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Yazbeck AS, Nguyen SN, Escobar ML. How Health Systems World-wide Fail Type 2 Diabetics. Health Syst Reform 2025; 11:2437898. [PMID: 39847757 DOI: 10.1080/23288604.2024.2437898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 11/24/2024] [Accepted: 12/01/2024] [Indexed: 01/25/2025] Open
Abstract
For over 50 years, health systems the world over have failed people with type 2 diabetes mellitus (T2DM). The WHO documents a quadrupling of people with diabetes in a 34-year period to 422 million in 2014, the overwhelming majority of whom were T2DM. This happened despite extensive scientific literature on the causes of, as well as proven treatments for, this disease. Using a health systems prism to review the extensive medical and nutritional T2DM published research, we identified three main shortcomings of health systems in T2DM: (i) failure in early detection; (ii) failure in understanding the actionable lifestyle drivers; and (iii) subsidizing the causes of the disease. Although small-scale success stories in T2DM control exist, the lack of documented evidence of any country-wide health system's successful attempt to address this epidemic is alarming. The immense and ever-growing health and economic burdens of T2DM should provide all the motivation needed for national and global efforts to counteract the political-economy constraints standing in the way of successful whole-of-system approaches to T2DM.
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Affiliation(s)
- Abdo S Yazbeck
- Lead Economist and Adjunct Faculty, Johns Hopkins University, Baltimore, USA
| | - Son Nam Nguyen
- Lead Health Specialist, The World Bank, Washington, DC, USA
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2
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Mao R, Li J. Construction of a molecular diagnostic system for neurogenic rosacea by combining transcriptome sequencing and machine learning. BMC Med Genomics 2024; 17:232. [PMID: 39272052 PMCID: PMC11396881 DOI: 10.1186/s12920-024-02008-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 09/09/2024] [Indexed: 09/15/2024] Open
Abstract
Patients with neurogenic rosacea (NR) frequently demonstrate pronounced neurological manifestations, often unresponsive to conventional therapeutic approaches. A molecular-level understanding and diagnosis of this patient cohort could significantly guide clinical interventions. In this study, we amalgamated our sequencing data (n = 46) with a publicly accessible database (n = 38) to perform an unsupervised cluster analysis of the integrated dataset. The eighty-four rosacea patients were partitioned into two distinct clusters. Neurovascular biomarkers were found to be elevated in cluster 1 compared to cluster 2. Pathways in cluster 1 were predominantly involved in neurotransmitter synthesis, transmission, and functionality, whereas cluster 2 pathways were centered on inflammation-related processes. Differential gene expression analysis and WGCNA were employed to delineate the characteristic gene sets of the two clusters. Subsequently, a diagnostic model was constructed from the identified gene sets using linear regression methodologies. The model's C index, comprising genes PNPLA3, CUX2, PLIN2, and HMGCR, achieved a remarkable value of 0.9683, with an area under the curve (AUC) for the training cohort's nomogram of 0.9376. Clinical characteristics from our dataset (n = 46) were assessed by three seasoned dermatologists, forming the NR validation cohort (NR, n = 18; non-neurogenic rosacea, n = 28). Upon application of our model to NR diagnosis, the model's AUC value reached 0.9023. Finally, potential therapeutic candidates for both patient groups were predicted via the Connectivity Map. In summation, this study unveiled two clusters with unique molecular phenotypes within rosacea, leading to the development of a precise diagnostic model instrumental in NR diagnosis.
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Affiliation(s)
- Rui Mao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, Changsha, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
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3
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Han XM, Zhou YM, Cen LS. Ocular rosacea without facial erythema involvement manifesting as bilateral multiple recurrent chalazions: A case report. World J Clin Cases 2024; 12:3253-3258. [PMID: 38898849 PMCID: PMC11185401 DOI: 10.12998/wjcc.v12.i17.3253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/10/2024] [Accepted: 04/19/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND In addition to the non-specific symptomatology of ocular rosacea, currently, there are no reliable diagnostic tests for the disease, which may lead to its misdiagnosis. Here, we report a case of ocular rosacea presenting with multiple recurrent chalazion on both eyelids. CASE SUMMARY A 63-year-old female patient presented with multiple chalazion and dry eyes in both eyes, with no facial erythema. Initial management done were application of steroid eye ointment on both eyelids, hot compresses, and eyelid margin cleaning; noting that there was no relief of symptoms. Surgical excision of the chalazion was done on both eyes, however, bilateral recurrence occurred post-operatively. The pathological studies showed infiltration of a small amount of fibrous tissue with many chronic inflammatory cells. Immunohistochemistry studies were positive for LL-37. Resolution of the chalazion occurred after oral administration of doxycycline and azithromycin. CONCLUSION Our findings show that ophthalmologists should recognize the ocular manifestations of skin diseases.
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Affiliation(s)
- Xue-Mei Han
- Department of Ophthalmology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang Province, China
| | - Yi-Mai Zhou
- The First Clinical Medical College, Zhejiang Chinese Medicine University, Hangzhou 310053, Zhejiang Province, China
| | - Lu-Sha Cen
- Department of Ophthalmology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310006, Zhejiang Province, China
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Yao H, Shen S, Gao X, Song X, Xiang W. The causal relationship between blood metabolites and rosacea: A Mendelian randomization. Skin Res Technol 2024; 30:e13796. [PMID: 38895784 PMCID: PMC11187845 DOI: 10.1111/srt.13796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND An increasing amount of research demonstrates that metabolic disorders are related to rosacea. However, the correlations and causal relationships among them remain unknown. METHODS We conducted not only forward 2-sample MR (Mendelian randomization) analyses but also reverse MR analyses which showed positive results in the forward MR analysis. In the forward MR analyses, inverse-variance weighted (IVW) and MR-Egger were performed as MR analyses. Cochran's Q test and the MR-Egger Intercept were used for sensitivity analyses. Concerning reverse MR analyses, IVW, MR-Egger, weighted median, simple mode, and weighted mode were applied. Cochran's Q test, MR-Egger Intercept, and MR pleiotropy residual sum and outlier (MR-PRESSO) outlier test were applied as sensitivity analyses. RESULTS A total of 24 metabolites and 1 metabolite ratio were shown to have a causal effect on rosacea. N-lactoyl phenylalanine (N-Lac-Phe) was estimated as statistically significant by Bonferroni correction. Interestingly, we found three metabolites that were negatively associated with rosacea, especially caffeine, which are in line with the results of a large cohort study of females. For reverse MR analysis, we revealed that rosacea could potentially decrease the generation of two metabolites: octadecenedioate (C18:1-DC) and methyl vanillate sulfate. CONCLUSION This study identified blood metabolites that may be associated with the development of rosacea. However, the exact mechanism by which these positive metabolites influence rosacea remains uncertain due to the paucity of experimental investigations. The combination of genetics and metabolomics offers novel viewpoints on the research of underlying mechanisms of rosacea and has significant value in screening and prevention of rosacea.
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Affiliation(s)
- Huiyi Yao
- Department of DermatologyZhejiang Chinese Medical UniversityHangzhou Third People's Hospital Affiliated to Zhejiang Chinese Medical UniversityHangzhouChina
| | - Sihao Shen
- Department of DermatologyZhejiang Chinese Medical UniversityHangzhou Third People's Hospital Affiliated to Zhejiang Chinese Medical UniversityHangzhouChina
| | - Xingyue Gao
- Department of DermatologyZhejiang Chinese Medical UniversityHangzhou Third People's Hospital Affiliated to Zhejiang Chinese Medical UniversityHangzhouChina
| | - Xiuzu Song
- Department of DermatologyHangzhou Third People's HospitalHangzhouChina
| | - Wenzhong Xiang
- Department of DermatologyHangzhou Third People's HospitalHangzhouChina
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Algarin YA, Pulumati A, Jaalouk D, Tan J, Nouri K. The role of vitamins and nutrients in rosacea. Arch Dermatol Res 2024; 316:142. [PMID: 38695936 PMCID: PMC11065919 DOI: 10.1007/s00403-024-02895-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 02/22/2024] [Accepted: 04/16/2024] [Indexed: 05/05/2024]
Abstract
Rosacea is a common inflammatory skin condition displaying symptoms like flushing, erythema, papules, and pustules. Oral antibiotics, despite long-term adverse effects, are often used due to topical treatment limitations, underscoring the need for cost-effective choices like dietary modifications. Our review investigates the role of vitamins and minerals in rosacea, and provides evidence-based recommendations for supplementation and topical treatment of these nutrients for rosacea. An online search was performed on PubMed, Web of Science, Science Direct, Google Scholar, and ClinicalTrials.gov from 1998 to 2023. Included studies were summarized and assessed for quality and relevance in rosacea management. Varied outcomes emerged concerning the impact of essential vitamins and minerals on rosacea treatment. Vitamin A derivatives, specifically oral isotretinoin, demonstrated significant efficacy, with a 90% reduction in lesions, complete remission in 24% of patients, and marked improvement in 57% of patients. Vitamin B3 derivatives, such as topical 1-methylnicotinamide 0.25% and NADH 1%, improved symptoms in 76.4% (26/34) and 80% of patients, respectively. Outcomes for vitamin D, vitamin C, and zinc supplementation varied across studies. However, zinc sulfate solution 5% significantly reduced acne rosacea severity for patients with 40% and 60% exhibiting a moderate or good response, respectively. Omega-3 fatty acids showed significant improvement in alleviating xerophthalmia in 64% of patients with ocular rosacea. Vitamins and minerals hold potential in managing rosacea symptoms, offering a safe and cost-effective alternative or adjunctive treatment option. Currently, there are no established recommendations regarding their supplementation for rosacea. Studies assessing serum levels of vitamins and minerals in relation to rosacea are warranted, as this avenue holds potential for future advancements in the field.
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Affiliation(s)
- Yanci A Algarin
- Department of Dermatology, Eastern Virginia Medical School, Norfolk, VA, USA.
