Inflammatory Pustules Research Articles

Current views on pathogenesis of rosacea

Rosacea is a chronic inflammatory disease that usually affects the central part of the face. The primary symptoms include facial flushing, persistent erythema, telangiectasia, inflammatory pustules and papules. Based on groups of these symptoms, four basic rosacea subtypes have been defined: erythematotelangiectatic, papulopustular, ocular, phymatous; and one variant, granulomatous rosacea. Although the pathophysiology of this disorder is not fully known, many components such as immune and neurovascular dysregulation, oxidative stress, genetic background, gut microbiome, skin microbiome as well as external aspects are thought to play a role. In this article, we present the main factors that are speculated to be involved in the pathogenesis of rosacea. Methods and materials: We reviewed the literature available on PubMed and Google Scholar using the words "rosacea”, „rosacea pathogenesis”, „demodex”, „reactive oxygen species”, „rosacea microbiome”. Summary Rosacea is a chronic dermatosis whose etiology, despite many studies, is not fully understood. Currently, an abnormal inflammatory reaction caused by excessive stimulation of TLR-2 receptors is suspected as the main factor in the pathomechanism of the disease. Vascular disorders, transmission disorders, genetic factors, skin and intestinal dysbiosis also participate in the pathogenesis of rosacea. It is assumed that exogenous factors such as diet and exposure to UV radiation also play a role in the development of the disease.

Pathways from Trait Emotional Intelligence to factors of distress in Rosacea: The mediating role of Social Phobia and Self-Esteem

BackgroundRosacea is a skin disease characterized by facial erythema and inflammatory pustules that may result in emotional distress. Social Phobia and Self-Esteem appear to be linked to the development of higher levels of distress in dermatological conditions, while Trait Emotional Intelligence (Trait EI) has been consistently associated with greater levels of adaptation to one's chronic condition. Hence, it seems extremely relevant to observe the interplay between these dimensions in the context of Rosacea. The goal of the current study is to test the hypothesis that an association between Trait EI and General Distress, in individuals with Rosacea would be mediated by Self-Esteem and Social Phobia. MethodsQuestionnaires were administered to 224 individuals suffering from Rosacea to assess Trait EI, Social Phobia, Self-Esteem, and General Distress. ResultsResults highlighted that Trait EI was positively related to Self-Esteem and negatively related to Social Phobia and General Distress. In addition, both Self-Esteem and Social Phobia showed a mediating role in the relationship between Trait EI and General Distress. LimitationsThe main limitations of this work consist in the cross-sectional nature of the data, the small number of participants, also it was not possible to differentiate the participants according to the type of rosacea. DiscussionThese results emphasize how individuals with Rosacea may be vulnerable to internalizing states and how high levels of Trait EI may constitute a protective factor for the onset of distressing states and it would be useful to create programs aimed at fostering Trait EI in Rosacea sufferers.

The effects ofcombined diamond microdermabrasion and a mixture of cosmetic acids on the condition of acne prone skin: a case report

Background: Exfoliating treatments are widely used in cosmetology and dermatology forthe treatment of skin lesions and, above all, toreduce the number of skin eruptions that occur with acne vulgaris. An effective treatment that can be offered to people suffering from this disease is diamond microdermabrasion. The addition of acid peeling to this treatment may lead to even better results than in the case of monotherapy. Aim of the study: To assess the effectiveness of a combination of microdermabrasion and acid peeling on a 21-year-old woman suffering from acne vulgaris. Case report: The patient suffered from acne vulgaris, too high a level of sebum on the entire surface of the face, and, over the course of the disease, developed open and closed blackheads and inflammatory pustules. The sebum level was measured with a DermaUnitSCC3 device and the number of skin eruptions was determined using the global acne severity scale (GAGS). Conclusion: The series of cosmetological treatments led to a reduction in the sebum on the surface of the epidermis and the number of skin eruptions.

