Facial Skin Of Patients Research Articles

34481 A dual regimen skincare treatment for hyperpigmented and photodamaged facial skin

Background: Broad-spectrum mineral sunscreens have assisted in correction of pigmentary disorders. A vitamin C moisturizer (VCM) containing 30% tetrahexyldecyl (THD) ascorbate clinically demonstrated improvement in patients with mild to moderate wrinkles and hyperpigmentation in a standalone study. A dual regimen treatment containing a 100% mineral TMS and a VCM, may offer further benefits in patients concerned with their hyperpigmented and photodamaged facial skin. Study design: MatTek EpiDerm tissues topically treated with 100% mineral TMS, exposed to UVB (300 mJ/cm2) 24 hours posttreatment, and incubated for an additional 24 hours, were analyzed by ELISA for CPD formation, 8-OHdG content, and H2A.X phosphorylation (n = 3). In a multicenter, open-label study, 36 female subjects (35-60 years) with moderate to severe facial hyperpigmentation and moderate global face photodamage were recruited to assess the efficacy and tolerability of a skincare regimen containing VCM and 100% mineral TMS over 12 weeks. Clinical grading using a modified Griffith 10-point scale for hyperpigmentation, overall photodamage, and skin tone evenness were performed at baseline, weeks 4, 8, and 12. Results: The 100% mineral TMS repaired UVB induced DNA damage, including CPD formation by 85% (P < .05). When paired together, the VCM and 100% mineral TMS improved hyperpigmentation and photodamaged facial skin in patients across three clinical sites compared with baseline (P < .05). Conclusion: In vitro results coupled with in vivo results strongly suggest that the dual regimen containing 100% mineral TMS paired with the VCM was strongly effective and tolerable in improving hyperpigmented and photodamaged skin.

The Microbiome in Comedonal Contents of Inflammatory Acne Vulgaris is Composed of an Overgrowth of Cutibacterium Spp. and Other Cutaneous Microorganisms.

BackgroundAcne vulgaris (acne) and cutaneous resident microorganisms are considered to be closely related. However, the bacterial and fungal microbiota in the comedonal contents of inflammatory acne lesions have not yet been investigated in detail.PurposeTo clarify the relationship between cutaneous microorganisms and acne, we examined the microbiome in the comedonal contents of inflammatory acne and on the facial skin of patients with acne using 16s rRNA and ITS gene sequencing with a next-generation sequencer (NGS).Patients and MethodsTwenty-two untreated Japanese acne outpatients were examined. The comedonal contents of inflammatory acne lesions on the face were collected using a comedo extractor. Skin surface samples from facial skin were collected using the swab method.ResultsThe results obtained revealed that the predominant bacteria in the comedonal contents of inflammatory acne were Cutibacterium spp. (more prominent in areas with large amounts of sebum), while those on the skin surface were Staphylococcus spp. Malassezia spp., particularly Malassezia restricta, were the predominant fungi in both the comedonal contents of inflammatory acne and on the skin surface. The bacterial microbiome in comedonal contents exhibited stronger metabolic activity, including the production of enzymes related to acne, than that on the skin surface.ConclusionThese results indicate that acne is an inflammatory disease involving the overgrowth of Cutibacterium acnes and other cutaneous resident microorganisms, including Malassezia spp.

Analysis of minimally invasive cosmetic technique in the repair of emergency facial skin and soft tissue injuries

