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PubMed2003

Treatment of rosacea with intense pulsed light.

Rosacea is a chronic disease that affects millions of men and women. Topical and oral antibiotics are effective, yet often leave individuals with treatment plateau associated erythema and persistent flushing. We investigated the use of intense pulsed light for treatment of the redness, flushing, and breakouts associated with rosacea. Thirty-two consecutive patients of Fitzpatrick skin types I-III underwent 1 to 7 treatments with intense pulsed light. Patients were assessed clinically and photographically. In addition, patients completed a detailed questionnaire regarding their response to treatment. Following treatment, eighty-three percent of patients had reduced redness, 75% noted reduced flushing and improved skin texture, and 64% noted fewer acneiform breakouts. Complications were minimal and transitory. It appears that intense pulsed light is an effective treatment for the signs and symptoms of rosacea and represents a new category of therapeutic options for the rosacea patient.

Adult↗
PubMed2004

Ultraviolet light and rosacea.

The general consensus among clinicians is that rosacea is a photoaggravated disorder. Pathophysiologic processes induced by UV radiation, which are processes similar to those seen in photoaging, contribute to the signs and symptoms of rosacea. Because of the purported role of solar radiation, clinicians may want to use photosensitizing antibiotics with discretion in patients with rosacea. In addition to topical and oral therapy for rosacea, clinicians should recommend that patients use sunscreens or sunblocks (inorganic chemicals such as zinc oxide or titanium dioxide).

Anti-Bacterial Agents↗
PubMedDate not supplied

Helicobacter pylori and rosacea.

Recent reports have suggested an increased prevalence of Helicobacter pylori infection in patients with rosacea, with some evidence of dermatological improvement in patients treated with antibiotics for this infection. Our study investigates the prevalence of H. pylori infection in rosacea patients in Kerman. Serological examination was done for 29 patients with classical identification of rosacea using the enzyme-linked immunosorbent assay IgG antibody method. Comparison of antibody titres with those of a control group revealed that the prevalence of positive serological tests for H. pylori was significantly higher in the test group. This supports the suggestion of some form of relationship between rosacea and H. pylori infection, though further investigations with larger sample sizes are required for a definite conclusion.

Adult↗
PubMed2005

The pharmacologic therapy of rosacea: a paradigm shift in progress.

A number of topical and systemic pharmacologic therapies, some of which remain investigational, have been used to treat rosacea. The pathophysiology of rosacea appears to be inflammatory, and most of the interventions modulate the inflammatory process in some way. Topical agents include various formulations of sodium sulfacetamide and sulfur, metronidazole, azelaic acid, and benzoyl peroxide/clindamycin. Oral agents include antibiotics in conventional and subantimicrobial doses. A paradigm shift in progress in the management of rosacea encompasses the use of these and other agents either alone or, increasingly, in different combinations, based on the subtype of rosacea.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Topical metronidazole combination therapy in the clinical management of rosacea.

Metronidazole was the first topical agent approved by the U.S. Food and Drug Administration for the treatment of rosacea. Several controlled studies have confirmed the efficacy and safety of topical metronidazole 0.75% gel, lotion and cream and 1% cream for rosacea. At present, little data exists regarding the use of combination topical therapy in rosacea management, although anecdotal evidence and preliminary studies suggest at least some additive benefit when topical metronidazole is used in combination with sulfacetamide 10% /sulfur 5%. In this paper, the results of observational experience evaluating topical metronidazole 0.75% gel used in combination with other topical rosacea therapies and/or subantimicrobial dose doxycycline are reported.

Administration, Topical↗
PubMed2005

Role of psychological factors in course of the rosacea.

