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Brimonidine rosacea

Giuseppe Micali, Peter Arne Gerber, Francesco Lacarrubba, Gregor Schäfer
Rosacea is a chronic inflammatory disease that can present with a variety of cutaneous symptoms. Erythematotelangiectatic rosacea is a subtype characterized by flushing (transient erythema), persistent central facial erythema (background erythema), and telangiectasias. The severity of individual symptoms differs in each patient, which can complicate the selection of an appropriate treatment strategy. Evaluation of these specific symptoms has been greatly improved by the routine use of diagnostic tools such as (video) dermatoscopy...
July 2016: Journal of Clinical and Aesthetic Dermatology
Martin Schaller, Lena Gonser
Rosacea is a chronic inflammatory disease that can manifest as a spectrum of symptoms including erythema, inflammatory lesions, edema, and telangiectasia. Treatment decisions need to be adapted to reflect the nature and severity of the different symptoms present. In this report, we discuss the case of a female patient diagnosed with severe, inflamed papulopustular rosacea (PPR) presenting with a large number of inflammatory lesions and severe background erythema. This patient responded well to a treatment regimen consisting of a short course of antibiotics in combination with a corticosteroid, followed by monotherapy with isotretinoin to reduce the inflammation...
September 2016: Drugs in R&D
James R Docherty, Martin Steinhoff, Dianne Lorton, Michael Detmar, Gregor Schäfer, Anna Holmes, Anna Di Nardo
: Rosacea is a chronic inflammatory disease with transient and non-transient redness as key characteristics. Brimonidine is a selective α2-adrenergic receptor (AR) agonist approved for persistent facial erythema of rosacea based on significant efficacy and good safety data. The majority of patients treated with brimonidine report a benefit; however, there have been sporadic reports of worsening erythema after the initial response. A group of dermatologists, receptor physiology, and neuroimmunology scientists met to explore potential mechanisms contributing to side effects as well as differences in efficacy...
August 25, 2016: Advances in Therapy
Joseph F Fowler
Rosacea is a chronic skin disorder associated with flushing, erythema, dryness, burning and stinging, and inflammatory papules and pustules. New treatments available or in development target the inflammatory and erythematous components of the disease. These agents include the selective α2 receptor agonist brimonidine, the topical agents ivermectin cream 1% and azelaic acid foam 15%, and use of tetracyclinetype antibiotics, which affect the cathelicidin pathway. Semin Cutan Med Surg 35(supp6):S107-S109.
June 2016: Seminars in Cutaneous Medicine and Surgery
Jonette Keri
Acne and rosacea are common conditions seen every day by dermatologists. This review will discuss the most recent therapeutic options for patients with these conditions. Specifically, for acne, there will be a discussion of the use of isotretinoin at higher cumulative doses as well as a new formulation of isotretinoin, isotretinoin-lidose. Adult women with acne represent a growing population of patients who present for treatment of acne; the use of hormonal therapies as well as topical dapsone gel will be reviewed for these patients...
June 2016: Seminars in Cutaneous Medicine and Surgery
Erin Lowe, Scott Lim
In 2013 brimonidine tartrate gel 0.33% (Mirvaso Gel, Galderma Laboratories, LP, Fort Worth, TX) was approved by the US Food and Drug Administration for the treatment of facial erythema of rosacea. It is the first and only drug on the market to address the hallmark redness of this chronic, inflammatory disease. Commonly reported adverse events include erythema/flushing worse than at baseline, most often occurring with the first application. We report a unique case of facial erythema of rosacea that responded to brimonidine gel with effective blanching for two years until the patient developed a paradoxical erythema reaction...
June 1, 2016: Journal of Drugs in Dermatology: JDD
Nannie Bangsgaard, Louise A N Fischer, Claus Zachariae
No abstract text is available yet for this article.