Objective To observe the curative effect of minimally invasive cosmetic technique in emergency patients with facial soft tissue trauma. Methods From January 2015 to October 2017, 92 patients with emergency facial soft tissue trauma in Rongjun Hospital of Zhejiang Province were selected and randomly divided into two groups according to the digital table, with 46 cases in each group.The observation group was treated with minimally invasive cosmetic technique.The control group was treated with conventional technique.The patients were followed up for one year, the facial scar color score, facial skin flatness score, facial skin elasticity score, wound healing rate, quality of life score and satisfaction were compared between the two groups. Results The facial scar color score, facial skin smoothness score and facial skin elasticity score in the observation group were (0.36±0.12)points, (0.52±0.23)points and (0.49±0.23)points, respectively, which were lower than those in the control group [(0.89±0.17)points, (1.12±0.31)points, (0.95±0.12)points] (t=17.725, 10.542, 12.026, all P<0.05). The wound healing rate of the observation group was 91.30%(42/46) and the satisfaction rate was 95.65%(44/46), which were higher than 81.74%(33/46) and 73.91%(34/46) of the control group(χ2=5.845, 8.425, all P<0.05). The quality of life score of the observation group[(102.65±2.78)points] was higher than that of the control group[(89.24±2.36)points](t=24.941, P<0.05). Conclusion Minimally invasive cosmetic technique has better curative effect on patients with emergency facial skin and soft tissue trauma.The rate of grade A wound healing is high, which is helpful to repair the facial skin of patients, improve the satisfaction of patients and improve the quality of their daily life. Key words: Facial injuries; Soft tissue injuries; Emergency treatment; Surgical procedures, minimally invasive; Cosmetic techniques; Wound healing; Skin physiological phenomena; Cicatrix; Patient satisfaction

Intra-rater reproducibility of shear wave elastography in the evaluation of facial skin.

IntroductionRecently, esthetic medicine has been gaining its momentum worldwide, mostly due to the development of minimally invasive techniques. In our opinion, elastography can be a candidate for an objective quantitative method to evaluate facial skin condition. The aim of this study was to determine intra-rater reproducibility of shear wave elastography (SWE) in the evaluation of facial skin in patients qualified for minimally invasive nonsurgical facial rejuvenation treatment.AimTo determine intra-rater reproducibility of shear wave elastography (SWE) in the evaluation of facial skin in patients qualified for minimally invasive nonsurgical facial rejuvenation treatment.Material and methodsThe study included 57 women between 40 and 67 years of age (mean: 51.5 ±7.3 years). Prior to the laser treatment, all participants were subjected to ultrasonographic examination and elastography of the skin. Upon visualization of the area of interest, the thickness of the dermis, subcutaneous tissue and superficial muscular aponeurotic system (SMAS) in millimeters was measured. Then, SWE was performed.ResultsNo statistically significant differences were found in intraclass coefficient values (ICC) for elastographic parameters of the skin on the right and left side of the face (0.953 ±0.001 vs. 0.953 ±0.001, p = 0.992). Moreover, no significant differences were observed in the ICC values for the SWE parameters of various skin layers: dermis, subcutaneous tissue and SMAS (0.945 ±0.001 vs. 0.953 ±.001 vs. 0.961 ±0.001, p = 0.597). Women with normal body weight and overweight did not differ significantly in terms of their elastographic parameters of facial skin.ConclusionsShear wave elastography is a reliable method for the evaluation of facial skin elasticity, providing highly reproducible results in all patients, regardless of their age and body weight.

Topical Treatment of Rosacea with Ivermectin Inhibits Gene Expression of Cathelicidin Innate Immune Mediators, LL-37 and KLK5, in Reconstructed and Ex Vivo Skin Models

IntroductionNumerous intrinsic and extrinsic factors have been associated with the pathophysiology of rosacea, including dysregulation of innate immunity. A high level of cathelicidin antimicrobial peptides (e.g., LL-37) has been shown in the facial skin of patients with rosacea. Excessive production of both LL-37 and KLK5, the serine protease responsible for its cleavage, has been suggested to play a role in the pathophysiology of rosacea. Ivermectin 10 mg/g cream, indicated for the treatment of inflammatory lesions of rosacea, is reported to have dual anti-parasitic and anti-inflammatory properties. However, the exact mechanism of action of ivermectin cream in the treatment of rosacea is unknown.MethodsThis study aimed to evaluate the effect of ivermectin on the expression of KLK5 and the subsequent effect on the maturation process of cathelicidins. Experimental studies were performed either on normal human epidermal keratinocytes (NHEK), reconstructed human epidermis (RHE) or on human skin ex vivo stimulated with calcitriol (1α,25-dihydroxyvitamin D3), which is known to induce KLK5 and LL-37 expression.ResultsThe results show that ivermectin is able to inhibit KLK5 and CAMP gene expression and protein secretion in NHEK cells stimulated with calcitriol. Those results were confirmed in 3D models of the skin (RHE and skin ex vivo). The anti-inflammatory effects of ivermectin were associated with an inhibition of IL-8, IL-6 and MCP-1 (CCL2) secretion from NHEK cells.ConclusionsThese results suggest that ivermectin can prevent the inflammatory effects of rosacea triggered by abnormal LL-37 processing, through the inhibition of KLK5 gene expression in the epidermis. Funding: Nestlé Skin Health R&D.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-017-0176-3) contains supplementary material, which is available to authorized users.

