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At least 217 records · Page 12Linked to original sources
PubMed2002

S-allele diversity in Sorbus aucuparia and Crataegus monogyna (Rosaceae: Maloideae).

RT-PCR was used to obtain the first estimates from natural populations of allelic diversity at the RNase-based gametophytic self-incompatibility locus in the Rosaceae. A total of 20 alleles were retrieved from 20 Sorbus aucuparia individuals, whereas 17 alleles were found in 13 Crataegus monogyna samples. Estimates of population-level allele numbers fall within the range observed in the Solanaceae, the only other family with RNase-based incompatibility for which estimates are available. The nucleotide diversity of S-allele sequences was found to be much lower in the two Rosaceae species as compared with the Solanaceae. This was not due to a lower sequence divergence among most closely related alleles. Rather, it is the depth of the entire genealogy that differs markedly in the two families, with Rosaceae S-alleles exhibiting more recent apparent coalescence. We also investigated patterns of selection at the molecular level by comparing nucleotide diversity at synonymous and nonsynonymous sites. Stabilizing selection was inferred for the 5' region of the molecule, while evidence of diversifying selection was present elsewhere.

Alleles↗
PubMed2001

Rosacea fulminans triggered by high-dose vitamins B6 and B12.

Rosacea fulminans is a rare variant of rosacea conglobata that occurs almost exclusively in women well past adolescence. The aetiology is unknown, although immunological, hormonal, and vascular factors have been suggested. We report the case of a 17-year-old girl with rosacea fulminans that was temporally associated with daily ingestion of high-dose vitamin B supplements. The onset was sudden and cosmetically disabling. The eruption improved when the vitamin supplement was discontinued and a therapeutic regimen including isotretinoin and methylprednisolone was introduced. It seems appropriate to consider the possibility of such a vitamin B-triggered condition in cases of subjects presenting new or exacerbating facial eruptions.

Adolescent↗
PubMedDate not supplied

Rosacea-like demodicidosis in an immunocompromised child.

Demodex folliculorum is a saprophytic mite of the human pilosebaceous unit. It is rarely found in children. It has been implicated in the development of follicular pityriasis, rosacea-like demodicidosis, pustular folliculitis, blepharitis, and granulomatous rosacea. We describe a 4-year-old boy who developed asymptomatic facial lesions that histologically corresponded to demodicidosis. He was in clinical remission of acute lymphoblastic leukemia and currently receiving maintenance chemotherapy. Exanthems related to D. folliculorum are rare in children. Most cases occur in immunocompromised patients and the clinical and histologic findings are diverse. A differential diagnosis should be established with rosacea and perioral dermatitis. The role of Demodex in the pathogenesis of these disorders is controversial. Immunosuppression might increase the number of mites, favoring an inflammatory reaction, or there could exist an impaired cutaneous immunologic response to the parasites.

Animals↗
PubMed2001

Once-daily topical metronidazole cream formulations in the treatment of the papules and pustules of rosacea.

BACKGROUND: The papules and pustules of rosacea can be effectively treated with topical metronidazole. The optimal concentrations of metronidazole and optimum frequencies of application are uncertain. Traditionally, twice-daily applications have been advised, based on the pharmacokinetic profile of metronidazole. Once-daily applications may be safer and less expensive, and they may enhance patient compliance. OBJECTIVE: We compared the efficacy and safety of 2 commercially available topical metronidazole formulations (0.75% metronidazole cream formulation and 1.0% metronidazole cream formulation) when both were used in a once-daily regimen. METHODS: A multicenter, randomized, investigator-blind, parallel group trial was conducted at 3 separate clinical sites located in 3 US cities. The study enrolled 72 rosacea patients with at least 8 to 50 inflammatory facial lesions (pustules and papules) and moderately severe facial erythema. Patients were randomly assigned to receive either 0.75% metronidazole cream or 1.0% metronidazole cream and instructed to apply the medication once daily for 12 weeks. Patients' lesions were evaluated at baseline and at weeks 3, 6, 9, and 12. RESULTS: There were no significant differences between treatment groups for any of the efficacy parameters evaluated. The overall median percentage change in lesion count at end point for patients in the 0.75% metronidazole cream treatment group was -62% compared with -60% for the 1.0% metronidazole cream treatment group. The overall percentage change in erythema scores at endpoint for patients in the 0.75% metronidazole cream treatment group was -26% compared with -30% for patients in the 1.0% metronidazole cream treatment group. Regarding physician assessment of global severity, 57% of subjects (20/35) in the 0.75% metronidazole cream group compared with 37% of subjects (13/35) in the 1.0% metronidazole cream group were rated as having a clear to mild condition at end point. Both drugs were well tolerated; there was no significant difference in the number of drug-related adverse events between the two agents. CONCLUSION: This controlled trial demonstrates that both 0.75% metronidazole cream and 1.0% metronidazole cream, when used once daily, provide well-tolerated efficacy for moderate to severe rosacea.

