Facial Dermatoses Research Articles

52740 Prevalence, infestation rate and characteristics of Demodex positivity among patients with facial dermatoses attending Dermato-venereology Clinic Northern Tanzania

52740 Prevalence, infestation rate and characteristics of Demodex positivity among patients with facial dermatoses attending Dermato-venereology Clinic Northern Tanzania

Clinical trial of two-step photodynamic therapy for reduced pain in the treatment of precancerous squamous lesions (Actinic keratoses)

BackgroundPain associated with aminolevulinic acid photodynamic therapy (ALA-PDT) for the treatment of facial dermatoses results in low patient compliance. Two-step photodynamic therapy (two-step PDT) may improve comfort by optimizing light amplitude and exposure time. ObjectiveTo investigate the efficacy of two-step PDT in reducing the pain generated during the treatment of facial skin disorders. MethodsTwenty-six patients with AK were randomly divided into two groups; the experimental group was treated with two-step photodynamic therapy and the control group was treated with conventional photodynamic therapy. The pain intensity of the patients at different times was assessed using the pain numerical rating scale (NRS). ResultsA total of 26 patients completed three ALA-PDT treatments, 13 and 13 patients in each group, respectively. The mean NRS scores of patients in the experimental group (3.28±1.41, 3.33±1.43, 3.42±1.78) were lower than those of the control group (5.00±1.94, 5.09±1.86, 4.86±1.64) on each occasion. The incidence of certain adverse reactions was lower in the experimental group than in the control group. There was no difference between the two groups in terms of clinical outcome, recurrence rate and patient satisfaction. ConclusionTwo-step photodynamic therapy can reduce pain and the incidence of some adverse reactions, but does not affect clinical efficacy, recurrence rate and patient satisfaction.

Photodynamic therapy for facial dermatosis papulosa nigra: Efficacy and safety in a preliminary study

Dermatosis papulosa nigra (DPN) is a type of benign epidermal hyperplasia that affects the appearance of patients and poses a threat to their physical and mental health. Photodynamic therapy (PDT) has been shown to have the advantages of non-invasiveness, efficacy, and low recurrence in the treatment of skin disorders. However, no studies have been reported on the use of PDT for the treatment of DPN. Therefore, we used PDT for the first time to treat DPN and monitor its efficacy. Forty-five patients with DPN diagnosed at the outpatient clinic of Changzhou First People's Hospital were treated with 10 % 5-aminolevulinic acid (ALA) once a week for four consecutive weeks and followed for 3 months. After four treatment sessions, the cure rate among the 45 patients was 71.1 %, and the overall efficacy rate was 93.3 %. The most common adverse reactions were mild erythema, edema, and temporary pigmentation. PDT is expected to become a new and effective treatment for DPN.

Beyond the Surface: Understanding Demodex and Its Link to Blepharitis and Facial Dermatoses.

Demodex represents the most frequent ectoparasite found in humans. Although Demodex mites are considered commensals of human pilosebaceous units, an abnormally high mite density can cause several ocular and cutaneous symptoms and signs, sometimes to a severe degree. Both Demodex spp. (folliculorum and brevis) play a significant part in eye pathology and facial dermatoses. These mites have been related to blepharitis, ocular rosacea, meibomian gland dysfunction and various skin diseases, including rosacea, demodicosis and seborrheic dermatitis. Understanding the importance of Demodex in both eye and skin conditions is crucial for accurate diagnosis and appropriate management strategies, which may involve targeted treatments to control the mite population and reduce associated symptoms.

Demodex folliculorum (Trombidiformes: Demodecidae) infestation in medical students with facial dermatoses and healthy groups.

Demodex folliculorum (Simon, 1842) has been associated with various dermatological conditions. This study aimed to assess the prevalence of Demodex infestation in medical students with facial dermatoses compared with healthy medical students serving as controls. A total of 250 participants were enrolled, including 150 individuals with facial dermatoses and 100 healthy controls. Sampling was performed based on the standardized skin surface biopsy method. Demographic characteristics, specifically gender and age, were not statistically different between the patient and control groups. Among the facial dermatosis patients, 25 out of 150 (16.6%) were found to have Demodex infestation, while only three out of the 100 healthy controls (3%) exhibited infestations. The only identified species was D. folliculorum. The rates of Demodex infestation were significantly higher in the patients compared to the control groups. These findings indicate a higher prevalence of Demodex infestation among medical students with facial dermatosis, particularly in those diagnosed with folliculitis, acne vulgaris, and inflammatory papule, when compared to healthy controls. A better understanding of the relationship between D. folliculorum infestation and these dermatological conditions may lead to improved diagnostic and treatment strategies in the future.

