1/9. An unusual case of a relationship between rosacea and dental foci.rosacea is a chronic disorder affecting the facial convexities, characterized by frequent flushing, persistent erythema, and telangiectases. During episodes of inflammation, additional features are swelling, papules, and pustules. The exact etiology of this dermatitis is unknown, and theories abound. Infectious foci, especially dental foci, seem to be rarely associated with the onset and progression of this disease. Dermatologic treatments are determined by the severity of the disease. But eradication of infectious foci, and in this case eradication of dental foci, may generate a significant improvement and may lead to a recovery.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
2/9. Is demodex really non-pathogenic?Although usually considered a non-pathogenic parasite in parasitological textbooks, Demodex folliculorum has been implicated as a causative agent for some dermatological conditions, such as rosacea-like eruptions and some types of blepharitis. Several anecdotal reports have demonstrated unequivocal tissue damage directly related to the presence of the parasite. However, this seems to be exceedingly rare, in contrast with the marked prevalence of this infestation. We have had the opportunity to observe one of such cases. A 38-year-old woman presented with rosacea-like papular lesions in her right cheek. Histopathological examination revealed granulomatous dermal inflammation with a well-preserved mite phagocytized by a multinucleated giant cell. This finding may be taken as an evidence for the pathogenicity of the parasite, inasmuch as it does not explain how such a common parasite is able to produce such a rare disease.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
3/9. Facial granulomatous diseases: a study of four cases tested for the presence of mycobacterium tuberculosis dna using nested polymerase chain reaction.The histopathologic diagnosis of cutaneous tuberculosis (CTB) is often troublesome, because there are several other entities (tuberculids, demodicidosis, granulomatous rosacea, and acne agminata) that may display granulomatous inflammation with caseation necrosis. The current study describes four cases of granulomatous disease of the face. The final diagnosis (assessed on the basis of the clinical response to therapy) was CTB in three cases and granulomatous rosacea in one case. Histologically, epithelioid granulomas were a constant feature; in one case of CTB, they displayed a palisading (granuloma annulare-like) arrangement. Caseation necrosis was a prominent feature only in the case of granulomatous rosacea. Routinely processed biopsy specimens were evaluated with nested polymerase chain reaction (nPCR) for mycobacterium tuberculosis (MBT) dna. The correlation between nPCR results and clinical outcome was less than optimal; in fact, one case showed an excellent clinical response to the antituberculous drug therapy despite the absence of MBT dna amplification. In granulomatous diseases of the face, the importance of evaluating not only nPCR but the overall clinicopathologic picture so as to avoid diagnostic misinterpretations is emphasized.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
4/9. Recurrent phlyctenular keratoconjunctivitis: a forme fruste manifestation of rosacea.BACKGROUND: Phlyctenular keratoconjunctivitis represents a delayed type hypersensitivity response to a systemic antigen within the body. methods: We present a case of symptomatic, recurrent, phlyctenular keratoconjunctivitis in an 8-year-old child. The patient's inflammation responded favorably to topical steroids at each episode, but no specific antigen could be identified. CONCLUSION: After observing the father's erythematous facial lesions, we attributed the child's ocular inflammation to rosacea (as a forme fruste manifestation) and treated her with systemic erythromycin. The symptoms were rapidly relieved and the disease process was arrested.- - - - - - - - - - ranking = 2keywords = inflammation (Clic here for more details about this article) |