Microorganisms inhabiting follicular contents of facial acne are not only Propionibacterium but also Malassezia spp.

To clarify the relationship between major cutaneous microorganisms (Propionibacterium, Staphylococcus and Malassezia spp.) and acne vulgaris (acne), we examined the microbiota quantitatively in the follicular contents of inflammatory acne and on the facial skin of patients with acne. Fifteen Japanese untreated acne outpatients were studied. The follicular contents from inflammatory acne lesions of the face were collected using a comedo extractor. The skin surface samples were obtained by the swab method from 10 cm(2) of facial skin. The microbiota was analyzed using polymerase chain reaction. The microbiota in follicular contents was similar to that on the skin surface, namely, there were large populations of Propionibacterium spp., Staphylococcus spp. and Malassezia spp. Moreover, the number of Malassezia spp. on the skin surface was correlated with that of inflammatory acne and that in follicular contents. This study clarified that there are large populations of Propionibacterium spp., Staphylococcus spp. and Malassezia spp. in follicular contents. These results suggest the possibility that not only Propionibacterium acnes but also other cutaneous resident microorganisms are related to acne. Particularly, we considered that Malassezia spp. is closely related.

Facial lesions in frontal fibrosing alopecia (FFA): Clinicopathological features in a series of 12 cases

Facial lesions in frontal fibrosing alopecia (FFA) have been poorly described in published series. We sought to describe facial lesions in FFA. We reviewed our series of 55 cases of FFA, selecting 12 cases with clinically significant facial lesions. We performed a histologic study of these lesions. In addition to the observations already described in the literature such as facial papules or follicular red dots, we observed perifollicular and diffuse erythema, sometimes with a reticular pattern, and the gradual appearance of pigmented macules on facial skin. Biopsy specimens from the areas with facial erythema showed perifollicular and interfollicular lymphocytic infiltrate and fibrosis around vellus hair follicles. Histologic evaluation of pigmented macules sometimes exhibited an increased epidermal pigmentation and on occasions, pigmentary incontinence. More patients are needed to determine the prevalence of these lesions in FFA. On facial skin of patients with FFA, we can observe papules or perifollicular erythema secondary to vellus hair follicle involvement. We describe diffuse erythema, owing to follicular and interfollicular lichenoid infiltrate, and the gradual appearance of pigmented macules, which could be secondary to an increased epidermal pigmentation or to pigmentary incontinence.

Reflectance confocal microscopy for monitoring the density of Demodex mites in patients with rosacea before and after treatment.

