Rosacea » telangectasia http://rosacea-support.org Where the rosacea community meets to support each other Fri, 06 Nov 2009 03:25:25 +0000 http://wordpress.org/?v=2.8.5 en hourly 1 measuring broken blood vessels part 2 http://rosacea-support.org/measuring-broken-blood-vessels-part-2.html http://rosacea-support.org/measuring-broken-blood-vessels-part-2.html#comments Thu, 12 Oct 2006 07:24:00 +0000 Digital Davo http://rosacea-support.org/measuring-broken-blood-vessels-part-2.html A paper that I highlighted in January (see clinically measuring facial blood vessels) is now available as a full text web page and also as a PDF file.

Occasionally the Journal of the American Academy of Dermatology puts full text articles from an Issue up for free on their web site.

Given that we can now view the whole paper including photographs, it is worth revisiting this article.

The paper comes up with the conclusion that it is possible to discriminate rosacea from seborrheic dermatitis and those with healthy skin by accurately measuring the facial blood vessels.

Videocapillaroscopic alterations in erythematotelangiectatic rosacea (or as a PDF) Journal of the American Academy of Dermatology,
Volume 54, Issue 1, January 2006, Pages 100-104.

Outline

There are currently no objective measures or laboratory tests for assessing and monitoring the severity of rosacea, which rests only on clinical judgment. Most studies on rosacea have utilized subjective assessment of severity, sometimes supplemented by photographs or, in a few instances, measurements of color or hue. The development of instrumental techniques is obviously important for a more reproducible disease assessment and may allow a more rigorous comparison between studies, especially on drug efficacy. Erythema and telangiectases have been measured indirectly by assessing color changes. Capillaroscopy has been considered superior to indirect technique (eg, laser-Doppler, transcutaneous Po2) for the clinical investigation of cutaneous microcirculation in various skin diseases.

In this study, we have used the videocapillaroscopic technique to evaluate qualitative and quantitative microvessel alterations of facial rosacea and compared them with those of seborrheic dermatitis. Our results indicate that videocapillaroscopy may represent a valid adjunctive method in the early identification and measurement of erythematotelangiectatic rosacea.

Discussion

Capillaroscopy is widely used on the nailfold region to diagnose and monitor rheumatologic diseases (scleroderma, dermatomyositis) and to distinguish primary from secondary Raynaud’s phenomenon. More recently, capillaroscopy has been used to study the dynamics of microcirculation and to quantitate microvessel abnormalities in psoriasis. In this study, we used videocapillaroscopy to characterize and provide objective measures of vessel changes in erythematotelangiectatic rosacea. Facial rosacea was found to present characteristic alterations of skin vessels, with a pattern distinct from that of facial seborrheic dermatitis. In particular, neoangiogenesis, larger polygons, more prominent telangiectases, and larger vessel diameter was observed only in rosacea, whereas seborrheic dermatitis displayed polygon irregularities and vessel tortuosity. In contrast, no alterations were found in the nailfold region, suggesting that rosacea specifically affects the facial microvasculature.

Therapy for rosacea is directed primarily at reducing overall erythema, and many therapies are expected to only marginally alter telangiectases. Therefore objective evaluation of erythema in rosacea is very important. In this study, erythema was assessed in a 2-color arbitrary scale, as videocapillaroscopy is not suitable for measuring this parameter. Nonetheless, videocapillaroscopy is a noninvasive and easily repeatable technique that can disclose specific and measurable vessel alterations in the skin affected by erythematotelangiectatic rosacea and that may thus represent a valid adjunctive method in the early diagnosis and measurement of this common disorder.

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]]> http://rosacea-support.org/measuring-broken-blood-vessels-part-2.html/feed 0 a new way to see facial blood vessels http://rosacea-support.org/new-way-to-see-facial-blood-vessels.html http://rosacea-support.org/new-way-to-see-facial-blood-vessels.html#comments Mon, 01 May 2006 23:51:00 +0000 Digital Davo http://rosacea-support.org/a-new-way-to-see-facial-blood-vessels.html Some interesting looking technology that one day might prove to be another tool in treating vascular rosacea. Anything that can help a laser treatment target vessels more accurately will be a bonus for sufferers.
Vein-viewing Tech Launched

Luminetx ships an imaging device that flashes the body’s veins onto the skin

With the help of infrared light, Luminetx has developed an imaging device that can clearly project veins onto the surface of the skin.
…
Beyond increasing “first stick” success rates for patients who give blood or need an IV, the technology can be used for other medical treatments like inserting catheters and removing varicose or spider veins.
…
The visual clarity the device provides would make it easier to treat spider veins more thoroughly, especially when compared to other vein-viewing technology on the market, he said.

