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PubMed1984

[Treatment of rosacea with metronidazole internally and externally].

Twenty-two patients suffering from rosacea papulosa or rosacea papulo-pustulosa were treated with Metronidazole at a low dosage (125 or 250 mg/d) for 2 to 6 months. According to our observations during a follow-up period of 12 months, this long-term therapy is well-tolerated and early recurrences are rare in comparison to the former short-term therapy with Metronidazole. It may be called an alternative to tetracycline therapy.

Administration, Oral↗
PubMed1980

Epigastric rosacea.

A 49-year-old man was observed to have a strong flushing reaction in both the epigastric and facial areas after drinking wine. He had severe facial erythematous telangiectatic rosacea. Similar prominent intense changes in the epigastric skin probably represent extrafacial erythematous telangiectatic rosacea.

Abdomen↗
PubMed1980

Infrared photographic studies of rosacea.

Three patients with erythematotelangiectatic rosacea were examined using infrared photography. The vascular patterns in the malar areas of all the patients were completely obliterated in the photographs. A review of the results of infrared studies on other cutaneous vascular lesions indicates that the disorder in rosacea is not associated with the superficial, collecting veins.

Humans↗
PubMedDate not supplied

[Acne rosacea complicated with demodicosis].

Demodicosis caused by infestation with Demodex folliculorum hominis is a parasitic acariasis disease which may affect nasal skin. Acne rosacea with demodicosis must be distinguished from nasal furunculi which require antiinflammatory, hyposensitizing treatment. If the latter fails, it is acna rosacea with demodicosis that must be suspected. The diagnosis is made by investigation of nasal skin scrapings. If the mites are found, the patient should be referred to dermatologist for specific treatment.

Humans↗
PubMed1994

Acne rosacea.

Rosacea is a multifactorial skin disorder that usually affects middle-aged persons. Little is known about the etiology of rosacea, although the disease most likely represents a vascular anomaly occurring in patients with fair skin. The mainstay of treatment for inflammatory lesions has been oral antibiotics, but topical metronidazole also may be effective. Because recurrences are common after discontinuation of therapy, doses should be tapered as tolerated. Antibiotics are more effective for inflammatory lesions than for erythema and telangiectasia. Isotretinoin may be effective for inflammatory lesions, edema and rhinophyma in some resistant cases, but its use is limited by its side effects and teratogenicity. Ablation of telangiectasia with the tunable dye laser and various surgical approaches to rhinophyma are effective newer treatments but are more expensive and less available than conventional therapy.

Diagnosis, Differential↗
PubMed1994

A comparison of the efficacy of topical tretinoin and low-dose oral isotretinoin in rosacea.

BACKGROUND AND DESIGN: Twenty-two patients with severe or recalcitrant rosacea were divided into three treatment groups in a randomized, double-blind trial that compared low-dose oral isotretinoin (10 mg/d), topically applied tretinoin (0.025% cream), and the combined use of both isotretinoin and tretinoin. For the first 16 weeks of the trial, subjects received one of these three trial regimens. For the final 16 weeks, isotretinoin was withheld while tretinoin cream or a placebo cream was continued. RESULTS: Twenty subjects completed the trial. Each treatment produced therapeutic benefits with regard to the number of papules and pustules and erythema. Treatment with oral isotretinoin appeared to give a more rapid onset of improvement, but there were no differences between the groups after 16 weeks. This level of improvement continued during the succeeding 16 weeks of observation whether the subjects used the tretinoin or the placebo cream. Adverse events were minimal and well tolerated in all groups. CONCLUSIONS: Low-dose oral isotretinoin and topical tretinoin cream therapy appear to be beneficial in the treatment of severe or recalcitrant rosacea. No additive benefit is noted with the combined use of these two modalities.

Administration, Oral↗
PubMed1995

A pilot study of 5 percent permethrin cream versus 0.75 percent metronidazole gel in acne rosacea.

Acne rosacea is a common skin condition characterized by flushing episodes, erythema, telangiectasia, and recurrent crops of inflammatory papules and pustules that involve the face in a symmetrical distribution. A pilot study was conducted to compare topical 5 percent permethrin cream and 0.75 percent metronidazole gel in the treatment of acne rosacea. Six patients began treatment with 0.75 percent metronidazole gel twice daily to the right side of the face and permethrin 5 percent cream applied daily to the left side. Clinical evaluation was performed every two weeks. Five patients completed the study. The patients were treated for a range of seven to ten weeks. There were minimal adverse effects. Moderate improvement was seen on both sides.

Administration, Topical↗
PubMed1998

A double-blind, multicenter clinical trial comparing efficacy of once-daily metronidazole 1 percent cream to vehicle in patients with rosacea.