Efficacy of Low-Dose Isotretinoin in the Treatment of Rosacea: A Systematic Review and Meta-Analysis.

Rosacea is a common cutaneous condition caused by persistent, recurring lesions in facial skin vessels. It is a chronic skin condition with a variety of clinical symptoms and an unknown cause. Rosacea begins with the widening of capillaries and a flushed appearance. Following that, telangiectasia appears, and reddened patches persist, particularly on the cheeks and nose. Erythema persists due to repeated vasodilationand telangiectasia. In addition, skin inflammation manifests as papules, pustules, lymphedema, and fibrosis. Despite recent advances in treatment, rosacea, a chronic inflammatory relapsing central facial dermatosis, can be extremely difficult to manage. The purpose of this meta-analysis and systematic review was to evaluate the effectiveness of low-dose isotretinoin in the treatment of rosacea. Following the guidelines set forth by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA), the researcher employed the following search terms in the EMBASE, Web of Science, PubMed, Cochrane Library, and Google Scholar databases to provide a therapeutic update relevant to clinical practice: "low dose isotretinoin," "isotretinoin and rosacea," "isotretinoin treatment of rosacea," and "effectiveness of isotretinoin in treating rosacea". The search was carried out by the researcher for articles published from February 2019 to February 2024. The articles included were all published in the English language. The overall frequency of patients with adverse events differed significantly between the groups treated with low-dose isotretinoin and the comparators(minocycline, pulsed dye laser, evening primrose oil, Lactobacillus plantarum, doxycycline, combined dose or placebo) (0.80, 95% CI 0.73 to 0.88, p = 0.0001). Sub-group analysis indicated that there was a difference between the interventions used in the treatments all in favor of low-dose isotretinoin treatment. The results showed that the moderate group had RR: 0.76, 95% CI: 0.44-1.30, I2 = 0%;the mild group had RR: 0.94, 95% CI: 0.56-1.57, I2 = 0%;and the group with severe rosacea had RR: 0.73, 95% CI: 0.47-1.13, I2 = 0%. According to this study, rosacea can be treated effectively with low-dose isotretinoin even in patients at severe stages of the disease by using the recommended dose once a week. Further, the intervention has also been shown to have fewer side effects on the patients. Therefore, this study recommends randomized controlled trials to be done to fully investigate the best combination options for isotretinoin on mild to severe rosacea based on the fact that some of the treatments combined have shown to be effective on treatment.

Facial Segmental Infantile Haemangioma: A Cutaneous Mosaicism Quandary.

Mosaicism has long been considered the underlying mechanism of segmental infantile hemangiomas (SIH). This was a prospective pilot case-control study conducted with the objective to quantify the percentage overlap of silhouettes of facial SIH with those of Blaschko lines (the most well studied archetypical pattern of mosaicism on face) as compared to other mosaic disorders on face. Lesional silhouettes of 8 patients with SIH (Group A) and 6 patients with other facial dermatosis known to have blaschkoidal distribution (Group B), were overlapped on a standardized template with Blaschkoidal lines on the frontal view of face. The alignment was done via the auto align tool of Photoshop and the percentage of overlap was calculated with an online image comparison software (IMGonline.com.ua). There was a significant difference in mean overlap in Group A (72.92 ± 15.6 %) as compared to Group B (90.1 ± 4.3%; P=0.018). Hence, we concluded that facial SIH do not follow lines of Blaschko.

Lupus Miliaris Disseminatus Faciei – A Rare Facial Dermatosis Successfully Treated with Dapsone: A Case Report

Lupus Miliaris Disseminatus Faciei – A Rare Facial Dermatosis Successfully Treated with Dapsone: A Case Report

Facial Dermatoses Associated With Mask-Wearing in the COVID-19 Era: A Nationwide, Cross-Sectional, Multicenter, Questionnaire-based Study.

