Rosacea

IF 2.2 4区 医学 Q2 DERMATOLOGY
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The intradermal microinjection technique of injecting diluted onabotulinum toxin A into the involved facial pattern can produce a significant improvement in the degree of both flushing and pain, where other therapies have failed.</p><p><b>Methods:</b> A 37-year-old female with long history of facial flushing, burning skin of the cheeks, forehead and chin and conjunctival hyperaemia, was diagnosed with a combination of neurogenic and ocular rosacea. She had previously failed therapies including topical metronidazole, brimonidine, ivermectin, oral doxycycline, beta blockers, alpha blockers, mirtazapine, amitriptyline and vascular laser therapy. In addition, patch testing was performed as well blood evaluation to rule out alternative diagnoses. The onabotulinum toxin A (1.67 units per 0.1 mL) diluted in saline, was injected using multiple sites approximately 1 cm apart, and approximately 0.05 mL per injection site, with 25 units in total used over the upper forehead, cheeks, upper lip and chin areas, which were areas most effected by erythema. An additional 14 IU onabotulinum toxin A (100 IU diluted with 2.5 mL saline) diluted was injected into the glabellar complex.</p><p><b>Results:</b> Improvement of symptoms were noticed by the patient within 2 weeks of the first treatment, and a second treatment, 4 months later was requested because of its efficacy. The Rosacea-specific Quality-of-Life instrument (RosQol) showed improvement from a score of 76 to 58 four months after the first treatment.</p><p><b>Conclusion:</b> Neurogenic rosacea is difficult to treat, and dilute intradermal onabotulinum toxin A, may be beneficial therapy to consider in refractory cases.</p><p><span>James Fuller</span><sup><span>1</span></sup>; Cathal O'Connor<sup>2</sup>; Michelle Murphy<sup>2</sup></p><p><sup><i>1</i></sup><i>Skin Health Institute, Melbourne, Victoria, Australia;</i> <sup><i>2</i></sup><i>South Infirmary Victoria and University Hospital, Cork, Ireland</i></p><p><b>Aim:</b> Rosacea is a common chronic inflammatory skin disease with a complex aetiology and major psychological impact. Patients with rosacea have higher incidences of embarrassment, social anxiety, depression and decreased quality-of-life (QoL) compared to the rest of the population. In the modern era of internet chat forums and social media platforms, patients can research rosacea anonymously using unverified resources, rendering them susceptible to misinformation and conspiracy theories in their desire to improve their QoL. We aimed to assess the content of rosacea-related misinformation online.</p><p><b>Methods:</b> A formal review of PubMed was performed in January 2023, using the terms ‘rosacea’ AND ‘misinformation’ OR ‘disinformation’ OR ‘conspiracy theory’, along with informal Google searches using combinations of these terms. Information in the form of images and direct quotations was collected from the first 10 pages of each Google search. Further targeted searches were also conducted on social media including Twitter, Facebook, Instagram and TikTok.</p><p><b>Results:</b> Key areas of misinformation identified in the search included mislabelling of rosacea as adult acne; falsehoods about rosacea only occurring in older adults or in individuals with lightly pigmented skin; incorrect causes of rosacea such as makeup or diet; and misleading ‘cures’, some of which may lead to exacerbation of the underlying rosacea.</p><p><b>Conclusion:</b> Patients with rosacea may rely on peer-generated information through online social media and internet platforms due to the major psychological impact of the condition and its incurable nature. Relying on online forums can have negative consequences for patients, due to the rapid spread of false information with a perturbing lack of monitoring or verification. Dermatologists must be aware of the large amount of rosacea misinformation trending online and be prepared to counteract them with evidence to optimize patient care.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 S1","pages":"120-121"},"PeriodicalIF":2.2000,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14288","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australasian Journal of Dermatology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ajd.14288","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Miranda Wallace1; Nancy Todes-Taylor2; Margot Whitfeld3

1Pacific Dermatology, St Leonards, New South Wales, Australia; 2St Leonards Dermatology & Laser, St Leonards, New South Wales, Australia; 3Department of Dermatology, St Vincent's Hospital, Sydney, New South Wales, Australia

Aim: Neurogenic rosacea is a form of rosacea due to neurogenic dysregulation and is characterised by severe facial erythema, burning, stinging and pain sometimes out of proportion to the degree of flushing. It is an uncommon, and often debilitating condition with severe effect on quality of life, and often refractory to traditional rosacea therapies. The intradermal microinjection technique of injecting diluted onabotulinum toxin A into the involved facial pattern can produce a significant improvement in the degree of both flushing and pain, where other therapies have failed.

