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****** DATA-MÉDICOS *********

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LA ROSÁCEA / THE ROSACEA

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***** DERMAGIC-EXPRESS No 14 ******

****** 06 NOVIEMBRE 1.998 ******* 

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EDITORIAL ESPAÑOL

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Amigos del Cyber, DERMAGIC los saluda de nuevo, LA ROSÁCEA, o ACNÉ ROSACEA, es el tema que revisé en estos días, EL METRONIDAZOL, sigue siendo una buena alternativa de tratamiento, ha sido sacado al mercado en crema al 1%, (NORITATE, Dermik Laboratories). Otra Casa, GenDerm tiene un producto, el NOVACET (Sulfacetamida sódica al 10% con azufre al 5% que demostró ser bastante útil en esta patología. Laser, isotretinoina, clindamicina, tetraciclinas, son otras alternativas. Estas 32 REFERENCIAS nos ilustran el tema.

como conocimiento general sobre la Rosácea te digo lo siguiente:

La rosácea es una enfermedad crónica de la piel que comúnmente afecta la cara. Se produce enrojecimiento, granos (barros o pústulas y pápulas), hinchazón y dilatación de pequeños vasos sanguíneos superficiales denominados telangiectasias. A menudo las zonas más afectadas son la nariz, las mejillas, la frente y el mentón. En casos severos, puede ocurrir una condición llamada "rinofima", en la cual la nariz se enrojece e hincha. Se desconoce la causa de la rosácea. Los factores de riesgo probablemente incluyen antecedentes familiares de la enfermedad. 

Los factores que pueden empeorar los síntomas incluyen el calor, el ejercicio, la luz solar, los resfriados, las comidas picantes, el alcohol, la menopausia, el estrés psicológico y el uso de cremas con esteroides en el rostro. El diagnóstico se basa en los síntomas. Para tratar la rosácea se utilizan antibióticos como la doxiciclina, la minociclina,las sulfas y tópicamente formulas magistrales. 

Desde una perspectiva tópica, también se ha descubierto que el metronidazol tópico - como lo explique - es muy útil para esta afección. Cuando hay afección ocular se deben utilizar gotas con antibióticos. 

Un buen jabón antiseborreico y un protector solar pueden ayudar muchísimo  en el tratamiento. Algunos autores dicen que no tiene cura, pero yo creo que con el tratamiento adecuado desaparecerá por completo. Dependiendo de los hábitos de cuidado facial del paciente, las recurrencias pueden ocurrir a largo  o corto plazo.

Amigos de la RED-DERMATOLÓGICA, hasta una nueva oportunidad.

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DERMAGIC/EXPRESS(14)

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LA ROSÁCEA / THE ROSACEA ======================================================================

1.) Rosaceous lymphedema: a rare variant of a common disorder. 

2.) Comparison of the long-pulse dye (590-595 nm) and KTP (532 nm) lasers

in the treatment of facial and leg telangiectasias. 

3.) Rhinophyma: treatment with CO2 laser. 

4.) [Rosacea with ocular involvement in a child] 

5.) Rosacea: recognition and management for the primary care provider. 

6.) The significance of Demodex folliculorum density in rosacea. 

7.) A study of the prevalence of Helicobacter pylori infection and other

markers of upper gastrointestinal tract disease in patients with rosacea. 

8.) Inflammatory cytokines in the tears of patients with ocular rosacea. 

9.) Rosacea: how to recognize and treat an age-related skin disease. 

10.) Topical metronidazole maintains remissions of rosacea. JUNIO 1.998

11.) Effective sunscreen ingredients and cutaneous irritation in patients with rosacea. 

12.) Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. 

13.) Ocular rosacea: patient characteristics and follow-up. 

14.) Cutaneous angiosarcoma of the face: clinicopathologic and

immunohistochemical study of a case resembling rosacea clinically. 

15.) A study on Demodex folliculorum in rosacea. 

16.) A double-blind, multicenter clinical trial comparing efficacy of

once-daily metronidazole 1 percent cream to vehicle in patients with rosacea. 

17.) The Demodex mite population in rosacea [see comments]

18.) Treatment of rosacea: topical clindamycin versus oral tetracycline.

19.) [Double-blind study versus excipient of 0.75% metronidazole gel in the treatment of rosacea]

20.) Oral spironolactone therapy in male patients with rosacea.

21.) Childhood rosacea.

22.) A clinical and histopathologic study of granulomatous rosacea.

23.) Flash lamp pumped dye laser for rosacea-associated telangiectasia and erythema.

24.) Topical metronidazole for severe and recalcitrant rosacea: a prospective open trial.

25.) An epidemiological study of rosacea.

26.) Isotretinoin treatment of rosacea.

27.) May Helicobacter pylori be important for dermatologists?

28.) Efficacy and safety of topical azelaic acid (20 percent cream): an overview of 

results from European clinical trials and experimental reports. (rosacea and acne)

29.) Ocular rosacea. Signs, symptoms, and tear studies before and after treatment with 

doxycycline [see comments]

30.) [Dapsone in granulomatous rosacea]

Dapson bei granulomatoser Rosazea.

31.) ROSACEA EN LA WEB: Noritate Available For Treatment Of Rosacea 

32.) ROSACEA EN LA WEB: Lotion Proven Safe, Effective For Rosacea 

====================================================

1.) Rosaceous lymphedema: a rare variant of a common disorder. 

====================================================

Author 

Harvey DT; Fenske NA; Glass LF 

Address 

Division of Dermatology and Cutaneous Surgery, University of South

Florida College of

Medicine 33612, USA. 

Source 

Cutis, 61(5):321-4 1998 Jun 

Abstract 

Rosaceous lymphedema is considered to be a rare and disfiguring

variant of acne rosacea.

Cases remain difficult to treat and can challenge afflicted patients

both cosmetically and

psychologically. We describe an unusual presentation of rosaceous

lymphedema and review

the differential diagnosis of persistent facial edema. 

====================================================

2.) Comparison of the long-pulse dye (590-595 nm) and KTP (532 nm) lasers

in the treatment of facial and leg telangiectasias. 

====================================================

Author 

West TB; Alster TS 

Address 

Washington Institute of Dermatologic Laser Surgery, Washington, DC, USA. 

Source 

Dermatol Surg, 24(2):221-6 1998 Feb 

Abstract 

BACKGROUND: Telangiectasias develop on the face secondary to genetic

predisposition,

chronic actinic damage, collagen vascular disease, topical steroid

application, and disorders

of vascular regulation including acne rosacea. Linear and "spider"

telangiectasias develop on

the legs, especially in women beginning in the second to third decade,

secondary to multiple

factors including genetic predisposition, gravity, pregnancy, and

trauma. OBJECTIVE: The

purpose of this investigation was to compare the 590- and 595-nm

long-pulse (1.5 msec)

dye laser and KTP (532 nm) laser in the treatment of facial and leg

telangiectasias.

