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1.
An Bras Dermatol ; 95(2): 187-193, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32113677

RESUMO

BACKGROUND: Demodex mites are found on the skin of many healthy individuals. Demodex mites in high densities are considered to play a pathogenic role. OBJECTIVE: To investigate the association between Demodex infestation and the three most common facial dermatoses: acne vulgaris, rosacea and seborrheic dermatitis. METHODS: This prospective, observational case-control study included 127 patients (43 with acne vulgaris, 43 with rosacea and 41 with seborrheic dermatitis) and 77 healthy controls. The presence of demodicosis was evaluated by standardized skin surface biopsy in both the patient and control groups. RESULTS: In terms of gender and age, no significant difference was found between the patients and controls (p>0.05). Demodex infestation rates were significantly higher in patients than in controls (p=0.001). Demodex infestation rates were significantly higher in the rosacea group than acne vulgaris and seborrheic dermatitis groups and controls (p=0.001; p=0.024; p=0.001, respectively). Demodex infestation was found to be significantly higher in the acne vulgaris and seborrheic dermatitis groups than in controls (p=0.001 and p=0.001, respectively). No difference was observed between the acne vulgaris and seborrheic dermatitis groups in terms of demodicosis (p=0.294). STUDY LIMITATIONS: Small sample size is a limitation of the study. The lack of an objective scoring system in the diagnosis of Demodex infestation is another limitation. CONCLUSION: The findings of the present study emphasize that acne vulgaris, rosacea and seborrheic dermatitis are significantly associated with Demodex infestation. Standardized skin surface biopsy is a practical tool in the determination of Demodex infestation.


Assuntos
Acne Vulgar/parasitologia , Dermatite Seborreica/parasitologia , Dermatoses Faciais/parasitologia , Infestações por Ácaros/complicações , Rosácea/parasitologia , Acne Vulgar/patologia , Adolescente , Adulto , Fatores Etários , Idoso , Biópsia , Estudos de Casos e Controles , Dermatite Seborreica/patologia , Dermatoses Faciais/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infestações por Ácaros/patologia , Estudos Prospectivos , Rosácea/patologia , Fatores Sexuais , Pele/parasitologia , Pele/patologia , Estatísticas não Paramétricas , Adulto Jovem
2.
J Dermatolog Treat ; 31(2): 168-174, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31120382

RESUMO

Objective: To characterize rosacea features suitable for identification of high-burden (HB) subjects in clinical practice.Design: Global online survey with subjects recruited using an online panel from the United States, Canada, Italy, United Kingdom, Germany and France. Subjects self-reported a physician's diagnosis of rosacea.Measurements: HB subjects were defined as those with ≥3/4 domains (quality of life, lifestyle adaptation, time trade-off, willingness to pay) greater than the median. Group characteristics were analyzed and multivariate-logistic modeling used to investigate factors most associated with HB.Results: 710 subjects completed the survey, including 158 HB subjects. HB was observed in all self-declared rosacea severities. HB subjects were more likely to spend more time daily on skin care and experienced approximately double the impact of health problems on work productivity in the past 7 days (p < .01). In the past 12 months, HB subjects were more likely to have at least one visit to the emergency room (41.8% vs 11.2%; p < .01). In the multivariate risk analysis, factors most associated with HB included rosacea severity, impact of health problems on regular daily activities and age at first symptoms.Conclusion: Rosacea has a distinct subset of HB subjects who can be successfully characterized.


Assuntos
Rosácea/patologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Internet , Estilo de Vida , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Qualidade de Vida , Fatores de Risco , Rosácea/economia , Rosácea/psicologia , Autorrelato , Índice de Gravidade de Doença , Inquéritos e Questionários , Adulto Jovem
3.
Dermatol Ther ; 32(6): e13093, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31579993