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA.
| | - Anika Pulumati
- Department of Dermatology, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Dana Jaalouk
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
| | - Jiali Tan
- Department of Dermatology, Albany Medical College, Albany, NY, USA
| | - Keyvan Nouri
- Department of Dermatology and Cutaneous Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, FL, USA
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6
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Lee JJ, Chien AL. Rosacea in Older Adults and Pharmacologic Treatments. Drugs Aging 2024; 41:407-421. [PMID: 38649625 DOI: 10.1007/s40266-024-01115-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2024] [Indexed: 04/25/2024]
Abstract
Rosacea is a chronic inflammatory skin condition that is often more severe in older patients. The main clinical features are erythema, telangiectasia, and inflammatory lesions of the face. The pathogenesis of this condition is not fully understood but certainly multifaceted. Immune and inflammatory dysregulation, genetics, neurogenic dysregulation, microbiome dysbiosis, and systemic disease have all been implicated in rosacea pathogenesis. As we better understand the various pathways that lead to rosacea, we acknowledge that the different symptoms may have unique underlying triggers and mechanisms. Aging also impacts rosacea diagnosis and treatment. Older adults have more severe rosacea symptoms while also having more sensitive and fragile skin than younger patients; therefore, rosacea treatments for older patients require a balance between delivering adequate potency while also minimizing skin irritation and other adverse effects. Until recently, rosacea diagnoses were based on concrete subtypes that did not necessarily capture each patient's manifestation of rosacea. There is now an emphasis on more personalized phenotype-based diagnoses and treatments, which allows for more emphasis on treating individual symptoms and accounting for the unique characteristics of older patients. Centrofacial erythema is best treated with brimonidine and oxymetazoline, while phymatous change and telangiectasia are best treated with surgery and laser ablation. Treatment for rosacea papules and pustules ranges from topicals, such as azelaic acid, ivermectin, metronidazole, minocycline, and encapsulated benzoyl peroxide, to systemics, such as doxycycline and isotretinoin. It is important to understand these treatments in relation to adverse effects and drug interactions that may specifically arise in older populations to provide optimal care. As we advance in understanding rosacea's pathogenesis and adopt personalized phenotype-based approaches, optimizing care for older patients becomes crucial. Continued research into novel treatments is essential to address their unique needs.
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Affiliation(s)
- Jennifer J Lee
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA
| | - Anna L Chien
- Department of Dermatology, Johns Hopkins University School of Medicine, 601 N. Caroline St., Baltimore, MD, 21287, USA.
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7
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Guertler A, Hering P, Pacífico C, Gasche N, Sladek B, Irimi M, French LE, Clanner-Engelshofen BM, Reinholz M. Characteristics of Gut Microbiota in Rosacea Patients-A Cross-Sectional, Controlled Pilot Study. Life (Basel) 2024; 14:585. [PMID: 38792606 PMCID: PMC11122217 DOI: 10.3390/life14050585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/22/2024] [Accepted: 04/28/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Recent studies have suggested a possible connection between rosacea and patients' gut microbiota. OBJECTIVE To investigate the differences in fecal microbial profiles between patients with rosacea and healthy controls. METHODS Gut microbiota of 54 rosacea patients (RP) were analyzed using MiSeq 16S rRNA sequencing. Enterotypes, the Firmicutes/Bacteroides (F/B) ratio, the significance of alpha and beta diversity, and differential abundance analysis (DAA) were calculated and compared with age- and gender-matched controls (CP, n = 50). RESULTS Significant changes in the enterotypes and F/B ratio were observed between the RP and CP (p = 0.017 and p = 0.002, respectively). The RP showed a decreased microbial richness and diversity compared to the CP (Shannon p = 0.012, inverse Simpson p = 0.034). Beta diversity also differed between both groups (PERMANOVA, p = 0.006). Fourteen significantly different taxa were detected according to DAA. Faecalibacterium prausnitzii (coef. -0.0800, p = 0.008), Lachnoospiraceae ND 3007 group sp. (coef. -0.073, p < 0.001), and Ruminococcaceae (coef. -0.072, p = 0.015) were significantly decreased; Oscillobacter sp. (coef. 0.023, p = 0.031), Flavonifractor plautii (coef. 0.011, p = 0.037), and Ruminococccaceae UBA 1819 (coef. 0.010, p = 0.031) were significantly increased in the RP compared to the CP. CONCLUSION Significant alterations in gut microbiota were present in the RP. Taxonomic shifts and reduced richness and diversity were observed when compared to the CP. Larger prospective studies are needed to investigate correlations with clinical features and to translate these findings into future therapeutic approaches.
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Affiliation(s)
- Anne Guertler
- Department of Dermatology and Allergy, LMU University Hospital Munich, 80337 Munich, Germany (L.E.F.)
| | - Pascal Hering
- Department of Dermatology and Allergy, LMU University Hospital Munich, 80337 Munich, Germany (L.E.F.)
| | | | | | | | - Miriam Irimi
- Department of Dermatology and Allergy, LMU University Hospital Munich, 80337 Munich, Germany (L.E.F.)
| | - Lars E. French
- Department of Dermatology and Allergy, LMU University Hospital Munich, 80337 Munich, Germany (L.E.F.)
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | | | - Markus Reinholz
- Department of Dermatology and Allergy, LMU University Hospital Munich, 80337 Munich, Germany (L.E.F.)
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8
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Kulaklı S, Yıldırmak S, Oğuz ID, Usta M, Tosun A, Akşan B. Evaluation of atherosclerotic risk in rosacea patients through serum fetuin-A and carotid intima media thickness. J Cosmet Dermatol 2024; 23:1075-1084. [PMID: 37994275 DOI: 10.1111/jocd.16094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 10/23/2023] [Accepted: 11/09/2023] [Indexed: 11/24/2023]
Abstract
BACKGROUND The link between rosacea and various systemic conditions has been growing in prominence, even though the relationship between rosacea and cardiovascular disease remains a subject of debate in current research. AIMS Detecting the connection between rosacea and subclinical atherosclerosis using laboratory and ultrasonographic parameters. METHODS Fifty rosacea patients and 49 control were included in the study. Demographic, clinical, and laboratory data, including serum high sensitivity C-reactive protein (hs-CRP), fetuin-A (FA), and matrix gla protein levels were assessed. Carotid intima-media thickness (CIMT) was measured by carotid ultrasonography. RESULTS Serum hs-CRP levels (p = 0.009) and mean CIMT (p = 0.001) were significantly higher, while serum FA levels were significantly lower (p < 0.001) in the rosacea patients compared with control. The number of patients with mean CIMT>75th percentile according to age and sex were significantly higher in the rosacea group (p = 0.001). Rosacea patients with ocular involvement exhibited significantly higher hs-CRP values in comparison to those without ocular involvement (p = 0.008). No significant correlation was detected between disease duration, severity, subtype and the study parameters. CONCLUSIONS This study results suggest that rosacea poses an independent risk for subclinical atherosclerosis regardless of its severity, duration, or subtype. Therefore, individuals diagnosed with rosacea should receive careful evaluation and monitoring to detect possible cardiovascular complications promptly. Furthermore, our study hints at a potential elevated risk of subclinical inflammation in rosacea patients with ocular involvement, warranting additional attention and further investigation.
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Affiliation(s)
- Sevgi Kulaklı
- Department of Dermatology and Venereology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Sembol Yıldırmak
- Department of Medical Biochemistry, Mersin University Faculty of Medicine, Mersin, Turkey
| | - Işıl Deniz Oğuz
- Department of Dermatology and Venereology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Murat Usta
- Department of Medical Biochemistry, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Alptekin Tosun
- Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Burak Akşan
- Department of Dermatology and Venereology, Giresun University Faculty of Medicine, Giresun, Turkey
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9
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Yang B, Man MQ. Improvement in Cutaneous Conditions Can Benefit Some Health Conditions in the Elderly. Clin Interv Aging 2023; 18:2031-2040. [PMID: 38058550 PMCID: PMC10697145 DOI: 10.2147/cia.s430552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/17/2023] [Indexed: 12/08/2023] Open
Abstract
As we are aging, a number of cutaneous and extracutaneous disorders will be developed. Although the pathogenesis of these aging-associated disorders is not clear yet, abnormalities in the skin are linked to some aging-associated disorders at least to some extent. Inflammatory dermatoses such as psoriasis and atopic dermatitis predispose to the development of cardiovascular diseases, obesity and type 2 diabetes. In addition, both chronologically aged skin and individuals with some aging-associated systemic conditions display altered epidermal function, such as reduced stratum corneum hydration levels, which can provoke cutaneous inflammation. Because aged skin exhibits higher expression levels of inflammatory cytokines, which play a pathogenic role in a variety of aging-associated health condition, the association of the skin with some aging-associated disorders is likely mediated by inflammation. This postulation is supported by the evidence that improvement in either epidermal function or inflammatory dermatoses can mitigate some aging-associated disorders such as mild cognitive impairment and insulin sensitivity. This perspective discusses the association of the skin with aging-associated disorders and highlights the potential of improvement in cutaneous conditions in the management of some health conditions in the elderly.
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Affiliation(s)
- Bin Yang
- Dermatology Hospital of Southern Medical University, Guangzhou, 510091, People’s Republic of China
| | - Mao-Qiang Man
- Dermatology Hospital of Southern Medical University, Guangzhou, 510091, People’s Republic of China
- Dermatology Services, Veterans Affairs Medical Center and University of California, San Francisco, CA, 94121, USA
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10
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Ay İE, Soylu S, Er A, Durusu İN, Doğan M, Gobeka HH. Optical coherence tomography angiography aspects of the retinal and optic disc microvascular morphology in erythemato-telangectatic rosacea. Photodiagnosis Photodyn Ther 2023; 43:103657. [PMID: 37336467 DOI: 10.1016/j.pdpdt.2023.103657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 06/13/2023] [Accepted: 06/16/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND To investigate retinal and optic disc (OD) microvascular morphological changes in erythemato-telangiectatic rosacea (ETR) patients using optical coherence tomography angiography (OCTA), and compare the findings to age- and gender-matched healthy individuals. METHODS This study included newly diagnosed 31 ETR patients (31 right eyes, group 1) who were clinically diagnosed by two experienced dermatologists. A control group had 32 healthy individuals (32 right eyes, group 2). Demographic data, including age and gender were collected, followed by a thorough ophthalmologic exam. A 6 × 6 mm macular OCTA analysis of superficial and deep capillary plexus (SCP and DCP) vessel densities (VDs), as well as foveal avascular zone (FAZ) area, FAZ perimeter (PERIM), foveal VDs 300 µm area around FAZ (FD-300), and flow areas in the outer retinal and choriocapillaris, was then performed. RESULTS Mean age in groups 1 and 2 was 43.70 ± 13.02 and 43.62 ± 12.30 years, respectively (p=0.979). Male-to-female ratio in group 1 was 4:27 and 4:28 in group 2. Capillary flow analysis revealed slightly higher values in group 1 than in group 2, with the former having a significantly higher select area in the outer retinal layer (p=0.001) and flow area in the choriocapillaris (p=0.002). Despite slightly higher values in group 1, there were no significant differences in SCP and DCP VDs (p > 0.05), FAZ area (p=0.471), PERIM (p=0.778), or FD-300 (p=0.527). CONCLUSIONS ETR appears to be associated with posterior segment changes, especially retinal microvascular morphology, even in asymptomatic ocular conditions. Given the disease's high rate of misdiagnosis, understanding rosacea-induced ocular manifestations is critical for ophthalmologists.