RESULTS: For both facial and lower extremity telangiectasias, the

difference in improvement

ratings between the two lasers following both one and two treatment

sessions was statistically

significant. CONCLUSION: Both the flashlamp-pumped long-pulse dye

laser and the KTP

laser may play a role in the treatment of facial and leg

telangiectasias. However, when used to

treat vessels on the lower extremities, both of these laser systems

are probably best used in

conjunction with sclerotherapy of the larger "feeding" reticular

veins. While long-pulse dye

laser irradiation achieves superior vessel clearance, patients may

prefer multiple treatments

with the KTP laser due to its low side effect profile and decreased

associated pain. 

====================================================

3.) Rhinophyma: treatment with CO2 laser. 

====================================================

Author 

Lomeo P; McDonald J; Finneman J 

Address 

Department of Otolaryngology--Head and Neck, Mercy/General Health

Partners,

Muskegon, Michigan, USA. 

Source 

Ear Nose Throat J, 76(10):740-3 1997 Oct 

Abstract 

Rhinophyma is an acne rosacea which primarily affects the midface of

elderly men, and

causes disfigurement as well as obstruction. There are numerous ways

of treating this

condition and, in our institution, a CO2 laser is the treatment of

choice. 

====================================================

4.) [Rosacea with ocular involvement in a child] 

====================================================

Author 

Bourrat E; Rybojad M; Deplus S; Morel P 

Address 

Service de Dermatologie, H^opital Saint-Louis, Paris. 

Source 

Ann Dermatol Venereol, 123(10):664-5 1996 

Abstract 

INTRODUCTION: Rosacea ia an uncommon facial eruption in children. We

report a case

of rosacea associated with a specific episcleritis. CASE REPORT: A

10-year-old girl

consulted for an erythematous papular and pustular eruption of the mid

face of 1 month

duration. The child complained that she had had a red painful right

eye for 6 months. There

was no argument for acne, periorificial granulomatous dermititis or

for sarcoidosis. The

ophthalmological examination gave the diagnosis of ocular and

cutaneous rosacea. Oral

antibiotics followed by erythromycin gave favorable results for both

skin and ocular lesions.

DISCUSSION: Ocular involvement is a frequent complication of rosacea

in adults. It is

exceptional in children in whom rosacea is in itself rare. The

presence of blepharitis,

keratoconjunctivitis or episcleritis may suggest the diagnosis in a

child with a mid facial

eruption. As in the adult, skin and ocular rosacea responds well to

prolonged oral antibiotics.

The choice of the antibiotic depends on the age of the child. Cyclins

are not authorized in

children under the age of 8 years. 

====================================================

5.) Rosacea: recognition and management for the primary care provider. 

====================================================

Author 

Chalmers DA 

Address 

Integrated Cardiovascular Therapeutics, Woodbury, N.Y., USA. 

Source 

Nurse Pract, 22(10):18, 23-8, 30 1997 Oct 

Abstract 

Rosacea is a common facial dermatitis that currently affects an

estimated 13 million

Americans. It is a chronic and progressive cutaneous vascular

disorder, primarily involving

the malar and nasal areas of the face. Rosacea is characterized by

flushing, erythema,

papules, pustules, telanglectasia, facial edema, ocular lesions, and,

in its most advanced and

severe form, rhinophyma. Ocular lesions are common, including mild

conjunctivitis, burning,

and grittiness. Blepharitis, the most common ocular manifestation, is

a nonulcerative condition

of the lid margins. Rosacea most commonly occurs between the ages of

30 to 60, and may

be seen in women experiencing hormonal changes associated with

menopause. Women are

more frequently affected than men; the most severe cases, however, are

seen in men. Fair

complexioned individuals of Northern European descent are most likely

to be at risk for

rosacea; most appear to be pre-disposed to flushing and blushing.

Alcohol, stress, spicy

foods, and extremes of temperature have all been implicated, but have

not been found to

actually cause rosacea. Early diagnosis by the primary care

practitioner, management with

systemic antibiotics such as tetracycline, and topical agents such as

metronidazole, in

conjunction with patient education and lifestyle modifications, can

achieve remission in most

instances. 

====================================================

6.) The significance of Demodex folliculorum density in rosacea. 

====================================================

Author 

Erba¨gci Z; Ozg¨ozta¸si O 

Address 

Department of Dermatology, Faculty of Medicine, Gaziantep University,

Turkey. 

Source 

Int J Dermatol, 37(6):421-5 1998 Jun 

Abstract 

BACKGROUND: Demodex folliculorum has been reported in rosacea in a

number of

clinical studies. As the Demodex mite is also present in many healthy

individuals, it has been

suggested that the mite may have a pathogenic role only when it is

present in high densities.

Moreover, some authors have proposed that a mite density above 5/cm2

may be a criterion

for the diagnosis of inflammatory rosacea. In this study, the possible

role of D. folliculorum

and the importance of mite density in rosacea were investigated using

a skin surface biopsy

technique. METHODS: Thirty-eight patients with rosacea and 38

age-and-sex-matched

healthy subjects entered the study. With the skin surface biopsy

technique, we obtained

samples from three facial sites. We then determined the mite

positivities, the mean mite counts

in both study groups, the mean mite densities at each facial site and

in the rosacea subgroups,

and the mite densities above 5/cm2. RESULTS: The mean mite count in

the rosacea group

(6,684) was significantly higher than that in controls (2,868; p <

0.05). The cheek was the

most frequently and heavily infested facial region. Ten rosacea

patients and five normal

subjects had mite densities over 5/cm2; the difference was not

statistically significant (p >

0.05). CONCLUSIONS: Rosacea is a disease of multifactorial origin, and

individual

properties may modify the severity of the inflammatory response to

Demodex. We suggest

that a certain mite density is not an appropriate criterion in the

diagnosis of the disease;

nevertheless, large numbers of D. folliculorum may have an important

role in the pathogenesis

of rosacea, together with other triggering factors. 

====================================================

7.) A study of the prevalence of Helicobacter pylori infection and other

markers of upper gastrointestinal tract disease in patients with rosacea. 

====================================================

Author 

Sharma VK; Lynn A; Kaminski M; Vasudeva R; Howden CW 

Address 

Department of Internal Medicine, University of South Carolina School

of Medicine,

Columbia, USA. 

Source 

Am J Gastroenterol, 93(2):220-2 1998 Feb 

Abstract 

OBJECTIVE: Recent reports have suggested that patients with rosacea, a

chronic

inflammatory skin disorder of unknown etiology, have an increased

prevalence of

Helicobacter pylori infection. However, no causal relation has been

identified. This study was

designed to determine the prevalence of H. pylori infection and upper

gastrointestinal

symptoms in rosacea patients and in subjects without chronic skin

disorders. METHODS:

Forty-five patients with rosacea and 43 healthy subjects underwent

serological testing for H.

pylori infection. Demographics, gastrointestinal symptoms, and

medication use were recorded

using a structured questionnaire. RESULTS: There was no significant

difference in the

seroprevalence of H. pylori infection between rosacea patients and

healthy subjects (26.7%

vs 34.9%; p = 0.40). Significantly more patients with rosacea

complained of indigestion

(66.7% vs 32.6%; p = 0.001) and used antacids (60% vs 32.6; p = 0.01).