RESUMO

Ivermectin is a drug approved for the treatment of papulopustular rosacea (PPR). Although clinical guidelines recommend the use of ivermectin as the first-line treatment in patients with almost clear and mild rosacea, studies concerning its use on them are lacking. This study investigated the effectiveness and the tolerability of ivermectin in almost clear to severe rosacea and assessed the antiparasitic effect on Demodex mites. This is a retrospective study based on 50 patients affected by PPR and treated with topical ivermectin 1% once daily over 16 weeks. The disease severity, the patient-examined improvement, and the safety assessment of patients were evaluated. Demodex mites were studied with the standardized skin surface biopsy. PPR to all severity achieved a therapeutic success. The number of inflammatory lesions was significantly decreased in almost clear (p < .0001), mild, moderate, and severe (p < .001) forms. A complete remission of inflammatory lesions was achieved by almost clear (p < .001) and mild (p = .005) with 82% with none-to-mild cutaneous adverse events. Thirty-two percent were positive for Demodex mites, and all of them turned negative after 16 weeks. Ivermectin is an effective treatment not only in moderate to severe PPR but also in almost clear/mild rosacea.


Assuntos
Antiparasitários/administração & dosagem , Ivermectina/administração & dosagem , Infestações por Ácaros/tratamento farmacológico , Rosácea/tratamento farmacológico , Administração Cutânea , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Antiparasitários/efeitos adversos , Feminino , Humanos , Ivermectina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Ácaros , Estudos Retrospectivos , Rosácea/patologia , Índice de Gravidade de Doença , Resultado do Tratamento
4.
Turkiye Parazitol Derg ; 43(3): 143-148, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31502805

RESUMO

Objective: The aim of the study was to investigate the Demodex prevalence in patients with dermatological complaints who were admitted to our hospital, and to evaluate the socio-demographic characteristics and risk factors of the patients. Methods: A total of 133 patients who were sent for Demodex screening were included and questionnaire for risk factors was administered. Samples were taken by standard superficial skin biopsy method and the different developmental stages were investigated under microscope. Results: Demodex species were found in 93 (69.9%) of the patients. Demodex folliculorum was found in 58 (62.4%) of the patients, Demodex brevis in 13 (14%), Demodex folliculorum and Demodex brevis in 4 (4.3%) and Demodex species in 18 (19.4%) of the patients. At least one of the Demodex species was found in 77.1% of patients with acne rosacea. No statistically significant relation was found between Demodex positivity and age, gender, number of weekly baths, use of makeup, and common towel use. Though statistically not significant, an increase of Demodex infestation with increasing age was observed. Conclusion: Demodex mite infestations are widespread worldwide without showing important racial and gender differences. In the present study, prevalence of Demodex infestation in patients with acne rosacea was high and this should be taken into consideration, when such patients are treated for their symptoms.


Assuntos
Face , Infestações por Ácaros/epidemiologia , Rosácea/complicações , Adulto , Animais , Biópsia , Face/parasitologia , Face/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infestações por Ácaros/complicações , Ácaros/crescimento & desenvolvimento , Prevalência , Fatores de Risco , Rosácea/patologia , Fatores Sexuais , Pele/patologia , Fatores Socioeconômicos
5.
Cutis ; 104(1): 38-41, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31487335

RESUMO

Rosacea is a chronic inflammatory cutaneous disorder that may be underreported and underrecognized in skin of color (SOC) patients. There are several skin disorders that can present with the classic features of rosacea, such as erythema, papules, and pustules, which can confound the diagnosis. To promote accurate and timely diagnosis of rosacea, we review possible rosacea mimickers in SOC patients.


Assuntos
Rosácea/diagnóstico , Dermatopatias/diagnóstico , Pigmentação da Pele , Doença Crônica , Eritema/diagnóstico , Eritema/patologia , Humanos , Rosácea/patologia , Dermatopatias/patologia
8.
J Dtsch Dermatol Ges ; 17(5): 518-533, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31115996