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Affiliation(s)
- İbrahim Ethem Ay
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Seçil Soylu
- Department of Dermatology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Aynur Er
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - İrem Nur Durusu
- Department of Dermatology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Mustafa Doğan
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hamidu Hamisi Gobeka
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
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11
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Paiva-Santos AC, Gonçalves T, Peixoto D, Pires P, Velsankar K, Jha NK, Chavda VP, Mohammad IS, Cefali LC, Mazzola PG, Mascarenhas-Melo F, Veiga F. Rosacea Topical Treatment and Care: From Traditional to New Drug Delivery Systems. Mol Pharm 2023; 20:3804-3828. [PMID: 37478169 PMCID: PMC10410666 DOI: 10.1021/acs.molpharmaceut.3c00324] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/23/2023]
Abstract
Rosacea is a multifactorial chronic inflammatory dermatosis characterized by flushing, nontransient erythema, papules and pustules, telangiectasia, and phymatous alterations accompanied by itching, burning, or stinging, the pathophysiology of which is not yet fully understood. Conventional topical treatments usually show limited efficacy due to the physical barrier property of the skin that hinders skin penetration of the active ingredients, thereby hampering proper drug skin delivery and the respective therapeutic or cosmetic effects. New advances regarding the physiopathological understanding of the disease and the underlying mechanisms suggest the potential of new active ingredients as promising therapeutic and cosmetic approaches to this dermatosis. Additionally, the development of new drug delivery systems for skin delivery, particularly the potential of nanoparticles for the topical treatment and care of rosacea, has been described. Emphasis has been placed on their reduced nanometric size, which contributes to a significant improvement in the attainment of targeted skin drug delivery. In addition to the exposition of the known pathophysiology, epidemiology, diagnosis, and preventive measures, this Review covers the topical approaches used in the control of rosacea, including skin care, cosmetics, and topical therapies, as well as the future perspectives on these strategies.
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Affiliation(s)
- Ana Cláudia Paiva-Santos
- Department
of Pharmaceutical Technology, Faculty of Pharmacy of the University
of Coimbra, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
- LAQV,
REQUIMTE, Department of Pharmaceutical Technology, Faculty of Pharmacy
of the University of Coimbra, University
of Coimbra, Azinhaga
Sta. Comba, 3000-548 Coimbra, Portugal
| | - Tatiana Gonçalves
- Department
of Pharmaceutical Technology, Faculty of Pharmacy of the University
of Coimbra, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
| | - Diana Peixoto
- Department
of Pharmaceutical Technology, Faculty of Pharmacy of the University
of Coimbra, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
- LAQV,
REQUIMTE, Department of Pharmaceutical Technology, Faculty of Pharmacy
of the University of Coimbra, University
of Coimbra, Azinhaga
Sta. Comba, 3000-548 Coimbra, Portugal
| | - Patrícia
C. Pires
- Department
of Pharmaceutical Technology, Faculty of Pharmacy of the University
of Coimbra, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
- LAQV,
REQUIMTE, Department of Pharmaceutical Technology, Faculty of Pharmacy
of the University of Coimbra, University
of Coimbra, Azinhaga
Sta. Comba, 3000-548 Coimbra, Portugal
- Health
Sciences Research Centre (CICS-UBI), University
of Beira Interior, Av.
Infante D. Henrique, 6200-506 Covilhã, Portugal
| | - K. Velsankar
- Department
of Physics, Sri Sivasubramaniya Nadar College
of Engineering, SSN Research Centre, Kalavakkam, Tamil Nadu 603110, India
| | - Niraj Kumar Jha
- Department
of Biotechnology, School of Engineering
and Technology, Sharda University, Greater Noida, Uttar Pradesh 201310, India
- Department
of Biotechnology, School of Applied and
Life Sciences (SALS), Uttaranchal University, Dehradun, Uttarakhand 248007, India
- School
of
Bioengineering and Biosciences, Lovely Professional
University, Phagwara, Punjab 144411, India
- Department
of Biotechnology Engineering and Food Technology, Chandigarh University, Mohali, Punjab 140413, India
| | - Vivek P. Chavda
- Department
of Pharmaceutics and Pharmaceutical Technology, L. M. College of Pharmacy, Ahmedabad, Gujarat 380008, India
| | - Imran Shair Mohammad
- Department of Radiology, City of Hope Cancer Center, 1500 East Duarte Rd., Duarte, California 91010, USA
| | - Letícia Caramori Cefali
- Institute
of Biology, University of Campinas (UNICAMP), Campinas, São Paolo 13083-862, Brazil
- Center
for Biological and Health Sciences, Mackenzie
Presbyterian University, São
Paulo, São Paulo 01302-907, Brazil
| | - Priscila Gava Mazzola
- Faculty
of Pharmaceutical Sciences, University of
Campinas (UNICAMP), Campinas, São Paolo13083-871, Brazil
| | - Filipa Mascarenhas-Melo
- Department
of Pharmaceutical Technology, Faculty of Pharmacy of the University
of Coimbra, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
- LAQV,
REQUIMTE, Department of Pharmaceutical Technology, Faculty of Pharmacy
of the University of Coimbra, University
of Coimbra, Azinhaga
Sta. Comba, 3000-548 Coimbra, Portugal
| | - Francisco Veiga
- Department
of Pharmaceutical Technology, Faculty of Pharmacy of the University
of Coimbra, University of Coimbra, Azinhaga Sta. Comba, 3000-548 Coimbra, Portugal
- LAQV,
REQUIMTE, Department of Pharmaceutical Technology, Faculty of Pharmacy
of the University of Coimbra, University
of Coimbra, Azinhaga
Sta. Comba, 3000-548 Coimbra, Portugal
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12
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Lagacé F, D’Aguanno K, Prosty C, Laverde-Saad A, Cattelan L, Ouchene L, Oliel S, Genest G, Doiron P, Richer V, Jfri A, O’Brien E, Lefrançois P, Powell M, Moreau L, Litvinov IV, Muntyanu A, Netchiporouk E. The Role of Sex and Gender in Dermatology - From Pathogenesis to Clinical Implications. J Cutan Med Surg 2023; 27:NP1-NP36. [PMID: 37401812 PMCID: PMC10486181 DOI: 10.1177/12034754231177582] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/29/2023] [Accepted: 04/09/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Sex and gender have increasingly been recognized as significant risk factors for many diseases, including dermatological conditions. Historically, sex and gender have often been grouped together as a single risk factor in the scientific literature. However, both may have a distinct impact on disease incidence, prevalence, clinical presentation, severity, therapeutic response, and associated psychological distress. OBJECTIVES AND PROJECT DESCRIPTION The mechanisms that underlie differences in skin diseases between males, females, men, and women remain largely unknown. The specific objectives of this review paper are:To highlight the biological differences between males and females (sex), as well as the sociocultural differences between men and women (gender) and how they impact the integumentary system.To perform a literature review to identify important sex- and gender-related epidemiological and clinical differences for various skin conditions belonging to a range of disease categories and to discuss possible biological and sociocultural factors that could explain the observed differences.To discuss dermatological skin conditions and gender-affirming treatments within the transgender community, a population of individuals who have a gender identity which is different than the gender identity they were assigned at birth. FUTURE IMPACT With the rising number of individuals that identify as non-binary or transgender within our increasingly diverse communities, it is imperative to recognize gender identity, gender, and sex as distinct entities. By doing so, clinicians will be able to better risk-stratify their patients and select treatments that are most aligned with their values. To our knowledge, very few studies have separated sex and gender as two distinct risk factors within the dermatology literature. Our article also has the potential to help guide future prevention strategies that are patient-tailored rather than using a universal approach.
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Affiliation(s)
- François Lagacé
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | | | - Connor Prosty
- Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Alexandra Laverde-Saad
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Leila Cattelan
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Lydia Ouchene
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Sarah Oliel
- Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Genevieve Genest
- Division of Allergy and Immunology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Philip Doiron
- Division of Dermatology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Vincent Richer
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Abdulhadi Jfri
- Department of Dermatology, Brigham and Women’s Hospital/Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Elizabeth O’Brien
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Philippe Lefrançois
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Mathieu Powell
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Linda Moreau
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Ivan V. Litvinov
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Anastasiya Muntyanu
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Elena Netchiporouk
- Division of Dermatology, Faculty of Medicine, McGill University, Montréal, Québec, Canada
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13
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Karaosmanoglu N, Ozdemir Cetinkaya P, Orenay OM. Evaluation of inflammatory status in blood in patients with rosacea. Sci Rep 2023; 13:9068. [PMID: 37277425 DOI: 10.1038/s41598-023-36247-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 05/31/2023] [Indexed: 06/07/2023] Open
Abstract
Rosacea is a chronic inflammatory skin disease that is characterized by recurrent episodes of erythema, telangiectasia and papulopustular lesions. Although the pathogenesis is not well established, growing knowledge suggests that multiple etiological factors play a role resulting in inflammation. The aim of the present study is to investigate inflammatory status of patients with rosacea by evaluating CBC parameters and systemic immune inflammation (SII) index and compare these parameters with control group. Thus, it is aimed to understand the role of systemic inflammation in the pathogenesis of the disease. This retrospective, case-control study included 100 patients with rosacea and 58 sex- and age-matched controls. Laboratory examinations including CBC, ESR, CRP, HDL, LDL, and triglyceride levels were recorded and neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR), monocyte-to-high-density lipoprotein ratio (MHR) and SII index were calculated. Monocyte and platelet count, SII index, ESR and CRP were significantly higher in patients with rosacea than in the control group. No statistically significant difference was found in other parameters. There was no significant correlation between disease severity and ESR, CRP, and SII index. The findings of this study suggest that apart from the inflammatory pathways at the level of skin, there is an inflammatory state in the blood of patients. Rosacea is a skin disease, but it may have systemic implications and/or associations that need to be clarified completely.