Daily usage of facial masks during coronavirus disease 2019 pandemic influenced on facial dermatoses. This study investigated the impact of mask-wearing habits on facial dermatoses. A nationwide, observational, questionnaire-based survey was conducted from July through August 2021, involving 20 hospitals in Korea. Among 1,958 facial dermatoses, 75.9% of patients experienced aggravation or development of new-onset facial dermatoses after wearing masks. In aggravated or newly developed acne patients (543 out of 743), associated factors were healthcare provider, female gender, and a long duration of mask-wearing. Irritating symptoms, xerosis, and hyperpigmentation were more frequently observed in this group. Aggravated or newly developed rosacea patients (515 out of 660) were likely to be female, young, and have a long duration of mask-wearing per day. Seborrheic dermatitis patients who experienced aggravation or de novo development (132 out of 184) were younger, and they more frequently involved the chin and jaw in addition to the nasolabial folds and both cheeks. Contact dermatitis patients (132 out of 147) with aggravation or de novo development tended to be female, involve both cheeks, and complain of pruritus. Aggravated or newly developed atopic dermatitis patients (165 out of 224) were more likely to be female, and had a higher baseline investigator global assessment score before mask-wearing. Clinical features and factors related to aggravation were different according to the types of facial dermatoses.

Comparison of Patch Test Results Before and After Mask Use in Patients With Facial Dermatoses

Comparison of Patch Test Results Before and After Mask Use in Patients With Facial Dermatoses

Dermoscopy of Inflammatory Dermatoses (Inflammoscopy) in Skin of Color - A Systematic Review by the International Dermoscopy Society "Imaging in Skin of Color" Task Force.

Dermoscopic patterns of inflammatory dermatoses (inflammoscopy) have been extensively studied in the recent years, though data on patients with darker phototypes (IV-VI) are sparse. The aims of this systematic review were to summarize the current state of knowledge on inflammoscopy applied to skin of color and provide a standardized nomenclature of reported findings. Besides dermoscopic features, type of setting and magnification, number of cases, and histopathological correlation were analyzed. Eighty-five papers addressing 78 different dermatoses (25 papulosquamous dermatoses, 19 hyperpigmented dermatoses, eight hypopigmented dermatoses, four granulomatous dermatoses, two sclerotic dermatoses, five facial inflammatory dermatoses, and 15 miscellaneous conditions) for a total of 2073 instances were retrieved. Only one study showed a level of evidence of III (cross-sectional study), whereas 10 and 74 displayed a level of evidence of IV (case-control studies) and V (case-series and case-reports), respectively. Moreover, our analysis also highlighted that most of papers focalized on a limited number of dermatoses, with several conditions having only single dermoscopic descriptions. Additionally, few studies compared findings among phototypes belonging to the "skin of color" spectrum. Further studies designed according to a systematic approach and considering the above-mentioned issues are therefore needed.

Mask-related Facial Dermatoses in an Asian Pediatric Population in the Era of COVID-19 Pandemic: A Cross-sectional Study

Abstract Introduction: Mask-related dermatoses have been widely reported in adults since the global COVID-19 pandemic. Compulsory mask wearing has been mandated in many countries. As pediatric dermatologists, we aim to characterize different types of mask-related dermatoses in the pediatric population, evaluate the prevalence, and potential exacerbating and mitigating factors to improve compliance in children in this era of regular mask wearing. Methods: We conducted a cross-sectional study from November 1, 2020, to January 31, 2021, at a tertiary hospital in the form of an anonymous online questionnaire. This included all children aged (2–20 years old) in our pediatric dermatology clinics, tertiary education students (16–20 years old), and children of hospital/health-care cluster staff (2–20 years old). Results: Of the 577 participants who reported regular mask wearing, 140 (24.3%) reported symptoms. The most common symptoms were itching (74.5%), dryness (49.6%), dyspnea (32.1%), and oily skin (29.9%). The most common rashes were acne (48.9%), eczema (27%), dryness/peeling (23.4%), urticaria (18.2%), and cheilitis (16.8%). The most statistically significant risk factors for developing mask-related symptoms and/or rashes were (a) prolonged duration of mask wearing/day and (b) preexisting dermatoses and/or atopic history (especially atopic dermatitis). Conclusions: As the pediatric population remains vulnerable to emerging COVID-19 variants and other respiratory viruses, masks remain an important form of protection in daily life. Like in adults, regular mask wearing can lead to various facial symptoms/dermatoses in pediatric wearers, adding to dermatological burden during a pandemic. Those with preexisting risk factors should be made aware of this. We recommend all pediatric mask wearers should not exceed continuous mask wearing for 4 h and to take scheduled “mask breaks” in safe, well-ventilated areas.