]]> http://rosacea-support.org/new-way-to-see-facial-blood-vessels.html/feed 0 clinically measuring facial blood vessels http://rosacea-support.org/clinically-measuring-facial-blood.html http://rosacea-support.org/clinically-measuring-facial-blood.html#comments Mon, 09 Jan 2006 00:25:00 +0000 Digital Davo http://rosacea-support.org/clinically-measuring-facial-blood-vessels.html Videocapillaroscopic alterations in erythematotelangiectatic rosacea.

Journal American Academy Dermatology. 2006 Jan;54(1):100-4

Rosina P, Zamperetti MR, Giovannini A, Chieregato C, Girolomoni G.

BACKGROUND: Rosacea is a common chronic dermatosis that involves the cutaneous microvasculature of the face. There are no objective measures for assessing the severity of erythematotelangiectatic rosacea.

OBJECTIVE: Our purpose was to characterize and provide objective measures of vessel changes in erythematotelangiectatic rosacea by videocapillaroscopy.

METHODS: We compared 30 patients with erythematotelangiectatic rosacea with 30 age- and sex-matched patients with facial seborrheic dermatitis and 30 healthy control subjects. Videocapillaroscopy was performed both on the cheeks and on the nasailfold region. The analyzed parameters of the face were morphological (background color, vessel irregularities) and quantitative (polygonal net perimeter, telangiectasia, and vessel diameters).

RESULTS: Characteristic alterations of skin vessels were observed in facial rosacea, with a pattern distinct from that of facial seborrheic dermatitis. In particular, rosacea showed neoangiogenesis and significantly larger polygons (13.21 +/- 3 vs 7.8 +/- 3 mm; mean +/- standard deviation, P < .001), more prominent telangiectases (267.8 +/- 108 vs 118.2 +/- 35 microm; P < .001) and larger mean vessel diameter (46.71 +/- 9 vs 24 +/- 10 microm; P < .001) compared with seborrheic dermatitis. Seborrheic dermatitis displayed more polygon irregularities and vessel tortuosity. In contrast, no differences were found in the nailfold region.

LIMITATIONS: Vessel irregularities and overall erythema may be difficult to quantify.

CONCLUSIONS: Videocapillaroscopy may represent a valid adjunctive method in the early diagnosis and measurement of erythematotelangiectatic rosacea.

Update: Some more comments based on the full text of this paper, see measuring broken blood vessels part 2.

]]> http://rosacea-support.org/clinically-measuring-facial-blood.html/feed 0 ktp laser good for red face and facial vessels http://rosacea-support.org/ktp-laser-good-for-red-face-and-facial.html http://rosacea-support.org/ktp-laser-good-for-red-face-and-facial.html#comments Mon, 05 Dec 2005 01:00:00 +0000 Digital Davo http://rosacea-support.org/ktp-laser-good-for-red-face-and-facial-vessels.html This is the third promising looking paper on KTP Laser in the last 2 years. KTP stands for Potassium Titanyl Phosphate – aren’t you glad you asked !

Treatment of erythematotelangiectactic rosacea with a KTP YAG laser., Journal of Drugs in Dermatology. 2005 Nov-Dec;4(6):760-2., Miller A., St Louis Skin Solutions, MO 63131, USA.

The flushing and telangiectasias associated with rosacea are notoriously difficult to treat with standard medications. Newer technologies, namely medical lasers and light sources, have made it possible to control and improve erythematotelangietatic signs of rosacea. The potassium-titanyl-phosphate laser in particular is an efficacious and safe tool for treatment of this disease.

Conclusion: The latest addition to the laser armamentarium is the KTP YAG laser. Its relatively short wavelength at 532 nm and high affinity for oxyhemoglobin makes it ideal for targeting vasculature that is superficial in the skin. Unlike the PDL, which causes explosive vessel rupture and leakage, the KTP YAG allows for a slower, more gentle heating, coagulation, and collapse of the vessel. This minimizes pain and purpura.

The KTP YAG laser has the advantage of being able to produce high fluences like the PDL, but is able to deposit that energy over a longer period of time due to longer pulse widths. This allows for adequate thermal damage to the target, while minimizing damage to surrounding tissues. These characteristics make it ideal for treating the pathology involved in erythematotelangiectatic rosacea. As laser treatment becomes more common in the outpatient setting, the KTP YAG may prove to be the most useful modality for this stubborn form of rosacea.

