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Hoffman L, Ahmed S, Krakowski AC, Chapas A. Practices in Pediatric Cosmetic Dermatologic Procedures: A National Survey. Dermatol Surg 2024:00042728-990000000-00849. [PMID: 38889095 DOI: 10.1097/dss.0000000000004287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
BACKGROUND Adult populations have traditionally been the primary recipients of cosmetic treatments, but a growing trend shows an increase in such procedures among pediatric patients. OBJECTIVE The objective of the authors' study was to investigate types of procedures currently being performed by pediatric and cosmetic dermatologists and factors that may influence their choice of treatments in a pediatric population. METHODS The authors conducted an anonymous online survey targeting healthcare practitioners who frequently use lasers for pediatric cutaneous conditions. The survey collected information on participants' primary scope of practice, pediatric cosmetic procedures they performed, counseling topics, and procedural details. RESULTS Of 85 survey respondents, 73 (86.00%) completed all questions. Most respondents identified as pediatric dermatologists (77.65%), followed by general dermatologists (18.82%), cosmetic dermatologists (8.24%), and dermatologic/Mohs surgeons (1.18%). Top pediatric cosmetic conditions treated included hypertrophic/traumatic scars (95.29%), acne (89.41%), axillary and facial hyperhidrosis (77.65%), hypertrichosis/hirsutism (67.06%), and pigmented lesion removal (64.71%). Commonly performed procedures were vascular lasers (77.65%), laser hair removal (50.59%), and pigmented lasers (28.24%), among others. Respondents prioritized understanding risks/benefits, clinically indicated treatment, and the natural course of the condition. CONCLUSION As the first multisociety, national survey, these results offer valuable insight into the current landscape of pediatric cosmetic treatments from the perspective of dermatologists.
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Affiliation(s)
| | - Sarah Ahmed
- Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania
| | - Andrew C Krakowski
- Department of Dermatology, St. Luke's University Health Network, Easton, Pennsylvania
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Ruan J, Zheng Y, Cai S. Efficacy and safety comparison between pulsed dye laser and intense pulsed light configured with different wavelength bands in treating erythematotelangiectatic rosacea. Lasers Med Sci 2024; 39:146. [PMID: 38822948 DOI: 10.1007/s10103-024-04098-9] [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: 08/20/2023] [Accepted: 05/23/2024] [Indexed: 06/03/2024]
Abstract
Previous clinical studies have shown that pulsed dye laser (PDL) and intense pulsed light (IPL) are effective for treating erythematotelangiectatic rosacea(ETR). This article aims to compare the efficacy and safety of PDL and IPL at three different wavelength bands (broad-band, single-narrow-band, and dual-narrow-band) in treating ETR. Sixty subjects with ETR were randomly categorized into four groups and received one of the following laser treatments: PDL (595 nm), IPL with Delicate Pulse Light (DPL, 500-600 nm), IPL with M22 590 (590-1200 nm), or IPL with M22 vascular filter (530-650 nm and 900-1200 nm). Four treatment sessions were administered at 4-week intervals, with one follow-up session 4 weeks after the final treatment. The efficacy of the four lasers was evaluated by comparing the clinical symptom score, total effective rate, VISIA red area absolute score, and RosaQoL score before and after treatment. The safety was evaluated by comparing adverse reactions such as pain, purpura, erythematous edema, and blister. All 60 subjects completed the study. Within-group effects showed that the clinical symptom score, VISIA red area absolute score, and RosaQoL score of all four groups were significantly reduced compared to before treatment (p < 0.001). Between-group effects showed no statistically significant difference among the four laser groups. Safety analysis showed that all four lasers were safe, but the incidence of blister was higher in the M22 vascular group. Nonpurpurogenic PDL, DPL, M22 590, and M22 vascular were equally effective in treating ETR and were well-tolerated. ClinicalTrial.gov Identifier: NCT05360251.
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Affiliation(s)
- Jiali Ruan
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yuxin Zheng
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Suiqing Cai
- Department of Dermatology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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3
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von Stebut J, Mallach M, Schneider-Burrus S, Heiland M, Rendenbach C, Preissner R, Preissner S. Rosacea is strongly associated with melanoma in Caucasians. Sci Rep 2024; 14:11949. [PMID: 38789467 PMCID: PMC11126582 DOI: 10.1038/s41598-024-62552-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
Rosacea is often considered a cosmetic problem but is known to be associated with a variety of comorbidities. To identify such risks, we generated two age- and sex-matched real-world cohorts of 122,444 patients each with and without rosacea. In contrast to earlier studies, we found significant associations with malignant melanoma (OR 6.02, 95% CI 5.76-6.32). This association does not exist for an Asian sub-cohort, which could explain previous inconclusive or conflicting reports. Several strongly associated comorbidities like visual disturbances (ICD-10: H53-H54; OR 4.80, 4.68-4.92), metabolic disorders (E73-E79; OR 3.17, 3.11-3.22), joint problems (M25; OR 4.16, 4.08-4.25) and type 2 diabetes (E11; OR 1.62, 1.58-1.65) should be watched as a risk for rosacea patients. Rosacea is associated with some comorbidities and ethnicity may be a risk factor in melanoma development. The retrospective nature of this study and the sole use of ICD-10 code based filtering calls for future validation of our findings. Additionally, confounding factors such as skin type and previous UV exposure should be included in future studies.
