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1.
Ophthalmologe ; 118(1): 68-73, 2021 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-33296015

RESUMO

Ocular rosacea in children is a rare but often underdiagnosed condition. It is typically associated with chronic blepharoconjunctivitis, chalazia, corneal opacity and corneal neovascularization. The recommended treatment consists of topical (eyelid hygiene, steroids, cyclosporin, lubricants) and systemic (antibiotics e.g. erythromycin) measures. This case series of 8 children demonstrates the efficacy of local 1.5% azithromycin treatment together with eyelid hygiene in pediatric ocular rosacea. A further advantage of this topical treatment is that the required application of only twice daily for 3 days followed by 7 days without treatment is convenient and improves adherence to treatment.


Assuntos
Blefarite , Rosácea , Administração Tópica , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Blefarite/diagnóstico , Blefarite/tratamento farmacológico , Criança , Humanos , Soluções Oftálmicas/uso terapêutico , Rosácea/diagnóstico , Rosácea/tratamento farmacológico
2.
An Bras Dermatol ; 95 Suppl 1: 53-69, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33172727

RESUMO

BACKGROUND: Rosacea is a chronic inflammatory disease of the skin, relatively more frequent in women over 30 with a low phototype and proven genetic predisposition. Although its etiology is unknown and possibly multifactorial, the immunological abnormality, associated with neurovascular dysregulation and triggering factors, are important elements in its pathophysiology, which lead to the main changes of inflammation, vasodilation, and angiogenesis that are responsible for the clinical manifestations. Despite the lack of cure, numerous therapeutic options are available for the different clinical presentations of the disease, with satisfactory responses. OBJECTIVE: To reach a consensus, with recommendations from experts, on the therapeutic management of rosacea suitable to the Brazilian setting. METHODS: The study was conducted by five specialized dermatologists from university centers, representatives of the different Brazilian regions, with experience in rosacea, who were appointed by the Brazilian Society of Dermatology. Based on the adapted DELPHI methodology, the experts contributed through an updated bibliographic review of the scientific evidence, combined with personal experiences. RESULTS: The group of experts reached a consensus on the relevant aspects in the therapeutic management of rosacea, providing information on epidemiology, pathophysiology, triggering factors, clinical condition, classification, quality of life, and comorbidities. Consensus was defined as approval by at least 90% of the panel. CONCLUSION: Despite the impossibility of cure, there are several therapeutic alternatives specific to each patient that provide excellent results, with chances of total improvement and long periods of remission, promoting a positive impact on quality of life. This consensus provides detailed guidance for clinical practice and therapeutic decisions in rosacea.


Assuntos
Dermatologia , Rosácea , Brasil , Consenso , Humanos , Qualidade de Vida , Rosácea/diagnóstico , Rosácea/tratamento farmacológico
3.
Curr Opin Ophthalmol ; 31(6): 503-507, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33009083

RESUMO

PURPOSE OF REVIEW: To revisit ocular rosacea as an underappreciated condition which can cause permanent blindness if inadequately treated, and to review data supporting improved diagnostic and treatment strategies. RECENT FINDINGS: Ocular rosacea has an underrecognized prevalence in children and individuals with darker skin tone. Rosacea has several associations with other significant systemic diseases. Variations in local and systemic microbiome, including demodex infestation, may play a role in pathogenesis, severity, and in explaining the different phenotypes of rosacea. The National Rosacea Society Expert Committee established an updated classification system of rosacea in 2017. New treatment algorithms based on these clinical subtypes are suggested. SUMMARY: With continued advancements in the understanding of the epidemiology and pathogenesis of rosacea, randomized controlled trials specific for ocular rosacea remain lacking. There is overall consensus that rosacea and ocular rosacea require chronic maintenance treatment strategies involving combination topical and systemic therapies.


Assuntos
Rosácea , Cegueira , Humanos , Prevalência , Rosácea/diagnóstico , Rosácea/terapia
4.
An Bras Dermatol ; 95(6): 754-756, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32912800

RESUMO

Lupus miliaris disseminatus faciei or acne agminata is a chronic inflammatory disorder of the skin, considered an intriguing entity due to its pathogenesis, which is still largely speculative. It has been linked to tuberculosis, sarcoidosis, rosacea, and other granulomatous diseases, but it is considered an independent entity.


