Rosacea Abstracts 1

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Gastric secretion in psoriasis, eczema and dermatitis herpetiformis
            (Ayres, 1929) Download
The results of fractional gastric analyses have been tabulated in a series of nineteen cases of psoriasis, four cases of determatitis herpetiformis and eleven cases of eczema. The cases studied in this series show a predominance of abnormal acid curves, of which 52 per cent of the cases of psoriasis, 75 per cent of the cases of dermatitis herpetiformis, and 72 per cent of the cases of eczema showed a low total acid and a low free hydrochloric acid.

Fractional gastric analysis in diseases of the skin: Further observation in 316 cases, with special reference to rosacea
            (Brown et al., 1935) Download
Symptoms of gastric disturbance were present in 61% of a gronp of 75 patients with rosacea. The percentage of cases showing achlorhydria and extreme hypochlorhydria is lower in the rosacea group, viz. 28%, as compared with 35% in other dermatoses. A much more extensive study of the gastric analysis, as detailed in this paper, has led us to conclude that marked subacidity is not a feature pecuhar to rosacea as was originally thought. A degree of subacidity seems to be a feature of chronic dermatoses in general.

Some Observations On The Fractional Method Of Gastric Analysis In Diseases Of The Skin.
            (Brown, 1925) Download
The fractional method of gastric analysis is one of the recent new clinical methods of investigation of skin conditions. Ryle and Barber were the first in this country to adopt the fractional method of gastric analysis in the investigation of sldn conditions. In their original communication they particularly restricted their investigation to rosacea, which is the one skin-affection specially associated with gastric disturbance. Though they examined only 12 cases, their findings in these were very startling. In 5 cases there was complete achlorhydria, i. e. 41 par cent, ; in 2 cases there was extreme hypochlorhydria, i.e, 16 per cent. ; i.e. 7 out of 12 cases, = 58 per cent., showed complete or extreme hypochlorhydria, an exceedingly high figure. They recorded also " almost magical " effects in some cases by the administration of large doses of dilute HCL.

 

Gastric secretion and other digestive factors in rosacea
            (Eastwood, 1928) Download
The result has been to confirm with rosacea, for 54 of the 63, i. e. 86%, patients were complaining of some degree of digestive disturbance, 4 had no such symptoms, 5 had no symptoms recorded and are presumed to have had none. An unbalanced diet, with excess of carbohydrate foods, has been very frequently noted. Hydrochloric acid has been found to have a therapeutic efficiency which has not been explained. Even with apparently normal gastric secretion and motor activity this has been found.

Acne Rosacea: With Particular Reference to Gastric Secretion
            (Epstein and Susnow, 1931) Download
The purpose of this paper is to report the result of gastric secretion studies in twenty-four cases of acne rosacea; and to give a brief description of the disease itself. Conclusions: 1. A marked hypochlorhydria was demonstrated in 75 percent of this series of cases of rosacea. 2. Definite clinical improvement followed the internal administration of dilute hydrochloric acid.

Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication
            (Parodi et al., 2008) Download
BACKGROUND & AIMS: To better understand the role of small intestinal bacterial overgrowth (SIBO) in rosacea, we aimed to assess the presence of SIBO in patients with rosacea and the clinical effectiveness of its eradication. METHODS: We enrolled 113 consecutive rosacea ambulatory patients (31 M/82 F; mean age, 52 +/- 15 years) and 60 healthy controls who were sex- and age-matched. Patients and controls underwent lactulose and glucose breath tests (BTs) to assess the presence of SIBO. Patients positive for SIBO were randomized to receive rifaximin therapy (1200 mg/day for 10 days) or placebo. A group of patients with negative BTs were also treated with rifaximin. Eradication was assessed 1 month after the end of therapy. Two dermatologists, unblinded on therapy, evaluated rosacea patients before and after treatment on the basis of an objective scale. RESULTS: The prevalence of SIBO was higher in patients than controls (52/113 vs 3/60, P < .001). After eradication, cutaneous lesions cleared in 20 of 28 and greatly improved in 6 of 28 patients, whereas patients treated with placebo remained unchanged (18/20) or worsened (2/20) (P < .001). Placebo patients were subsequently switched to rifaximin therapy, and SIBO was eradicated in 17 of 20 cases. Fifteen had a complete resolution of rosacea. After antibiotic therapy, 13 of 16 patients with negative BTs for SIBO remained unchanged, and this result differed from SIBO-positive cases (P < .001). CONCLUSIONS: This study demonstrated that rosacea patients have a significantly higher SIBO prevalence than controls. Moreover, eradication of SIBO induced an almost complete regression of their cutaneous lesions and maintained this excellent result for at least 9 months.

