluate contact sensitivity in patients with rosacea. Methods A total of 50 rosacea patients and 50 age- and sex-matched healthy controls were enrolled. Both groups were patch tested with the European Baseline Series. Results A positive reaction to at least one allergen of the European Baseline Series was observed in 15 (30%) of rosacea patients and 10 (20%) of the healthy controls. Although the rate of positive reaction in the rosacea group was higher than in the controls, no statistically significant difference was documented. In addition, the total number of positive reactions to allergens in the rosacea group was higher than the control group, namely, 26 versus 17. Conclusion Contact hypersensitivity may coexist with rosacea. Its identification holds significant clinical relevance, influencing the long-term management and justifying the application of patch testing in rosacea patients.
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Affiliation(s)
- Antigoni Alevizou
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School, “Andreas Syggros” Hospital for Cutaneous and Venereal Diseases, Athens, Greece
| | - Stamatios Gregoriou
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School, “Andreas Syggros” Hospital for Cutaneous and Venereal Diseases, Athens, Greece
| | - Antonios Tsimpidakis
- 1st Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Medical School, “Andreas Syggros” Hospital for Cutaneous and Venereal Diseases, Athens, Greece
| | - Georgia Pappa
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, “Attikon” General University Hospital, Athens, Greece
| | | | - Alexandros Katoulis
- 2nd Department of Dermatology and Venereology, National and Kapodistrian University of Athens, Medical School, “Attikon” General University Hospital, Athens, Greece
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Choi ME, Lee WJ, Ko JY, Kim KJ, Kim JE, Kim HS, Park KY, Park MY, Suh DH, Shin K, Shin MK, Ahn HH, Lee WJ, Lee JB, Lee HJ, Jang MS, Cheong SH, Cho S, Choi YS, Choi YW, Choi H, Lee MW. Facial Dermatoses Associated With Mask-Wearing in the COVID-19 Era: A Nationwide, Cross-Sectional, Multicenter, Questionnaire-based Study. Ann Dermatol 2024; 36:81-90. [PMID: 38576246 PMCID: PMC10995613 DOI: 10.5021/ad.23.061] [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: 08/02/2023] [Revised: 10/10/2023] [Accepted: 11/08/2023] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Daily usage of facial masks during coronavirus disease 2019 pandemic influenced on facial dermatoses. OBJECTIVE This study investigated the impact of mask-wearing habits on facial dermatoses. METHODS A nationwide, observational, questionnaire-based survey was conducted from July through August 2021, involving 20 hospitals in Korea. RESULTS Among 1,958 facial dermatoses, 75.9% of patients experienced aggravation or development of new-onset facial dermatoses after wearing masks. In aggravated or newly developed acne patients (543 out of 743), associated factors were healthcare provider, female gender, and a long duration of mask-wearing. Irritating symptoms, xerosis, and hyperpigmentation were more frequently observed in this group. Aggravated or newly developed rosacea patients (515 out of 660) were likely to be female, young, and have a long duration of mask-wearing per day. Seborrheic dermatitis patients who experienced aggravation or de novo development (132 out of 184) were younger, and they more frequently involved the chin and jaw in addition to the nasolabial folds and both cheeks. Contact dermatitis patients (132 out of 147) with aggravation or de novo development tended to be female, involve both cheeks, and complain of pruritus. Aggravated or newly developed atopic dermatitis patients (165 out of 224) were more likely to be female, and had a higher baseline investigator global assessment score before mask-wearing. CONCLUSION Clinical features and factors related to aggravation were different according to the types of facial dermatoses.
