Ocular signs, symptoms and tear function tests of papulopustular rosacea patients receiving azithromycin

Background  Tetracycline derivatives provide moderate benefit in the treatment of ocular rosacea. Recently, azithromycin has been found to be an effective alternative in the treatment of cutaneous papulopustular rosacea.
Objective  We planned a study to evaluate the effects of azithromycin on ocular symptoms, signs and tear function tests of papulopustular rosacea patients.
Methods  An open-labelled study was performed in a population of 20 papulopustular rosacea patients.
Results  Eighteen subjects completed the trial. Significant improvement was seen in ocular symptoms, eyelid findings and conjunctival hyperaemia scores ( P  = 0.002, P <  0.0001, and P  = 0.005, respectively). Therapeutic benefit was not observed in ocular surface staining scores. Baseline values of Schirmer test results were within normal limits. No significant side-effects were observed.
Limitations  The study population is limited to dermatology patients who had been referred to the ophthalmology clinic.
Conclusion  Azithromycin may be a new promising therapeutic alternative in ocular rosacea.

Conflicts of interest

None declared.     

Clinical evaluation of 30 patients with localized nasal rosacea

The clinical features of localized nasal rosacea have not been described in detail. This study was designed to analyze the subtypes and severity of localized nasal rosacea. Our present study included 30 patients with localized nasal rosacea. The erythematotelangiectatic subtype (13/30, 43.3%) was the most common type, followed by the phymatous subtype (9/30, 30%). The duration of rosacea was shorter and the severity of localized nasal rosacea was lower in the erythematotelangiectatic subtype cases compared with the patients with mixed or phymatous subtypes. Almost all of the papulopustular eruptions or phymatous lesions were associated with erythematotelangiectatic lesions. These findings suggest that the erythematotelangiectatic subtype may be considered the initial phase of localized nasal rosacea.     

Epidemiological and clinical features of rosacea in Korea: A multicenter cross‐sectional study

Rosacea is a common chronic inflammatory skin condition. Although several epidemiological and etiologic studies with large sample sizes have been conducted on Caucasians, such data regarding Asian populations are lacking. A total of 580 patients diagnosed with rosacea were enrolled from October 2014 to February 2015 at 14 general hospitals. Questionnaires, including the standard classification and grading system, were used for evaluation. The average age of the patients was 47.9 years. While 83.8% of patients revealed a single subtype, 16.2% of patients revealed mixed subtypes showing two or more subtypes simultaneously. Erythematotelangiectatic rosacea (ETR) was the most prevalent subtype. ETR combined with papulopustular rosacea showed the highest proportion in the mixed subtype group. Mild severity was revealed in 71.9% of patients. The most common aggravating factor was emotional changes (51.7%), followed by stress (48.4%). Approximately half of the patients (47.4%) showed relatively low awareness of rosacea. By identifying the epidemiological and etiologic features in Korea, we can suggest valuable clinical avenues for research, education and awareness among rosacea patients.     

玫瑰痤疮难治性红斑治疗进展

玫瑰痤疮伴发的难治性红斑给患者带来了极大的困扰。目前治疗方法有α-肾上腺素能受体激动剂、β 肾上腺素能受体阻滞剂、肉毒素、激光和光子等。本文就玫瑰痤疮难治性红斑治疗进展进行综述。     

Differences in clinical characteristics of rosacea across age groups: A retrospective study of 840 female patients

Background

Aging remains a common influencing factor for many diseases. Previous studies have shown that age is significantly associated with rosacea among female cases and that the incidence of rosacea increases with age. However, previous studies did not specifically analyze the clinical characteristics of different age groups.

Objective

This study aimed to analyze and compare the clinical characteristics of female patients of rosacea among different age groups.

Methods

We conducted a retrospective study of 840 female rosacea subjects and compared cutaneous features, aggravating factors, systemic diseases, and psychological states across age groups. The patients were divided into three groups according to their age at diagnosis: ≤30 years,31–44 years,and ≥45 years.