Current practices and perceived effectiveness of polynucleotides for treatment of facial erythema by cosmetic physicians.

Polynucleotides (PN) are increasingly used for the treatment of facial erythema in the Republic of Korea. However, there are limited pre-clinical and clinical data on the efficacy of polynucleotides for facial erythema. In this study, we investigated the current practice and perceived effectiveness of polynucleotide treatment for facial erythema among cosmetic physicians. By conducting a survey among clinicians who use PN in clinical practice, we explored the current practices and assessed the perceived effectiveness of polynucleotides in treating facial erythema. A total of 557 physicians who used polynucleotides for facial erythema participated in the survey. Polynucleotides were used by 84.4%, 66.4%, and 47.4% of physicians for facial erythema caused by inflammatory facial dermatosis, repeated laser/microneedle radiofrequency, and steroid overuse, respectively. Among those users, 88.1%, 90%, and 83.7% respectively in those same categories answered that polynucleotides were "highly effective" or "effective." Furthermore, they agreed that polynucleotides have the following properties: wound healing/regeneration (95.8%), protection of skin barrier (92.2%), hydration (90.5%), vascular stabilization (81.0%), and anti-inflammation (79.5%). Our findings showed that cosmetic physicians in the Republic of Korea have used PN as a part of combination treatment for facial erythema resulting from inflammatory facial dermatosis and repeated laser/ microneedle radiofrequency, rather than from steroid overuse. Also, most clinicians agreed that PN was effective for treatment of facial erythema. Given the lack of pre-clinical and clinical trial evidence, the empirical responses of practicing physicians provide useful information to guide clinical practice and further research.

Long-term benefits of a therapeutic make-up consultation for patients with various facial dermatoses.

Therapeutic make-up has previously been proven to be efficacious in improving the quality of life of patients with facial dermatoses, but its efficacy has only been assessed in the short term (less than one month). This study aimed to determine whether the effect of therapeutic make-up on patients' quality of life persists in the longer term, i.e., after one year. This study included 53 patients who benefited from a therapeutic make-up consultation in the context of various facial dermatoses (pigmentation disorders, scars, acne, rosacea, eczema, adverse events of chemotherapy, etc.). Patients were asked to complete a quality-of-life questionnaire to obtain the Skindex score at baseline, and one month (M1) and one year (M12) after the first consultation. The difference in scores between baseline and M12 was calculated and Student's t-test was used to assess the significance of the values. Our results showed a significant difference (p<0.001) with an improvement in quality-of-life score by more than 10% between baseline and M12, for all the dimensions of the score (Emotion, Symptoms and Functioning). Based on the subgroup analysis, this score particularly improved for patients suffering with acne or rosacea (p=0.009) and scars (p=0.43), as well as for younger patients (<30years old) (p=0.009). This is the first study to demonstrate a persistent long-term effect of therapeutic make-up on the quality of life of patients with facial dermatoses.

Papulpustular dermatoses of the face, clinicopathological spectrum and response to treatment

The papulopustular rash on face may be a feature of several inflammatory skin disorders. Clinical features may provide clue to the etiology whereas microbiological testing and histopathologic examination confirm the diagnosis. In adults, facial papulopustular dermatoses include rosacea, perioral dermatitis, eosinophilic folliculitis, infections and medication induced. Our aim was to study variable causes of papulopustular lesions of the face. We conducted a prospective study which included 60 dermatology outpatient clinic patients of variable age groups whom presented with papulopustular lesions involving the face and review their clinicopathological findings as well as their response to therapy. Several diseases were reported including rosacea (47%), demodecosis (20%), bacterial folliculitis (13%), drug induced (7%) and periorificial dermatitis (3%). One case of tinea barbae, pityriosporum folliculitis, eosinophilic folliculitis, lupus miliaris disseminatus faciei, Behcet's disease and perforating folliculitis were reported. In conclusions; Papulopustular dermatoses involving the face are an important problem among dermatology patients with an overlapping in signs and symptoms. Awareness of various causes and their clincopathological features is important for accurate diagnosis and proper management.

