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PubMed1997

A study on Demodex folliculorum in rosacea.

A random sample of 16 female patients suffering from papulopustular rosacea (PPR) as well as (16) normal female healthy subjects as control group were adopted in this study to assess of Demodex folliculorum pathogenesis. It was done through determination of mite density using a standard skin surface biopsy 10.5 cm2 from different designated 6 areas on the face, and scanning electron microscopic study (SEM) as well as total IgE estimation. A trial of treatment using Crotamiton 10% cream with special program was also attempted. All subjects ranged between 35-55 years old. All patients with rosacea and 15 of the control group i.e. 75.93% were found to harbour mites. The mean mite counts by site distribution were 28.6 & 6.9 on the cheeks, followed by 14.5 & 3.0 on the forehead and lastly 6.8 & 0.8 on the chin in PPR and control groups respectively. The total mean mite count in patients was 49.9 initially and 7.9 after treatment. In the control group it was 10.7 & 10.6 respectively. The mean total IgE was 169.4 & 168.4 and 96.3 & 98.4 in PPR and control groups respectively Light and scanning electron microscopy revealed that all mites were pointing in one direction. Some of them were containing bacteria inside their gut and on their skin. After treatment 3 cases (18.75%) were completely cured, 10 cases (62.5%) gave moderate response while 3 cases (18.75) have no response. In conclusion, this study supports the pathogenic role of D. folliculorum in rosacea.

Adult↗
PubMed1997

Periorbital edema as an initial presentation of rosacea.

Rosacea is a common dermatosis with a variety of clinical manifestations. The eyes are often affected. The most frequent ocular findings are blepharitis and conjunctivitis. We describe three patients with rosacea in whom periorbital edema was the initial presentation. This symptom may be confused with other dermatoses and may be refractory to conventional treatments for rosacea.

Adult↗
PubMed2000

The granule-bound starch synthase (GBSSI) gene in the Rosaceae: multiple loci and phylogenetic utility.

We sampled the 5' end of the granule-bound starch synthase gene (GBSSI or waxy) in Rosaceae, sequencing 108 clones from 18 species in 14 genera representing all four subfamilies (Amygdaloideae, Maloideae, Rosoideae, and Spiraeoideae), as well as four clones from Rhamnus catharticus (Rhamnaceae). This is the first phylogenetic study to use the 5' portion of this nuclear gene. Parsimony and maximum-likelihood analyses of 941 bases from seven complete and two partial exons demonstrate the presence of two loci (GBSSI-1 and GBSSI-2) in the Rosaceae. Southern hybridization analyses with locus-specific probes confirm that all four Rosaceae subfamilies have at least two GBSSI loci, even though only one locus has been reported in all previously studied diploid flowering plants. Phylogenetic analyses also identify four clades representing four loci in the Maloideae. Phylogenetic relationships inferred from GBSSI sequences are largely compatible with those from chloroplast (cpDNA: ndhF, rbcL) and nuclear ribosomal internal transcribed spacer (nrITS) DNA. Large clades are marked by significant intron variation: a long first intron plus no sixth intron in Maloideae GBSSI-1, a long fourth intron in Rosoideae GBSSI-1, and a GT to GC mutation in the 5' splice site of the fourth intron in all GBSSI-2 sequences. Our data do not support the long-held hypothesis that Maloideae originated from an ancient hybridization between amygdaloid and spiraeoid ancestors. Instead, Spiraeoideae genera (Kageneckia and Vauquelinia) are their closest relatives in all four GBSSI clades.

Base Sequence↗
PubMed1998

Cloning and characterization of cDNAs encoding S-RNases from almond (Prunus dulcis): primary structural features and sequence diversity of the S-RNases in Rosaceae.

cDNAs encoding three S-RNases of almond (Prunus dulcis), which belongs to the family Rosaceae, were cloned and sequenced. The comparison of amino acid sequences between the S-RNases of almond and those of other rosaceous species showed that the amino acid sequences of the rosaceous S-RNases are highly divergent, and intra-subfamilial similarities are higher than inter-subfamilial similarities. Twelve amino acid sequences of the rosaceous S-RNases were aligned to characterize their primary structural features. In spite of their high level of diversification, the rosaceous S-RNases were found to have five conserved regions, C1, C2, C3, C5, and RC4 which is Rosaceae-specific conserved region. Many variable sites fall into one region, named RHV. RHV is located at a similar position to that of the hypervariable region a (HVa) of the solanaceous S-RNases, and is assumed to be involved in recognizing S-specificity of pollen. On the other hand, the region corresponding to another solanaceous hypervariable region (HVb) was not variable in the rosaceous S-RNases. In the phylogenetic tree of the T2/S type RNase, the rosaceous S-RNase fall into two subfamily-specific groups (Amygdaloideae and Maloideae). The results of sequence comparisons and phylogenetic analysis imply that the present S-RNases of Rosaceae have diverged again relatively recently, after the divergence of subfamilies.