Assuntos
Dermatoses Faciais , Rosácea , Diagnóstico Diferencial , Edema/diagnóstico , Dermatoses Faciais/diagnóstico , Humanos , Rosácea/diagnóstico , Pele
5.
Cesk Slov Oftalmol ; 75(6): 329-333, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32911949

RESUMO

The authors present case reports of two women, who were hospitalized in Department of Ophthalmology, University hospital Hradec Králové for ocular symptoms of rosacea. In the beginning there were relatively severe objective findings in the anterior segment of the eye in both cases - significant cornea graying with superficial and deep cornea vascularization in both eyes. On faces of both patients there were more or less typical sings of general illness. Especially in the first case there were severe papulopustules with crust all over the face. Subjectively Patients describe characteristic symptoms of dry eye. After dermatological consultation local and general anti-inflammatory treatment was set with consequent condition improving in both cases patients. In both cases we use two different general therapy formula according to literature (Azitromycin x Doxyhexal). In one case report, we found distinctive non-compliance during aftercare on our department with serious consequences. The purpose of our report is to point out ocular complications of rosacea and importance of oftalmologist´s and dermatologist´s cooperation during therapy of this illness with can lead to permanent damage of front segment of the eye and significant loss of visual acuity.


Assuntos
Síndromes do Olho Seco , Oftalmologia , Rosácea , Córnea , Feminino , Humanos , Rosácea/complicações , Rosácea/diagnóstico , Acuidade Visual
6.
Dermatol Online J ; 26(6)2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32815689

RESUMO

We present a 32-year old woman with a 9-year history of upper facial swelling. A workup by the ophthalmology department led to the diagnosis of Melkersson-Rosenthal syndrome. Re-evaluation in our dermatology clinic confirmed a diagnosis of Morbihan disease. Herein, we review case reports and case series of upper facial swelling in the dermatologic and ophthalmologic literature. Although the two entities share histopathological changes, they tend to have different clinical presentations. Melkersson-Rosenthal syndrome appears to be more likely diagnosed in the ophthalmologic literature when the clinical presentation and histopathology may be more consistent with Morbihan disease. In a patient with upper facial swelling, an absence of orolabial swelling, and lack of facial neuropathy, we argue for a diagnosis of Morbihan disease over Melkersson-Rosenthal syndrome, especially if the patient has a history of rosacea.


Assuntos
Edema/diagnóstico , Síndrome de Melkersson-Rosenthal/diagnóstico , Adulto , Diagnóstico Diferencial , Edema/patologia , Eritema/diagnóstico , Feminino , Humanos , Rosácea/complicações , Rosácea/diagnóstico , Pele/patologia
7.
Niger J Clin Pract ; 23(8): 1039-1043, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788478

RESUMO

Aim: The aim of this study was to investigate the relationship between the presence of Demodex on the face and within the eyelash follicles in patients with rosacea. Subjects and Methods: This prospective cross-sectional study included 80 participants, 40 patients with rosacea and 40 individuals with no rosacea as controls. The presence of Demodex on the face was assessed by standard superficial skin biopsy. Sixteen eyelashes were epilated from each patient and control. Results: The rate of Demodex infestation and severe infestation on the face in patients with rosacea was significantly higher than the control group. Demodex count within the eyelash follicle was significantly higher in patients with erythematotelangiectatic type rosacea than the control group. There was no increase in blepharitis in rosacea patients but when blepharitis was present, the rate of the presence of Demodex was higher in this group. There was a statistically significant relationship between the presence of Demodex within the eyelashes and itchy eyes in people without blepharitis. Conclusion: When at least one Demodex is found on the face in rosacea patients, the eyelashes should be examined for effective treatment of the mite. Itchy eyes may be an important sign of the presence of Demodex in people without blepharitis.


Assuntos
Infecções Oculares Parasitárias/parasitologia , Pestanas/parasitologia , Infestações por Ácaros/parasitologia , Rosácea/parasitologia , Pele/patologia , Adulto , Animais , Biópsia , Blefarite/diagnóstico , Blefarite/epidemiologia , Blefarite/parasitologia , Estudos de Casos e Controles , Conjuntivite , Estudos Transversais , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/epidemiologia , Face , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infestações por Ácaros/diagnóstico , Infestações por Ácaros/epidemiologia , Ácaros , Estudos Prospectivos , Prurido , Rosácea/diagnóstico , Rosácea/epidemiologia
10.
Pediatr. aten. prim ; 22(85): 39-41, ene.-mar. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-193439