PURPOSE: (1) Investigation of dependence between first symptoms of the rosacea and with surviving of critical life events. (2) Description of the dissimilarity in intensity of the stress at illness and healthy. (3) Estimation of impact of stressful situations for escalating of changes in course of the disease. (4) Comparison of the subjective estimation of patients' health. MATERIAL AND METHODS: 40 persons with rosacea, in the age of 25-75 years, were examined and 40 healthy volunteers, matched to the sex, age, social-economic background. The Holms' and Rahes' modified Social Readjustment Rating Scale questionnaire was applied and the WZS questionnaire by Sek and Szałdziński. RESULTS: Investigations showed dissimilarities of events met in the number and intensity of the stress between sick people and volunteers. Symptoms of the acne are escalating as a result of caused emotions with primary evaluation. The image of the subjective estimation of patients' health is showing their motivation to recover. CONCLUSIONS: (1) Patients with rosacea in the period before the occurring of first symptoms of the disease, comparatively with persons from the control group, they experienced the bigger number of critical life events. (2) The stress intensity resulting from the number of critical life events, is significantly higher at sick people in the relation to the control group. (3) At patients with rosacea emotions resulting of the estimation of the primary stressful situation tightening symptoms of the disease. (4) The subjective estimation of patients' health is essential predicate of psychodermatological therapy releasing potential health possibilities at the patient.

Adult↗
PubMed2005

Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea.

A growing body of literature suggests that some moisturizers can improve stratum corneum barrier function, as well as ameliorate dry skin. The clinical signs and symptoms of rosacea, which include increased facial skin dryness and sensitivity, suggest a possible role for such moisturizers as an adjuvant in the management of this condition. This randomized, investigator-blind, controlled observational study (N = 50) was designed to assess whether a niacinamide-containing facial moisturizer would improve the stratum corneum barrier and thus provide a clinical benefit to subjects with rosacea. Subjects with rosacea applied the test moisturizer to their face and to one forearm twice daily for 4 weeks. The other forearm remained untreated as a control. Barrier function on the forearms was assessed instrumentally and using a dimethyl sulfoxide (DMSO) chemical probe. Stratum corneum hydration also was measured instrumentally. The dermatologist investigator evaluated each subject's rosacea condition over the course of the study, and subjects self-assessed their facial skin condition at study end. Instruments provided objective measures of stratum corneum barrier function and hydration on the face.

Administration, Topical↗
PubMed2006

Rosacea: clinical presentation and pathophysiology.

Acne rosacea is one of the most common diagnoses seen in the clinical dermatologic practice. The classic presentation of rosacea, acneiform papules, and pustules on a background of telangiectasia, is often easily identified by primary care physicians, patients, or their similarly afflicted friends or family members. However, rosacea actually represents a spectrum of disease from chronic skin hypersensitivity and flushing to rhinophyma. Although the pathogenesis of rosacea remains unknown, it is important to understand its various presentations and possible etiologies prior to developing individualized treatment protocols.

Helicobacter Infections↗
PubMed2006

The use of topical azelaic acid for common skin disorders other than inflammatory rosacea.

Topical azelaic acid (AzA) is approved for the treatment of acne vulgaris and inflammatory (papulopustular) rosacea. Because of diverse mechanisms of action that correlate with potential therapeutic benefit, AzA has been used to treat several common dermatoses including acne vulgaris, inflammatory rosacea, erythematotelangiectatic rosacea, perioral dermatitis, melasma, and postinflammatory hyperpigmentation. This article reviews the therapeutic use of topical AzA for the treatment of common skin disorders other than the US Food and Drug Administration (FDA)-approved indications of acne vulgaris and inflammatory rosacea.

Administration, Cutaneous↗
PubMed1990

Topical metronidazole: a new therapy for rosacea.

The chemistry, mechanism of action, pharmacokinetics, and adverse effects of topically applied metronidazole are reviewed, and the drug's use and efficacy in the treatment of rosacea and other conditions are discussed. Metronidazole is a synthetic, nitroimidazole-derivative antibacterial and antiprotozoal agent. For topical use, metronidazole is available in the United States as an aqueous gel. Polar reduction products of the drug appear to be responsible for its antimicrobial effects, which include disruption of DNA. The mechanism by which metronidazole ameliorates the lesions and erythema of rosacea may be related to anti-inflammatory or immunosuppressive actions of the drug rather than to suppression of skin bacteria. Metronidazole does not seem to be appreciably absorbed after topical application to the skin. Little is known about the distribution and elimination of topically applied metronidazole. Topical metronidazole has been designated an orphan drug by the FDA for the treatment of rosacea. In clinical studies metronidazole 0.75% topical gel or 1% cream resulted in improvement in inflammatory lesions in 68-96% of patients. Like other currently available therapies, metronidazole is only palliative; when the drug is withdrawn, symptoms commonly recur. Topical metronidazole has been used with some success in the treatment of decubitus and other ulcers and in certain dental conditions. The drug seems to have low toxicity and generally is well tolerated when applied topically. The principal adverse effects are local reactions, such as burning and stinging. Topical metronidazole provides another option for the treatment of rosacea.