Amino Acid Sequence↗
PubMed1999

Detection and clinical characterization of patients with oral allergy syndrome caused by stable allergens in Rosaceae and nuts.

BACKGROUND: A minority of patients with oral allergy syndrome (OAS) induced by Rosaceae or nuts are positive on skin prick tests with commercial food extracts. This suggests reactivity against distinct stable allergens. OBJECTIVES: (1) To define the prevalence of subjects positive on skin prick tests with commercial extracts among patients with OAS caused by Rosaceae and/or nuts and (2) To investigate whether commercial extracts-positive subjects show some peculiar clinical feature and may represent a specific subset with food allergy. METHODS: Skin prick tests were carried out with a large panel of commercial extracts of airborne allergens (Allergopharma) and of vegetable foods (Dome/Hollister-Stier) in 298 adults with OAS caused by Rosaceae (n = 237) and or nuts (n = 161), positive on skin prick tests with fresh offending foods. RESULTS: 25/237 (11%) patients were positive on prick tests with commercial plum extract. This subgroup showed a higher incidence of systemic symptoms (64% versus 6%; P < .001) and a lower incidence of birch pollen allergy (12% versus 99%; P < .001) than commercial extract-negative patients; moreover, 36% versus 0%, respectively, did not have respiratory allergy (P < .001). Apple and peach were the main offending foods among commercial extract-negative and commercial extract-positive patients, respectively (87% versus 44% for apple, P < .001; and 52% versus 88% for peach, P < .005). Eight of one hundred sixty-one (5%) nuts-sensitive patients were positive on prick test with commercial walnut extract. This subgroup showed a higher proportion of patients who experienced systemic symptoms (63% versus 6%, P < .001), a lower prevalence of birch pollen allergy (13% versus 97%, P < .001), and a higher prevalence of grass pollen allergy (88% versus 41%, P < .05) than commercial extract-negative subjects. Further, reactivity against commercial walnut extract was associated with skin reactivity against commercial extracts of peanut (88% versus 37%, P < .005), tomato (75% versus 5%, P < .001), and plum (63% versus 8%, P < .001), and inversely related with skin reactivity against fresh apple (P < .001). In most cases, high levels of IgE specific for peach, apple, and hazelnut were associated with peanut reactivity rather than with clinical sensitivity to specific foods. In a preliminary investigation, most commercial extract-positive patients reacted against a 10-kDa protein characterized as a lipid transfer protein (LTP). CONCLUSIONS: Skin prick tests with commercial extracts of plum and walnut may be usefully employed to detect patients with OAS reacting against stable allergens. The high prevalence of systemic symptoms in these patients suggests that allergens' stability is associated with a higher resistance to the gastrointestinal environment and strongly influences the clinical expression of vegetable food allergy. At least some stable allergens, namely lipid transfer protein might be shared by botanically unrelated fruits such as nuts, peanuts, legumes, tomato, and Prunoideae.

Adult↗
PubMed2005

Ocular rosacea.

Rosacea is a common skin disease that frequently involves the eye. Although the pathogenesis of the disease remains undefined, recent findings suggest that an altered inflammatory response plays an important role in both cutaneous and ocular rosacea. Ocular manifestations include lid and ocular surface alterations. Chronic inflammation can lead to corneal vascularization, which may compromise vision. Treatment of ocular rosacea is aimed at preventing irritation of the ocular surface (e.g., lubricants, lid hygiene) and controlling inflammation with topical and systemic anti-inflammatory drugs. Systemic tetracyclines are the mainstay of treatment. These drugs act multifactorially by decreasing bacterial flora and the expression of matrix metalloproteinases, altering meibum secretion, inhibiting the production of bacterial lipases, and providing an immunomodulatory effect.

Journal Article↗
PubMed1992

Pyoderma faciale. A review and report of 20 additional cases: is it rosacea?