RESUMO

El granuloma aséptico facial idiopático es una lesión nodular e indolora exclusiva de la infancia que suele aparecer en la zona de las mejillas. Presenta un amplio diagnóstico diferencial con otras lesiones nodulares. Se ha relacionado con el espectro de la rosácea por lo que, debido a las posibles implicaciones oculares de esta, se recomienda el seguimiento oftalmológico de los pacientes. Debido a su carácter benigno y autorresolutivo, como demuestra el caso clínico presentado, se recomienda un tratamiento conservador


Idiopathic facial aseptic granuloma is a pediatric condition characterized by red-violaceous nodule usually located on the cheeks. Differential diagnosis with other facial nodules must be done. The pathogenesis is still unclear but seems to be associated with rosacea. It is important keeping in mind the possible ophthalmological damage of rosacea so follow up is recommended. As we show in the case report, it is a benign lesion and it tends to spontaneous resolution, so we can avoid invasive treatments


Assuntos
Humanos , Masculino , Pré-Escolar , Granuloma/diagnóstico , Dermatoses Faciais/diagnóstico , Rosácea/diagnóstico , Diagnóstico Diferencial , Remissão Espontânea
12.
J Am Acad Dermatol ; 82(5): 1166-1173, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32004648

RESUMO

BACKGROUND: Efficacious topical medications for rosacea are needed. FMX103 1.5% is a novel topical minocycline foam that may have therapeutic benefits in treating rosacea while minimizing systemic adverse effects due to its topical route of delivery. OBJECTIVE: To determine the efficacy, safety, and tolerability of 12 weeks of treatment with FMX103 1.5% topical minocycline foam for papulopustular rosacea. METHODS: Two 12-week, phase 3, randomized, multicenter, double-blind, vehicle-controlled, 2-arm studies were performed in patients with moderate to severe papulopustular rosacea. RESULTS: Participants who received FMX103 1.5%, versus control individuals treated with vehicle, exhibited a significantly greater reduction in the number of inflammatory lesions (FX2016-11: -17.57 vs -15.65; P = .0031; FX2016-12: -18.54 vs -14.88; P < .0001) and higher rates of Investigator Global Assessment treatment success (FX2016-11: 52.1% vs 43.0%; P = .0273; FX2016-12: 49.1% vs 39.0%; P = .0077). No serious treatment-related treatment-emergent adverse events occurred. LIMITATIONS: The generalizability of these data from a controlled clinical trial should be examined in a real-world setting. CONCLUSIONS: FMX103 1.5% was efficacious for moderate to severe papulopustular rosacea and maintained a favorable safety profile.


Assuntos
Fármacos Dermatológicos/administração & dosagem , Minociclina/administração & dosagem , Rosácea/tratamento farmacológico , Administração Tópica , Adulto , Relação Dose-Resposta a Droga , Método Duplo-Cego , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Rosácea/diagnóstico , Índice de Gravidade de Doença , Resultado do Tratamento , Estados Unidos , Adulto Jovem
14.
J Am Acad Dermatol ; 82(2): 336-343, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31150711

RESUMO

BACKGROUND: Randomized controlled studies of combination therapies in rosacea are limited. OBJECTIVE: Evaluate the efficacy and safety of combining ivermectin 1% cream (IVM) and doxycycline 40-mg modified-release capsules (ie, 30-mg immediate-release and 10-mg delayed-release beads) (DMR) versus IVM and placebo for treatment of severe rosacea. METHODS: This 12-week, multicenter, randomized, investigator-blinded, parallel-group comparative study randomized adult subjects with severe rosacea (Investigator's Global Assessment [IGA] score, 4) to receive either IVM and DMR (combination arm) or IVM and placebo (monotherapy). RESULTS: A total of 273 subjects participated. IVM and DMR displayed superior efficacy in reduction of inflammatory lesions (-80.3% vs -73.6% for monotherapy [P = .032]) and IGA score (P = .032). Combination therapy had a faster onset of action as of week 4; it significantly increased the number of subjects achieving an IGA score of 0 (11.9% vs 5.1% [P = .043]) and 100% lesion reduction (17.8% vs 7.2% [P = .006]) at week 12. Both treatments reduced the Clinician's Erythema Assessment score, stinging/burning, flushing episodes, Dermatology Life Quality Index score, and ocular signs/symptoms and were well tolerated. LIMITATIONS: The duration of the study prevented evaluation of potential recurrences or further improvements. CONCLUSION: Combining IVM and DMR can produce faster responses, improve response rates, and increase patient satisfaction in cases of severe rosacea.