Rosacea: With A Study Of Accompanying Conditions.
            (Rulison, 1927) Download
Reference to textbooks on dermatology discloses a consensus of opinion that rosacea is commonly associated with derangement of the gastrointestinal tract. Complete gastrointestinal examinations were made on 50 patients suffering from rosacea. Two-thirds of them were found to have a group of functional abnormalities grouped as follows: A neurotic tendency, subnormal weight, low blood pressure, poor muscle tone, faulty posture, visceroptosis, chronic constipation, spasticity of the large bowel, and gastric subacidity.

Gastric Analysis In Acne Rosacea.
            (Ryle and Barber, 1920) Download
Twelve cases of acne rosacea have been investigated by the fractional method of gastric analysis. All the patients were women. In five cases there was complete achlorhydria. In two other cases there was an extreme degree of hypochlorhydria. Of the remaining five  cases, one showed no secretion of free hydrochloric until after one hour, and two showed a temporary high peak in the curve of acidity, with an abrupt fall to the base line.

Diagnosis Of Gastric Disease
            (Ryle, 1929) Download
There are plenty of functional dyspepsias after the age of 35 which may be recognised and classified clinically, and in which it is quite unnecessary to subject the patient to the trouble and expense of an Xray examination.


 

Rosacea and small intestinal bacterial overgrowth: prevalence and response to rifaximin
            (Weinstock and Steinhoff, 2013) Download
A total of 32 of 63 patients (51%; 6 male and 26 female) with rosacea were given the diagnosis of SIBO compared with 7 of 30 general population control subjects (23%; relative risk, 2.1; 95% confi- dence interval, 1.1-4.3; P 1⁄4 .02) and 3 of 30 com- pletely healthy control subjects (10%; relative risk, 5.0; 95% confidence interval, 1.7-15.1; P \ .001). Of he patients with SIBO, 28 were treated with rifax- imin: 46% reported cleared or markedly improved rosacea, 25% reported moderately improved rosa- cea, and 11% reported mildly improved rosacea. All 4 patients with ocular rosacea and SIBO reported marked improvement. Rosacea was unchanged in 18% of patients. In this study, a subset of patients with rosacea and indirect evidence of SIBO was identified and a significant majority improved after treatment with a nonabsorbable antibiotic.

 


References

Ayres, S (1929), ‘Gastric secretion in psoriasis, eczema and dermatitis herpetiformis’, Arch Derm and Syph, 20 (6), 854-59. PubMed:
Brown, W H, M S Smith, and A D Mclachlan (1935), ‘Fractional gastric analysis in diseases of the skin: Further observation in 316 cases, with special reference to rosacea’, British Journal of Dermatology, 47 (5), 181-90. PubMed:
Brown, W. H. (1925), ‘Some Observations On The Fractional Method Of Gastric Analysis In Diseases Of The Skin.’, British J Dermatology, 37 (5), 213-26. PubMed:
Eastwood, S. R. (1928), ‘Gastric secretion and other digestive factors in rosacea’, British J Dermatology, 40 (3), 91-104. PubMed:
Epstein, N. and D. Susnow (1931), ‘Acne Rosacea: With Particular Reference to Gastric Secretion’, Cal West Med, 35 (2), 118-20. PubMed: 18741832
Parodi, A., et al. (2008), ‘Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication’, Clin Gastroenterol Hepatol, 6 (7), 759-64. PubMed: 18456568
Rulison, RH (1927), ‘Rosacea: With A Study Of Accompanying Conditions.’, Am J Medical Sciences, 174 (1), 60-69. PubMed:
Ryle (1929), ‘Diagnosis Of Gastric Disease’, Lancet, 1197. PubMed:
Ryle, JA and HW Barber (1920), ‘Gastric Analysis In Acne Rosacea.’, The Lancet, 196 (5076), 1195-96. PubMed:
Weinstock, L. B. and M. Steinhoff (2013), ‘Rosacea and small intestinal bacterial overgrowth: prevalence and response to rifaximin’, J Am Acad Dermatol, 68 (5), 875-76. PubMed: 23602178