Articles: rosacea.
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The pathogenesis of rosacea - a common, chronic inflammatory skin disease mainly affecting the central portions of the face - is only partly understood. In affected skin the expression of cathelicidin - an antimicrobial peptide and effector of innate immunity - is strongly increased. In addition, the activity of cutaneous proteases is greatly increased leading to the generation of cathelicidin peptide fragments with pro-inflammatory activity. ⋯ Retinoids, azelaic acid and doxycycline inhibit both skin proteases and TLR expression and could mediate their anti-inflammatory effects in rosacea through these mechanisms. These data increase our understanding of the pathogenesis and therapy of rosacea. Also, these insights might uncover novel targets for innovative therapies of this common, stigmatizing skin disease.
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Review Meta Analysis
Effective and evidence-based management strategies for rosacea: summary of a Cochrane systematic review.
Rosacea is a common chronic skin disease affecting the face. There are numerous treatment options, but it is unclear which are the most effective. The aim of this review was to assess the evidence for the efficacy and safety of treatments for rosacea. ⋯ One study reported that ciclosporin ophthalmic emulsion was significantly more effective than artificial tears for treating ocular rosacea. Although the majority of included studies were assessed as being at high or unclear risk of bias, there was some evidence to support the effectiveness of topical metronidazole, azelaic acid and doxycycline (40mg) in the treatment of moderate to severe rosacea, and ciclosporin 0·05% ophthalmic emulsion for ocular rosacea. Further well-designed, adequately powered randomized controlled trials are required.
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Erythematotelangiectatic rosacea is a frequent condition and affected patients benefit from medical treatments and dermatological procedures but also a complementary dermocosmetic assistance that aims at obtaining optimal skin comfort and preventing irritation of these particularly overreactive skins. Choice of dermocosmetics is crucial - especially in respect to their texture and the simplicity in ingredients - in order to optimize the application of the products and their tolerance. The addition of soothing and decongestant active ingredients is particularly important. Finally, photoprotection and a specific medical make-up are useful to attenuate the unattractive appearance of « red faces ».
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Rosacea is a common disfiguring skin disease of primarily Caucasians characterized by central erythema of the face, with telangiectatic blood vessels, papules and pustules, and can produce skin thickening, especially on the nose of men, creating rhinophyma. Rosacea can also produce dry, itchy eyes with irritation of the lids, keratitis and corneal scarring. The cause of rosacea has been proposed as over-production of the cationic cathelicidin peptide LL-37. ⋯ Anionic polysaccharides, exemplified by SAGEs, offer potential as novel mechanism-based therapies for rosacea and by extension other LL-37-mediated and RAGE-ligand driven skin diseases.
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Rosacea is a common chronic skin condition affecting the face, characterised by flushing, redness, pimples, pustules, and dilated blood vessels. The eyes are often involved and thickening of the skin with enlargement (phymas), especially of the nose, can occur in some patients. A range of treatment options are available but it is unclear which are the most effective. ⋯ Although the majority of included studies were assessed as being at high or unclear risk of bias there was some evidence to support the effectiveness of topical metronidazole, azelaic acid, and doxycycline (40 mg) in the treatment of moderate to severe rosacea, and cyclosporine 0.5% ophthalmic emulsion for ocular rosacea. Further well-designed, adequately-powered randomised controlled trials are required.