Administration, Topical↗
PubMed1999

Double-blind comparison of azelaic acid 20% cream and its vehicle in treatment of papulo-pustular rosacea.

Previous investigations have indicated that topical azelaic acid has beneficial effects in rosacea. This 3-month randomized, double-blind, multicentre study compared the efficacy and safety of azelaic acid 20% cream with its vehicle, in the treatment of papulo-pustular rosacea. A total of 116 patients were enrolled in the study and medication was applied twice daily. Azelaic acid cream produced significantly greater mean reductions in total inflammatory lesions than did vehicle (azelaic acid: 73.4%; vehicle: 50.6%; (p = 0.011), and erythema severity score (azelaic acid: 47.9%; vehicle: 37.9%; (p = 0.031). Azelaic acid cream treatment also resulted in significantly more favourable overall improvements than vehicle in both physician (p = 0.020) and patient ratings (p = 0.042). Neither azelaic acid cream nor vehicle produced any clinically relevant improvement in telangiectasia. Local adverse events were transient and mainly mild or moderate, and rates were similar for azelaic acid cream (39.5%) and vehicle (38.5%). Burning was the symptom most frequently reported. More than 90% of patients rated the overall local tolerability of their treatment as good or acceptable. In conclusion, azelaic acid 20% cream is effective and well tolerated in the treatment of papulo-pustular rosacea.

Administration, Cutaneous↗
PubMed2001

Pseudokeratoconus caused by rosacea.

PURPOSE: A case of inferior corneal thinning and high astigmatism with features of keratoconus in a patient with long-standing ocular rosacea is described. METHODS: Axial curvature mapping was performed with the Tomey TMS-1 videokeratoscopy instrument and corneal thickness mapping was performed with the Orbscan Corneal Topography System (CTS). Tear clearance was assessed by measuring the concentration of fluorescein in the tear fluid with a fluorometer. RESULTS: There were inferior corneal thinning and opacification in both eyes. Tear fluorescein clearance was markedly delayed in the right eye. There was asymmetric inferior corneal steepening in both eyes with I-S values of 1 in the right eye and 5.9 in the left eye. There were 5.9 diopters of astigmatism at 85 degrees in the right eye and 7.3 diopters of astigmatism at 73 degrees in the left eye. Corneal pachymetry mapping with the Orbscan CTS showed a normal central corneal thickness and maximal thinning in the inferotemporal periphery of the right cornea and inferonasal periphery of the left cornea. CONCLUSION: Chronic ocular rosacea can produce inferior corneal thinning and high astigmatism with some features of keratoconus. The inferior pattern of thinning in rosacea may be related to chronic exposure of the inferior cornea to inflammatory and matrix-degrading factors in the inferior tear meniscus.

Administration, Oral↗
PubMed2001

Resolution of granulomatous rosacea after eradication of Helicobacter pylori with clarithromycin, metronidazole and pantoprazole.

The aetiopathogenetic role of Helicobacter pylori in rosacea remains controversial. We report a 27-year-old man with a 4-year history of intractable rosacea. Histopathology showed epithelioid granulomas. H. pylori infection was proven directly on gastroscopy and by serological testing. Treatment with clarithromycin, metronidazole and pantoprazole eradicated H. pylori. Skin changes were markedly improved by the end of this therapy and had resolved completely 2 months later. The patient has been followed up, and has remained free of symptoms for 3 years. We suggest that H. pylori may be involved in the aetiopathogenesis of granulomatous rosacea.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed2004

Ocular rosacea can mimic trachoma: a case of cicatrizing conjunctivitis.

PURPOSE: To report the case of a patient with upper eyelid chronic cicatrizing conjunctivitis and entropion, presumably secondary to ocular rosacea. METHODS: Case report and review of medical literature. RESULTS: The patient has a history of chronic cicatrizing conjunctivitis since 1999. Despite an extensive workup for other possible causes, the patient's known history of acne rosacea is the most substantive explanation for her ocular disease. CONCLUSION: The presence of chronic cicatrizing conjunctivitis affecting mainly the upper eyelids, previously thought to be unique to trachoma, can be associated with ocular rosacea.

Adult↗
PubMed2005

Dendritic keratopathy in ocular rosacea.