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Affiliation(s)
- Jennifer von Stebut
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
- Centre for Dermatosurgery, Havelklinik, Gatower Str. 191, 13595, Berlin, Germany
| | - Michael Mallach
- Structural Bioinformatics Group, Science-IT and Institute for Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | | | - Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Carsten Rendenbach
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Robert Preissner
- Structural Bioinformatics Group, Science-IT and Institute for Physiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Saskia Preissner
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Berlin Institute of Health, Humboldt-Universität zu Berlin, Berlin, Germany.
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4
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Lee JJ, Chien AL. Rosacea in Older Adults and Pharmacologic Treatments. Drugs Aging 2024; 41:407-421. [PMID: 38649625 DOI: 10.1007/s40266-024-01115-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 04/25/2024]
Abstract
Rosacea is a chronic inflammatory skin condition that is often more severe in older patients. The main clinical features are erythema, telangiectasia, and inflammatory lesions of the face. The pathogenesis of this condition is not fully understood but certainly multifaceted. Immune and inflammatory dysregulation, genetics, neurogenic dysregulation, microbiome dysbiosis, and systemic disease have all been implicated in rosacea pathogenesis. As we better understand the various pathways that lead to rosacea, we acknowledge that the different symptoms may have unique underlying triggers and mechanisms. Aging also impacts rosacea diagnosis and treatment. Older adults have more severe rosacea symptoms while also having more sensitive and fragile skin than younger patients; therefore, rosacea treatments for older patients require a balance between delivering adequate potency while also minimizing skin irritation and other adverse effects. Until recently, rosacea diagnoses were based on concrete subtypes that did not necessarily capture each patient's manifestation of rosacea. There is now an emphasis on more personalized phenotype-based diagnoses and treatments, which allows for more emphasis on treating individual symptoms and accounting for the unique characteristics of older patients. Centrofacial erythema is best treated with brimonidine and oxymetazoline, while phymatous change and telangiectasia are best treated with surgery and laser ablation. Treatment for rosacea papules and pustules ranges from topicals, such as azelaic acid, ivermectin, metronidazole, minocycline, and encapsulated benzoyl peroxide, to systemics, such as doxycycline and isotretinoin. It is important to understand these treatments in relation to adverse effects and drug interactions that may specifically arise in older populations to provide optimal care. As we advance in understanding rosacea's pathogenesis and adopt personalized phenotype-based approaches, optimizing care for older patients becomes crucial. Continued research into novel treatments is essential to address their unique needs.
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Affiliation(s)
- Jennifer J Lee
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA.
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Semenescu I, Similie D, Diaconeasa Z, Danciu C. Recent Advances in the Management of Rosacea through Natural Compounds. Pharmaceuticals (Basel) 2024; 17:212. [PMID: 38399428 PMCID: PMC10892689 DOI: 10.3390/ph17020212] [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: 12/22/2023] [Revised: 01/29/2024] [Accepted: 02/01/2024] [Indexed: 02/25/2024] Open
Abstract
Rosacea is a chronic skin disorder that affects more than 5% of the world's population, with the number increasing every year. Moreover, studies show that one-third of those suffering from rosacea report a degree of depression and are less compliant with treatment. Despite being the subject of prolonged studies, the pathogenesis of rosacea remains controversial and elusive. Since most medications used for the management of this pathology have side effects or simply do not yield the necessary results, many patients lose trust in the treatment and drop it altogether. Thus, dermato-cosmetic products with natural ingredients are gaining more and more notoriety in front of synthetic ones, due to the multiple benefits and the reduced number and intensity of side effects. This review is a comprehensive up-to-date report of studies that managed to prove the beneficial effects of different botanicals that may be useful in the short and long-term management of rosacea-affected skin. Based on recent preclinical and clinical studies, this review describes the mechanisms of action of a large array of phytochemicals responsible for alleviating the clinical symptomatology of the disease. This is useful in further aiding and better comprehending the way plant-based products may help in managing this complex condition, paving the way for research in this area of study.
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Affiliation(s)
- Iulia Semenescu
- Department of Pharmacognosy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (I.S.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Diana Similie
- Department of Pharmacognosy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (I.S.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Zorita Diaconeasa
- Department of Food Science and Technology, Faculty of Food Science and Technology, University of Agricultural Science and Veterinary Medicine, Calea Manastur, 3-5, 400372 Cluj-Napoca, Romania;
| | - Corina Danciu
- Department of Pharmacognosy, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (I.S.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluation, “Victor Babeș” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
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6
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Hessler-Waning M, Heinecke G. Diagnosis and Management of Common Inflammatory Skin Diseases in Older Adults. Clin Geriatr Med 2024; 40:11-23. [PMID: 38000855 DOI: 10.1016/j.cger.2023.09.007] [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: 11/26/2023]
Abstract
Inflammatory skin conditions affect people of all ages, genders, and races. These common conditions are frequent causes of visits to the dermatologist. The geriatric population is often afflicted by these conditions because many are chronic and relapsing diseases. These inflammatory conditions include but are not limited to psoriasis, atopic dermatitis, contact dermatitis, seborrheic dermatitis, rosacea, and Grover disease. Chronic inflammatory skin conditions place a large burden on the health care system in the United States and have many associated comorbidities. This article discusses these inflammatory dermatoses that affect the geriatric population and common therapeutic options.