There was no

significant difference in the prevalence of H. pylori infection

between symptomatic and

asymptomatic rosacea patients, or in those using antacids. There were

no differences in the

frequency of heartburn, history of peptic ulcer disease, family

history of peptic ulcer disease,

use of H2-receptor antagonists, or use of nonsteroidal

antiinflammatory drugs.

CONCLUSIONS: Patients with rosacea have similar rates of H. pylori

infection as healthy

subjects. Rosacea patients complain significantly more frequently of

"indigestion" and use

more antacids unrelated to H. pylori infection. 

====================================================

8.) Inflammatory cytokines in the tears of patients with ocular rosacea. 

====================================================

Author 

Barton K; Monroy DC; Nava A; Pflugfelder SC 

Address 

Ocular Surface and Tear Center, Bascom Palmer Eye Institute,

University of Miami School

of Medicine, Florida, USA. 

Source 

Ophthalmology, 104(11):1868-74 1997 Nov 

Abstract 

OBJECTIVE: The purpose of the study is to compare tear fluid

concentrations of

interleukin-1alpha (IL-1alpha), tumor necrosis factor-alpha

(TNF-alpha), and epidermal

growth factor (EGF) in ocular rosacea with those in control subjects

and to examine the

relation between tear functions, such as production and clearance

rate, and the

concentrations of cytokines in tear fluid. PARTICIPANTS AND INTERVENTION:

Fourteen patients with severe meibomian gland disease, facial rosacea,

and symptoms of

ocular irritation were examined for ocular surface disease, tear

production, and tear clearance

rate (TCR). Twelve control subjects, frequency-matched for age, and 15

ideal normal

subjects with no ocular symptoms and normal tear function were

assessed using the same

parameters. Minimally stimulated tear samples (20 microl) were drawn

from each subject and

analyzed using a sandwich enzyme-linked immunosorbent assay to detect

IL-1alpha,

TNF-alpha, and EGF. RESULTS: Tear IL-1alpha concentration was

significantly higher in

patients with rosacea than in age-matched (P = 0.003) and ideal

control subjects (P <

0.001). Tumor necrosis factor-alpha was not detected in patients or

control subjects,

indicating levels of less than 10 pg/ml. Epidermal growth factor was

not significantly higher in

patients with rosacea than in age-matched control subjects. Tear

turnover LN(TCR) was

lower in patients with rosacea than in both age-matched (P = 0.048)

and ideal control

subjects (P = 0.002). Schirmer I scores were statistically lower in

patients with rosacea than

in ideal control subjects (P = 0.013), but not age-matched control

subjects.

Interleukin-1alpha was correlated inversely with LN(TCR) (r= -0.58, P

< 0.0001) and

Schirmer I (r = -0.39, P = 0.012). CONCLUSIONS: Concentrations of

IL-1alpha are

present in normal tears but are elevated in ocular rosacea, whereas

TNF-alpha is not present

in either case. The reduced tear turnover, LN(TCR), its inverse

correlation with IL-1alpha,

and the absence of TNF-alpha in the tears of these patients suggest

that the increased

concentration of IL-1alpha observed may be largely because of

clearance failure of cytokine

normally produced at the ocular surface. 

====================================================

9.) Rosacea: how to recognize and treat an age-related skin disease. 

====================================================

Author 

Litt JZ 

Address 

Case Western Reserve University School of Medicine, Cleveland, OH, USA. 

Source 

Geriatrics, 52(11):39-40, 42, 45-7 1997 Nov 

Abstract 

Rosacea is an age-related disorder of the central portion of the

facial skin whose peak onset

occurs in persons in their 40s and 50s. A chronic and progressive

condition of flare-ups and

remissions, rosacea can be disfiguring if left untreated. Rosacea can

be characterized as

having three stages. Target areas for all symptoms include the cheeks,

nose, chin, or

forehead. Rosacea resembles a number of other dermatologic conditions,

particularly acne

vulgaris. The combination of oral and topical antibiotic therapy

usually brings about remission.

The key is to recognize the early signs and clinical picture so that

accurate diagnosis can be

made and therapy and counseling instituted. 

====================================================

10.) Topical metronidazole maintains remissions of rosacea. 

====================================================

Author 

Dahl MV; Katz HI; Krueger GG; Millikan LE; Odom RB; Parker F; Wolf JE

Jr; Aly R;

Bayles C; Reusser B; Weidner M; Coleman E; Patrignelli R; Tuley MR;

Baker MO;

Herndon JH Jr; Czernielewski JM 

Address 

Department of Dermatology, University of Minnesota, Minneapolis, USA. 

Source 

Arch Dermatol, 134(6):679-83 1998 Jun 

Abstract 

BACKGROUND: Rosacea is a chronic skin disease that requires long-term

therapy. Oral

antibiotics and topical metronidazole successfully treat rosacea.

Because long-term use of

systemic antibiotics carries risks for systemic complications and

adverse reactions, topical

treatments are preferred. OBJECTIVE: To determine if the use of

topical metronidazole gel

(Metrogel) could prevent relapse of moderate to severe rosacea.

DESIGN: A combination

of oral tetracycline and topical metronidazole gel was used to treat

113 subjects with

rosacea (open portion of the study). Successfully treated subjects (n

= 88) entered a

randomized, double-blind, placebo-controlled study applying either

0.75% topical

metronidazole gel (active agent) or topical metronidazole vehicle gel

(placebo) twice daily

(blinded portion of the study). SETTING: Subjects were enrolled at 6

separate sites in large

cities at sites associated with major medical centers. SUBJECTS: One

hundred thirteen

subjects with at least 6 inflammatory papules and pustules, moderate

to severe facial

erythema and telangiectasia entered the open phase of the study.

Eighty-eight subjects

responded to treatment with systemic tetracycline and topical

metronidazole gel as measured

by at least a 70% reduction in the number of inflammatory lesions.

These subjects were

randomized to receive 1 of 2 treatments: either 0.75% metronidazole

gel or placebo gel.

INTERVENTIONS: Subjects were evaluated monthly for up to 6 months to

determine

relapse rates. MAIN OUTCOME MEASURES: Inflammatory papules and

pustules were

counted at each visit. Relapse was determined by the appearance of a

clinically significant

increase in the number of papules and pustules. Prominence of

telangiectases and dryness

(roughness and scaling) were also observed. RESULTS: In the open

phase, treatment with

tetracycline and metronidazole gel eliminated all papules and pustules

in 67 subjects (59%).