Demodex mites seem to serve as a pathogenic trigger in many Demodex-associated diseases such as rosacea. In facial skin of patients with rosacea significantly higher numbers of Demodex mites have been shown compared with healthy controls. Reflectance confocal microscopy (RCM) allows the detection and quantification of Demodex mites in vivo noninvasively. It is hypothesized that a reduction of Demodex mites under rosacea therapy can be monitored by RCM. To use RCM to monitor the density of Demodex mites in patients with rosacea before and after treatment. In 25 patients with facial rosacea RCM was performed before and after therapy. Mosaics of 5 × 5 mm(2) and 8 × 8 mm(2) were scanned, and the total numbers of mites per follicle and per area were counted, along with the number of follicles per area. In all patients Demodex folliculorum could be detected and quantified using RCM. RCM showed significant differences pre- and post-treatment (P = 0.0053 for 5 × 5 mm(2) and P < 0.001 for 8 × 8 mm(2)). The mean numbers of mites per follicle were 0.63 (range 0.16-2.28) per 8 × 8 mm(2) area and 0.70 (range 0.11-2.20) per 5 × 5 mm(2) area before treatment, and 0.41 (range 0.074-1.75) and 0.51 (range 0.094-1.70), respectively, after treatment. The corresponding mean numbers of mites were 155 (range 45-446) and 86.2 (range 12-286), respectively, before treatment and 96.2 (range 18-363) and 58.5 (range 12-230), respectively, after treatment. By RCM, a reduction in the density of Demodex mites in facial skin of patients with rosacea under therapy, correlating to clinical improvement, can be quantified and monitored noninvasively. Possible reasons for this therapeutic effect are discussed.

The dynamics of morphological changes of facial skin in patients with malasseziasis at stages of antimycotic and anti-aging therapy.

The dynamics of morphological changes of facial skin in patients with malasseziasis at stages of antimycotic and anti-aging therapy.

UV-induced red fluorescence on facial part of patients with acne vulgaris and seborrheic dermatitis: a fluorescence spectrum study

Objective To measure the fluorescence spectral information of UVRF in the facial skin of patients with acne vulgaris and seborrheic dermatitis and to comprehend the optical properties of UVRF. Methods The lesions were squeezed to extract the sebaceous secretions containing UVRF in the facial skin. Ocean Optics USB2000+ F02243 Spectrometer and the 308nm excimer laser were used as an excitation light source to measure the signal of the LIF spectrum of UVRF in 6 acne vulgaris and 4 seborrheic dermatitis patients' facial part, compared with protoporphyrin Ⅸ. Results 1-4 peaks were detected in 10 patients' UVRF specimen respectively. The fluorescence spectra's characteristic peak of UVRF in 10 patients was at 680 nm. Protoporphyrin Ⅸ was at 688 nm and more gentle and generous than UVRF's characteristic peak. Conclusions LIF system can be used to detect the fluorescence spectroscopy of UVRF. UVRF has similar spectral characteristics to protoporphyrin Ⅸ, but it is not the same species. Key words: Acne; Seborrheic dermatitis; Fluorescence spectrum; Red fluorescence; Laser induced fluorescence

Efecto de la suplementación con omega 3 en la piel facial de los pacientes de un centro médico del distrito de Miraflores en el año 2013

The research set out to answer a central problem about the effects of supplementation with Omega 3 in facial skin in different age groups of patients in a medical center in Miraflores District, considering moisture, uniformity and wrinkle between January and December 2013. The three specific problems were selected from the main problem considering the variables moisture, smoothness and wrinkle. To answer the questions a general objective and three specific objectives according to the variables were formulated. The theoretical framework used for essential fatty acids in nutrition served to substantiate the results of work. The research is descriptive, developed with the comparative and descriptive method. The design is quasi-experimental and longitudinal section. Statistically, measures of central tendency were used to describe the results and the Student T test. So the relationship between Omega 3 and the reactions in facial skin of patients is established. The population was 100 patients attending the Medical Center, but the purification process were applied in 92 subjects in the sample. For purposes of data collection instrument was used as the team Aram SG (dermatological analyzer) with construct validity and reliability to 0.01%. The results found show that, in general terms, skin moisture increased 17.48%, uniformity improved 18.26% and wrinkles were attenuated 32.23%. The results demonstrate the significant and obvious improvement after supplementation of Omega 3.