Enhanced Antibacterial Activity of Piper betle Extract Niosome Serum Gel and Its Irritation Effects

Masks are personal protective equipment essential for COVID-19 prevention, but for the use of masks has led to an increase in the severity of both acne (maskne) and rosacea (mask rosacea). Long-time mask-wearing can increase acne’s flare by modifying the cutaneous facial microenvironment and triggering facial dermatoses. To minimize this, the skin needs to be protected by using an antibacterial product. This study aimed to develop and determine the antibacterial effect of Piper betle extract in niosome serum gel and its irritation effect. 5% Piper betle extract was formulated into a niosome system and incorporated into the serum gel with varying concentrations of 30%, 40%, and 50%. The niosome system was characterized by particle size, Polydispersity Index (PI), zeta potential, and pH value, and then evaluated physicochemical properties for niosome serum gel preparation. Further, the antibacterial effect against Propionibacterium acne, Staphylococcus aureus, and Staphylococcus epidermidis was tested using a well-diffusion test. The preparation stability was evaluated using freeze-thaw methods, and the irritation test was assessed using the HET-CAM (Hen’s Egg Chorioallantoic Membrane) method. The results showed that the preparation has a good physicochemical, while the best inhibition zone diameter was 7,29±0,21; 7,77±0,12; and 8,24±0,40, against P.acne, respectively. However, the results of the stability test of the preparation showed a significant change in the pH but had no irritation effect on CAM. It can concluded that the niosome serum gel of Piper betle extract has a potential antibacterial impact for acne, especially against P. acne.&#x0D; Keywords: Piper betle, Niosome serum gel, antibacterial effect, stability, irritation effect

The dermoscopic characteristics of melasma in relation to different skin phototypes, distribution patterns and wood lamp findings: a cross-sectional study of 236 melasma lesions.

Melasma is an acquired, pigmentary disorder characterized by the appearance of brown to bluish-gray patches with well-demarcated or ill-defined borders, most commonly on the face. This challenging hyperpigmentation disorder is generally observed in women; sun exposure, pregnancy, oral contraceptive use, genetic influences and chemical agents are some etiopathogenetic factors. Even though readily diagnosed by clinical examination; dermoscopy, Wood lamp findings and histopathology may also help the clinicians to confirm the diagnosis and to disclose the features of the melasma such as melanin depth and melasma type. In our study, we aimed to investigate the dermoscopic properties of facial melasma in accordance with different skin phototypes, age, distribution patterns, presence of other facial dermatoses, etiological factors and wood lamb findings. In the present cross-sectional study, patients clinically diagnosed with facial melasma in a secondary care hospital were included. Demographical data, personal history, distribution patterns of the melasma, dermoscopic features, Wood lamp examination findings, the presence of any other facial dermatosis, possible underlying risk factors and skin phototypes were determined. One hundred fifty nine patients with a total number of 236 melasmas with variable distribution patterns were included. The mean age was 37.91years, whereas the mean age at the onset of the melasma was 32.43years. One hundred thirty three participants were females, whereas 26 were males. The most prevalent risk factors of melasma were exposure to UV light (62.2%), pregnancy (50.6%) and genetic predisposition (43.6%). The most common melasma localization was cheek (43.6%) followed by T zone (33.1%). The most common dermoscopic findings were brown reticular pseudonetwork (73.3%), increased vascularity and telangiectasia (51.7%) and brown clods (33.1%). Brown reticular pseudonetwork was present at a higher rate in patients with skin phototype V compared to the ones with skin phototype II (p = 0.033). Our study shows that dermoscopic findings of melasma may differ across different skin phototypes, melasma localizations, possible associated risk factors and age.

IRRATIONAL USE OF TOPICAL STEROIDS FOR FACIAL DERMATOSES- A PROSPECTIVE STUDY.