The faces of 104 subjects (92%) displayed fewer papules and pustules

after treatment, and

82 subjects (73%) exhibited less erythema. In the randomized

double-blind phase, the use of

topical metronidazole significantly prolonged the disease-free

interval and minimized

recurrence compared with subjects treated with the vehicle. Eighteen

(42%) of 43 subjects

applying the vehicle experienced relapse, compared with 9 (23%) of 39

subjects applying

metronidazole gel (P<.05). The metronidazole group had fewer papules

and/or pustules after

6 months of treatment (P<.01). Relapse of erythema also occurred less

often in subjects

treated with metronidazole (74% vs 55%). CONCLUSION: In a majority of

subjects

studied, continued treatment with metronidazole gel alone maintains

remission of moderate to

severe rosacea induced by treatment with oral tetracycline and topical

metronidazole gel. 

====================================================

11.) Effective sunscreen ingredients and cutaneous irritation in patients with rosacea. 

====================================================

Author 

Nichols K; Desai N; Lebwohl MG 

Address 

Department of Dermatology, Mount Sinai School of Medicine, New York,

New York,

USA. 

Source 

Cutis, 61(5):344-6 1998 Jun 

Abstract 

Patients with rosacea are particularly susceptible to the irritation

caused by sunscreen

ingredients. The purpose of this bilateral comparison study was to

examine the effects of

different ingredients found in sunscreen on facial cutaneous irritancy

in patients with rosacea.

patients clinically diagnosed with rosacea were asked to test

different preparations of

common sunscreens on their faces. The results show that the presence

or absence of

appropriate protective ingredients, such as dimethicone and

cyclomethicone in the vehicle,

may prevent irritation from other sunscreen ingredients in patients

with inflammatory

conditions such as rosacea. 

====================================================

12.) Capillaropathy and capillaroneogenesis in the pathogenesis of rosacea. 

====================================================

Author 

Neumann E; Frithz A 

Address 

Department of Dermatology, S¨odersjukhuset, Stockholm, Sweden. 

Source 

Int J Dermatol, 37(4):263-6 1998 Apr 

Abstract 

BACKGROUND: Dilatation of vascular vessels in rosacea has generally

been attributed to

yielding to deranged connective tissue. In contrast, in a previous

study a degrading effect of

insufficient vascular vessels in connective tissue has been

demonstrated in connection with

diabetic microangiopathy. In yet another paper, it was demonstrated

that the fusing of

damaged capillaries, which had lost part of their adjacent walls due

to functional inadequacy,

led to the formation of dilated vessels. These pathogenetic patterns

are the main subjects of

this study of rosacea. METHODS: Punch biopsies from rosacea lesions

were examined by

light microscopy and immunochemistry in order to identify structural

changes leading to the

formation of telangiectasias. RESULTS: Deranged connective tissue is

secondary to

damaged capillaries. The primary damage may be evoked mostly by

environmental

influences, mainly the sun. CONCLUSIONS: Infections, infestations, and

granulomatous

formations are not primary in the development of rosacea. 

====================================================

13.) Ocular rosacea: patient characteristics and follow-up. 

====================================================

Author 

Akpek EK; Merchant A; Pinar V; Foster CS 

Address 

Department of Immunology, Massachusetts Eye and Ear Infirmary, Boston

02114, USA. 

Source 

Ophthalmology, 104(11):1863-7 1997 Nov 

Abstract 

PURPOSE: The purpose of this report is to review the presenting

symptoms and signs,

treatment regimens used, complications encountered, and outcome in a

cohort of patients

with ocular rosacea. METHODS: The medical records of 131 patients with

a diagnosis of

ocular rosacea were reviewed retrospectively. Data were entered in a

tabulated form, and a

descriptive analysis was performed. RESULTS: The age range at

presentation was between

23 and 85 years (mean, 56 years). Cutaneous manifestations of rosacea

were present in 112

of the patients at their first visit. The most common presenting

symptoms were foreign body

sensation and burning, and the most common signs were telangiectasia

and irregularity of lid

margins, and meibomian gland dysfunction. Thirteen patients had

decreased visual acuity at

the time of presentation due to corneal complications. Six of these

patients required

penetrating keratoplasty during the course of their disease. Seven

patients had severe

cicatrizing conjunctivitis at the time of referral. One hundred

thirteen patients were treated

with oral tetracycline derivatives. Seven patients were left with

visual acuity less than 20/400,

and one patient underwent enucleation for corneal perforation and

endophthalmitis.

CONCLUSIONS: Ocular rosacea is a common disease involving the skin and

the eyes. It is

widely underdiagnosed by many ophthalmologists despite the blinding

potential. Successful

therapy requires a multidisciplinary approach. 

====================================================

14.) Cutaneous angiosarcoma of the face: clinicopathologic and

immunohistochemical study of a case resembling rosacea clinically. 

====================================================

Author 

Mentzel T; Kutzner H; Wollina U 

Address 

Institute of Pathology, University of Jena, Germany. 

Source 

J Am Acad Dermatol, 38(5 Pt 2):837-40 1998 May 

Abstract 

An unusual cutaneous angiosarcoma resembling rosacea clinically is

described. A

66-year-old man presented with a red discoloration and a diffuse

swelling on his nose over a

2-year period that was diagnosed as rosacea. Despite antiinflammatory

treatment, the

infiltration increased and, after repeated skin biopsies, the

diagnosis of a well-differentiated

cutaneous angiosarcoma associated with a prominent inflammatory

infiltrate was considered.

The neoplasm was treated by surgery. The described case emphasizes

that diffuse swelling

and rosacea-like clinical features should be added to the variably

clinical features of

cutaneous angiosarcoma. 

====================================================

15.) A study on Demodex folliculorum in rosacea. 

====================================================

Author 

Abd-El-Al AM; Bayoumy AM; Abou Salem EA 

Address 

Department of Dermatology, Faculty of Medicine, Al-Azhar University,

Nasr City, Cairo. 

Source 

J Egypt Soc Parasitol, 27(1):183-95 1997 Apr 

Abstract 

A random sample of 16 female patients suffering from papulopustular

rosacea (PPR) as well

as (16) normal female healthy subjects as control group were adopted

in this study to assess

of Demodex folliculorum pathogenesis. It was done through

determination of mite density

using a standard skin surface biopsy 10.5 cm2 from different

designated 6 areas on the face,

and scanning electron microscopic study (SEM) as well as total IgE

estimation. A trial of

treatment using Crotamiton 10% cream with special program was also

attempted. All

subjects ranged between 35-55 years old. All patients with rosacea and

15 of the control

group i.e. 75.93% were found to harbour mites. The mean mite counts by

site distribution

were 28.6 & 6.9 on the cheeks, followed by 14.5 & 3.0 on the forehead

and lastly 6.8 &

0.8 on the chin in PPR and control groups respectively. The total mean

mite count in patients

was 49.9 initially and 7.9 after treatment. In the control group it

was 10.7 & 10.6

respectively. The mean total IgE was 169.4 & 168.4 and 96.3 & 98.4 in

PPR and control

groups respectively Light and scanning electron microscopy revealed

that all mites were

pointing in one direction. Some of them were containing bacteria

inside their gut and on their

skin. After treatment 3 cases (18.75%) were completely cured, 10 cases

(62.5%) gave

moderate response while 3 cases (18.75) have no response. In

conclusion, this study

supports the pathogenic role of D. folliculorum in rosacea. 