BACKGROUND AND DESIGN: Pyoderma faciale was originally described by O'Leary and Kierland in 1940. It is characterized by the sudden onset of monstrous coalescent nodules and confluent draining sinuses confined to the face of young women in their early 20s. This report summarizes our results in 20 cases. The women were 15 to 46 years old (mean, 25 years). RESULTS: All women were flushers and blushers. Histopathologic examination revealed a dense perivascular and periadnexial infiltrate, including granulocytes, eosinophils with epithelioid granulomas, and septal and lobular panniculitis. No consistent laboratory abnormalities were found. After much therapeutic experimentation, we developed an effective treatment plan, based on a combination of oral isotretinoin and corticosteroids. CONCLUSION: We regard it as an extreme form of rosacea and suggest it be renamed rosacea fulminans in analogy with its counterpart, acne fulminans.

Adolescent↗
PubMed1979

Chalazia and rosacea.

Fifty-seven percent of patients scheduled for excision of chalazia over 19 years of age and 64% of patients over the age of 29 were found to have rosacea. This compares to an incidence in our control group of 12% and 13%, respectively. Rosacea was almost twice as common in patients with recurrent chalazia as in those with only one occurrence.

Adult↗
PubMed1993

Acne rosacea with keratitis in childhood.

We present three cases of acne rosacea keratitis that developed in childhood. All three children were prepubescent and demonstrated characteristic dermatologic findings involving the nose, cheeks, and/or chin. The patients had complained of ocular irritation for at least 6 months, and in one case symptoms were reported by the family to have occurred intermittently since age 4 years. All three children showed evidence of meibomian gland inflammation; two patients demonstrated bilateral keratitis, the third had only unilateral involvement. In each case, oral tetracycline hydrochloride or doxycycline hyclate was necessary to relieve symptoms. Rosacea keratitis should be considered in the differential diagnosis of chronic keratoconjunctivitis during childhood.

Administration, Oral↗
PubMed1990

The inhibition of free radical generation by human neutrophils through the synergistic effects of metronidazole with palmitoleic acid: a possible mechanism of action of metronidazole in rosacea and acne.

Metronidazole is clinically effective in treating not only rosacea but also acne inflammation. Yet it is generally considered not to be very effective in inhibiting the growth of anaerobic Propionibacterium acnes. We report here our investigation into the synergistic effects of metronidazole and palmitoleic acid on the anaerobic growth of P. acnes as well as on human neutrophil functions, including the generation of reactive oxygen species (ROS). Both metronidazole and palmitoleic acid, when used alone, only slightly inhibited the growth of P. acnes, and no significant decrease in human neutrophil functions, including the generation of ROS, was observed. But metronidazole used in the presence of palmitoleic acid markedly inhibited the anaerobic growth of P. acnes and decreased ROS generation by neutrophils. However, ROS generated in the xanthine-xanthine oxidase system were not affected. Metronidazole was shown to be clinically effective by decreasing neutrophil-generated ROS at the sites of inflammation with the aid of palmitoleic acid, which is generally present in human skin. By inhibiting oxidative tissue injury under in vivo conditions, treatment with metronidazole results in remarkable improvement of rosacea and acne.

Acne Vulgaris↗
PubMed2004

[Treatment-resistant granulomatous rosacea-like dermatitis in a 9-year-old girl].

A 9-year-old female developed facial papules and pustules since four years. Clinically, perioral dermatitis was suspected. Different topical therapy regimens and systemic anibiotics had been unsuccessful and a skin biopsy showed granulomatous (lupoid) rosacea. Only systemic antibiotic treatment with minocyclin led to healing of the skin lesions. While granulomatous rosacea-like dermatitis is more frequently diagnosed in adults, it is only rarely encountered in children where, in most of the cases, it represents a therapeutic challenge.

Anti-Bacterial Agents↗
PubMed2007

[Steroid-aggravated rosacea: successful therapy with pimecrolimus].

Steroid-induced erythema in rosacea is a therapeutic challenge because of its tendency to rebound and the local characteristics of the facial skin. We describe 3 cases of steroid-induced rosacea with the typical history of steroid abuse with tachyphylaxis. Steroids with increasing potency had to be used with increasing frequency in the course of treatment in order to achieve a response. Acute exacerbations followed any attempt at withdrawal. The steroid treatment was discontinued and therapy with pimecrolimus cream 1% twice daily initiated. This brought rapid and marked improvement within a few days. The cases show that the calcineurin antagonist pimecrolimus offers an effective and well-tolerated therapy option in the acute therapy of steroid-aggravated facial dermatoses.