Protective effect of non-adhesive dressings about pressure sore of patients who use non-invasive ventilator mask with long-term

Objective To observe the protective effect of non-adhesive dressings on nasal facial skin in patients who used non-invasive ventilator mask continually for a long time.Methods Eighty-six patients who used non-invasive ventilation with long-term were divided into two groups according to its hospital identification number.Forty-three patients in the experimental group used non-adhesive dressings, whereas forty-three patients in the control group used adhesive dressings.Results The incidence of pressure sores in the experimental group was 6.98%, as well as it was 20.93%in the control group.The nasal and facial pressure sore rate difference had statistics significance between the two groups （χ^2 =4.44,P =0.035）.Conclusions No sticky foam dressings have better protective effect on nasal and facial skin of patients who use non-invasive ventilator mask continuously with long-term. Key words: Non-adhesive dressings; Non-invasive ventilator; Mask; Pressure sore

Physiometry of facial skin in patients with acne and healthy individuals

Objective To approch acne characteristics and to facilitate its treatment by comparing the skin physiology function of patients with acne and healthy individuals.Methods Forty patients with acne and 40 healthy controls were included into this study.Cutometer,Sebumeter,Corneometer,Tewameter,and Mexameter were used,respectively,to measure the skin elasticity,sebum,water,t rans-epidermis water loss and red pigment index in the following facial areas:forehead,lateral canthus,right and left cheek,right and left U-zone.Results A significant increase was observed in the level of sebum in the forehead,right and left cheek of patients as compared with controls (P＜ 0.05).A significant decrease was observed in the level of water in the right and left cheek and U-zone of patients compared with controls (P＜0.05).A significant decrease was observed in the level of trans-epidermis water loss in the right and left cheek and forehead of patients compared with controls (P＜0.05).A significant increase was observed in the level of red pigment index in the right and left cheek,forehead,right and left U-zone of patients compared with controls (P＜0.05).However,the level of skin elasticity was of no significant difference between the patients and controls (P＞0.05).Conclusions Compared with the controls facial sebum secretion is increased with reduced skin barrier function in patients with acne. Key words: Acne; Skin; Elasticity; Sebum; Water; Red pigment

Efficacy of a hyaluronic acid-containing dressing for facial skin wound healing in patients with freckles after intensive pulsed light treatment

Objective To evaluate the safety of a hyaluronic acid-containing dressing for wound healing of facial skin in patients with freckles after intensive pulsed light (IPL) therapy.Methods A multicenter,randomized,open,controlled clinical trial was conducted.A total of 298 IPL-treated patients with freckles were recruited into this study.After IPL therapy,all the patients were randomly divided into two groups to be topically treated with a hyaluronic acid-containing dressing (experiment group) or a sodium chloride physiological solutioncontaining face mask (control group).Skin physiological parameters,including sebum content,water content in stratum corneum,and transepidermal water loss,were invasively measured at the baseline,on day 3,7 and 14 after the start of topical treatment.The formation and desquamation of irradiation-induced crusts were observed,the degree of patient satisfaction was evaluated,and adverse reactions were recorded.Results The water content in stratum corneum and transepidermal water loss were (25.32 ± 4.14) ％ and (14.08 ± 3.32) g·cm-2·h-1,respectively,in the experimental group on day 14,significantly different from those before treatment (both P＜0.01) and those in the control group on day 14 (both P ＜ 0.01).Skin sebum content in the experiment group showed no significant changes during the 14-day treatment (P ＞ 0.05),and was similar to that in the control group on day 14 (P ＞ 0.05).The percentage of patients experiencing the initial desquamation of crusts within three days and that experiencing complete desquamation of crusts within seven days were significantly different between the experiment group and control group (x2 =7.774,P ＜ 0.01; x2 =4.692,P ＜ 0.05).Statistical differences were observed in the degree of patient satisfaction between the two groups (P ＜ 0.05).No adverse reactions were reported during the trial.Conclusion The hyaluronic acid-containing dressing can restore skin barrier function with a good safety profile,and may serve as an adjuvant therapy for wound healing of facial skin after IPL irradiation.