PURPOSE: To report a case of dendritic keratopathy secondary to ocular rosacea in a 62-year-old man. METHOD: Case report. RESULTS: We discuss the ophthalmologic findings, management, and course in a patient with an unusual dendritic corneal lesion resistant to medical therapy. Other causes of dendritic lesions on the cornea were ruled out after investigation. The patient experienced symptomatic and objective improvement in the lesion with treatment of ocular rosacea. CONCLUSION: This case represents an interesting presentation of rosacea with dendritic keratopathy associated with typical skin lesions.

Androstadienes↗
PubMed2007

Evaluation and treatment of children with ocular rosacea.

PURPOSE: To describe the clinical presentation and treatment of ocular rosacea in children, an often unrecognized entity. METHODS: Retrospective chart review of 20 patients (age, 22 months to 17 years) who presented during childhood with corneal pathology, lid margin disease, and skin changes consistent with ocular rosacea. All patients were evaluated by the Cornea/External Disease Division of a tertiary-care facility, Bascom Palmer Eye Institute, Miami, FL, between 1990 and 2003. RESULTS: Sixty percent of patients improved after treatment with systemic erythromycin or doxycycline and topical low-dose steroid preparations. Ten percent of patients experienced no change in symptoms with treatment, and 30% of patients had incomplete follow-up to determine success of treatment. The patients maintained remission for up to 4 years after a slow taper of systemic treatment. The mean length of follow-up was 19.6 months (range, 0-9 years). CONCLUSIONS: Early recognition and treatment of ocular rosacea in children may improve patient outcome by limiting progression of corneal pathology, including scarring and vascularization.

Adolescent↗
PubMed2005

Rosacea and contact allergy to cosmetics and topical medicaments--retrospective analysis of multicentre surveillance data 1995-2002.

The role of contact allergy in rosacea has rarely been investigated. In this retrospective study, 361 out of 76,697 patients tested and documented by the Information Network of Departments of Dermatology between 1995 and 2002 had rosacea. Patch tests included standard series and constituents of cosmetics and topical medicaments. 118/361 had additionally been patch tested with their own cosmetics/medicaments. Positive reactions occurred to nickel (II) sulfate in 9.3%, fragrance mix in 8.8%, thimerosal in 6.9%, Myroxylon pereirae resin in 5.9%, potassium dichromate in 4.6% and propolis in 2.8%. Whereas rosacea patients had a significantly higher risk of contact allergy to propolis compared to the remaining patients, in an age- and sex-adjusted analysis, contact allergy to nickel was significantly less frequent in this group. For Lyral, the risk was elevated, albeit not significantly. Only 2/329 patients were positive to neomycin sulfate and 1/100 to gentamicin sulfate, among the panel of (topical) antibiotics tested. Among 118 patients tested with their own products, 3 were tested to metronidazole, 1 reacting positively. Irritant or doubtful patch test reactions were provoked by various substances (vehicles, oxidants and preservatives of various creams), which might also be clinically important, considering the heightened sensitivity of rosaceous skin.

Administration, Cutaneous↗
PubMed1975

Rosacea of common male baldness.

Four patients are described in whom rosacea occurred on the face, and on the scalp in patches of baldness. Histopathological examination of the specimens taken from the scalp showed changes of rosacea and basophilic degeneration of collagen. In two patients direct immunofluorescence studies were performed; in one of these the presence of IgG deposits at the dermo-epidermal junction was demonstrated. These observations confirm the influence of external factors in the pathogenesis of rosacea.

Aged↗
PubMed1982

Alcohol-induced rosacea flushing blocked by naloxone.

We evaluated the roles of endogenous opioid peptides and histamine in the pathophysiology of alcohol-induced facial flushing in rosacea. Non-diabetic patients with rosacea ingested 360 ml of 6% ethanol after receiving either subcutaneous naloxone hydrochloride or oral chloropheniramine maleate. Only pretreatment with naloxone blocked the alcohol-induced rosacea flushing (AIRF), suggesting an active role of endogenous enkephalin and/or endorphin in this vascular reactivity. In this respect, AIRF is similar to chlorpropamide alcohol flushing and menopausal flushing.

Adult↗
PubMed1993

Treatment of rosacea: topical clindamycin versus oral tetracycline.

BACKGROUND: A new topical antibiotic preparation, clindamycin in a lotion base, was compared with oral tetracycline in the treatment of rosacea. Forty-three patients clinically diagnosed as having rosacea were examined in an investigator-blinded study. METHODS: Patients used topical clindamycin lotion applied twice daily or the usual oral dose of tetracycline hydrochloride (250 mg four times a day for 3 weeks, then 250 mg twice a day for the remaining 9 weeks). Patients' lesions were examined clinically at 3-week intervals over a period of 12 weeks. RESULTS: Topical clindamycin treatment produced similar clinical results to oral tetracycline and was superior in the eradication of pustules. CONCLUSIONS: These results show topical clindamycin in a lotion base to be a safe and effective alternative to oral tetracycline therapy in the treatment of rosacea.