The efficacy and safety of a new formulation of metronidazole 1 percent cream applied once daily was compared to vehicle cream in a double-blind, randomized, parallel group, ten-week clinical study. The results showed that metronidazole 1 percent cream was significantly better than vehicle in reducing the lesions of rosacea, improving erythema, and physician's global rosacea scores. The incidence of adverse events related to the skin was low.

Administration, Topical↗
PubMed2001

Allergy to nonspecific lipid transfer proteins in Rosaceae: a comparative study of different in vivo diagnostic methods.

BACKGROUND: Lipid transfer proteins (LTPs) are the major allergens in patients sensitive to Rosaceae (apple, peach, apricot, cherry, plum, and pear) who are not allergic to birch pollen. OBJECTIVE: The purpose of this study was to find a sensitive, specific, and relatively easy method for detection of LTP-sensitive patients. METHODS: We studied 36 persons who experienced oral allergy syndrome after the ingestion of fruits in the family Rosaceae. This study cohort was divided into two groups: 18 without allergy to birch pollen (patients) and 18 with birch pollen allergy (control subjects). All were tested by skin prick tests (SPTs) with fresh Golden Delicious apple, fresh peach, and extracts of peel and pulp from both fruits. Their specific IgE reactivities against peach peel extract were further investigated by immunoblot analysis. RESULTS: All 18 subjects in the control group showed strongly positive skin reactions with both fresh apple and fresh peach, whereas no skin reactivity was found with extracts from peach peel, peach pulp, or apple pulp. Extract of apple peel produced positive skin reactions in 17 of 18 control subjects; however, the wheals were generally smaller than those induced by fresh fruits. Immunoblot analysis showed no reactivity for peach peel extract. In contrast, the SPTs with fresh fruits showed that some of the 18 patients had strongly positive reactions, but others had weak reactions or negative responses. Further, in a high proportion of the patients, consecutive SPT with fresh apple yielded inconsistent results. In all patients, SPTs with extracts from apple pulp and peach pulp were negative, whereas SPTs with peel extracts were strongly positive in all patients. In most patients, the wheal area induced by SPT with peel extracts was larger than that induced by SPTs with fresh fruits. Immunoblot analysis showed that serum specimens from all 18 patients reacted with a 10-kD protein in peach peel. This is the molecular mass of LTPs. CONCLUSIONS: In birch pollen-allergic patients, the SPTs with fresh foods still remains the most reliable method of diagnosing vegetable food hypersensitivity. In contrast, in patients not allergic to birch pollen, the most reliable strategy for detection of patients sensitive to LTPs is skin prick testing with properly prepared fruit peel extracts. The loss of Bet v 1- and Bet v 2-like structures, which probably occurs during extraction, may facilitate immediate identification of the relevant allergen.

Antigens, Plant↗
PubMed1999

Peels of Rosaceae fruits have a higher allergenicity than pulps.

BACKGROUND: It is not uncommon that patients allergic to fruits such as apple, pear, and peach, refer adverse reactions after the ingestion of the whole fruit, but subsequently tolerate the pulp. OBJECTIVE: This study aimed to compare the allergenicity of peels and pulps of apple, peach, and pear in 33 patients allergic to these fruits. METHODS: Clinical reactivity to the ingestion of whole fruit (peel + pulp) and pulp was established by medical history. Peels and pulps were tested separately in skin prick tests (SPTs), histamine release tests (HRTs) and RASTs. Cross-allergenicity between peel and pulp of apple and peach was studied by RAST inhibition. RESULTS: Adverse reactions appeared more frequently and were more severe when the whole fruit was eaten. More than 40% of patients allergic to apple and pear tolerated the ingestion of the pulp of these fruits, and reactions were only elicited by the intake of the whole fruit. Peels induced higher SPTs, HRTs and RASTs than pulps. An important cross-allergenicity was found between the peel and pulp of apple and peach, although the amount of the shared allergenic epitopes seemed to be higher in peels. CONCLUSION: Our results suggest that peels of Rosaceae fruits such as apple, peach, and pear, have a higher allergenicity than pulps, which is clinically relevant. This aspect should be considered in the evaluation of patients allergic to Rosaceae fruits, and in the production of diagnostic materials.

Adolescent↗
PubMed1990

[The role of bacteria on facial rosacea-like dermatitis in adult type atopic dermatitis].