Noninvasivein vivodetection and quantification ofDemodexmites by confocal laser scanning microscopy

In many Demodex-associated skin diseases Demodex mites are present in abundance and seem to be at least partially pathogenic. So far all diagnostic approaches such as scraping or standardized superficial skin biopsy are (semi-)invasive and may cause discomfort to the patient. To see whether confocal laser scanning microscopy (CLSM) - a noninvasive method for the visualization of superficial skin layers - is able to detect and quantify D. folliculorum in facial skin of patients with rosacea. Twenty-five patients (34-72 years of age) with facial rosacea and 25 age- and sex-matched normal controls were examined by CLSM. Mosaics of 8 × 8 mm and 5 × 5 mm were created by scanning horizontal layers of lesional skin and quantification of mites per follicle and per area as well as follicles per area was performed. In all patients D. folliculorum could be detected by CLSM and presented as roundish or lengthy cone-shaped structures. CLSM allowed the quantification of Demodex mites and revealed significant differences (P < 0·0001): the mean number of mites was 165·4 per 8 × 8 mm area and 94·2 per 5 × 5 mm area in the patients compared with 34·7 and 22·4, respectively, in the controls. The corresponding mean number of mites per follicle was 0·7 and 0·8, respectively, in the patients and 0·1 and 0·2, respectively, in the controls. With the help of CLSM it is possible to detect, image and quantify Demodex mites noninvasively in facial skin of patients with rosacea.

Demodex mites and Malassezia yeast at patients with seborrheic dermatitis

Target. Studies of dynamics of species diversity and of abundance of Malassezia fungi, аs well as of pimple mites at the skin of patients, suffering from seborrheic dermatitis (SD) at the treatment with activated zinc pyrithione aerosol (ZPA). Маterial and methods. 60 patients with SD were examined. 2 groups were segregated: 1-st (n = 31) - patients with SD, receiving within 4 weeks the AZP therapy; 2-nd (n = 29) - patients with SD, not receiving local therapy. At the examination the gravity of symptoms, the dynamics of skin integument affection was assessed, the mycological skin analysis for Malassezia fungi, as well as the acarological analysis for Demodex mites was performed. Results. 4 kinds of Malassezia were revealed on the skin of patients, suffering with SD disease, with dominating M. globosa (10 7 КОЕ/cm 2). At patients, suffering with SD, 2 kinds of mites were revealed: Demodex: D. brevis and D. folliculorum. D. Brevis was dominating - 65%, D.folliculorum - 26%. After affected sites of the facer skin of patients, suffering from SD, with AZP aerosol within 4 weeks was revealed the statically authentic decrease at the average by a factor of 2 from the number of Malassezia yeast, and the decrease (to 16%) of the frequency of D.brevis reveal, аs well as the complete elimination of D.folliculorum. After the course of therapy with topical AZP aerosol is over the high therapeutic effect is revealed at 90% patients with SD. Opinion. So, AZP aerosol can be recommend to the decrease of the number of Malassezia fungi at Demodex mites at the facial skin of patients, suffering with SD.

Oestrogen and progesterone receptor expression in melasma: an immunohistochemical analysis

Melasma is a commonly acquired symmetrical hypermelanosis on sun-exposed areas of the skin. The development of melasma appears to be associated with increased levels of oestrogen, exposure to sunlight and a genetic predisposition. Several in vitro studies have partially clarified the effects of oestrogen and progesterone on melasma. However, oestrogen receptor (ER) and progesterone receptor (PR) expression in melasma-affected skin has not been investigated to date, except for one case report on ER expression. The purpose of this study was to compare ER and PR expression between hyperpigmented areas and unaffected areas of facial skin in patients with melasma. Biopsies were performed on skin lesions and adjacent-unaffected facial skin in 33 Korean women with melasma. The sections were stained using haematoxylin and eosin, Fontana-Masson, and antibodies to NKI/beteb, ERα, β and PR. The immunohistochemical expression of ERβ showed an increasing tendency in epidermal lesions without statistical significance. Expression of PR was significantly increased in the epidermal lesions compared with unaffected skin on the computer-assisted image analysis. Interestingly, there was increased ERβ expression in the dermal lesions especially around small blood vessels and fibroblast-like cells compared with unaffected dermis on the semi-quantitative analysis. However, there was no significant difference in the expression of PR between the dermal lesions and unaffected dermis. The results of this study may provide useful information for further investigation into the pathogenesis and therapeutic approaches for treating melasma in relation to hormonal factors. The role of ER in the dermis in association with dermal environment such as blood vessels and fibroblasts remains to be further clarified.