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Affiliation(s)
- Monica Hessler-Waning
- Department of Dermatology, Saint Louis University, 1225 South Grand Avenue, St. Louis, MO 63110, USA
| | - Gillian Heinecke
- Department of Dermatology, Saint Louis University, 1225 South Grand Avenue, St. Louis, MO 63110, USA.
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Huang WL, Huang CM, Chu CY, Hu FR. Comorbidity of Ocular and Facial Demodicosis. Am J Ophthalmol 2024; 257:201-211. [PMID: 37739203 DOI: 10.1016/j.ajo.2023.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 09/24/2023]
Abstract
PURPOSE To determine the association between ocular and facial demodicosis, and the effect of facial treatment on ocular demodicosis. DESIGN Prospective clinical cohort study. METHODS Ocular demodicosis outpatients from a tertiary medical center were enrolled from April to December 2020. The diagnosis was based on epilation of 4 eyelashes from each upper eyelid. High ocular Demodex load (ODL) was defined as ≥8 mites per eye. Facial infestation was assessed by direct microscopic examination, with facial Demodex overgrowth (FDO) defined as a density >5 mites/cm2. All patients were prescribed 3 months of ocular treatment, and FDO patients received dermatologic treatment. RESULTS Eighty-nine patients were enrolled. Among those that completed the treatment course, 39 presented high ODL. Lower cylindrical sleeve counts were found in low ODL patients (low ODL vs high ODL: 8 vs 14, P = .009). FDO was less prevalent in this group (49% vs 77%, P = .012). The Ocular Surface Disease Index score decreased in patients without FDO (20.0 ± 17.1 to 14.0 ± 16.6, P = .027) after 3 months of topical tea tree oil treatment. Topical ivermectin treatment on the facial skin provided a higher ocular Demodex eradication rate in FDO patients (76% vs 16%, P < .001). CONCLUSION Concurrence of ocular and facial demodicosis is common, especially in cases of severe ocular demodicosis. Although ocular treatment alone is effective for patients with ocular demodicosis only, cotreatment with topical ivermectin on the facial skin enhances ocular Demodex eradication in patients with comorbid facial Demodex overgrowth.
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Affiliation(s)
- Wei-Lun Huang
- From the Department of Ophthalmology, National Taiwan University Hospital Hsinchu Branch (W.-L.H.), Hsinchu, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University (W.-L.H.), Taipei, Taiwan
| | - Chang-Ming Huang
- Department of Dermatology, National Taiwan University Hospital, College of Medicine, National Taiwan University (C.-M.H., C.-Y.C.), Taipei, Taiwan
| | - Chia-Yu Chu
- Department of Dermatology, National Taiwan University Hospital, College of Medicine, National Taiwan University (C.-M.H., C.-Y.C.), Taipei, Taiwan
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University (F.-R.H.), Taipei, Taiwan.
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Fisher GW, Travers JB, Rohan CA. Rosacea pathogenesis and therapeutics: current treatments and a look at future targets. Front Med (Lausanne) 2023; 10:1292722. [PMID: 38193038 PMCID: PMC10773789 DOI: 10.3389/fmed.2023.1292722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/28/2023] [Indexed: 01/10/2024] Open
Abstract
Rosacea is a chronic inflammatory skin condition associated with a significant health and economic burden from costs and loss of productivity due to seeking medical treatment. The disease encompasses multiple phenotypic manifestations involving a complex and multi-variate pathogenesis. Although the pathophysiology of rosacea is not completely understood, ongoing research is continually elucidating its mechanisms. In this review, current concepts of rosacea pathogenesis will be addressed which involve skin barrier and permeability dysfunction, the innate and adaptive immune systems, and the neurovascular system. More specifically, the cathelicidin pathway, transient potential receptor channels, mast cells, and the NLRP3 inflammasome pathway are various targets of current pharmacologic regimens. Future therapies may seek different mechanisms to act on current treatment targets, like the potential use of JAK/STAT inhibitors in ameliorating skin barrier dysfunction or TLR antagonists in alleviating cathelicidin mediated inflammation. Other potential treatments aim for entirely different molecular targets such as microvesicle particle mediated local and systemic inflammation. Ultimately rosacea is associated with a significant health and economic burden which warrants deeper research into its pathogenesis and resultant new treatment discovery.
