Assessment of Skin Physiology Change and Safety After Intradermal Injections With Botulinum Toxin: A Randomized, Double-Blind, Placebo-Controlled, Split-Face Pilot Study in Rosacea Patients With Facial Erythema.

BACKGROUND: Botulinum toxin (BTX) has been used cosmetically with good clinical efficacy and tolerable safety. OBJECTIVE: This randomized, double-blind, split-face clinical study aimed to investigate the efficacy and safety of intradermal BTX in patients with rosacea. MATERIALS AND METHODS: Twenty-four participants were enrolled and randomly given intradermal injections of BTX and normal saline in both cheeks. Clinician Erythema Assessment (CEA) score, Global Aesthetic Improvement Scale (GAIS) score, skin hydration, transepidermal water loss (TEWL), melanin content, erythema index, elasticity, and sebum secretions were evaluated at baseline and 2, 4, 8, and 12 weeks. RESULTS: On the BTX-treated side, the CEA score significantly decreased and the GAIS score significantly increased. The erythema index decreased at Weeks 4 and 8. Skin elasticity was improved at Weeks 2 and 4 and skin hydration, at Weeks 2, 4, and 8. However, TEWL and sebum secretion did not show significant differences. CONCLUSION: Intradermal BTX injections reduced erythema and rejuvenated the skin effectively and safely in patients with rosacea.

Clinical assessment of rosacea severity: oriental score vs. quantitative assessment method with imaging and biomedical tools.

BACKGROUND: Rosacea is a common chronic inflammatory disorder affecting facial skin. Currently, no accurate and objective method is available for assessing the severity of rosacea. Most studies use the National Rosacea Society Standard (NRSS) grading method, which lacks objectivity and yields varying results. METHODS: Eighteen patients with rosacea were included. Clinical severity was assessed on the basis of the NRSS grade, Investigators' Global Assessment, Patients' Global Assessment, and Dermatology Quality of Life Index. A skin color analysis system was used to measure the facial area showing erythema, and biophysical parameters of facial skin (transepidermal water loss and skin surface hydration) were examined. To find statistical significant in classification severity of the rosacea, statistical analysis was performed with all parameters. RESULTS: A significant correlation (P < 0.05) was found between the NRSS grade, facial area showing erythema, and biophysical parameters. The latter two factors differed significantly among patients with rosacea of different levels of severity (mild, moderate, severe; P < 0.05). CONCLUSION: Color imaging systems can be useful and reliable for evaluating the severity of rosacea, in addition to biophysical parameter assessment. The combination of these two analytical methods enabled objective and quantitative evaluation of the severity of rosacea.

Clinical and instrumental assessment of the effects of a new product based on hydroxypropyl chitosan and potassium azeloyl diglycinate in the management of rosacea.

BACKGROUND: Rosacea is a chronic inflammatory skin disease affecting mostly facial skin. Its origin is multifactorial. Important steps in its treatment are avoidance of any triggering factor and control of skin inflammation. AIM: To assess the benefit of topical applications of a new product (P-3075). PATIENTS/METHODS: A randomized, multicenter, double-blind, placebo-controlled, parallel-group, pilot study was carried out to evaluate the efficacy and tolerability of a cream (P-3075) based on 5% potassium azeloyl diglycinate (PAD, Azeloglicina(®)) and 1% hydroxypropyl chitosan (HPCH). Forty-two patients (rosacea stages I and II) were enrolled and randomized, 28 in the P-3075 group and 14 in the placebo group. They were asked to apply the cream twice daily for 4 weeks. The main assessments were the objective quantification of erythema and skin hydration using the Mexameter(®) and Corneometer(®) devices, respectively. Clinical signs and symptoms were evaluated on a four-point scale. RESULTS: The P-3075 cream applied for 28 days was effective in skin protection by reducing erythema, evaluated both instrumentally and clinically. In addition, the clinical assessments of other symptoms such as flushing, stinging, and burning supported the beneficial effect of the P-3075 cream. CONCLUSIONS: The anti-inflammatory and moisturizing effects of potassium azeloyl diglycinate combined with the protective properties of HPCH allow the new product to be a good candidate for controlling signs and symptoms of rosacea.

[Assessment of microcirculatory system with conventional capillaroscopy in patients with rosacea--preliminary study]. / Ocena mikrokrazenia za pomoca konwencjonalnej kapilaroskopii u pacjentek z tradzikiem rózowatym--doniesienie wstepne.

UNLABELLED: Capillary microscopy is a non-invasive method, without any risk, easy to assess a microvascular abnormalities and influence of therapeutic methods. The aim of the study was to assess in conventional in vivo capillary microscopy a microvascular condition and its abnormalities in nail bed in patients with diagnosed rosacea in various clinical stages. MATERIAL AND METHODS: 16 female patients with diagnosed rosacea have undergone the clinical and capillary microscopic examination. The results were compared with healthy group of volunteers (16 females) . The results of clinical and microvascular studies in observed patients were shown. RESULTS: The age of patients with rosacea was between 20 and 70 years, average age was 49.38 years (SD 12.81 years). In the volunteers group the average age was 38.75 years, SD 9.48 years (min. 27, max. 55 years). A clinical type was categorized due to Plewig and Kligman classification. In the I stage there were 4 persons, in II--9 and in III phase--3 patients. The mean duration of rosacea was 5.56 years (SD 4.7 years). In the capillaroscopic examination in all patients with rosacea atypical capillaries were found. The abnormal capillaries were present in 10 volunteers (63%). In the rosacea group the most common occurred: Raynaud loops in 10 cases (62.5%), meandering capillaries and their elongation also in 10 patients (62.5%) and increasing number of the capillaries in 13 examined persons (81.25%). In the control group the presence of stenosed capillaries was confirmed in 3 examined persons (18.75%) with good visualized subpapillary venous plexus also in 3 cases (18.75%). In the rosacea group abnormalities of the color of the visual area were proved in 14 cases (88%) with indistinct field of vision in 3 cases (19%). In the control group the color of field of vision was normal in 11 examined persons (69%) and no abnormalities of visual area acuity were reported. CONCLUSION: Examination proved that conventional capillaroscopy seems to be a new diagnostic method in rosacea.

Assessment of skin barrier function in rosacea patients with a novel 1% metronidazole gel.

The skin of patients with rosacea is extremely sensitive and hyper-reactive to dietary, environmental, and topical factors. Accordingly, the management of rosacea involves not only choosing appropriate medication and treatment for daily skin care, but also avoiding known trigger factors. Recently, 1% metronidazole, a mainstay of topical rosacea therapy, was reformulated in a gel vehicle that contains hydrosolubilizing agents (HSA) niacinamide, beta cyclodextrin, and a low concentration of propylene glycol. It is designed to solubilize greater concentrations of metronidazole than is possible in water alone while reducing the potential for irritation and barrier disruption. A 2-week study was undertaken by the author to evaluate the effect of the new 1% metronidazole gel on the skin barrier in 25 women with mild to moderate rosacea. Statistically significant improvement in disease severity, erythema, desquamation, and skin irritation was noted by the investigator by the end of week 1, which continued throughout the study. After 2 weeks, subjects noted improvements in skin condition and rosacea. Results of noninvasive assessments showed no disruption of the skin barrier. Furthermore, there was an increasing trend in skin hydration that approached statistical significance.