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Affiliation(s)
- Myoung Eun Choi
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo Jin Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Joo Yeon Ko
- Department of Dermatology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Kwang Joong Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Jung Eun Kim
- Department of Dermatology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Kui Young Park
- Departments of Dermatology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mi Youn Park
- Department of Dermatology, National Medical Center, Seoul, Korea
| | - Dae Hun Suh
- Department of Dermatology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Kihyuk Shin
- Department of Dermatology, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Min Kyung Shin
- Department of Dermatology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hyo Hyun Ahn
- Department of Dermatology, Korea University College of Medicine, Seoul, Korea
| | - Weon Ju Lee
- Department of Dermatology, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jee Bum Lee
- Department of Dermatology, Chonnam National University Medical School, Gwangju, Korea
| | - Hee Jung Lee
- Department of Dermatology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Min Soo Jang
- Department of Dermatology, Kosin University College of Medicine, Busan, Korea
| | - Seung Hyun Cheong
- Department of Dermatology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea
| | - Soyun Cho
- Department of Dermatology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Yu Sung Choi
- Department of Dermatology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - You Won Choi
- Department of Dermatology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hoon Choi
- Department of Dermatology, Chosun University College of Medicine, Gwangju, Korea
| | - Mi Woo Lee
- Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Magdaleno-Tapial J, López-Martí C, García-Legaz-Martínez M, Martínez-Domenech A, Partarrieu-Mejías F, Casanova-Esquembre A, Lorca-Spröhnle J, Labrandero-Hoyos C, Peñuelas-Leal R, Sierra-Talamantes C, Pérez-Ferriols A, Zaragoza-Ninet V. [Translated article] Contact Allergy in Patients With Rosacea. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:T550-T554. [DOI: 10.1016/j.ad.2022.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 02/27/2022] [Indexed: 11/30/2022] Open
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Magdaleno-Tapial J, López-Martí C, García-Legaz-Martínez M, Martínez-Domenech A, Partarrieu-Mejías F, Casanova-Esquembre A, Lorca-Spröhnle J, Labrandero-Hoyos C, Peñuelas-Leal R, Sierra-Talamantes C, Pérez-Ferriols A, Zaragoza-Ninet V. Sensibilización alérgica de contacto en pacientes con rosácea. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:550-554. [DOI: 10.1016/j.ad.2022.02.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 02/04/2022] [Accepted: 02/27/2022] [Indexed: 10/18/2022] Open
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Guertler A, Niesert AC, Wilhelm KP, Knuhr K, Brandt M, French LE, Reinholz M. Efficacy and tolerability of a detergent and care component for rosacea patients: A split-face, vehicle-controlled, randomized trial. J Cosmet Dermatol 2021; 21:689-697. [PMID: 33825333 DOI: 10.1111/jocd.14130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The treatment of facial erythema and subjective symptoms of rosacea patients remains challenging in clinical practice. Cosmeceuticals, care components containing active ingredients such as phytochemicals, play a growing role in treatment plans. However, well-designed studies on their efficacy and limitations are widely missing. OBJECTIVE A foam and a cream for rosacea patients were assessed based on objective and subjective methodology. The tolerability of skin and eyes was evaluated. METHODS A randomized, double-blinded, split-face, and vehicle-controlled trial was conducted. At baseline and after four weeks of product use, dermatological and ophthalmological investigations were performed, employing image analysis of facial erythema, clinical assessments, and questionnaires. RESULTS The patient cohort comprised 33 females with persistent facial erythema due to rosacea. No significant differences were found between the vehicle and the verum. According to the analysis of facial erythema, a "less pronounced" or "much less pronounced" appearance was seen in two thirds of patients comparing V1 to V0. Especially, the dryness of the skin improved by the use of the vehicle and the verum. Adverse subjective skin sensations decreased by 61.3% for the verum side and by 58.6% for the vehicle side. Subjective and objective analysis of ocular manifestation differed, with subjective manifestations reported more frequently, thus highlighting underdiagnosis of ocular rosacea. CONCLUSIONS As no clear differences between the verum and the vehicle were found, an optimal skin care regime itself seems to have a superior effect in the relief of facial erythema and foremost of subjective symptoms, rather than certain active ingredients.