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Affiliation(s)
- Garrett W. Fisher
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
| | - Jeffrey B. Travers
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Department of Medicine (Dermatology), Dayton Veterans Administration Medical Center, Dayton, OH, United States
| | - Craig A. Rohan
- Departments of Pharmacology and Toxicology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Dermatology, Boonshoft School of Medicine at Wright State University, Dayton, OH, United States
- Department of Medicine (Dermatology), Dayton Veterans Administration Medical Center, Dayton, OH, United States
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Ghita AM, Iliescu DA, Ghita AC, Ilie LA. Susceptibility of Ocular Surface Bacteria to Various Antibiotic Agents in a Romanian Ophthalmology Clinic. Diagnostics (Basel) 2023; 13:3409. [PMID: 37998545 PMCID: PMC10670825 DOI: 10.3390/diagnostics13223409] [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: 10/03/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Periodic assessment of bacterial contamination is necessary as it allows proper guidance in cases of eye infections through the use of appropriate antibiotics. Due to the extensive use of antibiotic treatment, many strains of the microbiota that cause infections are resistant to the usual ophthalmic antibiotics. The present study provides an updated assessment of the susceptibility of Gram-positive and Gram-negative bacteria found on the ocular surface to the most commonly used antibiotic agents in patients undergoing cataract surgery. A total of 993 patients were included in the study with ages between 44 and 98 years old. Conjunctival cultures were collected 7 days before cataract surgery. The response of Gram-positive and Gram-negative bacteria to various antibiotic classes, such as glycopeptides, cephalosporins, carbapenems, fluoroquinolones, aminoglycosides, phenicols, tetracyclines, rifamycins, macrolides and penicillins, was assessed. From the tested antibiotics, vancomycin had 97.8% efficacy on Gram-positive bacteria. In the cephalosporin category, we observed a high level of resistance of the cefuroxime for both Gram-positive and negative bacteria. Antibiotics that have more than 90% efficacy on Gram-positive bacteria are meropenem, imipenem, netilmicin, amikacin and rifampicin. On Gram-negative bacteria, we found 100% efficacy of all tested fluoroquinolones, i.e., aminoglycosides (except for tobramycin), doxycycline, azithromycin, clarithromycin and chloramphenicol. The current study illustrates patterns of increased resistance in certain bacteria present on the ocular surface to some of the commonly used antibiotics in ophthalmological clinical practice. One such revealing example is cefuroxime, which has been highly used as an intracameral antibiotic for the prevention of bacterial endophthalmitis after cataract surgery.
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Affiliation(s)
- Aurelian Mihai Ghita
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Bld., 050474 Bucharest, Romania;
- Ophthalmology Department, Bucharest University Emergency Hospital, 169 Splaiul Independenței Street, 050098 Bucharest, Romania
- Ocularcare Ophthalmology Clinic, 128 Ion Mihalache Bld., 012244 Bucharest, Romania; (A.C.G.); (L.A.I.)
| | - Daniela Adriana Iliescu
- Department of Physiology, “Carol Davila” University of Medicine and Pharmacy, 8 Eroii Sanitari Bld., 050474 Bucharest, Romania;
- Ocularcare Ophthalmology Clinic, 128 Ion Mihalache Bld., 012244 Bucharest, Romania; (A.C.G.); (L.A.I.)
| | - Ana Cristina Ghita
- Ocularcare Ophthalmology Clinic, 128 Ion Mihalache Bld., 012244 Bucharest, Romania; (A.C.G.); (L.A.I.)
| | - Larisa Adriana Ilie
- Ocularcare Ophthalmology Clinic, 128 Ion Mihalache Bld., 012244 Bucharest, Romania; (A.C.G.); (L.A.I.)
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Chelnis J, Garcia CN, Hamza H. Multi-Frequency RF Combined with Intense Pulsed Light Improves Signs and Symptoms of Dry Eye Disease Due to Meibomian Gland Dysfunction. Clin Ophthalmol 2023; 17:3089-3102. [PMID: 37881780 PMCID: PMC10595163 DOI: 10.2147/opth.s426564] [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: 07/12/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023] Open
Abstract
Purpose To evaluate the efficacy of multi-frequency RF and IPL + MGX combination for treatment of Meibomian Gland Dysfunction (MGD). Patients and Methods Eligible subjects had signs and moderate-to-severe symptoms of DED (Dry Eye Disease) due to MGD. Subjects underwent 4 treatments at 2-week intervals. Each treatment consisted of intense pulsed light (IPL) followed by radiofrequency (RF) on the periocular skin, followed by meibomian gland expression (MGX). The main outcome measure was the quality of meibum in 15 meibomian glands along the lower eyelid, using the modified Meibomian Gland Score (mMGS). The main hypothesis was a reduction of mMGS between the baseline (BL) and the follow-up (FU). Other outcome measures, such as symptoms measured with the OSDI (Ocular Surface Disease Index) questionnaire, meibography, non-invasive tear break-up time (NIBUT), and matrix metallopeptidase 9 (MMP-9) levels in tear samples were evaluated as well. Results 31 subjects completed the FU. Between BL and FU, mMGS decreased from 30.4 (8.5) to 9.3 (9.5) (-69.3%, 95% CI: -55.6% to -82.9%, p<0.0001); OSDI decreased from 63.6 (17.2) to 25.0 (20.6) (-60.7%, 95% CI: -47.8% to -73.5%, p<0.0001); NIBUT did not change (p=0.92). An adjusted model with a historical control was constructed to allow the comparison of these subjects with those treated similarly with IPL+MGX (but without RF) in a different study. This analysis identified that the change in mMGS was larger when RF was included (-20.9 vs -18.3, adjusted p-value (p_adjusted) <0.05). The difference in OSDI change was not significant (-38.1 vs -25.5, p_adjusted = 0.196). Conclusion Combination of multi-frequency RF and IPL+MGX improves signs and symptoms of MGD. In comparison to a historical control, improvements were generally larger. A randomized controlled study comparing the combination of RF and IPL+MGX with IPL+MGX alone is required to further elaborate the relative contribution of RF.