Methods: A 37-year-old female with long history of facial flushing, burning skin of the cheeks, forehead and chin and conjunctival hyperaemia, was diagnosed with a combination of neurogenic and ocular rosacea. She had previously failed therapies including topical metronidazole, brimonidine, ivermectin, oral doxycycline, beta blockers, alpha blockers, mirtazapine, amitriptyline and vascular laser therapy. In addition, patch testing was performed as well blood evaluation to rule out alternative diagnoses. The onabotulinum toxin A (1.67 units per 0.1 mL) diluted in saline, was injected using multiple sites approximately 1 cm apart, and approximately 0.05 mL per injection site, with 25 units in total used over the upper forehead, cheeks, upper lip and chin areas, which were areas most effected by erythema. An additional 14 IU onabotulinum toxin A (100 IU diluted with 2.5 mL saline) diluted was injected into the glabellar complex.

Results: Improvement of symptoms were noticed by the patient within 2 weeks of the first treatment, and a second treatment, 4 months later was requested because of its efficacy. The Rosacea-specific Quality-of-Life instrument (RosQol) showed improvement from a score of 76 to 58 four months after the first treatment.

Conclusion: Neurogenic rosacea is difficult to treat, and dilute intradermal onabotulinum toxin A, may be beneficial therapy to consider in refractory cases.

James Fuller1; Cathal O'Connor2; Michelle Murphy2

1Skin Health Institute, Melbourne, Victoria, Australia; 2South Infirmary Victoria and University Hospital, Cork, Ireland

Aim: Rosacea is a common chronic inflammatory skin disease with a complex aetiology and major psychological impact. Patients with rosacea have higher incidences of embarrassment, social anxiety, depression and decreased quality-of-life (QoL) compared to the rest of the population. In the modern era of internet chat forums and social media platforms, patients can research rosacea anonymously using unverified resources, rendering them susceptible to misinformation and conspiracy theories in their desire to improve their QoL. We aimed to assess the content of rosacea-related misinformation online.

Methods: A formal review of PubMed was performed in January 2023, using the terms ‘rosacea’ AND ‘misinformation’ OR ‘disinformation’ OR ‘conspiracy theory’, along with informal Google searches using combinations of these terms. Information in the form of images and direct quotations was collected from the first 10 pages of each Google search. Further targeted searches were also conducted on social media including Twitter, Facebook, Instagram and TikTok.

Results: Key areas of misinformation identified in the search included mislabelling of rosacea as adult acne; falsehoods about rosacea only occurring in older adults or in individuals with lightly pigmented skin; incorrect causes of rosacea such as makeup or diet; and misleading ‘cures’, some of which may lead to exacerbation of the underlying rosacea.

Conclusion: Patients with rosacea may rely on peer-generated information through online social media and internet platforms due to the major psychological impact of the condition and its incurable nature. Relying on online forums can have negative consequences for patients, due to the rapid spread of false information with a perturbing lack of monitoring or verification. Dermatologists must be aware of the large amount of rosacea misinformation trending online and be prepared to counteract them with evidence to optimize patient care.