RESUMO

Granulomatous dermatoses comprise a wide range of etiologically and clinically distinct skin diseases that share a common histology characterized by the accumulation of histiocytes include macrophages. While the pathogenesis of these disorders is not fully understood, the underlying mechanism is thought to involve a reaction pattern caused by an immunogenic stimulus. Antigen-presenting cells and the effect of various cytokines play a key role. Our understanding of granulomatous reaction patterns has been advanced by insights drawn from observations of such reactions in patients on immunomodulatory therapy and in individuals with genetic immunodeficiency. Traditionally, a distinction is made between infectious and non-infectious granulomatous dermatoses. The present CME article addresses granulomatous skin diseases for which there is no evidence of a causative infectious agent. Common representatives include granuloma annulare, necrobiosis lipoidica and cutaneous sarcoidosis. Granulomatous dermatoses may be part of the clinical spectrum of various systemic disorders or may be associated therewith. Some neoplastic disorders may mimic granulomatous dermatoses histologically. Given the pathogenetic diversity involved, the clinical presentation, too, is quite varied. Overall, however, each disorder is characterized by typical clinical features. The diagnosis always requires thorough clinicopathologic correlation. Treatment is preferably based on the underlying pathogenesis and frequently involves anti-inflammatory agents. In most cases, however, there is insufficient study data. The dermal nature of these disorders frequently poses a therapeutic challenge, especially with respect to topical treatment.


Assuntos
Granuloma/patologia , Dermatopatias/patologia , Doença de Crohn/patologia , Dermatite Alérgica de Contato/patologia , Diagnóstico Diferencial , Reação a Corpo Estranho/patologia , Granuloma Anular/patologia , Histiócitos/patologia , Humanos , Necrobiose Lipoídica/patologia , Xantogranuloma Necrobiótico/patologia , Doenças não Transmissíveis , Doenças da Imunodeficiência Primária/patologia , Rosácea/patologia , Sarcoidose/patologia , Neoplasias Cutâneas/patologia
10.
J Drugs Dermatol ; 18(4): 381-386, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31013011

RESUMO

Objective: To describe patient characteristics, concerns, side effects, treatment satisfaction, and quality of life (QoL) of rosacea patients currently being treated with monotherapy azelaic acid foam based on patient-reported data. Methods: The study utilized a non-interventional, prospective, observational design. Patients were recruited in the United States and were eligible if the following criteria were met: diagnosed with rosacea by a medical professional, ≥18 years of age, currently receiving monotherapy with azelaic acid foam, and able to provide informed consent. Patients using other topical treatments for rosacea during enrollment were excluded. An online tool administered a survey of 3 questionnaires including the Rosacea Treatment Preference Questionnaire, Treatment Satisfaction with Medicines Questionnaire (SATMED-Q), and Dermatology Life Quality Index (DLQI). The survey collected demographics, clinical characteristics, treatment history, adverse events, and patient-reported outcomes related to treatment with azelaic acid foam and QoL with rosacea. Results: 54 patients met eligibility criteria. Participants were primarily female (90.7%), ranging from 26 to 63 years of age. The most common subtypes reported were erythematotelangiectatic and papulopustular (74.1% each) with 59.3% of participants reporting mild symptoms (16.7% "absent"; 24.1% "moderate") in the 4 weeks before enrollment. The majority reported no concerns (74.1%) with their treatment. The biggest concern was cost (11.1%), with a mean importance score (IS) on a 10-point scale of 9.3. A majority (77.8%) of patients reported no side effects. Side effects reported included dryness (13%; IS: 5.3), stinging (7.4%, IS: 2.5), itching (5.6%; IS: 4.7), or burning (3.7%; IS: 7.0). Global satisfaction (SATMED-Q) mean score was 79.0 and treatment effectiveness mean score was 70.8. QoL impact of rosacea was minimal (mean DLQI score: 2.35). In regression models, increasing dryness was significantly associated with worsening outcomes in SATMED-Q and DLQI. Conclusions: Patient characteristics of the study population closely mirror the distribution of rosacea by gender and subtype as in previous estimates. Findings indicate minimal patient concerns with azelaic acid foam and primarily pertained to cost. Patient-reported side effects were rare. Minor patient-reported side effects and concerns do not appear to affect rosacea-related QoL and medication satisfaction. Compared to a previously conducted study of similar design with patients using metronidazole gel and metronidazole cream, more patients in the current study reported no concerns with their treatment, while the number of patients reporting no side effects, as well as mean SATMED-Q and DLQI scores, were similar. Further research is necessary to directly compare the results of these 2 studies. J Drugs Dermatol. 2019;18(4):381-386.