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Affiliation(s)
- James Chelnis
- New York Eye & Ear Infirmary of Mount Sinai, New York, NY, USA
- Manhattan Face and Eye, New York, NY, USA
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Bernstein EF. A new 532 nm, variable-pulse-structure, dual-wavelength, KTP laser incorporating cryogen spray cooling, effectively treats rosacea. Lasers Surg Med 2023; 55:734-740. [PMID: 37418140 DOI: 10.1002/lsm.23700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND A new dual-wavelength, high-energy, solid-state laser incorporating both 532 and 1064 nm wavelengths was developed with cryogen spray cooling and the unique ability to deliver three types of pulse structures including single pulses of a specific pulse-duration or pulses composed of a train of subpulses in the millisecond or microsecond domain with an intervening delay over the selected pulse-duration. We investigate the efficacy of this laser using all three pulse structures and the 532 nm wavelength for treating rosacea. METHODS Twenty-one subjects were enrolled in this IRB-approved study. A total of up to three treatments were administered at monthly intervals. Each treatment consisted of a first pass tracing linear vessels with a 40 ms pulse-duration immediately followed by a second pass using a 5 ms pulse, using all three available pulse structures. Assessment of cross-polarized digital images by blinded physician observers compared baseline and 3-month follow-up images. RESULTS Blinded observers correctly identified the posttreatment images 89% of the time, in 17 of 19 subjects completing the study, with an average overall improvement rating of 39% after only three treatments. Side effects were limited to short-term erythema and edema. CONCLUSION This study demonstrates that this new, variable-pulse-structure, dual wavelength, solid state, KTP laser with dynamic cooling is a safe and effective for treating rosacea.
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Affiliation(s)
- Eric F Bernstein
- Center Director, Main Line Center for Laser Surgery, Ardmore, Pennsylvania, USA
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12
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Malagón-Liceaga A, Recillas-Gispert C, Ruiz-Quintero NC, Ruelas-Villavicencio AL. Treatment of ocular rosacea: A practical review from an interdisciplinary approach. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:577-585. [PMID: 37696488 DOI: 10.1016/j.oftale.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/13/2023] [Indexed: 09/13/2023]
Abstract
Rosacea is a chronic and inflammatory disease that primarily affects the skin, although more than half of cases also present with ocular symptoms ranging from blepharitis to conjunctivitis and keratitis. It represents a frequent reason for consultation with a psychosocial impact, affecting quality of life, and requires management involving ophthalmologists, dermatologists, and primary care physicians. For this paper, a search was conducted in several databases, including Medline, Embase, Cochrane, and Google Scholar, using the MeSH term "rosacea" in conjunction with other relevant keywords such as "ocular rosacea", "management", "treatment", and "guidelines". Available articles were reviewed. International and local guidelines recommend initiating the management of rosacea with lifestyle changes, including ocular hygiene and avoidance of triggers. Topical or oral treatment is recommended as the next step, with topical cyclosporine, topical azithromycin, topical tacrolimus, and oral doxycycline being the treatments most supported by evidence. Combination treatments are also recommended. Current management guidelines mainly focus on cutaneous manifestations, generating few guidelines on ophthalmologic treatment, and most recommendations are issued by experts. This work compares local and international treatment guidelines for rosacea, as well as other available medical literature, and suggests a practical and interdisciplinary treatment scheme for ocular involvement based on the reviewed bibliography.
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Affiliation(s)
- A Malagón-Liceaga
- Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - C Recillas-Gispert
- Departamento de Oftalmología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - N C Ruiz-Quintero
- Departamento de Oftalmología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - A L Ruelas-Villavicencio
- Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico.
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13
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Liu Y, Zhou Y, Chu C, Jiang X. The role of macrophages in rosacea: implications for targeted therapies. Front Immunol 2023; 14:1211953. [PMID: 37691916 PMCID: PMC10484341 DOI: 10.3389/fimmu.2023.1211953] [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: 04/25/2023] [Accepted: 07/14/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Rosacea, a widespread chronic skin condition, may be influenced by macrophages, key immune cells in the skin, although their exact role is not yet fully understood. This review delves into the function of macrophages, their potential contribution to rosacea pathogenesis, current treatments, and promising macrophage-targeted therapies. It concludes by identifying knowledge gaps and potential areas for future rosacea research. Method Leveraging systematic and narrative literature review techniques, we conducted a comprehensive search of databases such as PubMed, Embase, and Web of Science. Utilizing keywords like "rosacea" and "macrophages", we targeted English articles from the last 5 years (2018-2023). We manually checked reference lists of relevant articles for additional studies. We included only articles emphasizing macrophages' role in rosacea and/or the development of related therapies and published within the specified timeframe. Results The systematic search of electronic databases yielded a total of 4,263 articles. After applying the inclusion and exclusion criteria, 156 articles were selected for inclusion in this review. These articles included original research studies, review articles, and clinical trials that focused on the role of macrophages in rosacea and/or the development of macrophage-targeted therapies for the disease. The selected articles provided a comprehensive and up-to-date overview of the current state of research on macrophages in rosacea, including their function in the skin, the potential mechanisms through which they may contribute to rosacea pathogenesis, and the current treatments and therapies available for the disease. Additionally, the articles identified gaps in knowledge regarding the role of macrophages in rosacea and suggested potential areas for future research. Conclusion This literature review emphasizes the important role that macrophages, vital immune cells in the skin, may play in the pathogenesis of rosacea, a common chronic inflammatory skin disorder. The selected studies suggest potential mechanisms by which these cells might contribute to rosacea progression, although these mechanisms are not yet fully understood. The studies also spotlight current rosacea treatments and illuminate the promising potential of new macrophage-focused therapies. Despite these insights, significant gaps persist in our understanding of the precise role of macrophages in rosacea. Future research in this area could provide further insights into the pathogenesis of rosacea and contribute to the development of more effective, targeted therapeutic strategies.