红斑痤疮
米兰达-华莱士(Miranda Wallace)1;南希-托德斯-泰勒(Nancy Todes-Taylor)2;玛格特-惠特菲尔德(Margot Whitfeld)31澳大利亚新南威尔士州圣莱昂纳兹太平洋皮肤科;2澳大利亚新南威尔士州圣莱昂纳兹皮肤科&激光;3澳大利亚新南威尔士州悉尼圣文森特医院皮肤科:神经源性红斑痤疮是一种由于神经源性调节失调引起的红斑痤疮,其特征是严重的面部红斑、烧灼感、刺痛和疼痛,有时与潮红程度不成比例。这种病症并不常见,通常会使人衰弱,严重影响生活质量,传统的红斑痤疮疗法往往难以奏效。在其他疗法无效的情况下,采用皮内微注射技术,将稀释的奥博毒素 A 注射到受累的面部纹路中,可以显著改善潮红和疼痛的程度:一名 37 岁的女性,长期面部潮红,脸颊、前额和下巴皮肤灼热,结膜充血,被诊断为神经源性红斑痤疮和眼部红斑痤疮。她曾接受过多种治疗,包括甲硝唑外用药、溴莫尼丁、伊维菌素、口服多西环素、β受体阻滞剂、α受体阻滞剂、米氮平、阿米替林和血管激光治疗,但均无效。此外,还进行了斑贴试验和血液评估,以排除其他诊断。用生理盐水稀释的A型伊诺保妥适(1.67单位/0.1毫升)在多个部位注射,间隔约1厘米,每个注射部位约0.05毫升,在上额、脸颊、上唇和下巴部位共使用了25个单位,这些部位是受红斑影响最严重的部位。此外,还在睑板腺复合体注射了 14 IU 奥那布林毒素 A(100 IU,用 2.5 mL 生理盐水稀释):结果:患者在第一次治疗后的两周内发现症状有所改善,由于疗效显著,4 个月后又要求进行第二次治疗。酒糟鼻生活质量测试(RosQol)显示,第一次治疗后四个月,患者的生活质量从 76 分下降到 58 分:James Fuller1; Cathal O'Connor2; Michelle Murphy21Skin Health Institute, Melbourne, Victoria, Australia; 2South Infirmary Victoria and University Hospital, Cork, IrelandAim: 酒渣鼻是一种常见的慢性炎症性皮肤病,病因复杂,对患者的心理影响很大。与其他人群相比,红斑痤疮患者的尴尬、社交焦虑、抑郁和生活质量(QoL)下降的发生率较高。在互联网聊天论坛和社交媒体平台盛行的今天,患者可以使用未经证实的资源匿名研究酒渣鼻,这使他们在希望改善生活质量的过程中很容易受到错误信息和阴谋论的影响。我们旨在评估网上与酒渣鼻相关的错误信息的内容:2023 年 1 月,我们使用 "红斑痤疮"、"错误信息 "或 "虚假信息 "或 "阴谋论 "等词对 PubMed 进行了正式审查,并使用这些词的组合对谷歌进行了非正式搜索。从每次谷歌搜索的前 10 页中收集图片和直接引文形式的信息。此外,还在 Twitter、Facebook、Instagram 和 TikTok 等社交媒体上进行了更多有针对性的搜索:搜索中发现的错误信息主要包括:将红斑痤疮误认为成人痤疮;关于红斑痤疮只发生在老年人或皮肤色素较浅的人身上的错误说法;导致红斑痤疮的错误原因,如化妆品或饮食;以及误导性的 "治疗方法",其中一些方法可能会导致潜在的红斑痤疮恶化:结论:酒糟鼻患者可能会依赖网络社交媒体和互联网平台上由同龄人产生的信息,这是因为酒糟鼻会对患者造成严重的心理影响,而且酒糟鼻是无法治愈的。依赖网络论坛可能会给患者带来负面影响,因为虚假信息传播迅速,且缺乏监控或验证,令人不安。皮肤科医生必须了解网上流行的大量红斑痤疮错误信息,并准备好用证据来反驳它们,以优化患者护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
5.00%
发文量
186
审稿时长
6-12 weeks
期刊介绍: Australasian Journal of Dermatology is the official journal of the Australasian College of Dermatologists and the New Zealand Dermatological Society, publishing peer-reviewed, original research articles, reviews and case reports dealing with all aspects of clinical practice and research in dermatology. Clinical presentations, medical and physical therapies and investigations, including dermatopathology and mycology, are covered. Short articles may be published under the headings ‘Signs, Syndromes and Diagnoses’, ‘Dermatopathology Presentation’, ‘Vignettes in Contact Dermatology’, ‘Surgery Corner’ or ‘Letters to the Editor’.
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