Assuntos
Fármacos Dermatológicos/administração & dosagem , Ácidos Dicarboxílicos/administração & dosagem , Rosácea/tratamento farmacológico , Administração Cutânea , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Qualidade de Vida , Rosácea/patologia
11.
Georgian Med News ; (287): 95-98, 2019 Feb.
Artigo em Russo | MEDLINE | ID: mdl-30958297

RESUMO

The purpose of the study was to study the frequency of detection and population density of the mite in rosacea patients depending on the clinical form, the location of the morphological elements on the face and some parameters of the functional state of the skin. We observed 55 patients (38 women and 17 men) aged from 30 to 65 years old with disease duration from 6 months to 10 years. According to clinical forms, 35 had PPR and 20 - ETR (erythematous - telangiectatic rosacea). By location of the rash elements, the following types are distinguished: central, medial, asymmetric, lateral, and total. The mite was identified by a microscopic method. The functions of the skin barrier of the face skin: moisture, oiliness, dryness were determined using a bio-impedance analyzer (BIA). As shown by the results of the study of the above parameters in the observed patients, a high density of the mite population (> 5 per cm2) was noted in cases of total, medial and central type of their location. This indicator was in direct correlation with parameters such as skin fat content and moisture. 75% of patients in this group were diagnosed with PPR. In the group of patients with medium and low population density of mites (<5 per cm2), the lateral, asymmetric and central type of their location were dominated in 65% ​​of patients with ETNR. This group of patients showed low levels of skin fat and moisture, relatively high rates of dryness. Thus, the population density of the mites is dependent on the intensity of the anatomical location of the sebaceous glands of the face skin. An analysis of the results obtained in the study of the role of mite in the pathogenesis of rosacea led us to the conclusion: in rosacea patients, a correlation was found between the increase in the population density of mites, the type of element arrangement and the severity of dermatosis, which proves the role of the mite as one of the most frequent but not obligatory pathogenetic factors in the development of this dermatosis, especially its papulopustular form.


Assuntos
Infestações por Ácaros/complicações , Ácaros/patogenicidade , Rosácea/patologia , Pele/parasitologia , Adulto , Idoso , Animais , Face , Feminino , Humanos , Masculino , Microscopia , Pessoa de Meia-Idade , Rosácea/complicações , Rosácea/parasitologia
12.
J Dermatolog Treat ; 30(8): 809-812, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31017492

RESUMO

Objective: To assess the efficacy and safety of artemether emulsion in patients with papulopustular rosacea. Methods: A total of 130 (randomized 1:1) were externally administered either artemether emulsion (1%) or metronidazole emulsion (3%) twice daily for 4 weeks with an open-label 8-week follow-up. The primary endpoints included the proportion of patients who achieved clinical effective responses, as well as erythema and papule and pustule score at week 4. Results: Numerically more patients achieved an effective response at week 4 with artemether emulsion (87.1%) than metronidazole emulsion (80.0%) (p > .05). Patients with artemether emulsion had comparable baseline erythema score (2.45 ± 0.67 versus 2.42 ± 0.70, p = .809) and papule and pustule score (2.11 ± 0.96 versus 2.32 ± 0.83, p = .264), but significantly lower papule and pustule score (0.21 ± 0.52 versus 0.42 ± 0.83, p = .001) and comparable erythema score (0.53 ± 0.88 versus 0.62 ± 0.88, p = .999) compared to patients with metronidazole emulsion at week 4. There was a significantly higher proportion of patients with metronidazole emulsion relapse compared to metronidazole emulsion during the open-label 8-week follow-up period (21.6% versus 2.4%, p < .01). Conclusions: Artemether emulsion improved papulopustular rosacea in the metronidazole emulsion group as early as 4 weeks, but its beneficial effect was maintained through the 8-week follow-up period compared to metronidazole emulsion.