Matrix metalloproteinase-9 in the blood of acne patients: The possible use of matrix metalloproteinase-9 as a biomarker of acne severity

Objectives The aim of this study was to study the blood level of matrix metalloproteinase-9 (MMP-9) in acne patients and its relation to disease severity. Background The possible use of MMP-9 as a biomarker of acne severity. Patients and methods This case–control study was conducted on 45 patients with acne vulgaris collected from the Dermatology Outpatient Clinic in Menoufia University Hospital with age ranging from 18 to 25 years. The study was done during the period from June 2018 to January 2019. Acne grading was performed according to the Global Acne Grading System. Twenty normal controls matched for age and sex were included. Detailed history and clinical exa mination were carried out to exclude patients with hyperproliferative skin disorders such as psoriasis and lichen planus, patients with bullous diseases, therapy. MMP-9 was measured by the enzyme-linked immunosorbent assay method for patients and controls and the results were statistically analyzed and tabulated. Results The level of MMP-9 recorded significant elevation when compared with normal control level. In addition, a significant difference was obtained when comparing its level among mild, moderate, and severe cases. There was also an association between its level and the number of regions with inflammatory pustules and nodules but not with scars. Conclusion MMP-9 can be used in the future as a biomarker of acne severity to choose the best treatment modalities.

Acneiform Presentations of Folliculotropic Mycosis Fungoides.

Folliculotropic mycosis fungoides (FMF) is a variant of cutaneous T-cell lymphoma that has clinical overlap with a variety of inflammatory follicular unit disorders. However, we describe distinctive presentations of FMF with acneiform features that can be diagnostically challenging, leading to diagnostic delay. To highlight the importance of histopathologic and immunohistochemical evaluation for diagnostic confirmation of presumed inflammatory follicular unit-based disorders that are unusual in presentation or unresponsive to standard therapies. A cross-sectional retrospective study of 5 consecutive patients with a histopathologic diagnosis of FMF was conducted. The clinical, histopathologic, immunophenotypic, and molecular genetic features of cases are presented. We describe 5 patients with clinical and histopathologic presentations of FMF masquerading as hidradenitis suppurativa, furunculosis, or acne vulgaris (age range 34-66 years, 4:1 female to male). Clinical morphologies included open and closed comedones, inflammatory pustules, papules and nodules, follicular papules with keratotic plugging, cysts, and scarring involving the face, trunk, and intertriginous areas. All patients failed to respond to standard therapies, including topical and oral antibiotics, topical and oral retinoids, or topical corticosteroids, before receiving the diagnosis of FMF. Lesional skin biopsies showed a perifollicular CD4-positive T-lymphocytic infiltrate with pilotropism, intrafollicular mucin deposition, foreign-body granulomatous inflammation, acute inflammation, and follicular epithelial necrosis. None had concurrent systemic mycosis fungoides. Small retrospective cohort study. We present these cases to expand the clinical and histopathologic spectrum of FMF that may strikingly resemble acneiform disorders and to highlight the importance of diagnostic reconsideration with histopathologic evaluation.

Acne related to dietary supplements

Multiple prescription medications may cause or aggravate acne. A number of dietary supplements have also been linked to acne, including those containing vitamins B6/B12, iodine, and whey, as well as "muscle building supplements" that may be contaminated with anabolic-androgenic steroids (AAS). Acne linked to dietary supplements generally resolves following supplement discontinuation. Lesions associated with high-dose vitamin B6 and B12 supplements have been described as monomorphic and although pathogenesis is unknown, a number of hypotheses have been proposed. Iodine-related acne may be related to the use of kelp supplements and has been reported as monomorphic, inflammatory pustules on the face and upper trunk. Whey protein supplements, derived from milk and used for bodybuilding, are associated with papulonodular acne involving the trunk and sometimes the face. Finally, AAS-induced acne has been described as acne fulminans, acne conglobata, and acne papulopustulosa. With studies indicating that about half of US adults report using dietary supplements, it is important that dermatologists directly ask acne patients about their supplement use and educate them on the potential risks of even seemingly innocuous dietary supplements.