Results

In our study, the mean age of subjects was 35.9 ± 10.23 years. The common symptoms included telangiectasia (82.6%), persistent erythema (82.0%), burning/stinging sensation (89.3%), dry sensation (74.0%), and pruritis (41.9%). Hot temperature (89.9%), emotional changes (67.3%), spicy food (55.6%), and sun exposure (50.7%) were the common aggravating factors. Some patients had comorbidities of systemic disorders (20.4%). Of the patients, 48.8% presented with anxiety and 35.2% with depression. The clinical characteristics were found to be significantly different among the different age groups. Middle-aged and older patients (≥45 years) were more likely to have more serious persistent erythema and telangiectasia. And these patients were relatively less affected by some of the influencing factors and had more systemic diseases of the digestive system, endocrine metabolic system, and cardiovascular system (p < 0.05).

Conclusion

We revealed the impact of age on the characteristics of rosacea, which indicated that the clinical features of rosacea are more complex and more difficult to treat in females over the age of 45.     

Photodynamic therapy in a series of rosacea patients

BACKGROUND: Rosacea is a common disease that often has a chronic intermittent course despite current treatment; therefore, additional treatment options are desirable. The pathogenesis of the disease is unknown. OBJECTIVES: We have previously suggested that photodynamic therapy (MAL-PDT) may be of benefit as rosacea therapy. The purpose of this study was to further assess the possible benefit of this treatment of rosacea. METHODS: An exploratory review of case notes from rosacea patients treated with PDT was performed. Patients referred to our department with rosacea were offered PDT if requesting an alternative to previously tried conventional therapy. Routine MAL-PDT with methylaminolevulate and red light was given one to four times; results were evaluated 1-2 months after PTD was initiated and subsequently followed up. RESULTS: Good results were seen in 10 out of 17 patients, and fair results in another 4 patients. The majority of patients treated could stop or significantly reduce other rosacea therapy for a period lasting from about 3 months and up to 2 years. The study is limited by strong selection bias, and the clinical evaluation was obtained from case notes and photos. CONCLUSIONS: An apparent effect of MAL-PDT on rosacea could be observed. This is in accordance with our previous experience, and observations made by other researchers. A future randomized controlled trial therefore seems justifiable.     

Combined effects of silymarin and methylsulfonylmethane in the management of rosacea: clinical and instrumental evaluation

Objective   This study aims to evaluate a topical treatment based on silymarin/methylsulfonilmethane (S-MSM) to improve erythematous-telangiectactic rosacea.
Methods    Forty-six patients affected by stage I–III rosacea entered this double-blind, placebo-controlled study. Subjects were treated for 1 month. Clinical and instrumental evaluations were done at baseline, after 10 and 20 days, and at the end of the study. Itching, stinging, erythema, and papules were investigated clinically as well as hydration and erythema instrumentally with capacitance and color measurements.
Results    A statistically significant improvement was observed in many clinical and instrumental parameters investigated ( P <  0.001). In particular, improvement of skin redness, papules, itching, hydration, and skin color occurred.
Conclusions    The combination of silymarin and S-MSM can be useful in managing symptoms and condition of rosacea skin, especially in the rosacea subtype 1 erythemato-telangiectatic phase. The action can be considered multicentric and multiphase because of the direct modulating action on cytokines and angiokines normally involved and up-regulated in the case of such skin condition.     

Pimecrolimus 1% cream for the treatment of steroid-induced rosacea: an 8-week split-face clinical trial

BACKGROUND: Steroid-induced rosacea is a relatively common dermatosis that is caused by the prolonged application of topical steroid to the face. OBJECTIVES: The purpose of this investigator-blind, split-face study was to evaluate the efficacy and safety of pimecrolimus 1% cream for the treatment of steroid-induced rosacea. PATIENTS/METHODS: Patients were instructed to apply pimecrolimus 1% cream twice daily to the involved areas of a randomly allocated half side for the first 2 weeks, and to follow this by applying pimecrolimus 1% cream to both sides for a further 6 weeks. RESULTS: Fifteen of the 18 patients completed the 8-week study. After 1 week of application, a statistically significant improvement was observed for investigator's global assessments of erythema and papules on prior-treated sides (P-side). Later-treated sides (L-side) showed subsequent improvement after use of pimecrolimus on the L-side. Likewise, a statistically significant improvement was also observed for numbers of papules/pustules on P-sides after 1 week, and L-sides showed a significant improvement after application of pimecrolimus on the L-side. Comparative reflectance colorimetric assessments revealed that DeltaL*, Deltaa* and Deltab* tended to converge to zero during the first 4 weeks. A statistically significant improvement was observed for percentage area affected on P-sides after 1 week of application. The L-side showed a significant improvement after use of pimecrolimus cream on that side. The visual analogue scale of P-sides decreased more rapidly than those of L-sides. Cutaneous side-effects were mild and transient. CONCLUSIONS: This study suggests that pimecrolimus 1% cream is an effective and well-tolerated treatment for steroid-induced rosacea.     