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Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany
| | - Anne Charlotte Niesert
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany
| | - Klaus-Peter Wilhelm
- proDERM Institut für Dermatologische Forschung GmbH, Schenefeld/Hamburg, Germany
| | - Katrin Knuhr
- proDERM Institut für Dermatologische Forschung GmbH, Schenefeld/Hamburg, Germany
| | - Marianne Brandt
- proDERM Institut für Dermatologische Forschung GmbH, Schenefeld/Hamburg, Germany
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Markus Reinholz
- Department of Dermatology and Allergy, University Hospital of Munich, LMU, Munich, Germany
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Chen B, Yu F, Chen W, Yao Z, Yang X, Zhang D, Hao F. Contact sensitization to cosmetic series of allergens in female patients with rosacea: A prospective controlled study in China. J Cosmet Dermatol 2020; 20:2627-2634. [PMID: 33350569 DOI: 10.1111/jocd.13902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/25/2020] [Accepted: 12/07/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Allergic contact dermatitis to cosmetics (ACDC) complicates the diagnosis and treatment of rosacea, and is increasingly observed in daily practice. AIMS The present study aimed to identify the contact allergens responsible for ACDC in Chinese female rosacea patients with or without suspected ACDC (SACDC). METHODS From a total of 1267 women with rosacea, 122 with SACDC, 145 without SACDC, and 100 age-matched healthy controls without rosacea or SACDC were examined on a voluntary basis. Skin patch tests with C-1000 cosmetic series (Chemotechnique Diagnostics, Malmo, Sweden) were conducted, including 20 selected allergens. RESULTS Positive allergic reaction was found in 85.2% and 33.8% of SACDC and non-SACDC (P < .001), respectively, and 27.0% of healthy volunteers. Most reactions occurred at day 3, and the majority of all the examinees including normal controls reacted to more than 1 allergen. In SACDC patients, leading allergens were methylchloroisothiazolinone/methylisothiazolinone (28.7%), linalool hydroperoxide (27.1%), fragrance mix I (21.3%), methylisothiazolinone (17.2%), limonene hydroperoxides (16.4%), formaldehyde (14.8%), myroxylon pereirae (13.9%), and propolis (10.7%); the overall allergic reaction rate positively correlated with new onset of facial pruritus (P < .001). The occurrence of irritant contact reactions correlated with positive allergic reactions in rosacea patients with or without SACDC (P = .032 or P < .001, respectively). CONCLUSIONS Preservatives and fragrances are primary culprits for ACDC in Chinese female rosacea patients. Patch testing should be considered in the suspected patients.
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Affiliation(s)
- Bangtao Chen
- Department of Dermatology, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fubing Yu
- Department of Dermatology, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - WenChieh Chen
- Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany
| | - Zhengqiu Yao
- Department of Dermatology, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xi Yang
- Department of Dermatology, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Daojun Zhang
- Department of Dermatology, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fei Hao
- Department of Dermatology, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Zhang H, Tang K, Wang Y, Fang R, Sun Q. Rosacea Treatment: Review and Update. Dermatol Ther (Heidelb) 2020; 11:13-24. [PMID: 33170491 PMCID: PMC7858727 DOI: 10.1007/s13555-020-00461-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Indexed: 01/08/2023] Open
Abstract
Rosacea is a chronic and inflammatory skin disease characterized by flushing, nontransient erythema, papules/pustules, telangiectasia, and phymatous changes. Secondary manifestations, such as itching, burning, or stinging, are often observed in patients with rosacea. In 2017, a phenotype-based approach for diagnosis and classification was recommended. With the update of the diagnosis and classification of rosacea, treatment options for patients with rosacea have attracted the attention of dermatologists. Here, we summarize the latest advances in rosacea treatment, including skin care and cosmetic treatments, topical therapies, oral therapies, laser- and light-based therapies, injection therapies, treatments for specific types of rosacea, treatments for systemic comorbidities, and combination therapies. The impact of the phenotype-based approach on rosacea treatment and future directions are also discussed.
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Affiliation(s)
- Hanlin Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Keyun Tang
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yuchen Wang
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Rouyu Fang
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Qiuning Sun
- Department of Dermatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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Logger JGM, Peppelman M, van Vugt R, Driessen RJB. Rosacea and Use of Continuous Positive Airway Pressure Mask for Obstructive Sleep Apnea Syndrome: Report of Five Cases. Ann Dermatol 2020; 32:247-250. [PMID: 33911746 PMCID: PMC7992619 DOI: 10.5021/ad.2020.32.3.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/31/2019] [Accepted: 07/05/2019] [Indexed: 11/08/2022] Open
Abstract
Rosacea is a chronic inflammatory skin disease of unknown etiology. We noticed a series of patients who were diagnosed with rosacea as well as obstructive sleep apnea syndrome (OSAS), for which they used a continuous positive airway pressure (CPAP) mask. This case series aims to give insight in the possible relationship between rosacea and the use of a CPAP mask for OSAS. We present five patients with OSAS who developed or worsened rosacea symptoms after use of a CPAP mask covering nose and mouth. Two patients showed centrofacial symptoms consistent with the shape of the CPAP mask; three patients had nasal cutaneous symptoms. It is postulated that the occlusive effect of the CPAP mask, increasing skin humidity and temperature, can induce primary symptoms in patients with an underlying sensibility for rosacea. This could have implications for choice of CPAP mask type and topical therapeutic options for rosacea.
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Affiliation(s)
- Jade G M Logger
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Malou Peppelman
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Roel van Vugt
- Department of Anesthesiology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Rieke J B Driessen
- Department of Dermatology, Radboud University Medical Center, Nijmegen, The Netherlands
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