Assuntos
Artemeter/uso terapêutico , Rosácea/tratamento farmacológico , Adulto , Artemeter/efeitos adversos , Artemeter/química , Esquema de Medicação , Emulsões/química , Feminino , Humanos , Masculino , Metronidazol/química , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Projetos Piloto , Prurido/etiologia , Rosácea/patologia , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
13.
Bol Med Hosp Infant Mex ; 76(2): 95-99, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30907384

RESUMO

Background: Rosacea is a chronic inflammatory skin condition that usually occurs in adults and rarely has been reported in children, although both subtypes share the same clinical characteristics. Case report: A 10-year-old female presented dermostosis on the face, affecting cheeks and nose, characterized by erythema, papules, pustules, scars of two years of evolution, as well as bilateral conjunctivitis, blepharitis and corneal opacity. She referred recurrent exacerbations and partial remission of cutaneous lesions and ocular symptoms related to sun exposure. She responded dramatically to systemic and topical antibiotics. Conclusions: Childhood rosacea should be distinguished from other most common erythematous facial disorders, such as acne, granulomatous perioral dermatitis, and sarcoidosis. The distribution of papulopustular facial lesions together with the presence of telangiectasia, flushing and the ocular findings allow the differentiation of rosacea from other facial eruptions.


Assuntos
Antibacterianos/administração & dosagem , Dermatoses Faciais/diagnóstico , Rosácea/diagnóstico , Criança , Dermatoses Faciais/tratamento farmacológico , Dermatoses Faciais/patologia , Feminino , Humanos , Rosácea/tratamento farmacológico , Rosácea/patologia , Resultado do Tratamento
14.
Artigo em Inglês | MEDLINE | ID: mdl-30901061

RESUMO

INTRODUCTION: Erythematotelangiectatic rosacea is a common condition in Caucasians. The most frequently used lasers to treat this condition are pulsed dye laser (PDL) and neodymium:yttrium-aluminum-garnet laser (Nd:YAG). This study compares the treatment efficacy of purpuragenic PDL with that of sequential emission of 595 nm PDL and 1,064 nm Nd:YAG (multiplexed PDL/Nd:YAG). METHODS: We performed a prospective, randomized, and controlled split-face study. Both cheeks were treated, with side randomization to receive treatment with PDL or multiplexed PDL/Nd:YAG. Efficacy was evaluated by spectrophotometric measurement, visual photograph evaluation, the Dermatology Quality of Life Index questionnaire, and a post-treatment questionnaire. RESULTS: Twenty-seven patients completed the study. Treatment was associated with a statistically significant improvement in quality of life (p < 0.001). PDL and multiplexed PDL/Nd:YAG modalities significantly reduced the erythema index (EI; p < 0.05). When comparing the degree of EI reduction, no differences were observed between the two treatment modalities. PDL was associated with a higher degree of pain and a higher percentage of purpura. Multiplexed PDL/Nd:YAG modality was associated with fewer side effects and greater global satisfaction, and 96.3% of the patients would recommend this treatment to a friend. CONCLUSIONS: Both laser modalities are efficacious in the treatment of erythematotelangiectatic rosacea. The multiplexed PDL/Nd:YAG modality was preferred by the patients.


Assuntos
Dermatoses Faciais/radioterapia , Lasers de Corante/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Satisfação do Paciente/estatística & dados numéricos , Rosácea/radioterapia , Método Duplo-Cego , Estética , Dermatoses Faciais/patologia , Dermatoses Faciais/fisiopatologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Qualidade de Vida , Medição de Risco , Rosácea/patologia , Rosácea/fisiopatologia , Índice de Gravidade de Doença , Resultado do Tratamento
16.
J Dermatol ; 46(4): 314-321, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30714633

RESUMO

Rosacea is a chronic inflammatory skin disorder whose pathophysiological mechanism remains largely unknown. Although recent studies have revealed the hypersensitivity of the skin towards chemical, thermal and biological stimuli, there is no direct molecular evidence suggesting the skin barrier is impaired in rosacea. In this study, we demonstrated that the mRNA levels of most claudins (CLDN), the main components of tight junctions determining the major barrier of the paracellular pathway between epithelial cells, were lowered in lesional skin of rosacea patients, especially with erythematotelangiectatic (ETR) and papulopustular (PPR) subtypes. Immunohistochemical analysis showed a significant decrease in the expression of CLDN1, CLDN3, CLDN4 and CLDN5 in the epidermis of ETR and PPR patients. However, the expression of other skin barrier genes, such as filaggrin, loricrin and keratin 10, was not altered. In vitro, various rosacea trigger factors reduced the protein levels of CLDN1, CLDN3 and CLDN5 in keratinocytes. Taken together, our results demonstrate a significant decrease in the expression of CLDN rather than other skin barrier genes, which may be associated with an impaired skin barrier responsible for the development of rosacea.