An overview of Novel Drug Delivery Systems for Acne

Acne vulgaris is a type of chronic disease of the skin which is mainly caused by the blockage in the sebaceous gland or having any inflammation in those glands which is together is known as pilosebaceous units. It mainly affects the areas having the highest number of sebaceous follicles; those are the face, the back and upper region of the chest. It is a disease that mainly affects the adolescent age group but can be found in any age group. These are present as inflammatory pustules, papules, cysts and nodules, non-inflammatory closed comedones (whiteheads), ripen comedones (blackheads), or a mixture of lesions. Acne is most commonly seen in almost every human being at some point in their lives. There are 20-25 chances of progression of acne to the severe case which leads to permanent scarring. These complications lead to psychological problems like depression, social isolation, lowered self-esteem, and lowered self-confidence. The aim of treating acne is to prevent severe and long-term complications. The present review focuses on novel drug delivery systems for the treatment of acne. It also includes conventional treatments currently available in the market, its limitation and different strategies to overcome these limitations.

Prevalence of Bartonella spp. in Canine Cutaneous Histiocytoma

Canine cutaneous histiocytoma (CCH) is a common, benign neoplastic proliferation of histiocytes of Langerhans cell origin that often ulcerate, become secondarily infected and regress spontaneously. Bartonella is a fastidious genus of facultative intracellular pathogens that can be transmitted through arthropod bites and epidermal animal scratches and has been identified previously in the cytoplasm of histiocytes within granulomatous lesions and in skin biopsy samples of inflammatory pustules and papules. Based on the established inflammatory and oncogenic properties of Bartonella, we hypothesized that Bartonella spp. DNA could be amplified from CCH more often than from non-lesional skin and bacteria could be localized within skin tumours using indirect immunofluorescence (IIF). Paraffin wax-embedded surgical biopsy samples from dogs with CCH and non-neoplastic skin adjacent to osteosarcomas (control group selected due to wide surgical margins) were retrieved from the archive of the pathology service of North Carolina State University College of Veterinary Medicine. DNA was extracted and regions of the 16S-23S rRNA intergenic transcribed spacer (ITS) region and the pap31 and gltA genes were amplified by polymerase chain reaction (PCR) using Bartonella-specific primers. IIF was performed using a primary Bartonella henselae monoclonal antibody to localize B. henselae in tissues of PCR-positive dogs. Bartonella vinsonii subsp. berkhoffii was amplified from 1/17 (5.8%) control tissues and B. henselae was amplified from 4/29 (13.8%) CCH tissues. The prevalence of B. vinsonii subsp. berkhoffii (P=0.37) or B. henselae (P=0.28) did not vary statistically between study groups. B. henselae could be visualized in 2/4 (50.0%) CCH tissues using IIF. Based on this study, Bartonella spp. are unlikely to cause CCH.

Filaggrin Null Mutations Are Not a Protective Factor for Acne Vulgaris

Filaggrin Null Mutations Are Not a Protective Factor for Acne Vulgaris

Letter: Acne and hidden iodides.

To the Editor.— Kelp, the unmasked culprit of iodide-induced myxedema, 1 has worked its villainies on our dermatology clinic patients. Two teenagers with mild, untreated, comedonal developed crops of abscess-like inflammatory pustules and papulonodules on the face, neck, shoulders, and back. One had been recently introduced to daily kelp tablets as part of her mother's program for weight control; the other had started taking kelp-containing natural vitamins in an effort to feel better. Both youngsters' skins cleared within several weeks after they stopped taking the seaweed supplement. Another unexpected source of considerable amounts of iodides appears to be the food from America's fast-service snack establishments, according to a feature article in Consumer Reports (40:278, 1975). The syndrome recently described as McDonald's acne was attributed to contact with hot cooking oils and grease 2 ; the condition may actually be due to the ready availability of this high-iodide diet to the