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Affiliation(s)
- Yi Liu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Medical Cosmetic Center, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
| | - Yin Zhou
- Medical Cosmetic Center, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
| | - Chenyu Chu
- Medical Cosmetic Center, Chengdu Second People’s Hospital, Chengdu, Sichuan, China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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14
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Chen C, Wang P, Zhang L, Liu X, Zhang H, Cao Y, Wang X, Zeng Q. Exploring the Pathogenesis and Mechanism-Targeted Treatments of Rosacea: Previous Understanding and Updates. Biomedicines 2023; 11:2153. [PMID: 37626650 PMCID: PMC10452301 DOI: 10.3390/biomedicines11082153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Rosacea is a chronic inflammatory skin disease characterized by recurrent erythema, flushing, telangiectasia, papules, pustules, and phymatous changes in the central area of the face. Patients with this condition often experience a significant negative impact on their quality of life, self-esteem, and overall well-being. Despite its prevalence, the pathogenesis of rosacea is not yet fully understood. Recent research advances are reshaping our understanding of the underlying mechanisms of rosacea, and treatment options based on the pathophysiological perspective hold promise to improve patient outcomes and reduce incidence. In this comprehensive review, we investigate the pathogenesis of rosacea in depth, with a focus on emerging and novel mechanisms, and provide an up-to-date overview of therapeutic strategies that target the diverse pathogenic mechanisms of rosacea. Lastly, we discuss potential future research directions aimed at enhancing our understanding of the condition and developing effective treatments.
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Affiliation(s)
| | | | | | | | | | | | - Xiuli Wang
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200040, China
| | - Qingyu Zeng
- Institute of Photomedicine, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai 200040, China
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15
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Andreas M, Fabczak-Kubicka A, Schwartz RA. Ocular rosacea: an under-recognized entity. Ital J Dermatol Venerol 2023; 158:110-116. [PMID: 37153945 DOI: 10.23736/s2784-8671.23.07484-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
While rosacea is a common dermatologic condition, ocular rosacea is sometimes evident either with cutaneous rosacea or occasionally by itself. Manifesting with such varied symptoms as dry eye, Meibomian gland dysfunction, and corneal erosion, ocular rosacea can be confused with a multitude of other diseases. While ocular rosacea is commonly mild and rarely severe, physicians should still expand their examination to include ocular manifestations of rosacea. In addition, we propose diagnostic criteria for ocular rosacea, stressing the importance of early recognition and treatment.
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Affiliation(s)
| | | | - Robert A Schwartz
- Dermatology, Pathology and Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, USA -
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16
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Elhesaisy NA, Swidan SA, Tawfiq RA, El-Nabarawi MA, Teaima MH. Fabrication and characterization of anti-rosacea 3D nanofibrous customized sheet masks as a novel scaffold for repurposed use of spironolactone with pre-clinical studies. Int J Pharm 2023; 636:122816. [PMID: 36907278 DOI: 10.1016/j.ijpharm.2023.122816] [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: 10/21/2022] [Revised: 03/01/2023] [Accepted: 03/05/2023] [Indexed: 03/14/2023]
Abstract
The repurposed oral use of spironolactone (SP) as an anti-rosacea drug faces many challenges that hinder its efficacy and compliance. In this study, a topically applied nanofibers (NFs) scaffold was evaluated as a promising nanocarrier that enhances SP activity and avoids the friction routine that exaggerates rosacea patients' inflamed, sensitive skin. SP-loaded poly-vinylpyrrolidone (40% PVP) nanofibers (SP-PVP NFs) were electrospun. Scanning electron microscopy showed that SP-PVP NFs have a smooth homogenous surface with a diameter of about 426.60 nm. Wettability, solid state, and mechanical properties of NFs were evaluated. Encapsulation efficiency and drug loading were 96.34% ± 1.20 and 11.89% ± 0.15, respectively. The in vitro release study showed a higher amount of SP released over pure SP with a controlled release pattern. Ex vivo results showed that the permeated amount of SP from SP-PVP NFs sheets was 4.1 times greater than that of pure SP gel. A higher percentage of SP was retained in different skin layers. Moreover, the in vivo anti-rosacea efficacy of SP-PVP NFs using croton oil challenge showed a significant reduction in erythema score compared to the pure SP. The stability and safety of NFs mats were proved, indicating that SP-PVP NFs are promising carriers of SP.