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Affiliation(s)
- Nermin Karaosmanoglu
- Dermatology and Venereology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Pınar Ozdemir Cetinkaya
- Dermatology and Venereology, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
| | - Ozge Mine Orenay
- Dermatology and Venereology, Ankara Training and Research Hospital, Ankara, Turkey
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14
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Barberis N, Cannavò M, Trovato M, Verrastro V. Pathways from Trait Emotional Intelligence to factors of distress in Rosacea: The mediating role of Social Phobia and Self-Esteem. J Affect Disord 2023; 331:362-368. [PMID: 36906111 DOI: 10.1016/j.jad.2023.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 02/20/2023] [Accepted: 03/03/2023] [Indexed: 03/13/2023]
Abstract
BACKGROUND Rosacea is a skin disease characterized by facial erythema and inflammatory pustules that may result in emotional distress. Social Phobia and Self-Esteem appear to be linked to the development of higher levels of distress in dermatological conditions, while Trait Emotional Intelligence (Trait EI) has been consistently associated with greater levels of adaptation to one's chronic condition. Hence, it seems extremely relevant to observe the interplay between these dimensions in the context of Rosacea. The goal of the current study is to test the hypothesis that an association between Trait EI and General Distress, in individuals with Rosacea would be mediated by Self-Esteem and Social Phobia. METHODS Questionnaires were administered to 224 individuals suffering from Rosacea to assess Trait EI, Social Phobia, Self-Esteem, and General Distress. RESULTS Results highlighted that Trait EI was positively related to Self-Esteem and negatively related to Social Phobia and General Distress. In addition, both Self-Esteem and Social Phobia showed a mediating role in the relationship between Trait EI and General Distress. LIMITATIONS The main limitations of this work consist in the cross-sectional nature of the data, the small number of participants, also it was not possible to differentiate the participants according to the type of rosacea. DISCUSSION These results emphasize how individuals with Rosacea may be vulnerable to internalizing states and how high levels of Trait EI may constitute a protective factor for the onset of distressing states and it would be useful to create programs aimed at fostering Trait EI in Rosacea sufferers.
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Affiliation(s)
- Nadia Barberis
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
| | - Marco Cannavò
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy
| | - Mariachiara Trovato
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
| | - Valeria Verrastro
- Dipartimento di Scienze della salute. Università degli Studi Magna Graecia di Catanzaro, viale Europa, 88100 Catanzaro, Italy.
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15
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Sahin RB, Kilic FA, Hizli P, Baykan O. Serum zinc-alpha-2 glycoprotein and insulin levels and their correlation with metabolic syndrome in patients with rosacea. J Cosmet Dermatol 2023; 22:645-650. [PMID: 36207990 DOI: 10.1111/jocd.15447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/03/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Metabolic syndrome and insulin resistance may accompany rosacea. Zinc-alpha-2 glycoprotein (ZAG) is an adipokine involved in lipid, glucose, and insulin metabolism and might be associated with metabolic syndrome and insulin resistance. AIMS To investigate the serum ZAG levels, presence of metabolic syndrome, insulin resistance, and the correlation between ZAG levels, rosacea severity, and metabolic syndrome in patients with rosacea. PATIENTS/METHODS Seventy-nine patients with rosacea and 80 healthy volunteers were included. Anthropometric and demographic features, personal and family histories, clinical data, the subtype, severity, and duration of rosacea were recorded. Metabolic syndrome, insulin resistance, and dyslipidemia were evaluated in both groups. Fasting blood sugar, lipid panel, C-reactive protein, sedimentation rate, insulin, and serum ZAG levels were investigated. RESULTS Frequency of metabolic syndrome, systolic and diastolic blood pressures, and C-reactive protein levels were significantly higher in the rosacea group (p < 0.001 and p = 0.001, respectively). Frequency of dyslipidemia and insulin resistance did not significantly differ between the groups (p = 0.175 and 0.694, respectively). The mean serum ZAG levels were lower in the rosacea group, but no significant difference was evident. In rosacea patients with metabolic syndrome, serum ZAG levels were significantly lower (p = 0.043); however, serum ZAG levels, insulin, and the homeostasis model assessment-estimated insulin resistance values were significantly higher (p = 0.168, 0.013 and 0.001, respectively). CONCLUSION Metabolic syndrome, high blood pressure, and high C-reactive protein levels were associated with rosacea indicating chronic systemic inflammation. ZAG levels were associated with metabolic syndrome in patients with rosacea but not associated with rosacea subtype and disease severity.
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Affiliation(s)
| | - Fatma Arzu Kilic
- Department of Dermatology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Pelin Hizli
- Department of Dermatology, Faculty of Medicine, Balikesir University, Balikesir, Turkey
| | - Ozgur Baykan
- Department of Biochemistry, Faculty of Medicine, Balikesir University, Balikesir, Turkey
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16
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Yang F, Zhang Q, Song D, Liu X, Wang L, Jiang X. A Cross-Sectional Study on the Relationship Between Rosacea Severity and Quality of Life or Psychological State. Clin Cosmet Investig Dermatol 2022; 15:2807-2816. [PMID: 36573169 PMCID: PMC9789702 DOI: 10.2147/ccid.s390921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
Background Rosacea appears predominantly in highly visible areas of the facial region. Objective To investigate the psychological status and quality of life(QOL) of rosacea. Methods We used a hospital-based cross-sectional analytical study design between Jan 1, 2020, and Jan 1, 2021. We analyzed the differences and correlations in the severity of rosacea and its impacts on QOL and mental health, separately. Results 469 patients with rosacea were included. The mean Dermatology Life Quality Index (DLQI) score was 12.6±7.7 and the affected level of DLQI was moderately severe. The total score of Rosacea-specific Quality-of-Life instrument (RosQol) was 2.34 ± 0.84, and the scores of emotion, symptoms, and function were 2.41 ± 0.99, 2.37 ±0.82, and 2.03 ± 0.89, respectively. 44.8% of patients suffered from anxiety and 37.5% from depression. There were statistically significant differences in the incidence of anxiety (p <0.001), the DLQL (p =0.02), RosQol emotion (p =0.04), symptom (p <0.01) and function (p =0.02) scores in the different severity. In addition, worsening QOL was significantly associated with increased disease severity [Spearman's rank correlation index (r) ranging from 0.171 to 0.266,p<0.01 (RosQol); r =0.104,p =0.024 (DLQI)]. There was also a positive correlation between anxiety [r =0.155; p<0.01] and the different severity levels. Conclusion Rosacea maybe has a greater significant impact on patient's QOL and mental health. And the impact of QOL and mental health tend to deteriorate significantly with increasing disease severity. The relationship suggests that QOL assessment is of great interest in clinical practice and should be further explored.
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Affiliation(s)
- Fengjuan Yang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Qian Zhang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Deyu Song
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xu Liu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Lian Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China,Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, People’s Republic of China,Correspondence: Xian Jiang, Email
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17
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Durmaz I, Turkmen D, Altunisik N, Uremis N, Uremis MM, Sener S, Turkoz Y. Evaluation of serum TWEAK, TRAIL, and oxidative stress markers in rosacea patients. J Cosmet Dermatol 2022; 21:7050-7055. [PMID: 36083238 DOI: 10.1111/jocd.15365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Rosacea is a chronic inflammatory skin disease of unknown pathogenesis. TWEAK and TRAIL are two cytokines thought to have a role in the pathogenesis of some inflammatory and autoimmune diseases. AIMS The purpose of this study was to examine TWEAK and TRAIL serum levels and oxidative stress markers in patients with rosacea. MATERIAL AND METHOD Forty rosacea patients and 40 sex- and age-matched healthy controls were involved in the study. Serum TWEAK and TRAIL levels were evaluated with ELISA kits. Serum total antioxidant status, total oxidant status, total thiol, native thiol, disulfide levels were evaluated, and oxidative stress index was computed. RESULTS Serum levels of TWEAK, TRAIL, and oxidative stress markers did not differ statistically in the patients and controls. Both TWEAK and TRAIL levels in the patients were detected to be statistically higher in male than in female. CONCLUSION TWEAK and TRAIL may not have a systemic effect in rosacea, unlike other inflammatory diseases. More studies are needed to investigate the role of TWEAK and TRAIL in rosacea.
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Affiliation(s)
- Imge Durmaz
- Department of Dermatology, Inonu University, Malatya, Turkey
| | - Dursun Turkmen
- Department of Dermatology, Inonu University, Malatya, Turkey
| | - Nihal Altunisik
- Department of Dermatology, Inonu University, Malatya, Turkey
| | - Nuray Uremis
- Department of Medical Biochemistry, Inonu University, Malatya, Turkey
| | | | - Serpil Sener
- Department of Dermatology, Inonu University, Malatya, Turkey
| | - Yusuf Turkoz
- Department of Medical Biochemistry, Inonu University, Malatya, Turkey
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18
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Yamasaki K, Miyachi Y. Perspectives on rosacea patient characteristics and quality of life using baseline data from a phase 3 clinical study conducted in Japan. J Dermatol 2022; 49:1221-1227. [PMID: 36177741 PMCID: PMC10092295 DOI: 10.1111/1346-8138.16596] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/06/2022] [Accepted: 09/16/2022] [Indexed: 11/27/2022]
Abstract
There is a lack of contemporary data on rosacea originating in Japan. Using baseline data from a randomized, phase 3 study of 130 Japanese patients with rosacea treated with metronidazole gel (0.75%) or vehicle, the authors evaluated demographic and clinical characteristics, pretreatment quality of life, and exacerbating factors. In line with global data, most patients were women (82.3%; 107/130) and aged between 30 and 50 years (60.7%; 79/130). Patient-reported quality of life scores indicated that rosacea had an impact similar to that of other debilitating and disfiguring skin conditions (such as psoriasis), particularly in terms of the emotional burden. Anxiety or depression was reported by 30% of patients (39/130), with 6.9% (9/130) reporting moderate levels and 0.8% (1/130) reporting severe levels. The top five exacerbating factors reported to trigger worsening of rosacea were temperature changes, sun exposure, hot weather, seasonal variation, and heavy exercise. In addition, pollen exposure and menstruation were noted as triggers of rosacea symptoms; these are novel findings that require further investigation to fully understand the implications for patients and treatment. Rosacea is likely to be underdiagnosed and undertreated in Japan because of the current lack of consensus guidelines and standardized therapy. The authors anticipate that the results of this analysis will provide much needed information to help improve diagnosis and facilitate the management of rosacea in patients.
