Standard grading system for rosacea: report of the National Rosacea Society Expert Committee on the classification and staging of rosacea.
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INTRODUCTION: We have tried to assess the incidence and disclosing factors of ocular rosacea and its treatment in patients presenting with cutaneous rosacea. PATIENTS AND METHODS: We conducted a prospective study over two years of all the patients consulting the Dermatology department of the University hospital in Saint-Etienne for cutaneous rosacea, and signs of the ocular form using a questionnaire and clinical examination. Each patient's case report was then studied individually when the patient presented signs of ocular rosacea. RESULTS: Three hundred eighteen patients consulted for cutaneous rosacea. Only 19 patients (6%) exhibited an ocular rosacea. Erythrocouperose was the predominant cutaneous stage. Conjunctivitis and keratitis were the predominating ophthalmologic symptoms. Tetracyclines were the treatment generally used with 72% of good response. Among the patients presenting with ocular rosacea, 52% had been referred by their general practitioner. DISCUSSION: The severity of the ocular damage is not correlated with the stage of cutaneous involvement. Ocular rosacea in its most developed form still remains the domain of the ophthalmologist. This study confirms cyclines as the treatment of choice in this disease.
BACKGROUND: Peach is being developed as a model organism for Rosaceae, an economically important family that includes fruits and ornamental plants such as apple, pear, strawberry, cherry, almond and rose. The genomics and genetics data of peach can play a significant role in the gene discovery and the genetic understanding of related species. The effective utilization of these peach resources, however, requires the development of an integrated and centralized database with associated analysis tools. DESCRIPTION: The Genome Database for Rosaceae (GDR) is a curated and integrated web-based relational database. GDR contains comprehensive data of the genetically anchored peach physical map, an annotated peach EST database, Rosaceae maps and markers and all publicly available Rosaceae sequences. Annotations of ESTs include contig assembly, putative function, simple sequence repeats, and anchored position to the peach physical map where applicable. Our integrated map viewer provides graphical interface to the genetic, transcriptome and physical mapping information. ESTs, BACs and markers can be queried by various categories and the search result sites are linked to the integrated map viewer or to the WebFPC physical map sites. In addition to browsing and querying the database, users can compare their sequences with the annotated GDR sequences via a dedicated sequence similarity server running either the BLAST or FASTA algorithm. To demonstrate the utility of the integrated and fully annotated database and analysis tools, we describe a case study where we anchored Rosaceae sequences to the peach physical and genetic map by sequence similarity. CONCLUSIONS: The GDR has been initiated to meet the major deficiency in Rosaceae genomics and genetics research, namely a centralized web database and bioinformatics tools for data storage, analysis and exchange. GDR can be accessed at http://www.genome.clemson.edu/gdr/.
Seventy patients with rosacea were treated with systemic tetracycline for 6 months. Sixty-eight of them cleared with treatment. After withdrawal of the drug seventeen relapsed immediately and the overall relapse rate over 4 years was 69%. The serum tetracycline levels were not significantly different in two patients who failed to respond. Six patients had rosacea keratitis and responded dramatically within 1 month. Symptoms recurred as the drug was withdrawn. It is suggested that rosacea patients with keratitis should receive early and prolonged tetracycline medication.
BACKGROUND: Lupus miliaris disseminatus faciei is an eruption of discrete red-brown, dome-shaped papules, histologically characterized by epithelioid cell granulomas. The pathogenesis of the disorder remains controversial. OBJECTIVE: The authors discuss the place of lupus miliaris disseminatus faciei among granulomatous disorders. METHODS: This report reviews the available literature and presents 3 patients with lupus miliaris disseminatus faciei. RESULTS: The histopathologic characteristics of lupus miliaris disseminatus faciei--an epithelioid cell granuloma with central necrosis--may be found in granulomatous rosacea, whilst the clinical features and course of lupus miliaris disseminatus faciei are often similar to cutaneous sarcoidosis. CONCLUSIONS: We put forward lupus miliaris disseminatus faciei as a distinctive rosacea-like syndrome and not as a granulomatous form of rosacea.
Granulomatous rosacea is a variant of rosacea that may present similar to other granulomatous diseases. We present the case of a 45-year-old woman with a 2-year history of facial erythema with multiple papules and pustules on the cheeks, chin, and glabella. The patient responded to minocycline, resulting in healing 6 months without residual scarring. This patient's clinical and histological presentation and treatment outcome are to our assessment consistent with granulomatous rosacea. However, other clinically and histologically related entities will be discussed. These entities include, but are not limited to, perioral dermatitis, granulomatous periorificial dermatitis, lupus miliaris disseminatus faciei, facial afro-caribbean eruption syndrome, and sarcoidosis.
Estrogen- and androgen receptor levels were investigated in the skin of 11 male and 4 female rosacea patients. No significant difference in receptor distribution or in receptor levels could be found between rosacea lesions and normal skin of the same patients. Moreover, hormone serum levels were in the normal range. Data from the present investigation suggest that rosacea formation is not governed by endocrine, although clinical and electron microscopic observations indicate a possible endocrine influence at the vascular level.
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