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Affiliation(s)
- Nahla A Elhesaisy
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo, Egypt; Nanotechnology Research Centre (NTRC), The British University in Egypt, El-Shorouk City, Suez Desert Road, Cairo, Egypt
| | - Shady A Swidan
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo, Egypt; The Centre for Drug Research and Development (CDRD), Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo, Egypt.
| | - Rasha A Tawfiq
- The Centre for Drug Research and Development (CDRD), Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo, Egypt; Department of Pharmacology and Biochemistry, Faculty of Pharmacy, The British University in Egypt, El-Sherouk City, Cairo, Egypt
| | - Mohamed A El-Nabarawi
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Egypt
| | - Mahmoud H Teaima
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Egypt
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17
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Barberis N, Cannavò M, Trovato M, Verrastro V. Pathways from Trait Emotional Intelligence to factors of distress in Rosacea: The mediating role of Social Phobia and Self-Esteem. J Affect Disord 2023; 331:362-368. [PMID: 36906111 DOI: 10.1016/j.jad.2023.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Rosacea is a skin disease characterized by facial erythema and inflammatory pustules that may result in emotional distress. Social Phobia and Self-Esteem appear to be linked to the development of higher levels of distress in dermatological conditions, while Trait Emotional Intelligence (Trait EI) has been consistently associated with greater levels of adaptation to one's chronic condition. Hence, it seems extremely relevant to observe the interplay between these dimensions in the context of Rosacea. The goal of the current study is to test the hypothesis that an association between Trait EI and General Distress, in individuals with Rosacea would be mediated by Self-Esteem and Social Phobia. METHODS Questionnaires were administered to 224 individuals suffering from Rosacea to assess Trait EI, Social Phobia, Self-Esteem, and General Distress. RESULTS Results highlighted that Trait EI was positively related to Self-Esteem and negatively related to Social Phobia and General Distress. In addition, both Self-Esteem and Social Phobia showed a mediating role in the relationship between Trait EI and General Distress. LIMITATIONS The main limitations of this work consist in the cross-sectional nature of the data, the small number of participants, also it was not possible to differentiate the participants according to the type of rosacea. DISCUSSION These results emphasize how individuals with Rosacea may be vulnerable to internalizing states and how high levels of Trait EI may constitute a protective factor for the onset of distressing states and it would be useful to create programs aimed at fostering Trait EI in Rosacea sufferers.
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Affiliation(s)
- Nadia Barberis
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
| | - Marco Cannavò
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy
| | - Mariachiara Trovato
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
| | - Valeria Verrastro
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
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18
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Mast cell stabilization: new mechanism underlying the therapeutic effect of intense pulsed light on rosacea. Inflamm Res 2023; 72:75-88. [PMID: 36329130 DOI: 10.1007/s00011-022-01635-6] [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: 05/17/2022] [Revised: 08/11/2022] [Accepted: 08/29/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Rosacea, a chronic inflammatory disorder of the facial skin, is effectively treated by intense pulsed light (IPL). OBJECTIVE To explore the potential molecular mechanism underlying the photobiomodulation effect of IPL for rosacea treatment. METHODS Skin samples from patients with rosacea were subjected to histological and immunohistological staining. Ten patients were followed up after IPL treatment using the VISIA® skin analysis system, and the severity was assessed. In vivo, skin changes in mice with rosacea-like inflammation induced by intradermal injection of 320 μM LL-37 with or without IPL treatment were evaluated using L*a*b colorimetry as well as histological and immunological staining. In vitro, LL-37-stimulated mast cells (MCs) with or without IPL treatment were evaluated for protein expression of matrix metalloproteinase (MMP)-9, kallikrein-related peptidase 5 (KLK5), and cathelicidin using western blotting and qRT-PCR. RESULTS Profound infiltration of inflammatory cells and evident MC degranulation were found in rosacea skin lesions. The expression of rosacea-related biomarkers and inflammatory cytokines was higher in lesional areas than in non-lesional areas, as demonstrated via immunochemical staining. In all patients, rosacea severity reduced after IPL therapy. In vivo, IPL alleviated inflammation in mice with rosacea-like inflammation, as demonstrated by the significantly decreased MMP-9, KLK5, and cathelicidin expression and reduced percentage of degranulating MCs. In vitro, IPL decreased MMP-9, KLK5, and cathelicidin expression in P815 cells, reducing the release of inflammatory cytokines and inhibiting rosacea-like inflammatory reactions. CONCLUSION The photobiomodulation effect of IPL for rosacea treatment may inhibit MC degranulation and alleviate inflammatory reactions.