Assuntos
Doxiciclina/administração & dosagem , Ivermectina/administração & dosagem , Rosácea/tratamento farmacológico , Administração Oral , Adulto , Cápsulas , Preparações de Ação Retardada/administração & dosagem , Quimioterapia Combinada/métodos , Feminino , Humanos , Masculino , Satisfação do Paciente , Placebos/administração & dosagem , Qualidade de Vida , Rosácea/complicações , Rosácea/diagnóstico , Índice de Gravidade de Doença , Creme para a Pele/administração & dosagem , Fatores de Tempo , Resultado do Tratamento
15.
J Cosmet Dermatol ; 19(1): 105-111, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31102325

RESUMO

BACKGROUND: While a considerable number of cases with papulopustular rosacea (PPR) are resistant to conventional medications, therapeutic regimens are not currently established. Pulsed dye laser (PDL) and fractional microneedling radiofrequency (FMR) have previously demonstrated satisfactory results for anti-angiogenesis, anti-inflammation, and dermal remodeling. AIMS: To evaluate the efficacy and safety of novel combination regimen with low-dose oral isotretinoin, PDL, and FMR in the treatment of recalcitrant PPR. PATIENTS AND METHODS: A retrospective study was undertaken for recalcitrant PPR patients to evaluate the clinical course of novel combination regimen. Twenty-five PPR patients who had failed in previous first-line therapies were enrolled. They were treated with three sessions of PDL and FMR consecutively at 4-week intervals, maintaining daily oral administration of 10 mg isotretinoin for 8 weeks. Objective assessments, erythema index measurement, and patients' subjective satisfaction were evaluated at each visit and 16 weeks after the final treatment. RESULTS: At the final follow-up visit, the number of papules and pustules decreased by 71%, and erythema index by 54% compared with baseline (P < 0.05 for both). Physician's global assessment based on rosacea severity score and patients' subjective assessments paralleled with these results. No serious side effect was observed during whole study periods. CONCLUSION: This novel combination regimen demonstrated satisfactory efficacy with reasonable safety profiles for the treatment of recalcitrant PPR.


Assuntos
Isotretinoína/administração & dosagem , Lasers de Corante/uso terapêutico , Terapia com Luz de Baixa Intensidade/instrumentação , Terapia por Radiofrequência/instrumentação , Rosácea/terapia , Administração Oral , Adulto , Terapia Combinada/efeitos adversos , Terapia Combinada/instrumentação , Terapia Combinada/métodos , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Isotretinoína/efeitos adversos , Lasers de Corante/efeitos adversos , Terapia com Luz de Baixa Intensidade/efeitos adversos , Masculino , Pessoa de Meia-Idade , Agulhas/efeitos adversos , Satisfação do Paciente , Terapia por Radiofrequência/efeitos adversos , Estudos Retrospectivos , Rosácea/diagnóstico , Índice de Gravidade de Doença , Resultado do Tratamento
17.
Rev Med Inst Mex Seguro Soc ; 57(2): 113-117, 2019 Jul 31.
Artigo em Espanhol | MEDLINE | ID: mdl-31618566

RESUMO

Despite of the important technological advances which today allow a precise diagnosis through genetic or imaging studies, one of the fundamental pillars of medical diagnosis is, and always will be, patient examination. The visual identification of the signs that distinguish a disease is still important to make a clinical diagnosis. These very same examination skills and the knowledge on the disorders' appearance, as well as the technical abilities of the artists that once painted pictures, allow us to diagnose a rosacea among Rembrandt's self-portraits, or Marfan's syndrome amidst Egon Schiele's elongated figures. It is possible to find diseases represented in paintworks from long before someone ever described them in a book, longer even before someone considered them illnesses.