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Affiliation(s)
- Kenshi Yamasaki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Rifu Dermatology & Allergology Clinic, Rifu, Japan
| | - Yoshiki Miyachi
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
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19
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Relationships of Serum Homocysteine, Vitamin B12, and Folic Acid Levels with Papulopustular Rosacea Severity: A Case-Control Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5479626. [PMID: 35832851 PMCID: PMC9273444 DOI: 10.1155/2022/5479626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/18/2022] [Indexed: 02/07/2023]
Abstract
Background Rosacea is a chronic inflammatory skin disease with a multifactorial etiology. Recently, associations between serum homocysteine (Hcy) levels and inflammatory skin diseases, such as psoriasis and hidradenitis suppurativa, have been reported. However, no study has explored the levels of serum Hcy, folic acid, and vitamin B12 in patients with rosacea. Objective To investigate serum Hcy, vitamin B12, and folic acid levels in patients with papulopustular rosacea (PPR), we characterized the association of these levels with PPR severity. Methods This case-control study included 138 PPR patients and 58 healthy controls. The serum levels of Hcy, vitamin B12, and folic acid were measured. A correlation was assessed between disease severity and serum levels of Hcy, vitamin B12, and folic acid. Results Serum vitamin B12 and folic acid levels were significantly lower in PPR patients than in the healthy controls (p = 0.011 and p = 0.0173, respectively). Although serum Hcy levels did not significantly differ between PPR patients and healthy controls, PPR severity was positively correlated with serum Hcy levels (p < 0.001). Conclusions Our results suggest a possible association between hyperhomocysteinemia and vitamin B12 deficiency in patients with PPR.
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20
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Barakji YA, Rønnstad ATM, Christensen MO, Zachariae C, Wienholtz NKF, Halling AS, Maul JT, Thomsen SF, Egeberg A, Thyssen JP. Assessment of Frequency of Rosacea Subtypes in Patients With Rosacea: A Systematic Review and Meta-analysis. JAMA Dermatol 2022; 158:617-625. [PMID: 35385049 PMCID: PMC8988027 DOI: 10.1001/jamadermatol.2022.0526] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Four distinct rosacea subtypes have traditionally been recognized, but the frequency of these subtypes among patients with rosacea remains unknown. Objective To assess the frequency of 4 rosacea subtypes. Data Sources This systemic review and meta-analysis included a search of 2 databases, PubMed and Embase, from inception of the databases to November 2, 2021. The search was filtered to include only studies of human participants published in English, French, and German. Study Selection Studies were screened independently by 2 of the authors and were included if they were original with a sample size of 25 or more patients and reported absolute numbers or frequency of patients affected by rosacea subtypes. Studies that did not report sufficient data to calculate the proportions of subtypes were excluded. Data Extraction and Synthesis Data extraction was performed independently and in duplicate by 2 of the authors, using the search term rosacea, according to the Preferred Reporting items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search term, objectives, and study protocol methods were defined before the study was initiated. A total of 292 studies were included for full-text assessment. Owing to the heterogeneity of the included studies, a random-effects model was used. Main Outcome and Measures The main outcome was the proportion of patients with rosacea in each of the 4 major subtype groups defined by the 2002 National Rosacea Society classification system. Measures were absolute numbers or frequency of patients affected by each of the 4 rosacea subtypes. Results A total of 39 studies examining 9190 patients with rosacea were included. The pooled proportion of erythematotelangiectatic rosacea was 56.7% (95% CI, 51.4%-62.0%), of papulopustular rosacea was 43.2% (95% CI, 38.8%-47.6%), of phymatous rosacea was 7.4% (95% CI, 6.1%-8.9%), and of ocular rosacea was 11.1% (95% CI, 6.7%-16.3%). Subtype distribution occurred equally among men and women except for phymatous rosacea, which was more prevalent in men. Studies from Africa showed the lowest proportion of erythematotelangiectatic rosacea. Differences in frequency of subtypes were observed when stratification by publication year was performed. Conclusion and Relevance In this systematic review and meta-analysis, differences were found in rosacea subtypes by patient sex and by continent of origin and publication year of included studies. Erythematotelangiectatic and papulopustular rosacea were the most prevalent subtypes, but data should be interpreted with caution. Future studies should use the phenotype-based rosacea approach.
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Affiliation(s)
- Yousef A Barakji
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Maria O Christensen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Claus Zachariae
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Nita K F Wienholtz
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Sofie Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | | | - Simon F Thomsen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Alexander Egeberg
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jacob P Thyssen
- Department of Dermatology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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21
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Morss-Walton P, McGee JS. Rosacea, not just skin deep: Understanding thesystemic disease burden. Clin Dermatol 2021; 39:695-700. [PMID: 34809774 DOI: 10.1016/j.clindermatol.2020.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rosacea is a common inflammatory skin condition with four main clinical subtypes: erythematotelangiectatic, papulopustular, rhinophymatous, and ocular. Although several genetic and environmental factors have been linked with triggering rosacea, the pathogenesis still remains poorly understood. There is an increasing evidence in the literature to support that rosacea is a harbinger of several systemic comorbidities and may represent a chronic, systemic, inflammatory state. We have provided the most up-to-date evidence on the association between rosacea and several systemic diseases, discussing that rosacea is not just a skin disorder but a systemic disease process.
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Affiliation(s)
- Peyton Morss-Walton
- University of Massachusetts Medical School, Worcester, Massachusetts, USA; Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jean S McGee
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA.
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22
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Yi JZ, Lukac D, Pagani K, Li S, McGee JS. Rosacea and upper gastrointestinal disorders: a case-control study from a large, urban academic centre. J Eur Acad Dermatol Venereol 2021; 36:e227-e229. [PMID: 34661953 DOI: 10.1111/jdv.17758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J Z Yi
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - D Lukac
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - K Pagani
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - S Li
- Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - J S McGee
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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23
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Choi D, Choi S, Choi S, Park SM, Yoon HS. Association of Rosacea With Cardiovascular Disease: A Retrospective Cohort Study. J Am Heart Assoc 2021; 10:e020671. [PMID: 34558290 PMCID: PMC8649155 DOI: 10.1161/jaha.120.020671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background There is emerging evidence that rosacea, a chronic cutaneous inflammatory disease, is associated with various systemic diseases. However, its association with cardiovascular disease (CVD) remains controversial. We aimed to investigate whether patients with rosacea are at increased risk of developing CVD. Methods and Results This retrospective cohort study from the Korean National Health Insurance Service-Health Screening Cohort included patients with newly diagnosed rosacea (n=2681) and age-, sex-, and index year-matched reference populations without rosacea (n=26 810) between 2003 and 2014. The primary outcome was subsequent CVD including coronary heart disease and stroke. Multivariable Cox regression analyses were used to evaluate adjusted hazard ratios for subsequent CVD adjusted for major risk factors of CVD. Compared with the reference population (13 410 women; mean [SD] age, 57.7 [9.2] years), patients with rosacea (1341 women; mean [SD] age, 57.7 [9.2] years) displayed an increased risk for CVD (adjusted hazard ratios, 1.20; 95% CI, 1.03-1.40) and coronary heart disease (adjusted hazard ratios, 1.29; 95% CI, 1.05-1.60). The risk for stroke was not significantly elevated (adjusted hazard ratios, 1.12; 95% CI, 0.91-1.37). Conclusions This study suggests that patients with rosacea are more likely to develop subsequent CVD. Proper education for patients with rosacea to manage other modifiable risk factors of CVD along with rosacea is needed.
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Affiliation(s)
- Daein Choi
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea.,Department of Medicine Mount Sinai Beth IsraelIcahn School of Medicine at Mount Sinai New York NY
| | - Sungjun Choi
- Department of Dermatology Seoul National University Hospital Seoul South Korea
| | - Seulggie Choi
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea
| | - Sang Min Park
- Department of Biomedical Sciences Seoul National University Graduate School Seoul South Korea.,Department of Family Medicine Seoul National University Hospital Seoul South Korea
| | - Hyun-Sun Yoon
- Department of Dermatology SMG-SNU Boramae Medical Center Seoul South Korea
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24
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Demir Pektas S, Cinar N, Pektas G, Akbaba G, Kara A, Hancer HS, Demircioglu Duman D, Neselioglu S, Erel O, Yazgan Aksoy D. Thiol/disulfide homeostasis and its relationship with insulin resistance in patients with rosacea. J Cosmet Dermatol 2021; 21:2655-2661. [PMID: 34564928 DOI: 10.1111/jocd.14477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Rosacea is a chronic inflammatory cutaneous disease that can be associated with cardiometabolic disorders. Oxidative stress is included in the pathogenesis of rosacea, and thiol-disulfide homeostasis (TDH) acts as antioxidants. OBJECTIVE To evaluate the TDH and metabolic parameters in patients with rosacea. MATERIAL AND METHODS A total of 42 rosacea patients and 50 controls participated in this prospective study. Demographic data, clinical entities, anthropometric measurements, and laboratory findings were recorded. Additionally, TDH was measured by an automated spectrophotometric method. RESULTS Rosacea patients had greater body mass index values (27.9 ± 5.2 kg/m² vs. 23 ± 1.4 kg/m², p < 0.001), waist-hip ratios (0.87 ± 0.1 vs. 0.77 ± 0.8, p < 0.001), and insulin resistance (3.0 ± 2.0 vs. 1.3 ± 0.5, p < 0.001) compared with controls. Disulfide levels, the disulfide/native thiol ratio (DNTR), and the disulfide/total thiol ratio (DTTR) were increased (p < 0.05) in rosacea patients. Native thiol and total thiol levels and the native/total thiol ratio (NTTR) were decreased in rosacea patients (p < 0.05). Different rosacea subtypes had no effect on oxidative stress markers. The duration of illness and insulin resistance values significantly correlated with DNTR and DTTR in the rosacea group (p < 0.05). CONCLUSION Rosacea has a metabolic milieu with increased oxidative stress and insulin resistance.