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19
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Kang Y, Zhang C, He Y, Zhang Z, Liu H, Wei Z, Yang J. Thalidomide Attenuates Skin Lesions and Inflammation in Rosacea-Like Mice Induced by Long-Term Exposure of LL-37. Drug Des Devel Ther 2022; 16:4127-4138. [PMID: 36483458 PMCID: PMC9724583 DOI: 10.2147/dddt.s393122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/24/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose Most of the existing studies focus on the early inflammation of rosacea, with few interventions on the later development of fibrosis and the relationship between thalidomide and rosacea. The purpose of this study was to construct a long-term induction model and explore the effects of thalidomide on the later stage of inflammation and early stage of fibrosis in rosacea. Patients and Methods BALB/c male mice were randomly divided into four groups: control group, control plus thalidomide group, LL-37 group and LL-37 plus thalidomide group, Intradermal and intraperitoneal injections were given. After repeated induction, skin changes were recorded by taking photos. The animals were sacrificed, the back skin was used for HE staining and VG staining to detect histomorphological characteristics. Immunofluorescence staining and Western blot were used to detect the expression of inflammatory and fibrosis-related factors. Results The results were compared with the early stage of the model, wherein the skin inflammation of the 20-day mice was more obvious with a trend of fibrosis. Compared with the control group, histopathological examination showed that the inflammatory cell infiltration in the LL-37 group was significantly increased, and the skin was thickened with collagen deposition. LL-37 induction significantly increased the expression of inflammatory markers (eg, TNF-α and IL-1β) and fibrotic markers (eg, COL1, α-SMA, vimentin and N-Cadherin). Intervention with thalidomide significantly reduced erythema, inflammatory cell infiltration, collagen deposition, and down-regulate the expression of inflammation and fibrosis related factors in rosacea mice. Conclusion The long-term continuous induction of LL-37 in mice could simulate the occurrence and development of rosacea, and thalidomide could ameliorate the rosacea induced by long-term exposure to LL-37 by regulating inflammatory infiltration, collagen deposition and fibrosis-related processes.
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Affiliation(s)
- Yumeng Kang
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, People’s Republic of China
| | - Chuanxi Zhang
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, People’s Republic of China
| | - Yang He
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, People’s Republic of China
| | - Ziyan Zhang
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, People’s Republic of China
| | - Heliang Liu
- Hebei Key Laboratory for Organ Fibrosis Research, School of Public Health, North China University of Science and Technology, Tangshan, People’s Republic of China
| | - Zhongqiu Wei
- School of Basic Medical Sciences, North China University of Science and Technology, Tangshan, People’s Republic of China,Correspondence: Zhongqiu Wei, School of Basic Medical Sciences, North China University of Science and Technology, 21 Bohai Avenue, New City, Caofeidian District, Tangshan City, Hebei Province, People’s Republic of China, Tel +86-135-8258-8338, Email
| | - Jie Yang
- Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, Tangshan, People’s Republic of China,Jie Yang, Department of Dermatology, Affiliated Hospital of North China University of Science and Technology, 73 Jianshe South Road, Lubei District, Tangshan City, Hebei Province, People’s Republic of China, +86-188-3250-6999, Email
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20
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Delans K, Kelly K, Feldman SR. Treatment strategies, including antibiotics, to target the immune component of rosacea. Expert Rev Clin Immunol 2022; 18:1239-1251. [PMID: 36137266 DOI: 10.1080/1744666x.2022.2128334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Recent advances in the understanding of the pathophysiology of rosacea have led to increased focus on the disease's immunologic etiology and to the development of immunologically based treatments. With many patients suffering from incomplete control, addressing the immune components of the disease process may provide a more effective treatment option for rosacea patients that may improve quality of life. AREAS COVERED This review will provide a brief overview of the pathophysiology of rosacea, as well as specific immunologic contributions to the disease state. Current standard-of-care treatments will be described, including anti-parasitic, anti-inflammatory agents, and antibiotics. Emphasis will be placed on treatments that target the immune components of the disease process. EXPERT OPINION Rosacea remains a difficult dermatologic disease to treat, partially due to an incomplete understanding of the disease pathophysiology. The immune pathophysiology of rosacea, particularly the key role of inflammation, has been clarified over the past decade. Identification of specific molecules, including cytokines and nuclear transcription factors, may allow for the development of targeted rosacea-specific biologic and topical treatments. However, medication nonadherence is a limiting factor to achieving symptomatic control among rosacea patients. Focusing on the development of oral or injectable forms of therapy may circumvent poor adherence.
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Affiliation(s)
- Kristen Delans
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, USA
| | - Katherine Kelly
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, USA
| | - Steven R Feldman
- Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, USA.,Department of Pathology, Wake Forest School of Medicine, Winston-Salem, USA.,Department of Social Sciences & Health Policy, Wake Forest School of Medicine, Winston-Salem, USA.,Department of Dermatology, University of Southern Denmark, Odense, Denmark
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21
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Intense Pulse Light Therapy for Meibomian Gland Dysfunction. CURRENT OPHTHALMOLOGY REPORTS 2022. [DOI: 10.1007/s40135-022-00297-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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22
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Ring HC, Zachariae C, Thomsen SF, Thyssen JP, Egeberg A. Severe papulopustular rosacea successfully treated with a combination of oral azithromycin and isotretinoin. J DERMATOL TREAT 2022; 33:3205-3207. [PMID: 36165496 DOI: 10.1080/09546634.2022.2129953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Hans Christian Ring
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Simon Francis Thomsen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark.,Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacob P Thyssen
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
| | - Alexander Egeberg
- Department of Dermato-Venereology & Wound Healing Centre, Bispebjerg Hospital, Copenhagen, Denmark
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