5/9. Ocular rosacea in childhood.PURPOSE: To describe the clinical characteristics and treatment response of ocular rosacea in the pediatric population. DESIGN: Retrospective case series. methods: The clinic charts of consecutive pediatric cases of ocular rosacea were evaluated over a 34-month period. Minimal diagnostic inclusion criteria were the presence of posterior eyelid inflammation including meibomian gland inspissation and lid margin telangiectasis, in conjunction with conjunctival injection or episcleritis. RESULTS: Six patients ranged from 3 to 12 years of age at presentation. All shared a long history of ocular irritation and photophobia. Five patients (83%) were female and had bilateral involvement. Eyelid telangiectases and meibomian gland disease were present in all cases. Three patients (50%) had sterile corneal ulcers. Only two patients (33%) had cutaneous involvement at the time of diagnosis. All patients experienced significant improvement with a combination of oral antibiotics (doxycycline or erythromycin), with or without topical antibiotics (erythromycin or bacitracin) or topical steroids (fluorometholone). CONCLUSION: Ocular rosacea in children may be misdiagnosed as viral or bacterial infections. Unlike in adults, associated cutaneous changes are uncommon. Most disease is bilateral, although involvement may be asymmetric. Response to conventional treatment is excellent, although long-term treatment may be necessary to prevent relapses.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
6/9. Remission of rosacea induced by reduction of gut transit time.rosacea is a chronic disorder characterized by hypersensitivity of the facial vasculature, presenting with intense flushing eventually leading to chronic erythema and telangiectasia. Although the precise aetiology of rosacea is not known, numerous associations with inflammatory gastrointestinal tract disorders have been reported. Furthermore, substance p-immunoreactive neurones occur in considerably greater numbers in tissue surrounding affected blood vessels suggesting involvement of neurogenic inflammation and moreover plasma kallikrein-kinin activation is consistently found in patients. In this report, a patient without digestive tract disease is described, who experienced complete remission of rosacea symptoms following ingestion of a material intended to sweep through the digestive tract and reduce transit time below 30 h. It is possible that intestinal bacteria are capable of plasma kallikrein-kinin activation and that flushing symptoms and the development of other characteristic features of rosacea result from frequent episodes of neurogenic inflammation caused by bradykinin-induced hypersensitization of facial afferent neurones. The possible relevance of this hypothesis to other conditions featuring afferent hypersensitivity, such as fibromyalgia, is considered.- - - - - - - - - - ranking = 2keywords = inflammation (Clic here for more details about this article) |
7/9. Elephantoid oedema of the eyelids.We describe a male patient with rosacea who had a 2-year history of persistent bilateral oedema of the eyelids, leading to an elephantoid condition with blepharoptosis. An upper eyelid blepharoplasty was performed, but swelling progressively recurred over a few months. Based on the case history, clinical appearance and histological findings, rosaceous lymphoedema was considered to be the diagnosis. The latter is a bilateral, solid oedema of the mid-third of the face, regarded as a rare complication of rosacea. It is thought to occur as a result of chronic inflammation and lymphatic stasis, but its exact aethiopathogenesis remains elusive. Predominant eyelid involvement, causing severe visual impairment as in our patient, is unique.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
8/9. Sarcoidal reaction to lymphoma presenting as granulomatous rosacea.A patient with poorly differentiated lymphocytic lymphoma had rosacealike facial lesions noted at the time of diagnosis of the lymphoma. The skin lesions followed the course of exacerbations and remissions of the systemic lymphoma. A biopsy specimen showed a sarcoidal granulomatous inflammation in the skin, and later in subcutaneous nodules that developed on the face. This case is consistent with a sarcoidal tissue reaction to lymphoma, and is unique in its clinical presentation as granulomatous rosacea.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |
9/9. Acne rosacea with keratitis in childhood.We present three cases of acne rosacea keratitis that developed in childhood. All three children were prepubescent and demonstrated characteristic dermatologic findings involving the nose, cheeks, and/or chin. The patients had complained of ocular irritation for at least 6 months, and in one case symptoms were reported by the family to have occurred intermittently since age 4 years. All three children showed evidence of meibomian gland inflammation; two patients demonstrated bilateral keratitis, the third had only unilateral involvement. In each case, oral tetracycline hydrochloride or doxycycline hyclate was necessary to relieve symptoms. rosacea keratitis should be considered in the differential diagnosis of chronic keratoconjunctivitis during childhood.- - - - - - - - - - ranking = 1keywords = inflammation (Clic here for more details about this article) |