====================================================

16.) A double-blind, multicenter clinical trial comparing efficacy of

once-daily metronidazole 1 percent cream to vehicle in patients with rosacea. 

====================================================

Author 

Breneman DL; Stewart D; Hevia O; Hino PD; Drake LA 

Address 

Dermik Laboratories, Inc., Collegeville, Pennsylvania 19426-1200, USA. 

Source 

Cutis, 61(1):44-7 1998 Jan 

Abstract 

The efficacy and safety of a new formulation of metronidazole 1

percent cream applied once

daily was compared to vehicle cream in a double-blind, randomized,

parallel group,

ten-week clinical study. The results showed that metronidazole 1

percent cream was

significantly better than vehicle in reducing the lesions of rosacea,

improving erythema, and

physician's global rosacea scores. The incidence of adverse events

related to the skin was

low. 

====================================================

17.) The Demodex mite population in rosacea [see comments]

====================================================

CM - Comment in: J Am Acad Dermatol 1994 May; 30(5 Pt 1):812-3

SO - J Am Acad Dermatol 1993 Mar;28(3):443-8

AU - Bonnar E; Eustace P; Powell FC

AD - University Department of Ophthalmology, Mater Misercordiae Hospital, Dublin, Ireland.

MJ - Acne Rosacea [parasitology]; Mites; Skin [parasitology]

MN - Acne Rosacea [drug therapy]; Adult; Aged, 80 and over; Aged; Face; Middle Age; Tetracycline [therapeutic use]

MT - Animal; Female; Human; Male

PT - JOURNAL ARTICLE

AB - BACKGROUND: The cause of rosacea is unknown; among other factors a causative role has been postulated for the hair follicle mites Demodex folliculorum and Demodex brevis. OBJECTIVE: Our purpose was to compare the population density of Demodex mites in facial skin of defined categories of patients with rosacea with control subjects. We also assessed the impact of tetracycline therapy on the mite population. METHODS: The population density and distribution of Demodex mites were studied in the facial skin of 42 patients with rosacea and 42 age- and sex-matched control subjects. Mites were counted in measured skin surface biopsy specimens obtained from six standard facial sites with cyanoacrylate glue. RESULTS: The mean mite count was 49.8 (range 2 to 158) in patients with rosacea and 10.8 (range up to 97) in control subjects (p 0.001); the highest density of mites was found on the cheeks. A statistically significant increase in mites was found in all subgroups of rosacea, being most marked in those with steroid-induced rosacea. Mite counts in patients with rosacea before and after a 1-month course of oral tetracycline showed no significant difference. CONCLUSION: Increased mites may play a part in the pathogenesis of rosacea by provoking inflammatory or allergic reactions, by mechanical blockage of follicles, or by acting as vectors for microorganisms.

====================================================

18.) Treatment of rosacea: topical clindamycin versus oral tetracycline.

====================================================

SO - Int J Dermatol 1993 Jan;32(1):65-7

AU - Wilkin JK; De Witt S

AD - Department of Medicine, Ohio State University.

MJ - Acne Rosacea [drug therapy]; Clindamycin [analogs & derivatives]; Tetracycline [therapeutic use]

MN - Administration, Cutaneous; Administration, Oral; Adult; Aged; Clindamycin [therapeutic use]; Double-Blind Method; Follow-Up Studies; Middle Age

MT - Comparative Study; Human; Support, Non-U.S. Gov't

PT - CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

AB - BACKGROUND. A new topical antibiotic preparation, clindamycin in a lotion base, was compared with oral tetracycline in the treatment of rosacea. Forty-three patients clinically diagnosed as having rosacea were examined in an investigator-blinded study. METHODS. Patients used topical clindamycin lotion applied twice daily or the usual oral dose of tetracycline hydrochloride (250 mg four times a day for 3 weeks, then 250 mg twice a day for the remaining 9 weeks). Patients' lesions were examined clinically at 3-week intervals over a period of 12 weeks. RESULTS. Topical clindamycin treatment produced similar clinical results to oral tetracycline and was superior in the eradication of pustules. CONCLUSIONS. These results show topical clindamycin in a lotion base to be a safe and effective alternative to oral tetracycline therapy in the treatment of rosacea.

====================================================

19.) [Double-blind study versus excipient of 0.75% metronidazole gel in the treatment of rosacea]

====================================================

TT - [Etude en double insu contre excipient du metronidazole gel a 0.75 p. 100 dans le traitement de la rosacee.]

SO - Ann Dermatol Venereol 1993;120(2):129-33

AU - Espagne E; Guillaume JC; Archimbaud A; Baspeyras M; Boitier F; Bussiere M; Chamberlin J; Coin A; Di Crescenzo MC; Dolivo M; et al

AD - Groupe d'Essais Therapeutiques en Pratique de Ville, Hopital Henri Mondor, Creteil.

MJ - Acne Rosacea [drug therapy]; Metronidazole [therapeutic use]

MN - Administration, Topical; Adult; Double-Blind Method; Excipients; Gels; Metronidazole [administration & dosage]; Placebos

MT - Comparative Study; Female; Human; Male

MC - English Abstract

PT - CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

AB - INTRODUCTION. The proven value of tetracyclines and metronidazole administered orally in the treatment of the chronic and recurrent disease that is rosacea is tempered by the important undesirable effects observed in long-term therapy. The purpose of this study was to test the effectiveness of an 0.75 p. 100 metronidazole gel in the treatment of rosacea. PATIENTS AND METHODS. The study involved two groups of patients: one received the metronidazole gel and the other the vehicle of the gel used as placebo. The multicentre randomized trial was conducted in the double-blind fashion by 18 private dermatologists working in the Paris region. Fifty one patients who, since more than 3 months, had been presenting with rosacea, defined as at least 4 papulopustules associated with erythema and/or telangiectasia, entered the trial. Topical treatments and systemic treatments which had shown some activity against rosacea had been interrupted for 15 days or 2 months respectively. The product (or the placebo) was applied a.m. and p.m. on the whole dry face. The patients were seen on days 0, 21 and 42. The evaluation was purely clinical, and the principal criterion of judgement was a change in the number of papulopustules between days 0 and 42. RESULTS. The metronidazole gel reduced the number of papulopustules between day 0 and day 42, and this reduction was significantly greater than that observed with the excipient alone. The active product began to be effective during the third week and remained so during the next three weeks. Both the metronidazole gel and its excipient seemed to be poorly tolerated, with frequent complaints of dry skin, but in 5 women of the metronidazole group this dryness was alleviated by application of moisturizers. CONCLUSION. This study has demonstrated that the 0.75 p. 100 metronidazole gel is effective in the treatment of the papulopustular component of rosacea.

====================================================

20.) Oral spironolactone therapy in male patients with rosacea.