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Affiliation(s)
- Suzan Demir Pektas
- Department of Dermatology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Nese Cinar
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Gokhan Pektas
- Department of Internal Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Gulhan Akbaba
- Department of Endocrinology and Metabolic Diseases, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | - Ahmet Kara
- Department of Family Medicine, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey
| | | | | | - Salim Neselioglu
- Department of Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
| | - Ozcan Erel
- Department of Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey
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25
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Systemic comorbidities of rosacea: practice gaps among dermatologists. Arch Dermatol Res 2021; 314:995-997. [PMID: 34510277 DOI: 10.1007/s00403-021-02279-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 08/26/2021] [Accepted: 09/03/2021] [Indexed: 10/20/2022]
Abstract
Rosacea is a chronic inflammatory skin condition that is associated with multiple systemic comorbidities, with the strongest evidence linking rosacea to hypertension, dyslipidemia, inflammatory bowel disease, and anxiety and depression. To assess dermatologists' awareness of and screening practices for rosacea comorbidities, we developed a survey that was distributed to attendings and residents across four academic dermatology departments in Massachusetts. A total of 73 dermatologists with varying experience participated in the study. Findings demonstrated significant knowledge and practice gaps among academic dermatologists in managing systemic comorbidities in rosacea. In addition, dermatologists' awareness of rosacea comorbidities was negatively correlated with number of years out of residency training, highlighting the need to address this knowledge gap through increased continuing medical education. Importantly, we observed a low screening frequency despite a high awareness of the association between rosacea and ocular comorbidities, suggesting that additional financial, institutional, or practice barriers likely contribute to the low screening rate.
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26
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Wladis EJ, Adam AP. Immune signaling in rosacea. Ocul Surf 2021; 22:224-229. [PMID: 34481075 DOI: 10.1016/j.jtos.2021.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 08/24/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
Rosacea is a common chronic skin disease affecting mostly people aged 40 and above, with currently no cure. When it affects the eyelids and periocular skin, it leads to dry eye and potentially corneal damage. Research performed over the last decade shed light into the potential mechanisms leading to skin hypersensitivity and provided promising avenues for development of novel, rational therapeutics aimed at reducing the skin inflammatory state. In this review, we discuss the current knowledge on the mechanisms of rosacea in general and of periocular skin-affecting disease in particular, identify key questions that remain to be answered in future research, and offer a disease model that can explain the key characteristics of this disease, with particular emphasis on a potential positive feedback loop that could explain both the acute and chronic features of rosacea.
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Affiliation(s)
- Edward J Wladis
- Lions Eye Institute, Department of Ophthalmology, Albany Medical College, 1220 New Scotland Rd, Suite 302, Slingerlands, NY, 12159, United States.
| | - Alejandro P Adam
- Department of Molecular and Cellular Physiology and Department of Ophthalmology, Albany Medical College, United States
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27
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Şahin T, Öztekin A, Cevher S. Does Rosacea, a localized skin disease, affect the choroidal thickness? J Cosmet Dermatol 2021; 21:387-391. [PMID: 34473882 DOI: 10.1111/jocd.14428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 01/24/2023]
Abstract
INTRODUCTION This study aims to compare the choroidal thickness (CT) of patients with rosacea with healthy individuals. METHODS This study was conducted with 42 patients with Papulopustular Rosacea (PPR), 38 patients with Erythematotelangiectatic Rosacea (ETR), and gender and age-matched 37 healthy individuals in the control group. CT measurements were done using the spectral-domain optical coherence tomography. RESULTS Choroidal thickness means were measured as 352 ± 78 μm, 331 ± 67 μm, and 346 ± 83 μm at the subfoveal region; 323 ± 72.3 μm, 303.5 ± 68.4 μm, and 314 ± 80.3 μm at 1000 μm nasal; and 325.2 ± 71 μm, 304.4 ± 52.2 μm, and 309 ± 67 μm at 1000 μm temporal in the PPR, ETR, and control groups, respectively (p > 0.05). CONCLUSION Although rosacea is a common chronic skin disease that could have systemic findings, CT is not affected by this disease.
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Affiliation(s)
- Tayfun Şahin
- Department of Ophthalmology, Hitit University Medicine Faculty, Corum, Turkey
| | - Aynure Öztekin
- Department Of Dermatology, Hıtıt Unıversıty Medıcıne Faculty, Corum, Turkey
| | - Selim Cevher
- Department of Ophthalmology, Hitit University Medicine Faculty, Corum, Turkey
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28
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Zhang J, Yan Y, Jiang P, Liu Z, Liu Y, Liu Y, Wang X, Li M, Xu Y. Association between rosacea and cardiovascular disease: A systematic review and meta-analysis. J Cosmet Dermatol 2021; 20:2715-2722. [PMID: 33350031 DOI: 10.1111/jocd.13884] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Rosacea and cardiovascular diseases (CVD) are chronic inflammatory disorders. While CVD is the leading cause of mortality globally, increasing evidence indicates that CVD prevalence could be higher among patients with rosacea. AIMS This review aimed to determine the association between the prevalence of CVD and rosacea. PATIENTS/METHODS A systematic review of observational studies with controls available in MEDLINE, EMBASE, PubMed, Cochrane, and Web of Science databases was conducted. We performed a pooled meta-analysis using random-effects weighting. Overall, 11 studies met the inclusion criteria, which indicated increased odds for at least one risk factor of CVD, including diabetes, high blood pressure, or dyslipidemia. RESULTS The pooled meta-analysis indicated an association of rosacea with higher odds of insulin resistance or diabetes (odds ratio [OR], 1.18; 95% confidence interval [CI], 0.97-1.45), high systolic blood pressure (OR, 1.96; 95% CI, 1.35-2.84), dyslipidemia (OR, 1.50; 95% CI, 1.19-1.88), and CVD (OR, 6.65; 95% CI, 2.80-15.76). No publication bias was detected. The effect of confounding factors due to overlapping symptoms and lack of individual-level data were limitations of this review. CONCLUSION Patients with rosacea have a high risk of CVD. However, further studies are warranted to confirm the association between rosacea and CVD.
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Affiliation(s)
- Jiawen Zhang
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yang Yan
- Department of Cardiology, Ren Ji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peiyu Jiang
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zijing Liu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yunyi Liu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yixuan Liu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaoyan Wang
- Department of Dermatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Min Li
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yang Xu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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29
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Fatima F, Das A, Kumar P, Datta D. Skin and Metabolic Syndrome: An Evidence Based Comprehensive Review. Indian J Dermatol 2021; 66:302-307. [PMID: 34446955 PMCID: PMC8375528 DOI: 10.4103/ijd.ijd_728_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Metabolic syndrome is currently considered to be a global epidemic, causing a significant increase in the cost of health care, apart from deteriorating the quality of life. Skin serves as a mirror of underlying metabolic sinister. Various dermatological conditions like psoriasis, acanthosis nigricans, lichen planus, acne vulgaris, acrochordons, atopic dermatitis, etc. have been reported to be associated with metabolic syndrome. We hereby present an evidence-based review of the various dermatological conditions and their association with the development of metabolic syndrome.
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Affiliation(s)
- Farhat Fatima
- Department of Dermatology, Medical College and Hospital, Kolkata, West Bengal, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Piyush Kumar
- Department of Dermatology, Katihar Medical College and Hospital, Katihar, Bihar, India
| | - Debatri Datta
- Consultant Dermatologist, Oliva Skin and Hair Clinic, Kolkata, West Bengal, India
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30
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Demirbaş A, Yümer Y, Elmas ÖF, Ulutaş Demirbaş G, Atasoy M, Türsen Ü, Dursun R, Lotti T. Relationship between rosacea and chronic obstructive pulmonary disease: Rosacea and comorbidities. J Cosmet Dermatol 2021; 21:2255-2262. [PMID: 34411396 DOI: 10.1111/jocd.14389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/01/2021] [Accepted: 08/05/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND Rosacea is a chronic inflammatory skin disease that has been reported to be associated with many systemic disorders including respiratory diseases. AIMS This study aims to investigate respiratory function in patients with rosacea. PATIENTS/METHODS Patients with rosacea and age- and gender-matched healthy volunteers were included in this cross-sectional study. Spirometric pulmonary function tests including the percentage of forced vital capacity (FVC%), percentage of forced expiratory volume in one second (FEV 1%), forced expiratory flow at 25-75% of FVC (FEF 25-75%), and FEV 1/FVC ratio was assessed in both patient and controls. The potential relationship between rosacea severity and pulmonary functions was assessed. RESULTS A total of 120 patients with rosacea and 120 healthy controls were enrolled in the study. Compared to the controls, FEV 1%, FEV 1/FVC%, and FEF 25-75% values were significantly lower in patients with rosacea. Lower FEV 1/FVC% values were found to be associated with disease severity. FEV 1%, FEV 1/FVC%, and FEF 25-75% values were found to be more useful in differentiating the patients from healthy subjects. CONCLUSIONS This study showed that patients with rosacea may have abnormal respiratory function compared to healthy subjects. Besides, disease severity was associated with worse respiratory functions. We believe that patients with rosacea, particularly those with additional risk factors, should be screened for respiratory disorders.