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]]> http://rosacea-support.org/ktp-laser-good-for-red-face-and-facial.html/feed 0 KTP Laser and facial telangiectasias http://rosacea-support.org/ktp-laser-and-facial-telangiectasias.html http://rosacea-support.org/ktp-laser-and-facial-telangiectasias.html#comments Mon, 14 Nov 2005 00:00:00 +0000 Digital Davo http://rosacea-support.org/ktp-laser-and-facial-telangiectasias.html Treatment of superficial cutaneous vascular lesions: experience with the KTP 532 nm laser., Lasers in Medical Science, August 2004, 19(1):1-5. Clark C, Cameron H, Moseley H, Ferguson J, Ibbotson SH. Photobiology Unit, Department of Dermatology, Ninewells Hospital Medical School, University of Dundee, DD1 9SY, UK.

Abstract: Whilst most facial telangiectasias respond well to short-pulse-duration pulsed dye laser therapy, studies have shown that for the treatment of larger vessels these short-duration pulses are sub-optimal.

Long-pulse frequency-doubled neodymium:YAG lasers have been introduced with pulse durations ranging from 1-50 ms and treatment beam diameters of up to 4 mm.

We report the results of KTP/532 nm laser treatment for superficial vascular skin lesions. The aim was to determine the efficacy of the KTP/532 nm laser in the treatment of superficial cutaneous vascular lesions at a regional dermatology centre in a 2 year retrospective analysis. Patients were referred from general dermatology clinics to a purpose-built laser facility. A test dose was performed at the initial consultation and thereafter patients were reviewed and treated at 6 week intervals.

Outcome was graded into five classifications by the patient and operator independently based on photographic records: clear, marked improvement, partial response, poor response, and no change or worsening.

Over the 2 year period, 204 patients with 246 diagnoses were treated [156 female; median age 41 (range 1-74) years; Fitzpatrick skin types I-III]. Equal numbers of spider angioma (102) and facial telangiectasia (102) were treated. Of those patients who completed treatment and follow up, 57/58 (98%) of spider angiomas and 44/49 (90%) of facial telangiectasia markedly improved or cleared.

Satisfactory treatment outcomes, with one clearance and two partial responses, occurred in three of five patients with port-wine stain. Few patients experienced adverse effects: two declined further treatment due to pain, and a small area of minimal superficial scarring developed in one case. Two patients developed mild persistent post-inflammatory hyperpigmentation, and one subject experienced an episode of acute facial erythema, swelling and blistering after one treatment.

The KTP/532 nm frequency-doubled neodymium:YAG laser is a safe and effective treatment for common superficial cutaneous vascular lesions in patients with Fitzpatrick skin types I-III

Keywords: KTP 532 nm laser – Spider angioma – Superficial vascular lesions – Telangiectasia

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]]> http://rosacea-support.org/ktp-laser-and-facial-telangiectasias.html/feed 0 IPL for facial blood vessels (telangiectasias) http://rosacea-support.org/ipl-for-facial-blood-vessels.html http://rosacea-support.org/ipl-for-facial-blood-vessels.html#comments Tue, 20 Sep 2005 06:00:00 +0000 Digital Davo http://rosacea-support.org/ipl-for-facial-blood-vessels-telangiectasias.html This paper is discussing research that shows IPL is an effective and safe treatment for facial blood vessels. After between 1 and 4 treatments, the vast majority of patients had a 50% or better improvement in the number of blood vessels.

Intense pulsed light source for treatment of facial telangiectasias, Journal of Cosmetic and Laser Therapy, Volume 3, Number 4, 1 December 2001, pp. 169-173(5), Peter Bjerring, Kaare Christiansen, Agneta Troilius.

Keywords: dual mode filtering, intense pulsed light source, ipl purpura, telangiectasias treatment

Objective: The purpose of this clinical study was to evaluate the effectiveness of the first intense pulsed light source (IPL) with dual mode light filtering for treatment of facial telangiectasias, and to evaluate the incidence of adverse including purpura, pigmentation and scars.

Material and Methods: Twenty-four patients with facial telangiectasias were treated between one and four times with a new IPL system. This system differs from previous IPLs by eliminating wavelengths longer than 950 nm, which would otherwise lead to non-specific heating of tissue water. The treatments were performed at one-month intervals. Two months after the last treatment, the clinical effect was evaluated from close-up photographs.

Results: After one to four IPL treatments (mean: 2.54; SD: 0.96) for facial telangiectasias, 79.2% of the patients obtained a more than 50% reduction in number of vessels, and 37.5% obtained between a 75% and 100% reduction. Moderate erythema and oedema were the only adverse effects of the treatment. No purpura was registered and no long-term adverse effects such as scars or pigmentary disturbances occurred.

CONCLUSIONS: An IPL with dual mode filtering is efficient and safe for treatment of facial telangiectasias.

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