====================================================

SO - J Dermatol 1992 May;19(5):293-7

AU - Aizawa H; Niimura M

AD - Department of Dermatology, Jikei University School of Medicine, Tokyo, Japan.

MJ - Acne Rosacea [drug therapy]; Spironolactone [administration & dosage]

MN - Acne Rosacea [blood]; Administration, Oral; Adult; Middle Age; Sebaceous Glands [drug effects]; Sex Hormones [blood]; Spironolactone [pharmacology]

MT - Human; Male

PT - JOURNAL ARTICLE

AB - Spironolactone at 50 mg/day was orally administered for four weeks to 13 male patients with rosacea in order to observe its clinical effectiveness. Serum estradiol (E2), 17OH-progesterone (17OH-P4), testosterone (T), androstenedione (delta 4 A), dihydrotestosterone (DHT), dehydro-epiandrosterone sulfate (DHEA-S) were measured prior to and after treatment. Although there were no significant changes in T, delta 4A, DHT, or DHEA-S, the serum levels of 17OH-P4 increased significantly. E2 tended to increase, although the change was not significant. Two of the 13 patients discontinued spironolactone treatment because of general malaise, but seven of the remaining eleven patients exhibited an improvement in their rosacea. These findings demonstrate that a low dose of spironolactone is effective in the treatment of rosacea in some male patients and suggest that it is possible that changes in the metabolism of sex steroid hormones such as cytochrome p-450 isozymes have some bearing on the etiology of rosacea.

====================================================

21.) Childhood rosacea.

====================================================

SO - Pediatr Dermatol 1992 Mar;9(1):22-6

AU - Drolet B; Paller AS

AD - Department of Pediatrics and Dermatology, Children's Memorial Hospital, Northwestern University Medical School, Chicago, Illinois.

MJ - Acne Rosacea

MN - Acne Rosacea [diagnosis] [drug therapy]; Antibiotics [therapeutic use]; Child

MT - Case Report; Female; Human; Male

PT - JOURNAL ARTICLE

AB - Rosacea usually occurs in adults and rarely has been noted in children. We recently observed three children with rosacea, all of whom responded dramatically to systemic and topical antibiotics. Rosacea in childhood must be distinguished from other erythematous facial disorders, most commonly acne, granulomatous perioral dermatitis, and sarcoidosis. The distribution of facial lesions; the presence of telangiectasias, flushing, and pustules; and the appearance of lesional biopsy sections and the ocular lesions, if present, allow differentiation of rosacea from other facial eruptions.

====================================================

22.) A clinical and histopathologic study of granulomatous rosacea.

====================================================

SO - J Am Acad Dermatol 1991 Dec;25(6 Pt 1):1038-43

AU - Helm KF; Menz J; Gibson LE; Dicken CH

AD - Department of Dermatology, Mayo Clinic, Rochester, MN 55905.

MJ - Acne Rosacea [pathology]

MN - Acne Rosacea [drug therapy]; Aged, 80 and over; Aged; Blister [pathology]; Elastic Tissue [pathology]; Erythema [pathology]; Folliculitis [pathology]; Granuloma [drug therapy] [pathology]; Histiocytes [pathology]; Lymphocytes [pathology]; Middle Age; Retrospective Studies; Single-Blind Method; Skin Aging [pathology]; Skin [blood supply] [pathology]; Telangiectasis [pathology]

MT - Female; Human; Male

PT - JOURNAL ARTICLE

AB - A retrospective clinical and histopathologic study of 53 patients with granulomatous rosacea was undertaken. The patients had a broad clinical spectrum of lesions that ranged from primarily erythema to papulonodular lesions. Extrafacial lesions occurred in 15% of patients. Histologic examination showed mixed lymphohistiocytic inflammation (primarily lymphocytic inflammation in 40% of patients and primarily histiocytic with a few giant cells in 34%), epithelioid granulomas in 11% of patients, and epithelioid granulomas with caseation necrosis in 11%. Most patients had a good response to oral antibiotic therapy. Granulomatous rosacea is not a distinct disease but can be regarded and treated as a subtype of rosacea.

====================================================

23.) Flash lamp pumped dye laser for rosacea-associated telangiectasia and erythema.

====================================================

SO - J Dermatol Surg Oncol 1991 Jun;17(6):522-5

AU - Lowe NJ; Behr KL; Fitzpatrick R; Goldman M; Ruiz-Esparza J

MJ - Acne Rosacea [complications]; Erythema [surgery]; Laser Surgery; Telangiectasis [surgery]

MN - Adult; Aged; Erythema [etiology]; Middle Age; Prognosis; Telangiectasis [etiology]

MT - Female; Human; Male

PT - JOURNAL ARTICLE

AB - The persistence of facial telangiectasis and erythema in patients with rosacea frequently presents a major cosmetic problem. It may also contribute to relapses of papular and pustular lesions. This study of 27 patients treated for their telangiectasia and erythema with a flash lamp pumped dye laser tuned at 585 nm is described. The laser gave good or excellent reduction of telangiectasia and erythema and overall appearance in 24 of the patients with between one and three treatments. In addition, papule and pustule activity was decreased in 59.2% of the patients, with those with the most severe pre-treatment activity having the most significant improvement. It is suggested that this is a useful additional form of treatment that may improve the telangiectasia and erythematous component of rosacea.

====================================================

24.) Topical metronidazole for severe and recalcitrant rosacea: a prospective open trial.

====================================================

SO - Cutis 1989 Mar;43(3):283-6

AU - Lowe NJ; Henderson T; Millikan LE; Smith S; Turk K; Parker F

AD - Department of Dermatology, UCLA School of Medicine.

MJ - Acne Rosacea [drug therapy]; Metronidazole [administration & dosage]

MN - Administration, Topical; Adult; Aged; Clinical Trials; Facial Dermatoses [drug therapy]; Middle Age; Prospective Studies

MT - Female; Human; Male; Support, Non-U.S. Gov't

PT - CLINICAL TRIAL; JOURNAL ARTICLE

AB - Nineteen patients with severe or recalcitrant rosacea were treated twice daily with 0.75 percent metronidazole topical gel in an open label study. Sixteen of the patients (84 percent) showed 50 percent or greater reduction in inflammatory lesions, while fifteen (79 percent) demonstrated a reduction in erythema severity and an improvement when evaluated by the investigator global assessment. No positive response was recorded for any patient prior to topical medication, whereas six of nine patients previously treated with tetracycline/minocycline demonstrated improvement. Seven of these nine patients responded to topical metronidazole treatment. One additional patient who did not respond to minocycline or desonide treatment showed a good response to topical metronidazole. Only one patient reported local irritation after using metronidazole. These results demonstrate that topical metronidazole gel is safe and effective for the treatment of severe or recalcitrant rosacea.

====================================================

25.) An epidemiological study of rosacea.

====================================================

SO - Acta Derm Venereol 1989;69(5):419-23

AU - Berg M; Liden S

AD - Department of Dermatology, Karolinska Sjukhuset, Stockholm, Sweden.

