A Survey of Human Face Mites Demodex (Acari, Demodicidae) in Patients with Dermatological Symptoms in Baghdad, Iraq

Demodex spp. mites are external obligate parasites; they are transmitted between hosts through direct contact, and may induce several dermatological symptoms when found in large numbers. However, these symptoms may be similar to other commonly known diseases; this often leads dermatologists to neglect the pathogenic role of these mites. Therefore, a better diagnosis is recommended in order to avoid mistreatment. The aim of this study was to investigate the correlation between Demodex mites and dermatological diseases. Infestation rates in patients suffering from acne, rosacea, folliculitis, and psoriasis were compared with asymptomatic patients, along with the mites’ relation to gender, age, personal hygiene, time of year, and residency. These mites were mainly found in patients with rosacea (66.67%) followed by acne (64.41%), while they were only observed in 48.15% of asymptomatic patients, 40.00% in folliculitis, and 0.00% in psoriasis. The statistical analysis showed a significant relationship between infestation and the previously mentioned dermatological diseases (P<0.01). The infestation rates increased significantly with age, reaching 83.33% in patients above 60 years old, and especially during cold months with higher humidity rates. These mites were also more predominantly found in urban areas (56.10%), followed by rural areas (48.45%). However, there was no significant relationship according to gender or personal hygiene.

A Clinical Study of Jalaukavacharana and Panchanimba Churn in the Management of Acne Rosacea- A Research Article

Rosacea is a common skin disorder that predominately affects fair skin people. More then10 million cases per year are found in the India. It usually presents with erythema, telangiectasia, and papulo-pustular lesions on the cheeks chin and central forehead and usually triggered by sun exposure. It is generally affects facial skin and less commonly may involve the neck and chest, it may also happen at non-facial sites. It has characterized in its early on phases by erythema (flushing and redness) on the central face and across the cheeks, nose or forehead. Rosacea is not mentioned specifically in any Ayurveda text. According to description of sign & symptoms of rosacea in modern science, it is resemble as a type of Pitta Dusht Raktaj Vyadhi according to Ayurveda science. Based on these signs and symptoms, according to Ayurveda Acharya this disease is caused by Pitta Dushta Rakta. Ayurveda also implements broad line of management of skin disorders like medicinal and para-surgical approach. Acharya Sushruta clearly mentioned that if all conservative management fails then the disease should consider as blood vitiated disease and Raktamokshana is to consider as choice of treatment. Keywords: Rosacea, Pitta Dusht Rakta, Vyadhi, Raktamokshana, para-surgical, erythema, Panchanimba Churna.

Pruritus, Pain, and Depression Associated with the Most Common Skin Diseases: Data from the French Study “Objectifs Peau”

<b><i>Background:</i></b> The prevalence and impact of pruritus, pain, and other sensory symptoms in skin diseases are poorly known. <b><i>Objective:</i></b> To assess the frequency of these symptoms with dermatoses and their association with depression using data from the “Objectifs Peau” survey. <b><i>Methods:</i></b> A representative sample of 20,012 French individuals was created using the usual quota method. <b><i>Results:</i></b> When patients suffered from both pruritus and skin pain, they had a higher relative risk of psychological suffering (2.9) than those who suffered only from pruritus (1.4) or skin pain (1.2). Pruritus was reported in 48.55% of patients with acne, 43.24% with mycoses, 44.35% with warts, and 36.51% with rosacea. For skin pain, the results were 11.22%, 27.59%, and 16.13% for atopic dermatitis, acne, and warts, respectively. Other unpleasant sensations, such as tingling or burning, were also frequently reported. <b><i>Conclusion:</i></b> Pruritus, pain, or other sensory symptoms were found to be common not only in classic pruritic skin diseases but also in acne, rosacea, or warts. The association of pruritus and pain dramatically increased psychological suffering. These symptoms must be systematically searched for in patients, especially since new therapeutic possibilities are emerging for the symptomatic treatment of pruritus.

The Ugly Face of Face Masks

Introduction: Prolonged and tightly use of face masks has been identified as cause for skin damage during the COVID-19 pandemic. Case series presentation: We evaluated patients seen in the outpatient clinic between March and May 2020, during the lockdown period, focusing on skin damage related to the use of face masks. We aimed to highlight the major impact of routine usage of face masks on the skin of individuals of different ages and professions. Contact dermatitis was prevalent, but we also recorded many cases of outbreak of seborrheic dermatitis, acne, rosacea, perioral dermatitis, atopic dermatitis, folliculitis, as well as neurotic excoriations caused by anxiety, tinea, and impetigo. We also observed a delay in the diagnosis of benign and malignant tumors. Conclusions: The most important step should be the assessment of dermatologic pathology related to the use of face masks. They say a picture is worth a thousand words. So take off the face mask, and look at the skin!

