Oral tranexamic acid treats papulopustular rosacea by improving the skin barrier.

BACKGROUND: Papulopustular rosacea (PPR) is a chronic inflammatory disease with a significant impact on facial aesthetics. An impaired skin barrier is an important factor in the development and exacerbation of PPR. Tranexamic acid (TXA) has immune regulatory and anti-inflammatory effects, inhibits angiogenesis and endothelial hyperplasia, and promotes skin barrier repair. AIMS: We investigated the efficacy and safety of oral TXA for PPR treatment. PATIENTS/METHODS: In total, 70 patients were randomly assigned to receive traditional therapy plus oral TXA or traditional therapy alone for 8 weeks, with a 4-week follow-up period. The subjective improvement in rosacea was assessed using the clinical erythema assessment (CEA), investigator's global assessment (IGA), patient self-assessment (PSA) score, rosacea-specific quality of life (RQoL) score, and global aesthetic improvement score (GAIS). An objective improvement in rosacea was assessed using skin hydration, trans-epidermal water loss (TEWL), clinical photography, and an eight spectrum facial imager. RESULTS: CEA/IGA/PSA, dryness, and RQoL scores were significantly lower and GAIS was higher in the TXA group than in the traditional therapy group. Furthermore, oral TXA significantly improved skin barrier function, increased skin hydration, and decreased TEWL, with no significant side effects. Notably, we observed better outcomes and a greater improvement in skin barrier function with TXA treatment in patients with dry-type rosacea than in patients with oily skin. CONCLUSIONS: The addition of oral TXA to traditional therapy can lead to rapid and effective improvements in PPR, which may be attributed to improvements in skin barrier function.

The survival outcomes of very young and elderly patients with high-risk prostate cancer after radical treatments: A population-matched study.

Objective: This study evaluated the survival outcomes of young (<50 years) and elderly patients (>80 years) with high-risk prostate cancer (PCa) postradical local treatments. Materials and Methods: We identified <50 and >80-year-old patients with high-risk PCa between 2004 and 2015 in the Surveillance, Epidemiology, and End Results database. The patients aged 65 and 66 years were also identified as the control group. The propensity-score matching method was adopted to compare the young and elderly patients with the control group. Kaplan-Meier analysis and Cox regression were conducted to evaluate the PCa-specific survival (PCSS) and overall survival. Results: A total of 17726 patients were identified, and 3355 were under 50 years old, whereas 4798 of them were >80 years old. The young patient group (<50 years) had similar PCSS with the control group (65-66 years) in both the overall cohort (hazard ratio [HR]: 0.88, 95% confidence interval [CI] [0.73-1.06], P = 0.132) and matched cohort (HR: 0.96, 95% CI [0.74-1.24], P = 0.527). Young patients with both high-risk and very high-risk PCa after radical prostatectomy (RP) treatment had apparent longer mean cancer-specific survival time than those after external-beam radiotherapy (EBRT) and/or brachytherapy (BT) treatment (high-risk group: 153.38 ± 0.82 months vs. 149.72 ± 3.03 months; very high-risk group: 148.3 ± 1.84 months vs. 139.33 ± 3.25 months). For the elderly patients (>80 years), the PCSS outcomes were significantly worse than the control group (65-66 years) in both overall cohort (HR: 2.69, 95% CI [2.31-3.13], P < 0.001) and matched cohort (HR: 1.61, 95% CI [1.34-1.94], P < 0.001). Patients receiving RP treatment had similar PCSS outcomes with those receiving EBRT and/or BT in the high-risk PCa group (139.45 ± 9.98 months vs. 139.41 ± 1.84 months), and better PCSS in very high-risk PCa group (132.73 ± 13.56 months vs. 128.82 ± 3.43 months). Conclusion: The PCSS outcomes of young PCa patients (<0 years) were identical to those of the control group (65-66 years). RP had similar or better PCSS benefits than EBRT and/or BT in both young (<50 years) and elderly patients (>80 years).

Prognosis of men with high-risk prostate cancer stratified by risk factors: a population-based retrospective cohort study.

BACKGROUND: The aim was to evaluate the prognosis of men with all possible high-risk prostate cancers (PCa) stratified by risk factors. METHODS: Within the Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015, men with non-metastasis high-risk PCa were identified. Kaplan-Meier analysis and Cox regressions were adopted to evaluate the overall survival (OS) and prostate cancer-specific survival (PCSS). Nomograms were conducted to build a predictive model. Concordance index (C-index) and calibration curves were used to validate the model. RESULTS: A total of 151,799 patients were included. Seven risk groups were divided including one high-risk factor of T3-4 (A1), prostate-specific antigen (PSA) >20 ng/mL (A2), and Gleason score (GS) 8-10, two high-risk factors of T3-4 PSA >20 ng/mL (B1), T3-4 GS 8-10 (B2), PSA >20 ng/mL GS 8-10 (B3), and three high-risk factors of T3-4 PSA >20 ng/mL GS 8-10 (C). The survival curves of PCSS showed that A1 was the best among all groups. A2, A3 and B1 had similar results and were all better than B2 [with A2 as reference, A3 hazard ratio (HR): 1.09 (1.02-1.17), P=0.046; B1 HR: 0.93 (0.82-1.05), P=0.103; B2 HR: 1.42 (1.32-1.53), P<0.001]. There is no significant difference between B3 and C [HR: 0.94 (0.86-1.03), P=0.029] and these two present the worst survival in prognosis. The 10-year PCSS of A1, A2, A3, B1, B2, B3, and C groups were 95.8%, 86.9%, 86.1%, 86.9%, 80.8%, 64.7% and 65.6%, respectively. Three simplified groups were divided including a good prognosis group (A1), an intermediate prognosis group (A2, A3, B1 and B2), and a poor prognosis group (B3 and C). Compared to the good prognosis group, the HR of the intermediate and the poor prognosis group were 4.21 (3.96-4.48), P<0.001 and 11.36 (10.59-12.19), P<0.001. A nomogram was built based on these factors. The C-index of the nomogram was 0.772, indicating a good accuracy of the model. CONCLUSIONS: Men with the combination of PSA >20 ng/mL and GS 8-10 had the worst PCSS among all patients. PCa with three high-risk factors was not more aggressive than that with two high-risk factors of GS 8-10 and PSA >20 ng/mL.