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Affiliation(s)
- Abdullah Demirbaş
- Department of Dermatology, Evliya Çelebi Training and Research Hospital, Kütahya Health Sciences University, Kütahya, Turkey
| | - Yusuf Yümer
- Department of Pulmonary Diseases, Konya Numune Hospital, Konya, Turkey
| | - Ömer Faruk Elmas
- Department of Dermatology, Kırıkkale University, Kırıkkale, Turkey
| | - Gözde Ulutaş Demirbaş
- Department of Dermatology, Evliya Çelebi Training and Research Hospital, Kütahya Health Sciences University, Kütahya, Turkey
| | - Mustafa Atasoy
- Department of Dermatology, Kayseri City Hospital, Health Science University, Kayseri, Turkey
| | - Ümit Türsen
- Department of Dermatology, Mersin University, Mersin, Turkey
| | - Recep Dursun
- Department of Dermatology, Necmettin Erbakan University, Konya, Turkey
| | - Torello Lotti
- Department of Dermatology, Guglielmo Marconi University, Rome, Italy
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31
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Reproductive and hormonal factors and risk of incident rosacea among US White women. J Am Acad Dermatol 2021; 87:138-140. [PMID: 34274412 DOI: 10.1016/j.jaad.2021.06.865] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 11/21/2022]
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32
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Ghoz MT, Mohamed DA, Ibrahim ZA, Hassan GFR. Evaluation of the efficacy and safety of platelet rich plasma injection in treatment of rosacea. Dermatol Ther 2021; 34:e15049. [PMID: 34197656 DOI: 10.1111/dth.15049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 06/28/2021] [Indexed: 10/21/2022]
Abstract
Rosacea is a chronic relapsing inflammatory skin disease, with a high prevalence among adults. Treatment of rosacea is difficult, with high rate of recurrence. Due to the strong anti- inflammatory and antibacterial effects of platelet rich plasma (PRP), it was used in the medicine for treating many inflammatory diseases. To evaluate the role of PRP injection in treatment of rosacea. The study was carried on 40 patients with rosacea. They were treated by PRP injection in right side of the face (group A) and platelet poor plasma injection in left side (group B). They underwent one session every 2 weeks for 3 months (6 sessions). The patients were assessed clinically before and after treatment by the rosacea grading scale. Skin biopsies were taken to evaluate the clinical results. There was a statistically significant decrease in rosacea grading scale after treatment with PRP injection, 50% of the patients showed excellent improvement and 50% showed good improvement. The improvement was significantly better in group A than B. There was marked decrease in inflammatory cells by hematoxylin and eosin stain, and decrease in expression of nuclear factor kappa βeta after treatment with PRP. PRP was effective and safe technique in treatment of rosacea and alternative to other systemic modalities, especially if they are contraindicated.
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Affiliation(s)
- Maysa T Ghoz
- Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Dareen A Mohamed
- Department of Pathology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Zainab A Ibrahim
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ghada Fawzy Rezk Hassan
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Aksu Çerman A, Aktaş Karabay E, Kaya HE, Türe Özdemir F, Özkur E, Erdem Y, Kıvanç Altunay İ. Evaluation of fecal calprotectin as a marker of gastrointestinal inflammation in rosacea: A case-control study. Dermatol Ther 2021; 34:e14946. [PMID: 33719160 DOI: 10.1111/dth.14946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 02/14/2021] [Accepted: 03/11/2021] [Indexed: 12/11/2022]
Abstract
A higher incidence of gastrointestinal diseases has been well established in patients with rosacea. However, no screening tool has been introduced for gastrointestinal disease development in rosacea. Fecal calprotectin (FC) is a calcium-binding protein, mainly derived from polymorpho-nuclear cells, such as neutrophils. It has been established as a marker of gastrointestinal inflammation. The aim of the present study was to evaluate FC levels in patients with rosacea without any gastrointestinal diseases. A prospective, case-control study was planned to investigate the relationship between rosacea and gastrointestinal involvement by evaluating FC levels and the Gastrointestinal Symptom Rating Scale (GSRS). A total of 47 patients with rosacea and 39 healthy control subjects were included in the study. The FC levels were statistically significantly higher in rosacea group than in the control group (65.96 ± 58.86 ng/mL vs 31.99 ± 20.12 ng/mL, P = .026, respectively). A statistically significant difference was also observed in GSRS values between the patient and the control groups (30.26 ± 12.48 vs 22.62 ± 7.64, P = .001, respectively). A positive correlation was noted between FC levels and the values of GSRS in the study group (r: 0.354; P = .001) and in the rosacea group (r = 0.392, P = .006). The measurement of FC may be useful in the early detection of gastrointestinal system diseases that may accompany rosacea and may provide a pathway to develop treatment strategies targeting both skin and intestinal mucosa.
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Affiliation(s)
- Aslı Aksu Çerman
- Department of Dermatology and Venereology, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ezgi Aktaş Karabay
- Department of Dermatology and Venereology, Istanbul Prof Dr Cemil Taşçıoğlu City Hospital (Okmeydanı Training and Research Hospital), Istanbul, Turkey
| | - Hazel Ezgi Kaya
- Department of Dermatology and Venereology, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Filiz Türe Özdemir
- Department of Immunology, Marmara University, Faculty of Medicine, Istanbul, Turkey
| | - Ezgi Özkur
- Department of Dermatology and Venereology, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Yasemin Erdem
- Department of Dermatology and Venereology, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - İlknur Kıvanç Altunay
- Department of Dermatology and Venereology, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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34
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Chang J, Wang Y, Sun D, Zhang L, Man MQ, Tu Y, Jiang X, He L, Gu H. Characterization of rosacea in Chinese: An analysis of 254 cases. J Cosmet Dermatol 2021; 20:3666-3671. [PMID: 33655687 DOI: 10.1111/jocd.14039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Rosacea is a common chronic inflammatory dermatosis with uncertainty of etiology. Although clinical features and risk factors of the disease in Caucasians have been reported, this information in Chinese is largely unavailable. AIMS To analyze the clinical features and associated risk factors of rosacea in Chinese. METHODS A questionnaire was given to outpatients with rosacea who visited the dermatology department of the first affiliated hospital of Kunming Medical University from June 2018 to March 2019. Analyses included demographic characteristics of subjects, clinical characteristics, and risk factors of rosacea. RESULTS A total of 254 outpatients completed the questionnaire. The ratio of female to male was 5.68:1.00. The mean age at onset was 31.18 ± 10.23 years. Erythematotelangiectatic subtype accounted for 51.60%, while 39% of the subjects were of papulopustular subtype. The rest were phymatous type (9.40%). Subjects with flushing, persistent facial erythema, and telangiectasia accounted for 91.73%, 90.55%, and 83.07%, respectively. One hundred and thirteen subjects (44.49%) had papules or pustules, and 24 subjects (9.40%) were with phymatous changes. The most commonly involved sites were the cheeks (93.31%), followed by the nose (82.68%), the perioral area (61.42%), and the forehead (51.97%). The clinical symptoms included burning (93.70%), dryness (90.55%), and itching (75.59%). The main risk factors were sun exposure (90.94%), temperature change (87.40%), etc. Fifty-one (20.08%) patients had comorbidities. CONCLUSIONS Rosacea mainly affects young females. The common signs and symptoms include flushing, persistent facial erythema, and burning. Sun exposure and temperature changes are the common risk factors. Patients can have comorbidities of systemic disorders.
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Affiliation(s)
- Jinxiu Chang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yulan Wang
- Department of Dermatology, Second Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Dongjie Sun
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liyuan Zhang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mao-Qiang Man
- Department of Dermatology, Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Ying Tu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xin Jiang
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Li He
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Hua Gu
- Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming, China
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Rosacea, Germs, and Bowels: A Review on Gastrointestinal Comorbidities and Gut-Skin Axis of Rosacea. Adv Ther 2021; 38:1415-1424. [PMID: 33507499 PMCID: PMC7932979 DOI: 10.1007/s12325-021-01624-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/12/2021] [Indexed: 12/16/2022]
Abstract
Rosacea is a chronic inflammatory disease with complicated pathophysiology that involves genetic and environmental elements and dysregulation of innate and adaptive immunity, neurovascular responses, microbiome colonization or infection, resulting in recurrent inflammation. Rosacea has been reported associated with various gastrointestinal diseases including inflammatory bowel disease, celiac disease, irritable bowel syndrome, gastroesophageal reflux disease, Helicobacter pylori (HP) infection, and small intestine bacterial overgrowth (SIBO). The link may involve common predisposing genetic, microbiota, and immunological factors, comprising the theory of the gut–skin axis. Although the evidence is still controversial, interestingly, medications for eradicating SIBO and HP provided an effective and prolonged therapeutic response in rosacea, and conventional therapy for which is usually disappointing because of frequent relapses. In this article, we review the current evidence and discuss probable mechanisms of the association between rosacea and gastrointestinal comorbidities.
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De Pessemier B, Grine L, Debaere M, Maes A, Paetzold B, Callewaert C. Gut-Skin Axis: Current Knowledge of the Interrelationship between Microbial Dysbiosis and Skin Conditions. Microorganisms 2021; 9:353. [PMID: 33670115 PMCID: PMC7916842 DOI: 10.3390/microorganisms9020353] [Citation(s) in RCA: 285] [Impact Index Per Article: 71.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/25/2021] [Accepted: 02/07/2021] [Indexed: 02/06/2023] Open
Abstract
The microbiome plays an important role in a wide variety of skin disorders. Not only is the skin microbiome altered, but also surprisingly many skin diseases are accompanied by an altered gut microbiome. The microbiome is a key regulator for the immune system, as it aims to maintain homeostasis by communicating with tissues and organs in a bidirectional manner. Hence, dysbiosis in the skin and/or gut microbiome is associated with an altered immune response, promoting the development of skin diseases, such as atopic dermatitis, psoriasis, acne vulgaris, dandruff, and even skin cancer. Here, we focus on the associations between the microbiome, diet, metabolites, and immune responses in skin pathologies. This review describes an exhaustive list of common skin conditions with associated dysbiosis in the skin microbiome as well as the current body of evidence on gut microbiome dysbiosis, dietary links, and their interplay with skin conditions. An enhanced understanding of the local skin and gut microbiome including the underlying mechanisms is necessary to shed light on the microbial involvement in human skin diseases and to develop new therapeutic approaches.
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Affiliation(s)
- Britta De Pessemier
- Center for Microbial Ecology and Technology, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; (B.D.P.); (M.D.); (A.M.)
| | - Lynda Grine
- Department of Head & Skin, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium;
| | - Melanie Debaere
- Center for Microbial Ecology and Technology, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; (B.D.P.); (M.D.); (A.M.)
| | - Aglaya Maes
- Center for Microbial Ecology and Technology, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; (B.D.P.); (M.D.); (A.M.)
| | | | - Chris Callewaert
- Center for Microbial Ecology and Technology, Ghent University, Coupure Links 653, 9000 Ghent, Belgium; (B.D.P.); (M.D.); (A.M.)