June 2016: Contact Dermatitis
P Del Barrio-Díaz, C Moll-Manzur, C Vera-Kellet
BACKGROUND: Clinicians have recognized the impact of cutaneous signs and symptoms in patient's quality of life over the years. Often, systemic response to a certain therapy is faster than the cutaneous response, leading to patient frustration and treatment discontinuation. Brimonidine gel is an alpha-2 adrenergic agonist recently approved by the FDA for the treatment of persistent facial erythema of rosacea. OBJECTIVES AND METHODS: We describe 3 patients with recalcitrant facial erythema secondary to dermatomyositis, pityriasis rubra pilaris and systemic lupus...
March 16, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
L Themstrup, S Ciardo, M Manfredi, M Ulrich, G Pellacani, J Welzel, G B E Jemec
BACKGROUND: Brimonidine is a selective α2 adrenergic receptor agonist with potent vasoconstrictive activity topically used for treatment of facial flushing and erythema caused by rosacea. Direct evidence for the in vivo morphology changes in skin vessels induced by topical application of brimonidine is limited. Dynamic optical coherence tomography is a novel technology that combines conventional OCT with information on flow and thereby provides supplementary information about the microvasculature...
June 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
Hazel H Oon, Ziying Vanessa Lim
In this case report, we detail the response of a 37-year-old Caucasian man with an overlap of erythematotelangiectatic rosacea and telangiectatic photoaging to brimonidine tartrate gel. With the application of brimonidine only on half of his face, skin analysis images, clinician's and patient's assessment showed that there was significant improvement in the erythema. This case has lent insight into how brimonidine can be used to assess the extent of photoaging by eliminating the erythema of rosacea to some degree...
January 13, 2016: Australasian Journal of Dermatology
Martin Steinhoff, Martin Schmelz, Jürgen Schauber
Rosacea is a common chronic skin condition that displays a broad diversity of clinical manifestations. Although the pathophysiological mechanisms of the four subtypes are not completely elucidated, the key elements often present are augmented immune responses of the innate and adaptive immune system, and neurovascular dysregulation. The most common primary feature of all cutaneous subtypes of rosacea is transient or persistent facial erythema. Perilesional erythema of papules or pustules is based on the sustained vasodilation and plasma extravasation induced by the inflammatory infiltrates...
June 15, 2016: Acta Dermato-venereologica
Esther J van Zuuren, Zbys Fedorowicz
CLINICAL QUESTION: Which interventions are associated with highest efficacy and fewest adverse events for treating rosacea? BOTTOM LINE: There is high-quality evidence that topical brimonidine, azelaic acid, and ivermectin, as well as oral doxycycline and isotretinoin, are associated with improvements in rosacea. Lower-quality evidence is available for topical metronidazole, oral tetracycline, laser and light-based therapy, and topical cyclosporine for ocular rosacea...
December 8, 2015: JAMA: the Journal of the American Medical Association
Allison P Weinkle, Vladyslava Doktor, Jason Emer
Refining diagnostic criteria has identified key characteristics differentiating rosacea, a chronic skin disorder, from other common cutaneous inflammatory conditions. The current classification system developed by the National Rosacea Society Expert Committee consists of erythematotelangiectatic, papulopustular, phymatous, and ocular subtypes. Each subtype stands as a unique entity among a spectrum, with characteristic symptoms and physical findings, along with an intricate pathophysiology. The main treatment modalities for rosacea include topical, systemic, laser, and light therapies...
October 2015: Plastic Surgical Nursing
J Mark Jackson, Melissa Knuckles, John Paul Minni, Sandra Marchese Johnson, Kevin Tate Belasco
Rosacea is a chronic cutaneous condition with a prevalence rate ranging from 9.6% to 22% in recent studies. Facial erythema (transient and permanent) is considered a common denominator that is frequently observed in all subtypes of rosacea and is estimated to affect more than 40 million people worldwide. Brimonidine tartrate is a selective α2-adrenergic receptor agonist and is the first topical treatment approved for facial erythema of rosacea. Clinical trials have demonstrated that brimonidine tartrate provided significantly greater efficacy, compared to vehicle, for the treatment of moderate to severe erythema of rosacea...