MJ - Acne Rosacea [epidemiology]; Facial Dermatoses [epidemiology]

MN - Acne Rosacea [classification]; Adult; Facial Dermatoses [classification]; Middle Age; Sweden

MT - Female; Human; Male; Support, Non-U.S. Gov't

PT - JOURNAL ARTICLE

AB - In a non-selected population of 809 office employees (454 women and 355 men) 81 persons were diagnosed as having rosacea, giving a prevalence of 10% (women 14%, men 5%). The rosacea group was compared with the rest of the study population. Most of the cases were rather mild. The rosacea was of an erythematotelangiectatic type in 81% of the cases and of a papulopustular type in 19%. Unilateral lesions were found in 11 subjects (14%). Only 17% of those with rosacea were impaired by sunlight, whereas 26% improved. In the rosacea group, 27% were found to suffer from migraine and 42% from a tendency to flush, compared with 13% (p less than 0.001) and 16% (p less than 0.001) respectively in the comparison group. Flushing and the regulatory mechanism of the blood vessels thus seem to be of importance in the pathogenesis of rosacea. Individuals with good pigmentation ability showed a tendency to a decreased occurrence of rosacea. The frequency of eye complaints was the same in the two groups.

====================================================

26.) Isotretinoin treatment of rosacea.

====================================================

SO - Acta Derm Venereol 1987;67(1):89-91

AU - Turjanmaa K; Reunala T

MJ - Acne Rosacea [drug therapy]; Tretinoin [therapeutic use]

MN - Adult; Aged; Follow-Up Studies; Isomerism; Middle Age; Nasal Mucosa [drug effects]; Recurrence; Time Factors; Tretinoin [adverse effects]; Xerostomia [chemically induced]

MT - Female; Human; Male

PT - JOURNAL ARTICLE

AB - Twenty patients with severe rosacea were treated with isotretinoin for 3-6 months. Six patients initially received 1.0 mg/kg and 14 patients 0.5 mg/kg of isotretinoin. The response was good or excellent in all patients and the papulopustular lesions in particular cleared promptly. Patients receiving 1.0 mg/kg of isotretinoin experienced more side-effects and the dose had to be lowered in five of the six patients. Seventeen of the 20 patients had no relapses during a follow-up of one year showing that isotretinoin has a long-lasting favourable effect in rosacea.

====================================================

27.) May Helicobacter pylori be important for dermatologists?

====================================================

AU: Rebora-A; Drago-F; Parodi-A

AD: Department of Dermatology, University of Genoa, Italy.

SO: Dermatology. 1995; 191(1): 6-8

ISSN: 1018-8665

PY: 1995

LA: ENGLISH

CP: SWITZERLAND

AB: Helicobacter pylori, a microaerophilic gram-negative bacterium, is the major cause of gastritis, plays a key role in the etiology of peptic ulcer and is a risk factor for gastric cancer. Although 50% of the population is affected, dermatologist seem to be unaware of the impact H. pylori may have on cutaneous pathology. Among skin diseases, H. pylori has been related so far only with chronic urticaria and rosacea. In rosacea, histology of the stomach mucosa revealed tht 84% of 31 patients were H. pylori positive. Twenty percent of them were serologically negative, but, overall, 100% of the 20 patients with both histology and serology were H. pylori positive with either test. The consistency between clinical success with metronidazole and abatement of H. pylori isolates and serology after treatment was an additional evidence suggesting an etiologic relationship between rosacea and H. pylori infection. Rosacea has often been linked with gastrointestinal disturbances. H. pylori, therefore, may link them to the well-known beneficial activity of metronidazole on rosacea lesions. The role of H. pylori is more probable in erythrotic rosacea than in its papulopustular and granulomatous stages. As in Bacillus subtilis intoxication, a flush-inducing toxin cannot be excluded. Despite the difficulty to find patients accepting bioptic gastroscopies, large case-control studies should be done before a causal relationship with urticaria and rosacea is firmly established.

====================================================

28.) Efficacy and safety of topical azelaic acid (20 percent cream): an overview of 

results from European clinical trials and experimental reports.

====================================================

AU: Graupe-K; Cunliffe-WJ; Gollnick-HP; Zaumseil-RP

AD: Department of Clinical Development, Schering AG, Berlin, Germany.

SO: Cutis. 1996 Jan; 57(1 Suppl): 20-35

ISSN: 0011-4162

PY: 1996

LA: ENGLISH

CP: UNITED-STATES

AB: Azelaic acid cream (20 percent) is a new topical treatment for acne with an additional therapeutic potential in rosacea and hyperpigmentation disorders. Azelaic acid (AzA; HOOC-(CH2)7-COOH) is a naturally occurring compound that interferes with acne pathogenesis by virtue of its antikeratinizing, antibacterial, and anti-inflammatory properties. Vehicle-controlled studies have verified that AzA exercises a significant and clinically relevant effect on both non-inflammatory and inflammatory acne lesions. Comparisons with clinically proven therapies have shown that 20 percent AzA cream is an effective monotherapy in mild to moderate forms of acne, with an overall efficacy comparable to that of tretinoin (0.05 percent), benzoyl peroxide (5 percent), and topical erythromycin (2 percent). In the treatment of moderate to severe acne, 20 percent AzA cream may be favorably combined with minocycline (90 percent good and excellent results), and may contribute towards reducing recurrences following discontinuation of systemic therapy (maintenance therapy with AzA cream). Particular advantages of AzA therapy include its favorable safety and side effect profile. It is non-teratogenic, is not associated with systemic adverse events or photodynamic reactions, exhibits excellent local tolerability, and does not induce resistance in Propionibacterium acnes.

====================================================

29.) Ocular rosacea. Signs, symptoms, and tear studies before and after treatment with 

doxycycline [see comments]

====================================================

Quarterman MJ; Johnson DW; Abele DC; Lesher JL Jr; Hull DS; Davis LS

Department of Medicine, Medical College of Georgia, Augusta, USA.

Arch Dermatol (UNITED STATES) Jan 1997 133 (1) p49-54 ISSN: 0003-987X

Note: Comment in: Arch Dermatol 1997 Jan;133(1 ):89-90

Language: ENGLISH

Document Type: CLINICAL TRIAL; JOURNAL ARTICLE 

Journal Announcement: 9705

Subfile: AIM; INDEX MEDICUS

OBJECTIVE: To examine ocular signs, symptoms, and results of tear analysis in 

patients with cutaneous rosacea before, during, and after doxycycline therapy. 