Aged↗
PubMed1995

[Draining sinus in acne and rosacea. A clinical, histopathologic and experimental study].

The draining sinus is an unpleasant complication of acne conglobata, acne fulminans, acne inversa, rosacea conglobata and rosacea fulminans (pyoderma faciale). It is most common on the face, especially in the nasolabial folds, and on the neck below the mandibular line. Clinically, it is an elongated (2-5 cm long), elevated, periodically inflamed lesion, which sporadically discharges pus. The lesion persists with no tendency to spontaneous regression. Histopathologically, it consists of elaborate, epithelialized galleries connected to the skin surface at multiple points. It contains corneocytes, hairs, bacteria, serum, inflammatory cells and epitheloid granulomas. A surgical thread placed into the skin provides a model in which the generation of sinus tracts can be studied. Therapy is difficult. Intralesional corticosteroid injection, cryosurgery and isotretinoin are not always very effective. Sometimes complete excision of the lesion is necessary. The draining sinus is a special form of scar analogous to the pilonidal cyst.

Abscess↗
PubMed2002

Laser treatment of erythema and telangiectasia associated with rosacea.

The response of rosacea-associated erythema and telangiectasia to treatment with the pulsed tunable dye laser (PDL) was evaluated in 12 patients. Improvements in erythema, telangiectasia, flushing, the physician's and the patient's perception of overall severity, treatment tolerability, and the adverse side effects were examined. With the sole exception of the patient's assessment of overall severity we have found highly significant improvements in all other parameters evaluated, with excellent tolerance of treatment. We therefore conclude that the PDL is a safe and effective treatment for the erythemato-telangiectatic component of rosacea.

Adult↗
PubMed1986

Ocular rosacea in blacks.

In three black men (57, 64, and 61 years old) with the ocular manifestations of rosacea, the diagnosis was not initially suspected because the pathognomonic skin changes of rosacea were obscured by the skin hyperpigmentation. Ocular involvement ranged from blepharitis and conjunctival hyperemia to sight-threatening problems such as corneal neovascularization, thinning, ulceration, and perforation. Treatment with oral tetracycline and topical corticosteroids appeared to be as effective in these patients as in previously described white patients.

Black People↗
PubMed2004

Kaposi's varicelliform eruption in association with rosacea.

Kaposi's varicelliform eruption is characterized by disseminated vesiculopustules and erosions caused by a herpes virus infection superimposed on a pre-existing dermatosis. The eruption usually occurs in individuals with atopic dermatitis or other pre-existing dermatosis such as Darier's disease, pemphigus foliaceus, mycosis fungoides, Sezary syndrome, benign familial pemphigus, ichthyosis vulgaris, second-degree burns, multiple myeloma, and Grover's disease. We report here a new case of Kaposi's varicelliform eruption in a 38-year-old woman with rosacea. To our knowledge, this is the first case of Kaposi's varicelliform eruption associated with rosacea to be reported.

Adult↗
PubMed2005

Symptomatic treatment of idiopathic and rosacea-associated cutaneous flushing with propranolol.

Flushing has been associated with medications, rosacea, menopause, carcinoid syndrome, pheochromocytoma, polycythemia, and mastocytosis, although it can occur without known cause. There are no known specific treatments available, but beta-blockers have suppressed flushing reactions in some patients, particularly when associated with anxiety. The medical histories and clinical characteristics of 9 patients with either idiopathic flushing or flushing associated with rosacea were reviewed. Eight patients experienced subjective improvement with propranolol therapy.

Adrenergic beta-Antagonists↗
PubMed2006

The lipid transfer proteins (LTP) essentially concentrate in the skin of Rosaceae fruits as cell surface exposed allergens.

The localization and distribution of non-specific lipid transfer proteins (nsLTP) allergens in the skin and pulp of Rosaceae fruits (apple, peach, apricot, plum) has been investigated. nsLTP essentially concentrate in the pericarp of the fruits whereas the pulp contains lower amounts of allergens. Immunolocalization showed they are primarily located in the cytosol but are subsequently excreted and finally accumulate at the plasmalemma-cell wall interface and in the cell wall. However, high discrepancies were observed in the content of allergens among, e.g. different cultivars of apple. As a consequence, the consumption of peeled-off fruits is recommended to reduce the risk of severe allergic reactions (anaphylactic shock) in individuals sensitized to Rosaceae fruits.

Allergens↗