Assuntos
Claudinas/metabolismo , Epiderme/patologia , Rosácea/patologia , Adulto , Biópsia , Face , Feminino , Humanos , Queratinócitos/patologia , Pessoa de Meia-Idade , Junções Íntimas/patologia
17.
J Dermatol Sci ; 93(1): 58-64, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30658871

RESUMO

BACKGROUND: Rosacea is a chronic inflammatory skin condition whose etiology has been linked to mast cells and the antimicrobial peptide cathelicidin LL-37. Individuals with refractory disease have demonstrated clinical benefit with periodic injections of onabotulinum toxin, but the mechanism of action is unknown. OBJECTIVES: To investigate the molecular mechanism by which botulinum toxin improves rosacea lesions. METHODS: Primary human and murine mast cells were pretreated with onabotulinum toxin A or B or control. Mast cell degranulation was evaluated by ß-hexosaminidase activity. Expression of botulinum toxin receptor Sv2 was measured by qPCR. The presence of SNAP-25 and VAMP2 was established by immunofluorescence. In vivo rosacea model was established by intradermally injecting LL-37 with or without onabotulinum toxin A pretreatment. Mast cell degranulation was assessed in vivo by histologic counts. Rosacea biomarkers were analyzed by qPCR of mouse skin sections. RESULTS: Onabotulinum toxin A and B inhibited compound 48/80-induced degranulation of both human and murine mast cells. Expression of Sv2 was established in mouse mast cells. Onabotulinum toxin A and B increased cleaved SNAP-25 and decreased VAMP2 staining in mast cells respectively. In mice, injection of onabotulinum toxin A significantly reduced LL-37-induced skin erythema, mast cell degranulation, and mRNA expression of rosacea biomarkers. CONCLUSIONS: These findings suggest that onabotulinum toxin reduces rosacea-associated skin inflammation by directly inhibiting mast cell degranulation. Periodic applications of onabotulinum toxin may be an effective therapy for refractory rosacea and deserves further study.


Assuntos
Toxinas Botulínicas Tipo A/farmacologia , Degranulação Celular/efeitos dos fármacos , Eritema/tratamento farmacológico , Mastócitos/efeitos dos fármacos , Rosácea/tratamento farmacológico , Inibidores da Liberação da Acetilcolina , Animais , Peptídeos Catiônicos Antimicrobianos/administração & dosagem , Peptídeos Catiônicos Antimicrobianos/imunologia , Biópsia , Toxinas Botulínicas Tipo A/uso terapêutico , Degranulação Celular/imunologia , Células Cultivadas , Modelos Animais de Doenças , Eritema/imunologia , Eritema/patologia , Humanos , Injeções Intradérmicas , Mastócitos/imunologia , Camundongos , Camundongos Endogâmicos C57BL , Cultura Primária de Células , Rosácea/imunologia , Rosácea/patologia , Pele/citologia , Pele/imunologia , Pele/patologia , p-Metoxi-N-metilfenetilamina/farmacologia
18.
J Cosmet Laser Ther ; 21(3): 123-126, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29883220

RESUMO

BACKGROUND: Recently, treatment with acaricides, which is aimed at reducing excessive proliferation of demodex mites, has gained popularity due to its providing a significant improvement in the symptoms of diseases, such as rosacea, seborrhoeic dermatitis, and perioral dermatitis. The effect of IPL on demodex mites was reported in skin biopsy specimens in three patients; however, to the best of our knowledge, no study exists to date, which evaluates the effect of pulsed dye laser (PDL) on demodex density (Dd) in larger patient group. We aim here in to observe the Dd before and after PDL therapy with two different skin biopsy techniques. MATERIAL AND METHODS: Thirty-one patients diagnosed with rosacea were included in the study who received PDL treatment. Dds which were measured by using both the SSSB (standardized skin surface biopsy) and CTM (cellophane tape method) techniques before and after 3 weeks of PDL therapy were evaluated. RESULTS AND DISCUSSION: The Dd of patients before PDL treatment was 13.0 (interquartile range (IQR): 5.0-28.0) and after 3 weeks of PDL treatment it was 6.0 (IQR: 3.0-12.0) with SSSB. After PDL treatment, the Dd was significantly lower than pretreatment the Dd (p = 0.002). The present study shows that PDL significantly reduced Dd in facial skin with one session.