DESIGN: Before-after trial. SETTING: General community. PATIENTS OR OTHER 

PARTICIPANTS: Thirty-nine patients with cutaneous rosacea underwent dermatologic and 

ocular examinations, testing of tear break-up time, and Schirmer testing at baseline 

and 4, 8, and 12 weeks. Six patients did not complete the study. Baseline tear 

break-up time and results of Schirmer test were compared with those of 13 patients 

without rosacea who were matched for age and sex. INTERVENTION: Patients with 

rosacea were given doxycycline, 100 mg daily for 12 weeks. MAIN OUTCOME MEASURE: 

Statistically significant (P, .05) improvement in tear break-up time. RESULT: The 

most frequent ocular symptoms were dryness, itching, blurred vision, and 

photosensitivity, all of which improved significantly with treatment. All patients 

had signs of ocular disease, most commonly erythema and telangiectasia, meibomian 

gland dysfunction, and ciliary base injection. Significant improvement (P,.05) for 

scales, erythema and telangiectasia, ciliary base injection, bulbar injection, 

papillary hypertrophy, and punctate epithelial erosions was seen. Average tear break-

up time for the patients with rosacea was 5.7 seconds, which improved to 10.8 seconds 

after 12 weeks of treatment (P = .007). Baseline tear break-up time was 

significantly lower than for the comparison group of normal subjects (P = .001). 

There was no correlation between severity of cutaneous disease and ocular disease. 

CONCLUSIONS: All patients with cutaneous rosacea had some degree of ocular 

involvement. Tear break-up time is abnormal in patients with rosacea. Ocular 

erythema and telangiectasia, meibomian gland dysfunction, and short tear break-up 

time in patients with cutaneous rosacea are indicators of ocular rosacea. 

Doxycycline, 100 mg daily, will improve ocular disease and increase the tear break-up 

time.

====================================================

30.) [Dapsone in granulomatous rosacea]

Dapson bei granulomatoser Rosazea.

====================================================

Krause MH; Torricelli R; Kundig T; Trueb RM; Hafner J

Dermatologische Klinik und Poliklinik, Universitatsspital, Zurich.

Hautarzt (GERMANY) Apr 1997 48 (4) p246-8 ISSN: 0017-8470

Language: GERMAN Summary Language: ENGLISH

Document Type: 

JOURNAL ARTICLE English Abstract

Journal Announcement: 9709

Subfile: INDEX MEDICUS

We report on two patients with granulomatous rosacea and another patient with 

granulomatous perioral dermatitis who responded well to dapsone. Dapsone has a 

pharmacological double function as both an antibiotic and an antiphlogistic drug. 

Before the introduction of isotretinoin, dapsone had its place in the treatment of 

severe acne. To date, its use in granulomatous rosacea has not been described. When 

hematologic parameters are monitored, dapsone is considered a safe and cost-effective 

drug, especially in countries where isotretinoin is not readily available. However, 

the definite value of dapsone in granulomatous rosacea should be established by a 

controlled study.

====================================================

31.) Noritate Available For Treatment Of Rosacea 

====================================================

NEW YORK, NY -- January 22, 1998 -- Dermik Laboratories, Inc., has

announced the availability of Noritate(TM) (metronidazole cream) Cream, 1%,

the first prescription topical rosacea therapy cleared for once-daily dosing in

the treatment of inflammatory lesions and erythema (facial redness) associated

with the condition.

Cleared for marketing by the United States Food and Drug Administration

(FDA), this new treatment has been shown in studies to significantly reduce

inflammatory lesions of rosacea in as little as four weeks with minimal skin

dryness and irritation at the site of application. Rosacea is a chronic,

inflammatory skin disorder that affects an estimated 13 million Americans.

"The rapid efficacy, unique approval for once-a-day dosing and erythema

indication make Noritate an exciting new therapeutic option for patients with

rosacea," said Joseph Jorizzo, MD, chair of the department of dermatology,

Wake Forest University School of Medicine, who conducted clinical studies on

the product. "The once-daily dosage, in particular, is a major benefit that offers

an exciting opportunity that may improve patient compliance."

Rosacea therapies should become part of a patient's daily routine and be

consistently followed in order to manage the condition. According to Dr.

Jorizzo, daily regimens that are difficult to follow, time consuming or

inconvenient, may prevent patients from complying with their treatment. 

"Compliance has been a significant problem in treating rosacea," Dr. Jorizzo

said. "Patients are often reluctant to commit to complex treatment programs

and want a simplified routine."

Rosacea is a condition characterized by excessive redness and accompanied

by papules and pustules on the cheeks, chin, nose and forehead. Often

mistaken for acne, rosacea is most prevalent among fair-skinned women

between the ages of 30 and 50, but tends to be more severe when present in

men. It is frequently triggered or exacerbated by extreme temperatures, spicy

foods, alcoholic beverages, exercise and stress. The often embarrassing

condition rarely reverses itself and cannot be cured, but it can be controlled

with regular treatment.

Most of the 13 million Americans affected by rosacea are women, and many

who suffer from the condition may be concerned about their appearance

because of the unpredictable and unsightly flushing.

====================================================

32.) Lotion Proven Safe, Effective For Rosacea 

====================================================

LINCOLNSHIRE, Ill., June 5, 1997 -- A topical lotion used successfully for

years to treat acne has recently been proven effective and safe for treating

rosacea, a chronic skin disease. The study appears in the June issue of Journal

of Dermatological Treatment.

Rosacea is a chronic skin disease characterized by facial redness affecting the

nose, cheeks and chin. Approximately five percent of the U.S. population suffer

from the disease, which has disfigured the noses of individuals such as W.C.

Fields and J.P. Morgan.

"This study verifies what a growing number of dermatologists and other

physicians already know," says Scott B. Phillips, M.D., principal author of the

study. "The combination of sodium sulfacetamide and sulfur is a safe and

effective treatment for rosacea." Dr. Phillips is a dermatologist and clinical

assistant professor at the University of Chicago Hospitals.

Sodium sulfacetamide and sulfur are ingredients found in Novacet(R) Lotion

(sodium sulfacetamide 10 percent and sulfur 5 percent), a prescription

medication approved for the treatment of acne from GenDerm Corporation.

The vehicle controlled, double-blind study tested 103 patients suffering from

rosacea. Patients who used Novacet showed significant improvement with an

83 percent reduction in erythema (facial redness) and 78 percent decrease in

inflammatory lesions by the eighth week of the study.

Rosacea typically appears after age 30 and affects more women than men. In

the early stages of the disease, facial flushing or blushing will appear and

disappear. As the disease progresses, small red or pus-filled bumps appear.

These "bumps" are often mistaken for acne. For some individuals, the nose and

cheeks may appear puffy, and thick, knobby bumps may develop on the nose.

While there is no cure for rosacea, it can be controlled with early medical

treatment and lifestyle modification, such as avoiding spicy foods, reducing

one's stress, or not spending extended periods of time under the hot sun.

A variety of prescription medications are available for treating rosacea. These

include the use of oral and topical antibiotics, topical sulfur medications, laser

treatments or surgery.

For information about a free brochure called "Rosacea: The More You

Know...," people can call toll-free by dialing 888-278-4545. Or write to

Rosacea Help Line, 600 Knightsbridge Parkway, Lincolnshire, Illinois 60069. 

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DATA-MEDICOS/DERMAGIC-EXPRESS No.(14) 06/11/98 DR. JOSE LAPENTA R. DERMATOLOGO 

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