Administration, Topical↗
PubMed1984

13-cis-Retinoic acid in rosacea. Clinical and laboratory findings.

The paper presents clinical and laboratory data on 13-CIS-retinoic acid treatment in rosacea. Good-to-excellent results are reported for severe forms of rosacea. Side effects were tolerable and could easily be controlled. The role of sebaceous gland function was documented by both histological and skin sebum parameters. Diminution of sebaceous gland size and the decrease of skin sebum with alteration of single sebum fractions correspond with findings in acne. According to the findings the alteration of sebaceous gland function is one model of drug action in rosacea. Thus sebaceous gland dysfunction may play an important role in the pathogenesis of rosacea.

Adult↗
PubMed1983

[Psychosomatic aspects in patients with alopecia areata, rosacea and lichen ruber planus].

90 Patients suffering from alopecia areata, rosacea or lichen planus as well as 30 healthy persons at the age between 20 and 55 were psychologically examined. The findings reveal that the highest percentage of neuroses of the neurotic or psychasthenic type occurred in patients with rosacea (76.6% of the population). 91% of the patients with rosacea suspected a connection between the appearance of their cutaneous changes and stress situations. We conclude that psychogenic factors may be of great importance in the etiopathogenesis of rosacea.

Adult↗
PubMed1980

[Demodex folliculorum and rosacea: experimental and immunological studies].

When the immunological mechanism of the demodectic mange is well-known in dogs, few things are known about the role of Demodex mites in the pathogenesis of rosacea: the purpose of this study is the research of immunological reactions against Demodex antigens in 31 patients (24 papulopustular rosaceas and 7 granulomatous demodectic rosaceas histologically ascertained). Cultures or survival in vitro of human Demodex mites could not be obtained; therefore demodectic cysts of diseased goats (Demodex caprae) were gathered and soluble antigens were extracted by lyophilization. By different immunoserological methods, Demodex specific antibodies could be demonstrated in sera of rosacea (22%), of diseased goats and of rabbits sensitized with small amounts of demodectic antigen. Frequently cross-reactions were observed.

Animals↗
PubMed1996

Case report--ocular rosacea.

Rosacea is an uncommon disease of the eye and facial skin. Ocular rosacea is often undiagnosed by the ophthalmologist especially when skin manifestations are not evident yet. Early diagnosis and treatment is important to decrease morbidity of this potentially blinding disease. A case of ocular rosacea in a 14-year-old Chinese girl is reported. Our patient presented with chronic non-specific keratoconjunctivitis. Only much later did the characteristic corneal and facial skin lesions appear. She responded to guttae prednisolone, oral and guttae tetracycline. This case illustrates the difficulty of early diagnosis when ocular manifestations precede those of the skin. We believe this is the first case of ocular rosacea reported in Singapore.

Adolescent↗
PubMed1997

Rosacea: how to recognize and treat an age-related skin disease.

Rosacea is an age-related disorder of the central portion of the facial skin whose peak onset occurs in persons in their 40s and 50s. A chronic and progressive condition of flare-ups and remissions, rosacea can be disfiguring if left untreated. Rosacea can be characterized as having three stages. Target areas for all symptoms include the cheeks, nose, chin, or forehead. Rosacea resembles a number of other dermatologic conditions, particularly acne vulgaris. The combination of oral and topical antibiotic therapy usually brings about remission. The key is to recognize the early signs and clinical picture so that accurate diagnosis can be made and therapy and counseling instituted.