Specific gel‐cream as adjuvant to oral isotretinoin improved hydration and prevented TEWL increase – a double‐blind, randomized, placebo‐controlled study

Hydrating and emollient products are often recommended to patients under isotretinoin therapy to control the most frequent mucocutaneous side effects and to improve adherence to treatment. To assess, using noninvasive biophysical tests, the clinical and instrumental effectiveness of a hydrating gel-cream compared with placebo as an adjuvant to isotretinoin for treatment of facial skin in patients with inflammatory acne. Prospective, double-blind, randomized study, using MULTI SKIN MC750, on the adjuvant effect of a hydrating gel-cream for acne (active product) vs. a gel-cream without active substances (placebo). Follow-up lasted 3 months. Sixty-six patients were included. Thirty-four were administered the active product, and 32 placebo. Though the number of lesions fell significantly in both groups, the mean number of papules on day 30 was significantly lower in the active product group. The active product group showed a significant increase in hydration, while the placebo group showed a significant increase in transepidermal water loss (TEWL). Seborrhoea decreased significantly in both groups; there were no differences between them. Compared with placebo, the specific gel-cream with active products as an adjuvant to oral isotretinoin improved hydration, prevented TEWL increase, and reduced inflammatory acne lesions after 30 days.

The effect of azithromycin on reactive oxygen species in rosacea

Recent evidence suggests that inflammation in rosacea is associated with generation of reactive oxygen species (ROS) that are released by inflammatory cells. The efficacy of current therapeutic agents for rosacea such as tetracyclines and metronidazole has also been attributed to their antioxidant properties. Recently, a macrolide antibiotic, azithromycin, has been found to be an effective alternative in the treatment of rosacea. We planned a study to evaluate the antioxidant effects of azithromycin on ROS in rosacea. We compared basal ROS concentrations measured in the facial skin of patients with rosacea with the post-treatment levels and with those of healthy controls. Facial skin biopsies of 17 papulopustular patients with rosacea and 25 healthy controls were taken. Rosacea patients were assigned to receive oral azithromycin 500 mg on three consecutive days each week for 4 weeks. The total number of inflammatory lesions (the sum of papules and pustules) on the face of each patient with rosacea was counted at each visit. The luminol- and lucigenin-enhanced chemiluminescence (CL) levels of patients with rosacea were measured before and after 4 weeks of treatment and compared with those of healthy controls. Rosacea patients had higher ROS levels than healthy controls (P < 0.001). A statistically significant decrease of both luminol- and lucigenin-enhanced CL levels were observed in patients with rosacea after treatment with azithromycin (t = 4.602, P < 0.001; vs. t = 4.634, P < 0.001, respectively). Rosacea patients have higher ROS levels than healthy controls. The results of our study support the antioxidant properties of azithromycin in rosacea.

Determinants of satisfaction with the health state of the facial skin in patients undergoing surgery for facial basal cell carcinoma

Objective The main objective of the study was to assess which health beliefs predict and explain satisfaction with the facial health state of patients undergoing surgery for basal cell carcinoma. Methods Data were collected by administering a newly developed questionnaire pre-operatively and 6 months post-operatively ( n = 222). Results Results show that satisfaction as measured by post-operative worrying, susceptibility and fear of developing a new BCC at other facial sites can be predicted by pre-operative health beliefs. In addition, some patients an increase in perceived susceptibility, fear of recurrence of BCC on the same site or fear of developing a new BCC at other facial sites. Conclusion Our findings indicate that both pre- and post-operative perceptions predict and explain for a substantial part the extent to which patients are satisfied with their facial health state 6 months after surgery. Practice implications Administering a short questionnaire at the start of the treatment period will give physicians a better understanding of how patients experience this skin disease. It will also help them to adjust information about BCC and its consequences to the needs of the patient.