Background: Topical corticosteroids (TCs) are potent anti-inammatory medications that provide rapid symptomatic relief. Over-the-counter (OTC) availability of TCs and their unsupervised usage are responsible for various cutaneous adverse effects like rosacea, acneiform eruptions, demodicosis, etc. These are more pronounced over the face as the skin is relatively thin and sensitive. They are more difcult to treat and cause much more distress to patients than the primary conditions for which TCs were used. To ascertain the demographics, frequency, duration, Aim: underlying conditions, and the cutaneous adverse effects of misuse of TCs over face in a tertiary care center in Krishna district. Materials &amp; Methods: This was a prospective, observational, cross-sectional study done in a tertiary care center over a span of three months. Data was obtained from a self-constructed questionnaire, entered using MS Excel, and analyzed. A tot Results: al of 72 patients with cutaneous adverse effects following TCs abuse over the face were included in a span of three months. Most of them were females (80.56%) and the common age group was 19-28 years (47.22%). The commonest source of recommendation for TCs was- OTC without prescription (70.83%) and the average duration of usage was 1-6 months. The common underlying condition for which TCs were misused was complexion improvement (38.89%), followed by infection, and acne. The commonest adverse effects were pruritus (90.28%) and acneiform eruption (63.89%). The other adverse effects include irritation, spread of infection, topical steroid-dependent face (TSDF), altered morphology of existing lesions, etc. TCs misuse over Conclusion: face is being increasingly recognized as the cause for difcult-to-treat facial dermatoses. It can be addressed by increasing awareness about their adverse effects and by giving specic treatment based on the underlying condition

What do Patients Want to See on Social Media? Evidence From a Two-Year Experiment.

Dermatological information on social media is dominated by misleading and potentially harmful content from nonexperts. Literature suggests that, to address this issue, dermatologists should develop an online presence. However, the successful presence of dermatologists on social media has been criticized for focusing on cosmetic dermatology and not representing the broad spectrum of the specialty. The aim of this study was to systematically analyze which dermatological topics interest the public most, and to find out whether it is feasible for a dermatologist to become influential on social media while presenting all dermatological topics equally. The study was performed on an educational dermatology YouTube channel. The 101 videos published in a two-year period were divided into cosmetic (51 videos) and medical dermatology (50 videos). Student's t-test was conducted to determine whether there were significant differences in views. Medical dermatology videos were then classified into three categories: Acne, facial dermatoses (excluding acne) and other dermatological diseases. A Kruskal-Wallis test was used to compare these three categories and cosmetic dermatology. When comparing cosmetic and medical dermatology, no significant differences were found. When comparing the four categories, cosmetic dermatology and acne were found to generate significantly more views that other dermatological diseases. The public seems to be particularly interested in cosmetic dermatology and acne. This might make it challenging to become successful on social media while presenting a balanced portrayal of dermatology. However, focusing on popular topics can provide a real chance to be influential and protect vulnerable people from misinformation.

The Psychosocial Impact of Chronic Facial Dermatoses in Adults.

Skin diseases have negative psychological and social consequences, especially when they are chronic and affect a visible area of the body, such as the face. The purpose of this study is to investigate and compare the psychosocial impact of three common chronic dermatoses of the face: acne, rosacea, and seborrheic dermatitis. The Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and Social Appearance Anxiety Scale (SAAS) were used to compare acne, rosacea, and seborrheic dermatitis patients and healthy controls. The relationships between DLQI, HADS, and SAAS results were investigated, as well as their associations with disease duration and severity. The study included 166 acne patients, 134 rosacea patients, 120 seborrheic dermatitis patients, and 124 controls. The patient groups had significantly higher DLQI, HADS, and SAAS scores than the control group. Rosacea patients had the highest DLQI and SAAS scores, as well as the highest anxiety prevalence. Patients with seborrheic dermatitis had the highest rate of depression. The DLQI, HADS, and SAAS results were moderately correlated with each other, but their relationship with disease duration and severity was insignificant or weak at best. Chronic facial dermatoses have a detrimental impact on mood and quality of life. Although patients with acne, rosacea, and seborrheic dermatitis have distinct lesions, the outcomes in terms of quality of life, anxiety, and depression are largely similar. Furthermore, these patients report similar levels of social anxiety as a result of their overall appearance.