Anti-Bacterial Agents↗
PubMed1997

Ocular rosacea: patient characteristics and follow-up.

PURPOSE: The purpose of this report is to review the presenting symptoms and signs, treatment regimens used, complications encountered, and outcome in a cohort of patients with ocular rosacea. METHODS: The medical records of 131 patients with a diagnosis of ocular rosacea were reviewed retrospectively. Data were entered in a tabulated form, and a descriptive analysis was performed. RESULTS: The age range at presentation was between 23 and 85 years (mean, 56 years). Cutaneous manifestations of rosacea were present in 112 of the patients at their first visit. The most common presenting symptoms were foreign body sensation and burning, and the most common signs were telangiectasia and irregularity of lid margins, and meibomian gland dysfunction. Thirteen patients had decreased visual acuity at the time of presentation due to corneal complications. Six of these patients required penetrating keratoplasty during the course of their disease. Seven patients had severe cicatrizing conjunctivitis at the time of referral. One hundred thirteen patients were treated with oral tetracycline derivatives. Seven patients were left with visual acuity less than 20/400, and one patient underwent enucleation for corneal perforation and endophthalmitis. CONCLUSIONS: Ocular rosacea is a common disease involving the skin and the eyes. It is widely underdiagnosed by many ophthalmologists despite the blinding potential. Successful therapy requires a multidisciplinary approach.

Adult↗
PubMed1998

Effective sunscreen ingredients and cutaneous irritation in patients with rosacea.

Patients with rosacea are particularly susceptible to the irritation caused by sunscreen ingredients. The purpose of this bilateral comparison study was to examine the effects of different ingredients found in sunscreen on facial cutaneous irritancy in patients with rosacea. patients clinically diagnosed with rosacea were asked to test different preparations of common sunscreens on their faces. The results show that the presence or absence of appropriate protective ingredients, such as dimethicone and cyclomethicone in the vehicle, may prevent irritation from other sunscreen ingredients in patients with inflammatory conditions such as rosacea.

Dermatitis, Irritant↗
PubMed2000

Lipid-transfer proteins as potential plant panallergens: cross-reactivity among proteins of Artemisia pollen, Castanea nut and Rosaceae fruits, with different IgE-binding capacities.

BACKGROUND: Lipid-transfer proteins (LTPs), but not Bet v 1 homologues, have been identified as major allergens of apple and peach in the Rosaceae fruit-allergic population in the Mediterranean area. Many of these patients show cosensitization to mugwort pollen. LTPs have an ubiquitous distribution in tissues of many plant species, and have been proposed as a novel type of plant panallergens. OBJECTIVE: We sought to isolate LTPs from Artemisia pollen and from a plant food not belonging to the Rosaceae family, such as chestnut nut, and to compare their amino acid sequences and IgE-binding capacities with those of apple and peach LTPs. METHODS: Allergens (LTPs) were isolated by different chromatographic methods (gel-filtration, ion exchange and/or reverse-phase HPLC), and characterized by N-terminal amino acid sequencing and MALDI analysis. Specific IgE-quantification and immunodetection, as well as immunoblot and ELISA inhibition assays, were carried out using sera from patients allergic to both apple and peach. RESULTS: Purified LTPs from Artemisia pollen and from chestnut seed showed molecular masses about 9 700d, and 43-50% sequence identity with the equivalent allergens of apple and peach in the first 30 N-terminal residues, which comprise about one third of the total amino acid sequence. A similar degree of sequence identity (50%) was found between the Artemisia and chestnut proteins. Both isolated LTPs bound specific IgE of sera from Rosaceae fruits allergic patients. However, substantially lower values of specific IgE-binding and maximum ELISA inhibition percentages were obtained for Artemisia and chestnut LTPs when compared to those from apple and peach. CONCLUSION: LTPs from Artemisia pollen and chestnut crossreact with allergens (LTPs) of Rosaceae fruits, but significant differences in specific IgE-binding capacities were observed among members of the plant LTP family. Thus, further studies are needed to evaluate the clinical significance of the observed cross-reactivities of plant LTPs.

Allergens↗