#Julia hsu md skin#

One patient exhibited an increase in SST from 35.4☌ to 35.7☌ with no change in erythema. Twelve out of 13 patients experienced significant clinical improvement within one hour of injection. The dose of hydroxocobalamin at the first session was 1mg for 11 patients and 2mg for two patients. Two patients had been treated with methylcobalamin 500 μg one month prior to receiving hydroxocobalamin. Seven patients did not receive any treatment for rosacea in the previous two months. The demographic data, clinical features, preceding and concomitant treatments, and the clinical response to hydroxocobalamin injection are listed in Table 1. The disease duration ranged from six months to 30 years.

This study included 12 female patients and one male patient, aged 20 to 65 years. Herein, we report 13 rosacea patients whose persistent facial erythema responded to hydroxocobalamin, a nitric oxide (NO) scavenger. 10 Despite these treatment options, an unmet need remains for refractory facial erythema. 9 Some patients with persistent erythema are responsive to pulsed dye laser and intense pulsed light. 8 Carvedilol, a nonselective β-adrenergic blocker with α1 blocking activity and potent antioxidant activity, is effective in persistent erythema of rosacea, but is contraindicated in patients with low blood pressure or asthma.

7 β-blockers like propranolol can suppress flushing reactions, but the side effects of hypotension and bradycardia can pose problems. 6 Topical ivermectin cream has been reported to be effective in reducing facial erythema associated with rosacea. 5 Selective α-adrenergic receptor agonists with potent vasoconstricting activity, for example, brimonidine tartrate 0.5% gel and oxymetazoline hydrochloride 1% cream, have been approved for treatments of facial erythema. Treatment modalities of rosacea demonstrated various efficacies however, effective control of persistent facial erythema in some patients remains challenging for clinicians.

#Julia hsu md skin#

4 Immunohistochemical staining of skin samples has shown increased expression of inducible nitric oxide synthase (NOS) in patients with rosacea compared to controls. 3 Abnormal innate immunity and neurovascular dysregulation can contribute to and augment the inflammatory cascade, vasodilation, and angiogenesis in rosacea. 2 Although the exact pathogenesis of rosacea remains to be fully elucidated, various triggering factors, such as Demodex infestation, microbiota, ultraviolet radiation, heat, psychological stress, and skin barrier disruption are associated with the development or worsening of rosacea. 1 The presence of two or more major features, including papules/pustules, facial flushing, telangiectasia, and eye manifestations, is also considered diagnostic. His research focuses on the mechanobiology and genetics of keloid and other skin disorders.Rosacea is a chronic inflammatory facial disorder with diagnostic phenotype of fixed centrofacial erythema in a characteristic pattern that may periodically intensify, or phymatous changes. He led NCKU team to win Community leadership Skinpact Galderma Award in 2015 World Congress of Dermatology. He has published more than 80 papers, 65 on Pubmed, including JAMA, American Journal of Human Genetics, Journal of American Academy of Dermatology, JAMA Dermatology, Journal of Investigative in Dermatology, and some others. John McGrath) in London and studied dermatopathology and genodermatosis. From Dec 2014 to Dec 2016, he was a research fellow in St John’s Institute of Dermatology (Dr. In 2008, he studied filaggrin mutation in Department of Dermatology Hokkaido University Graduate School of Medicine (Prof. degree from the Institute of Clinical Medicine in NCKU under the supervision of Prof. He studied medicine in NCKU, and got his Ph.D. He has served as a certificated Dermatologist in NCKU Hospital for more than 10 years. Chao-Kai Hsu is the Associate Professor of Department of Dermatology in National Cheng Kung University (NCKU) in Taiwan.