Administration, Cutaneous↗
PubMed2004

Long-pulsed (6-ms) pulsed dye laser treatment of rosacea-associated telangiectasia using subpurpuric clinical threshold.

BACKGROUND: The pulsed dye laser (PDL), especially the 585-nm short-pulse width (450 micros) laser, has been extensively used in the treatment of facial telangiectasias. However, the resultant posttreatment purpura lasts for days and may not be cosmetically acceptable. OBJECTIVE: To examine the effect of long-pulsed (6 ms) PDL at subpurpuric clinical threshold in the treatment of rosacea-associated telangiectasia. METHODS: Twelve patients with rosacea-associated telangiectasia were recruited into the study. We used the 595-nm PDL at a pulse duration of 6 ms and titrated the fluence between 7 and 9 J/cm2 to produce immediate purpura lasting only a few seconds. Pretreatment cooling was achieved by cryogen spray. Assessment was made by comparing pretreatment and posttreatment photographs. Patients were evaluated 6 to 8 weeks after one PDL treatment. Results were reported as the percentage of reduction in the number of telangiectasias. Patients were asked for their own evaluation of improvement after treatment in terms of excellent, moderate, or poor outcome. Side effects such as pigmentary disturbance and scarring were also documented. RESULTS: Two of 12 patients had more than 75% improvement. Another two had 50% to 75% improvement, and five had 25% to 50% improvement. Overall, 9 (75%) of 12 patients had more than 25% improvement after a single treatment of PDL. None of the patients reported any lasting posttreatment purpura or complications. CONCLUSION: The long-pulsed 595-nm PDL using subpurpuric clinical threshold was effective for treatment of rosacea associated telangiectasia.

Adult↗
PubMedDate not supplied

The proposed inflammatory pathophysiology of rosacea: implications for treatment.

The pathophysiology of the vascular and inflammatory stages of facial rosacea and proposes an underlying cause is reviewed. It can be argued that all the stigmata of rosacea are manifestations of an inflammatory process: neutrophilic dermatosis. For this reason, treatments that block neutrophil involvement in the development of rosacea, such as topical metronidazole and systemic antibodies, should be considered first-line therapy for all stages of the disease.

Anti-Infective Agents↗
PubMedDate not supplied

Subantimicrobial dose doxycycline for acne and rosacea.

Acne vulgaris and rosacea present therapeutic challenges due to their chronicity, potential for disfigurement, and psychosocial impact. Although pathophysiologically distinct, both conditions have major inflammatory components. Consequently, topical and systemic antimicrobial agents are routinely prescribed for extended periods. Emergence of resistant strains of Propionibacterium acnes, adverse events, and compliance issues associated with chronic systemic tetracycline use have led to new treatment approaches. At subantimicrobial doses, tetracyclines reduce inflammation via anticollagenolytic, antimatrix-degrading metalloproteinase, and cytokine down-regulating properties. Subantimicrobial dose (SD) doxycycline (Periostat 20 mg) has clinical utility in periodontitis and has been investigated in a double-blind, placebo-controlled trial in the treatment of moderate facial acne as well as in an open label study in the treatment of rosacea. The results of subantimicrobial dose doxycycline treatment in early trials support its benefits and further investigation in acne and rosacea.

Acne Vulgaris↗
PubMed2004

Rosacea lymphoedema of the eyelid.

PURPOSE: To present a patient with rosacea lymphoedema of one upper eyelid resulting in unilateral complete ptosis. METHODS: A 51-year-old white man presented with a 12-month history of progressive painless swelling of the left upper eyelid. An incisional biopsy of the upper eyelid was performed. RESULTS: The biopsy showed dermal oedema with lymphangiectasia and telangiectasia, accompanied by a mild to moderate mixed chronic inflammatory infiltrate of lymphocytes, histiocytes, plasma cells and rare eosinophils. Stains for fungi and mycobacteria were negative. The lack of lichenoid reaction, dermal mucin or lip swelling indicated a lymphoedematous manifestation of rosacea. The patient was treated with minocycline and prednisolone with no effect. CONCLUSION: Rosacea lymphoedema involving the eyelid, as in our case, is a rare complication and can present diagnostic and therapeutic challenges to the ophthalmologist.

Anti-Bacterial Agents↗