Assuntos
Dermatoses Faciais/cirurgia , Lasers de Corante/uso terapêutico , Ácaros/efeitos da radiação , Rosácea/cirurgia , Adulto , Animais , Biópsia/métodos , Face/patologia , Dermatoses Faciais/patologia , Feminino , Seguimentos , Humanos , Lasers de Corante/efeitos adversos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Rosácea/patologia , Pele/patologia , Estatísticas não Paramétricas , Resultado do Tratamento
19.
Lasers Med Sci ; 34(1): 93-98, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30097757

RESUMO

Various lasers have been used for the treatment of erythematotelangiectatic rosacea (ETR), facial erythema (FE), and facial telangiectasias (FT). The assessment of the treatments of all of these conditions with a 577-nm pro-yellow laser has not been reported yet. The aim of this work was to assess the efficacy and safety of the 577-nm pro-yellow laser in ETR, FE, and FT. Forty patients suffering from ETR, FE, and FT (25 female and 15 male) were enrolled in this study. All of the patients were treated with 577-nm pro-yellow laser (QuadroStarPRO YELLOW® Asclepion Laser Technologies, Germany) at 4-week intervals, for one to four sessions. The assessment of the treatment was made based on the digital photographs and the percentage of fading of the erythema and telangiectasias in the lesions. Significant clinical improvement (80-100%) was observed in the first or second sessions of the treatment in FE and ETR patients and in second and fourth sessions of the treatment in FT patients. The treatment was very well tolerated. No side effect was observed except for a few patients who had mild to moderate erythema fading away in 12-24 h. This case series has shown that the pro-yellow laser is a very effective, safe, and well-tolerated treatment for ETR, FE, and FT.


Assuntos
Eritema/cirurgia , Face/patologia , Face/cirurgia , Lasers , Rosácea/cirurgia , Telangiectasia/cirurgia , Adolescente , Adulto , Eritema/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Rosácea/patologia , Telangiectasia/patologia , Resultado do Tratamento , Adulto Jovem
20.
Acta Derm Venereol ; 99(1): 47-52, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-30226528

RESUMO

Papulopustular rosacea and demodicosis are characterized by non-specific symptoms, which can make clinical diagnosis difficult. This retrospective study of 844 patients assessed the diagnostic importance of clinical signs and symptoms that are poorly recognized as being associated with these conditions. In addition to well-known signs (vascular signs (present in 80% of patients), papules (39%), pustules (22%) and ocular involvement (21%)), other signs and symptoms (discreet follicular scales (93%), scalp symptoms (pruritus, dandruff or folliculitis; 38%) and pruritus (15%)) may also suggest a diagnosis not only of demodicosis, but also of papulopustular rosacea. Facial Demodex densities (measured by 2 consecutive standardized skin biopsies) were higher when ocular or scalp involvement was present, suggesting more advanced disease, but further investigations are needed to confirm this hypothesis. Recognition of these clinical signs and symptoms should encourage dermatologists to perform a Demodex density test, thus enabling appropriate diagnosis to be made.


Assuntos
Dermatoses Faciais/patologia , Infestações por Ácaros/patologia , Rosácea/patologia , Pele/patologia , Adulto , Idoso , Biópsia , Diagnóstico Diferencial , Face , Dermatoses Faciais/imunologia , Dermatoses Faciais/parasitologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infestações por Ácaros/imunologia , Infestações por Ácaros/parasitologia , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Rosácea/imunologia , Couro Cabeludo , Pele/imunologia , Pele/parasitologia
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