Clinical characteristics of the well-defined upper eyelid vascular network pattern in patients with rosacea.

BACKGROUND: Rosacea is a chronic inflammatory skin disease. The diagnosis is based on the symptoms and physical signs, which still lacks objective laboratory tests or imaging tests. OBJECTIVES: To propose and evaluate the upper eyelid network pattern in rosacea. METHODS: Participants included patients diagnosed with rosacea, other facial erythematous skin diseases, and normal controls, all of whom underwent full-face imaging utilizing the VISIA® system software. According to these images, researchers evaluated the condition of the upper eyelid vascular network, developed the grading scale and then compared the difference of distribution in the three groups. RESULTS: The occurrence rate of upper eyelid vascular network in rosacea was significantly higher than that in other facial erythematous skin diseases (84.3 vs. 32.0%, P < 0.001) and normal controls (84.3 vs. 28.0%, P < 0.001). The upper eyelid vascular network pattern was proposed (none [no clearly reticular vessels], mild [10-50% area of reticular vessels], moderate-to-severe [>50% area of reticular vessels]). Moderate-to-severe grade was defined as well-defined upper eyelid vascular network pattern, which was specific to patients with rosacea (rosacea vs. other facial erythematous skin diseases, adjusted odds ratio [aOR] = 5.814, 95% confidence interval [CI]: 3.899-8.670) (rosacea vs. heathy controls, aOR = 12.628, 95% CI: 8.334-19.112). The severity of the well-defined pattern had no significant association with age, duration, and phenotypes of rosacea (P > 0.05). CONCLUSION: The well-defined upper eyelid vascular network pattern specifically appeared in patients with rosacea, which could be a possible clue to the diagnosis of rosacea.

Multi-Factors Associated With Efficacy and Adverse Events of Fractional Erbium:YAG Laser-Assisted Delivery of Topical Betamethasone for Stable Vitiligo: A Retrospective Analysis.

BACKGROUND AND OBJECTIVES: Although topical corticosteroids are still the first-line option for vitiligo, its efficacy is still unsatisfactory for stable vitiligo. A few studies have focused on laser-assisted drug delivery (LADD) but were limited by their sample deficiency and analyses of the influencing factors. To determine the efficacy, adverse events, and their influencing factors of fractional erbium: yttrium-aluminum-garnet (Er:YAG) laser-assisted topical delivery of corticosteroids in stable vitiligo. STUDY DESIGN/MATERIALS AND METHODS: We retrospectively reviewed 1,026 lesions in 684 patients with stable vitiligo who underwent treatment with fractional Er:YAG laser-assisted delivery of topical compound betamethasone solution between January 2014 and December 2017. Multi-factors associated with different outcomes were analyzed by logistic regression in this study. RESULTS: A total of 413 of 1,026 lesions (40.3%) were effective 12 months after the first treatment. Age (<14 years old), disease duration (<1 year), lesion location (on face and neck), hairy lesions, and drug concentration were independent factors associated with effective repigmentation. A common adverse event was hyperpigmentation (14.4%), which was highly correlated with 22% density. CONCLUSIONS: Fractional Er:YAG laser-assisted delivery of topical compound betamethasone is a good option for the management of vitiligo. The treatment may be suggested in these situations: younger patients, shorter disease duration, and lesions on the face and neck with hair. The appearance of white hair in the lesion area does not affect our confidence in vitiligo treatment. Density >22% may cause hyperpigmentation, but it does not significantly contribute to the efficacy. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.