Assuntos
Neoplasias da Mama/diagnóstico , Insuficiência Cardíaca/diagnóstico , Síndrome de Marfan/diagnóstico , Pinturas , Rosácea/diagnóstico , Feminino , História do Século XVI , História do Século XVII , História do Século XIX , História do Século XX , Humanos , Masculino , Pinturas/história , Tetralogia de Fallot/diagnóstico
18.
Lupus ; 28(13): 1583-1588, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31619142

RESUMO

BACKGROUND: Malar rash is one of the three cutaneous diagnostic criteria of systemic lupus erythematosus (SLE). Although its clinical recognition is often straightforward, the differential diagnosis with erythematotelangiectatic rosacea may sometimes be challenging. OBJECTIVE: To describe dermoscopic features of SLE malar rash and investigate the accuracy of dermoscopy for the differential diagnosis with erythematotelangiectatic rosacea. METHODS: A representative dermoscopic image of target areas was evaluated for the presence of specific features. Fisher's test was used to compare their prevalence between the two cohorts, and accuracy parameters (specificity, sensitivity, and positive and negative predictive values) were evaluated. RESULTS: Twenty-eight patients were included in the analysis, of which 13 had SLE malar rash and 15 erythematotelangiectatic rosacea. The main dermoscopic features of malar rash were reddish/salmon-coloured follicular dots surrounded by white halos ('inverse strawberry' pattern), being present in 53.9% of the cases, while network-like vessels (vascular polygons) turned out to be the main feature of erythematotelangiectatic rosacea, with a prevalence of 93.3%. The comparative analysis showed that the 'inverse strawberry' pattern was significantly more common in SLE malar rash, with a specificity of 86.7%, while vascular polygons were significantly more frequent in rosacea, with a specificity of 92.3%. CONCLUSION: Dermoscopy may be a useful support to distinguish SLE malar rash and erythematotelangiectatic rosacea by showing peculiar features.


Assuntos
Lúpus Eritematoso Cutâneo/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Rosácea/diagnóstico , Adulto , Dermoscopia/métodos , Diagnóstico Diferencial , Feminino , Humanos , Lúpus Eritematoso Cutâneo/patologia , Lúpus Eritematoso Sistêmico/patologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade , Adulto Jovem
19.
Prensa méd. argent ; 105(9 especial): 576-581, oct 2019.
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1046621

RESUMO

This work is aimed at studying the problems of timely diagnostics and therapy of various forms of rosacea, identifying the factors that influence the compliance, prognosis, and quality of life of the patients, as well as the stages of combination therapy. The efficiency of rosacea therapy is determined by the timely identification of patients, as well as the clinical variety of the disease. Complex therapy of rosacea includes identification of the precipitating factors, basic skincare, and the use of systemic and local pathogenetic preparations. The "Gold Standard" of topical rosacea therapy is the antimicrobial and antiprotozoal drug called metronidazole. An important role in disease therapy is played by active cooperation between the doctor and the patient. Comprehensiveness, timeliness, and rationality of rosacea therapy are defined not only by the mechanisms of the disease development but also by aggravating factors, the need for basic care and photosensitivity of the patients


Assuntos
Transtornos de Fotossensibilidade , Retinoides/uso terapêutico , Isotretinoína/uso terapêutico , Cooperação do Paciente , Tacrolimo/uso terapêutico , Rosácea/diagnóstico , Terapia Combinada , Metronidazol/uso terapêutico
20.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(8): 637-641, oct. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185501

RESUMO

El granuloma aséptico facial idiopático (GAFI) es una patología específica de la edad pediátrica caracterizada por la aparición de nódulos rojizos asintomáticos en la región facial. Su etiopatogenia es aún motivo de discusión, aunque la literatura actual orienta a que se encontraría dentro del espectro de la rosácea infantil. Tiene una evolución crónica pero benigna, y hay publicaciones que documentan la resolución espontánea de las lesiones en menos de un año. A pesar de no tener un tratamiento bien definido, se prefiere que sea conservador y se eviten las intervenciones agresivas


Idiopathic facial aseptic granuloma is a pediatric skin condition involving asymptomatic reddish nodules. The etiology and pathogenesis is still under discussion, although the literature tends to place this condition within the spectrum of childhood rosaceas. The clinical course is chronic but benign, and cases have been reported to resolve spontaneously in less than a year. Even though no well-defined treatment has emerged, a conservative approach that avoids aggressive therapies is preferred


Assuntos
Humanos , Criança , Granuloma/epidemiologia , Granuloma/etiologia , Dermatoses Faciais/diagnóstico por imagem , Granuloma/terapia , Dermoscopia/métodos , Dermatoses Faciais/fisiopatologia , Rosácea/diagnóstico , Face/patologia , Diagnóstico Diferencial , Pioderma/diagnóstico , Calázio/diagnóstico , Ultrassonografia Doppler em Cores
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