2015: Clinical, Cosmetic and Investigational Dermatology
Markus Reinholz, Markus Heppt, Julia K Tietze, Thomas Ruzicka, Gerd G Gauglitz, Jürgen Schauber
Cutaneous scars develop as a result of a defective wound healing process. Scars are commonly visible as erythematous, sometimes disfiguring lesions which might be stigmatizing for the affected patient. Only a few therapies to improve the appearance of scars are available. Recently, brimonidine - a selective α2-receptor-agonist which causes vasoconstriction of small cutaneous vessels - was approved for the treatment of erythemato-telangiectatic rosacea. Topical brimonidine might also be helpful to improve redness of immature scars...
September 30, 2015: Journal of Dermatological Case Reports
A M Layton, M Schaller, B Homey, M A Hofmann, A P Bewley, P Lehmann, C Nohlgård, D B Sarwer, N Kerrouche, Y M Ma
BACKGROUND: Facial redness contributes to impaired psychosocial functioning in rosacea patients and the only approved treatment for erythema is topical brimonidine gel 0.33%. OBJECTIVES: To evaluate patient-reported outcomes, as well as efficacy and safety, in subjects with self-perceived severe erythema treated with brimonidine gel 0.33% compared to vehicle. METHODS: An 8-day multicenter, randomized study comparing once-daily brimonidine gel 0...
December 2015: Journal of the European Academy of Dermatology and Venereology: JEADV
Anna D Holmes, Kimberly A Waite, Michael C Chen, Kiruthi Palaniswamy, Thomas H Wiser, Zoe D Draelos, Elyse S Rafal, W Philip Werschler, Alison E Harvey
BACKGROUND: The topical α2 adrenergic receptor agonist brimonidine gel 0.33% is an effective and safe pharmacological treatment for the facial erythema of rosacea. However, adverse events of worsened redness have occasionally been reported with its use. OBJECTIVE: A detailed analysis of adverse events is needed to accurately define worsening erythema and the adverse-events profile associated with brimonidine gel treatment. METHODS AND MEASUREMENTS: A retrospective review of related dermatological adverse events occurring in subjects enrolled in the two pivotal four-week Phase 3 studies and the 52-week long-term safety study for brimonidine gel was conducted...
August 2015: Journal of Clinical and Aesthetic Dermatology
Linda K Oge', Herbert L Muncie, Amanda R Phillips-Savoy
Rosacea is a chronic facial skin condition of unknown cause. It is characterized by marked involvement of the central face with transient or persistent erythema, telangiectasia, inflammatory papules and pustules, or hyperplasia of the connective tissue. Transient erythema, or flushing, is often accompanied by a feeling of warmth. It usually lasts for less than five minutes and may spread to the neck and chest. Less common findings include erythematous plaques, scaling, edema, phymatous changes (thickening of skin due to hyperplasia of sebaceous glands), and ocular symptoms...
August 1, 2015: American Family Physician
Jerry Tan, Matthew Leoni
BACKGROUND: Facial erythema is a primary feature of rosacea. Currently, no validated scales exist that can accurately capture a patient's self-assessment of their own facial erythema. During phase 2 studies for brimonidine tartrate gel, a 5-point numeric rating scale was developed as a tool to allow subjects to provide an independent assessment of visible changes to the facial erythema associated with their rosacea. OBJECTIVE: The objective of this study was to validate the revised patient's self-assessment (PSA) scale and evaluate it for statistical reliability and validity in quantification of facial erythema of rosacea...
August 2015: Journal of Drugs in Dermatology: JDD
Andrew William Johnson, Sandra Marchese Johnson
Rosacea is a chronic inflammatory skin condition that commonly presents with persistent facial erythema with or without the coincident presence of flushing, telangiectasias, inflammatory papules or pustules, phymatous changes, or ocular involvement. Patients often present with a constellation of various signs and symptoms of the disease, and an individualized treatment plan should be tailored to a patient's unique clinical presentation. Previously available medications for rosacea have all targeted the inflammatory erythematous papules and pustules frequently associated with the disease, leaving a therapeutic gap for the common manifestation of persistent facial erythema...
September 2015: Dermatology and Therapy
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