Recovery strategies intestinal mucosal barrier

The surface of the intestinal tract in healthy people is free of bacteria in all segments of the intestine. Thus, the attachment of bacteria to epithelial cells is a sign of infection. Unlike the mucous membrane, the intestinal lumen is never sterile. The reason for this is the polymicrobial nature of the gut microbiota. In the intestine, segments such as the stomach or small intestine, where bacteria are actively suppressed, the microbiota is random in appearance, composition, and concentration. However, the situation is completely different in the colon, where the growth of bacteria increases and their suppression is suspended. The concentration and diversity of bacteria in the colon reaches astronomical numbers. Some of these bacteria are required for the colon to function. Many of the local bacteria in the colon are potential pathogens: Bacteroides, Enterobacteriaceae, Enterococci, and Clostridium histolyticum. Control of pathogens in the colon is achieved through an impenetrable mucus layer. Inflammatory bowel disease is a polymicrobial infection characterized by persistent disruption of the mucosal barrier, subsequent migration of bacteria to the mucous membrane, and overgrowth of a complex bacterial biofilm on the surface of the epithelium, resulting in invasive and cytopathological effects. As long as the mucosal barrier function is impaired, the inflammatory process cannot successfully remove bacteria from the mucosal surface, and inflammation itself is detrimental. Due to the inflammatory reaction, the composition and structure of the fecal microbiota changes. Based on the biostructure of the fecal casts, active Crohn’s disease and ulcerative colitis can be distinguished from each other and from other gastrointestinal diseases. The relationship between the gut microbiome and various dermatological diseases (psoriasis, acne, rosacea, atopic dermatitis) is discussed.

Cosmeceutical Aptitudes of Azelaic Acid

Background: Azelaic acid (AZA) is a white crystalline dicarboxylic acid naturally found in grains, rye and barley. AZA has substantial biological and therapeutic abilities (viz a viz) its anti-inflammatory, anti-oxidant, anti-keratinizing, anti-microbial properties, etc. which contribute to its applicability in the management of mild to harsh dermatological complications (acne, rosacea, dermatitis, hyper-pigmentation, carcinomas, etc.). AZA has shown its effectiveness against varied non-inflammatory and inflammatory lesions by normalizing the hyper-keratinization statie and attenuating the increased levels of microbial content. Topically AZA, either alone or in conjunction with other active moieties, has proved to be effective in preventing acne and several other hyper-pigmentary conditions. Objectives: Chronic applicability of AZA has been evidenced with the effects like itching, burning, stinging, redness, etc. To deal with the former issues, research is being conducted to substitute the conventional formulations with novel preparations (liposome’s, niosomes, micro sponges, lipid nanocarriers, etc.), which could enhance the overall pharmaceutical and pharmacological profile of the drug. Conclusion: This article is an attempt to highlight the basic physiochemical properties of AZA, its physiological role (especially in dermatology), various commercial preparations and recent novel approaches that are in research with an aim to augment the therapeutic and safety profile of AZA.

Elucidating the immune infiltration in acne and its comparison with rosacea by integrated bioinformatics analysis

Background Acne vulgaris and rosacea are common inflammatory complications of the skin, both characterized by abnormal infiltration of immune cells. The two diseases can be differentiated based on characteristic profile of the immune cell infiltrates at the periphery of disease lesions. In addition, dysregulated infiltration of immune cells not only occur in the acne lesions but also in non-lesional areas of patients with the disease, thus characterizing the immune infiltration in these sites can further enhance our understanding on the pathogenesis of acne. Methods Five microarray data-sets (GSE108110, GSE53795, GSE65914, GSE14905 and GSE78097) were downloaded from Gene Expression Omnibus. After removing the batch effects and normalizing the data, we applied the CIBERSORT algorithm combined with signature matrix LM22, to describe 22 types of immune cells’ infiltration in acne less than 48 hour (H) old, in comparation with non-lesional skin of acne patients, healthy skin and rosacea (including erythematotelangiectatic rosacea, papulopustular rosacea and phymatous rosacea) and we compared gene expression of Th1 and Th17-related molecules in acne, rosacea and healthy control. Results Compared with the non-lesional skin of acne patients, healthy individuals and rosacea patients, there is a significant increase in infiltration of neutrophils, monocytes and activated mast cells around the acne lesions, less than 48 H after their development. Contrarily, few naive CD4+ T cells, plasma cells, memory B cells and resting mast cells infiltrate acne sites compared to the aforementioned groups of individuals. Moreover, the infiltration of Regulatory T cells (Tregs) in acne lesions is substantially lower, relative to non-lesional sites of acne patients and skin of healthy individuals. In addition, non-lesional sites of acne patients exhibit lower infiltration of activated memory CD4+ T cells, plasma cells, memory B cells, M0 macrophages, neutrophils, resting mast cells but higher infiltration of Tregs and resting dendritic cells relative to skin of healthy individuals. Intriguingly, we found that among the 3 rosacea subtypes, the immune infiltration profile of papulopustular rosacea is the closest to that of acne lesions. In addition, through gene expression analysis of acne, rosacea and skin tissues of healthy individuals, we found a higher infiltration of Th1 and Th17 cells in acne lesions, relative to non-lesional skin areas of acne patients. Conclusions Our study provides new insights into the inflammatory pathogenesis of acne, and the difference between acne and rosacea, which helps in differentiating the two diseases. Our findings also guide on appropriate target therapy of the immune cell infiltrates in the two disease conditions.