To investigate the role of bacteria on facial rosacea-like dermatitis lesion in adult type atopic dermatitis, we measured the numbers of bacteria on the skin, nasal and pharyngeal surface of each individual, and then examined its sensitivity to antibiotics. The numbers of bacteria on the surface of skin increased according to the severity of skin eruption. Staphylococcus aureus was detected from the skin and nasal surface more than pharyngeal surface. Bacteria on the pharyngeal surface were both staphylococcus aureus and haemophilus parainfluenzae. Therefore, it is suggested that bacterial flora on the pharynx is different from those of the skin and nose. The treatment with antibiotics was effective for exudative lesions, whereas lichenified lesion did not respond to antibiotic therapy. These results suggest that bacteria on the skin surface are one of precipitating factors of the rosacea-like dermatitis of atopic dermatitis.

Adolescent↗
PubMed1996

Polyprenols in leaves of fruit-trees of Rosaceae family.

In leaves of various species of fruit-trees belonging to the Rosaceae family, large amounts of polyprenyl acetates (0.5-5.0% of dry weight) were found. Discrete constant differences of polyprenol spectrum characteristic of each genus studied: Malus, Prunus and Pyrus were observed. In each species poly-cis-prenols composed of 19 and 20 isoprene units were predominating. In one of the 23 studied species (Prunus incisa) a fraction of long-chain polyprenols composed of 35-45 isoprene units was also present. It seems that this type of unusually long-chain polyprenols could occur also in other plants of the Rosaceae family.

Chromatography, Thin Layer↗
PubMed1990

Granulomatous acne rosacea of the eyelids.

We describe the clinicopathologic features of the papular form of granulomatous acne rosacea of the eyelids. This unusual cutaneous disorder is typified by painless eruptions of reddish to yellowish brown, occasionally ulcerative papules symmetrically distributed around the eyelids, lower part of the forehead, nasolabial folds, and upper lip. Histopathologically, the lesions display caseating and noncaseating dermal granulomas that mimic those seen in tuberculosis, tuberculoid leprosy, sarcoidosis, and other diseases. The disorder responds well to systemic tetracycline therapy but may involute spontaneously during a period of months to years. The distinction of this disorder from other dermal granulomatous diseases, such as tuberculosis, leprosy, syphilis, and foreign bodies, is important because of the different therapeutic implications.

Aged↗
PubMed1980

Flushing in rosacea: an experimental approach.

A simple method is described which causes rosacea patients to flush. This flush is experienced similarly to the flush which occurs spontaneously and its intensity can be measured and monitored quantitatively. Therefore, it can be used as a suitable experimental tool to measure and compare the inhibitory effects of some drugs, as well as the fluctuations of the blood level of certain chemical vasoactive mediators.

Adult↗
PubMed1982

Flushing in rosacea: a possible mechanism.

Flushing in rosacea has been investigated by means of (a) pharmacological inhibition of some possible chemical mediators and (b) titration of bradykinin as a possible effector directly in the blood. Clonidine-inhibited flushing was seen in all patients (mean 45%), other drugs had poorer results. Bradykinin increased in all patients at the climax of flushing (mean 60%). These findings support the hypothesis that epinephrine promotes a bradykinin release responsible for vasodilation.

Adult↗
PubMedDate not supplied

Use of topical metronidazole in moderate to severe rosacea.

Rosacea is a chronic condition requiring long-term therapy for control and maintenance. Numerous controlled studies have shown that metronidazole 0.75% in combination with oral antibiotics significantly reduces the number of papules and pustules and erythema severity scores in patients with severe disease. Topical metronidazole 0.75% also maintains long-term remissions after oral tetracycline has been discontinued. Although original studies involving topical metronidazole 0.75% used a twice-daily regimen, subsequent work has shown that this formulation used once daily is as effective as 1% metronidazole.

Administration, Cutaneous↗
PubMed1998

[Persistent erythema and edema of the face associated with rosacea and lymph vessel dysplasia].

A 24-year-old woman with lymph vessel dysplasia had experienced a progressive edema of her legs since her second year of life and progressive facial edema for the past year. She also had telangiectasias and papules on the background of a diffuse erythema as well as marked seborrhea on her face. Histopathological examination of a representative facial lesion revealed a granulomatous dermatitis with periadnexal distribution mainly consisting of lymphocytes and histiocytes. In addition, there was a moderate fibrosis of the dermis with numerous mast cells. By duplex ultrasound, a diagnosis of a massive edema of the legs without evidence for chronic venous insufficiency was made. The clinical and histopathological findings were consistent with solid persistent erythema and edema of the face associated with rosacea and lymph vessel dysplasia. The chronic course, absence of serological abnormalities and nonspecific histopathological features as well as resistance to therapy are the most important diagnostic criteria of this disease also known as Morbihan's disease.

Adult↗