Long-term prognosis of patients treated for erythema migrans in France

BACKGROUND: The long-term prognosis of patients treated for erythema migrans has only rarely been assessed. OBJECTIVES: To evaluate the clinical characteristics and long-term prognosis of patients treated for erythema migrans in the region of Alsace, France. METHODS: In a prospective study, 56 consecutive patients presenting with erythema migrans at the Strasbourg University Hospital between 1995 and 1999 were examined and a Borrelia burgdorferi enzyme immunoassay was performed. Patients were treated with tetracyclines or amoxycillin. Patients were re-examined 6 weeks later and a telephone interview was performed in summer 2000 to evaluate the long-term outcome. RESULTS: There were 25 women and 31 men of mean age 49 years presenting with single (n = 54) or multiple (n = 2) erythema migrans lesions. At the time of diagnosis, 30% of the patients had systemic signs, myalgias or arthralgias and only 36% of 50 patients were seroreactive against B. burgdorferi. None of the 51 patients evaluated at 6 weeks and none of the 37 patients interviewed after a median delay of 3 years had developed complications attributable to Lyme borreliosis. CONCLUSIONS: The prognosis of patients treated for Lyme borreliosis in this part of France is excellent. Therefore, a complete clinical examination is sufficient as an initial evaluation and long-term follow-up is not necessary.     

玫瑰痤疮的治疗进展

玫瑰痤疮药物治疗包括抗生素类、维A酸类、免疫抑制剂、α肾上腺素受体激动剂、抗幽门螺杆菌药物及ε氨基己酸(ACA)等,此外多种类型的激光已经越来越多地用于玫瑰痤疮的治疗。本文将对以上内容进行综述。     

短波理疗仪治疗红斑毛细血管扩张型玫瑰痤疮临床观察

目的:观察短波理疗仪治疗红斑毛细血管扩张型玫瑰痤疮(ETR)的临床疗效。方法:收集70例ETR患者,随机分为2组,其中治疗组40例,对照组30例。2组均每日早晚使用保湿霜,治疗组每隔1周进行1次短波理疗,疗程8周。治疗前、后由皮肤科医生盲态下对患者面部红斑及毛细血管扩张进行评分;患者对阵发性潮红、灼热及干燥症状进行评分。评分标准采用玫瑰痤疮4级评分。皮肤检测仪检测2组治疗前、后皮肤含水量和经皮水流失(TEWL)值。记录疗程中的不良反应。结果:治疗后治疗组患者面部红斑、灼热及干燥程度评分均较治疗前明显改善(P<0.05),治疗组改善优于对照组(P<0.05);对照组患者灼热及干燥程度评分均较治疗前明显改善(P<0.05)。2组毛细血管扩张评分及阵发性潮红评分比较,差异均无统计学意义(P>0.05)。治疗后2组患者皮肤含水量均增加,治疗组增加大于对照组(P<0.05);2组TEWL值均下降,治疗组下降大于对照组(P<0.05)。所有患者均无明显不良反应。结论:短波理疗仪治疗可明显改善ETR患者面部红斑、灼热及干燥症状,且安全性较好。     

强脉冲光治疗酒渣鼻疗效评价

目的:评价强脉冲光治疗酒渣鼻的疗效。方法:治疗组采用强脉冲光照射,每3周1次,4次为1疗程;对照组口服异维A酸10 mg,日2次,连续12周。结果:治疗组总有效率为89.74%,对照组为71.05%,差异有统计学意义(P0.05)。结论:强脉冲光治疗酒渣鼻疗效优于异维A酸。