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Daou H, Paradiso M, Hennessy K, Seminario-Vidal L. Rosacea and the Microbiome: A Systematic Review. Dermatol Ther (Heidelb) 2021; 11:1-12. [PMID: 33170492 PMCID: PMC7859152 DOI: 10.1007/s13555-020-00460-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
Rosacea, a chronic inflammatory skin disease characterized by recurrent episodes of facial flushing, erythema, pustules, and telangiectasia, largely affects fair-skinned women over 30 years of age. Although a long-recognized entity, the exact pathophysiology of this disease is still debated. Current theories highlight the role of the cutaneous microbiome and its associated inflammatory effects in rosacea's pathogenesis. However, microbiological reverberations are not limited to the skin, as recent studies have described the potential cutaneous effects of alterations in the gastrointestinal (GI) microbiome. Associations with additional GI pathologies, including small intestinal bacterial overgrowth (SIBO), irritable bowel syndrome (IBS), and inflammatory bowel disease (IBD), have been investigated, as well as Helicobacter pylori infection. In an attempt to better understand and characterize these relationships, as well as current treatment options, we conducted a systematic review of the literature in PubMed, Cochrane, and Embase from their inception to August 6, 2020. We have synthesized the literature findings within three sections of this manuscript: the cutaneous microbiome, the gut microbiome, and therapeutic strategies. Future studies should focus on specific mechanisms linking GI pathology with rosacea manifestations and the role of enteral drugs in mitigating cutaneous symptoms.
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Affiliation(s)
- Hala Daou
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | | | - Kerry Hennessy
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL, USA
| | - Lucia Seminario-Vidal
- Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, FL, USA.
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Yuan X, Yin D. Association between rosacea and smoking: A systematic review and meta-analysis. Dermatol Ther 2021; 34:e14747. [PMID: 33406295 DOI: 10.1111/dth.14747] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/15/2020] [Accepted: 12/30/2020] [Indexed: 11/30/2022]
Abstract
Rosacea is a chronic inflammatory disease of the centrofacial region. However, the association between rosacea and smoking remains controversial. To evaluate the association between rosacea and smoking, we performed a systematic review and meta-analysis. A comprehensive systematic search of literature published before October 15, 2020 on online databases (including Web of Science, PubMed, Cochrane Library, and Embase) was performed. The pooled odds ratios (ORs) were calculated. 12 articles were included, covering 80 156 controls and 54 132 patients with rosacea. Tobacco consumption was not found to increase the risk of rosacea. However, using subtype analysis (involving 5 articles), we found there was a decreased risk of rosacea in current smokers but an increased risk in ex-smokers. In addition, smoking appears to increase the risk of papulopustular rosacea and phymatous rosacea. Analysis of all included studies also showed that ex-smoking was associated with an increased risk, while current smoking was associated with a reduced risk of rosacea. In order to prevent many diseases, including rosacea, the public should be encouraged to avoid smoking.
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Affiliation(s)
- Xin Yuan
- Department of Dermatology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Dan Yin
- College of Medical Humanitles, Guizhou Medical University, Guiyang, China
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Ertekin SS, Koku Aksu AE, Koçyiğit A, Güler EM, Baykara Ulusan M, Gürel MS. Carotid intima-media thickness and serum proinflammatory cytokine levels in rosacea patients without cardiovascular risk factors. Dermatol Ther 2021; 34:e14733. [PMID: 33389789 DOI: 10.1111/dth.14733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/05/2020] [Accepted: 12/18/2020] [Indexed: 12/17/2022]
Abstract
There is a growing body of evidence linking rosacea to various systemic disorders, even though data regarding the association between rosacea and cardiovascular diseases are presently controversial. We sought to investigate the potential association of rosacea with subclinical atherosclerosis and serum proinflammatory/proatherogenic markers. This study included 44 patients with rosacea and 44 age-matched and sex-matched healthy control subjects. Patients with traditional cardiovascular risk factors or a history of cardiovascular events were excluded. Demographic, clinical, and laboratory data, including serum interleukin-1 beta (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) levels were assessed. Carotid intima-media thickness (CIMT) and carotid plaques were measured by carotid ultrasonography. Serum IL-1β (P < .001), IL-6 (P < .001), TNF-α (P < .001), and hs-CRP (P < .001) levels were significantly higher in the patient group compared with the control group. Mean CIMT values did not differ significantly between the patient group and control group (P > .05). Patients with moderate to severe rosacea had a significantly greater CIMT than those with mild rosacea (P = .047). Rosacea patients with eye involvement had a significantly greater CIMT than those without eye involvement (P = .008). There was no significant correlation between CIMT values and inflammation parameters. As conclusion, in the absence of other traditional cardiovascular risk factors, rosacea does not seem to affect mean CIMT value. However, specific subgroups such as patients with moderate to severe disease or with eye involvement are associated with increased subclinical atherosclerosis and may require additional attention for cardiovascular disease prevention.
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Affiliation(s)
- Sümeyre Seda Ertekin
- Department of Dermatology, İstanbul Training and Research Hospital, Health Science University, Istanbul, Turkey.,Department of Dermatology, Aksaray University, Aksaray Training and Research Hospital, Aksaray, Turkey
| | - Ayşe Esra Koku Aksu
- Department of Dermatology, İstanbul Training and Research Hospital, Health Science University, Istanbul, Turkey
| | - Abdurrahim Koçyiğit
- Department of Biochemistry, Bezmialem Vakif University Medical School, Istanbul, Turkey
| | - Eray Metin Güler
- Department of Biochemistry, Bezmialem Vakif University Medical School, Istanbul, Turkey.,Department of Biochemistry, Hamidiye Medicine Faculty, Health Science University, Istanbul, Turkey
| | - Melis Baykara Ulusan
- Department of Radiology, İstanbul Training and Research Hospital, Health Science University, Istanbul, Turkey
| | - Mehmet Salih Gürel
- Department of Dermatology, Göztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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Gönülal M, Teker K, Öztürk A, Yaşar FY. Investigation of thyroid blood tests and thyroid ultrasound findings of patients with rosacea. Dermatol Ther 2020; 34:e14632. [PMID: 33280224 DOI: 10.1111/dth.14632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 11/29/2022]
Abstract
We aimed to investigate the relationship between rosacea and thyroid diseases by analyzing thyroid blood tests and ultrasound findings of our patients recently diagnosed with rosacea. This study was designed as a prospective, single-center study. Dermatological examination findings, lesion locations were recorded, and rosacea clinical scores were calculated for all study group patients. The control group consisted of completely healthy women presented to our hospital during the study period for check-up purposes. Serum-free thyroxine, free triiodothyronine, thyroid-stimulating hormone, antithyroglobulin antibody, antithyroid peroxidase antibody levels were measured, and thyroid ultrasound examinations were performed for all study participants. The entire study cohort consisted of 123 patients (63 cases and 60 controls). There was no significant difference between the groups in terms of mean patient age (P < .05). Cheek was the most common lesion location (96.8%). There was no difference between the groups in terms of thyroid-related laboratory parameters. However, anti-TPO levels differed significantly with increasing disease severity (ie, RCSs). There were significant relationships between cheek lesions and fT4 (P = .021), while nose and chin lesions were associated with fT3 (P = .01, P = .001). Thyroid ultrasound findings revealed that rosacea patients tended to have larger thyroid nodules and more heterogeneous thyroid parenchymas than controls. Our findings indicate that thyroid blood tests, including thyroid autoantibodies, should be tested and thyroid ultrasounds should be performed in patients diagnosed with rosacea. However, these findings need to be validated by prospective studies conducted in larger patient series with more extended follow-up periods.
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Affiliation(s)
- Melis Gönülal
- Department of Dermatology, İzmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Kenan Teker
- Department of General Surgery, İzmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Aylin Öztürk
- Department of Dermatology, İzmir Tepecik Training and Research Hospital, Izmir, Turkey
| | - Fatma Y Yaşar
- Department of Radiology, İzmir Tepecik Training and Research Hospital, Izmir, Turkey
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Kim HO, Kang SY, Kim KE, Cho SY, Kim KH, Kim IH. Neurogenic rosacea in Korea. J Dermatol 2020; 48:49-55. [PMID: 33211906 DOI: 10.1111/1346-8138.15629] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/03/2020] [Indexed: 11/29/2022]
Abstract
Rosacea with severe neurological symptoms such as burning and stinging is often not treated effectively by conventional therapies. The aim of this study was to investigate the clinical characteristics of Korean rosacea patients with prominent neurological symptoms. The demographic features, medical history, clinical manifestations and treatment modalities of 17 neurogenic rosacea patients who had prominent neurological symptoms and 106 erythematotelangiectatic rosacea (ETR) patients as a control group were investigated. All 17 neurogenic rosacea patients had severe persistent erythema with burning/stinging sensation limited to both cheeks. Among these patients, 94.1% were female (16/17). Heat stimuli (58.8%, 10/17) and stress (52.9%, 9/17) were major aggravating factors. Fourteen of 17 patients (82.3%) improved after receiving anticonvulsants and antidepressants. In conclusion, rosacea patients with severe neurological symptoms show distinct clinical manifestations and should be classified separately, and a different therapeutic approach is necessary for them.
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Affiliation(s)
- Hye One Kim
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Seok Young Kang
- Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Ko Eun Kim
- Department of Dermatology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
| | - So Yun Cho
- Department of Dermatology, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang Ho Kim
- Department of Dermatology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Il-Hwan Kim
- Department of Dermatology, Korea University Ansan Hospital, Korea University College of Medicine, Seoul, Korea
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Chen Q, Shi X, Tang Y, Wang B, Xie HF, Shi W, Li J. Association between rosacea and cardiometabolic disease: A systematic review and meta-analysis. J Am Acad Dermatol 2020; 83:1331-1340. [DOI: 10.1016/j.jaad.2020.04.113] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 04/07/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
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Woo YR, Kim HS, Lee SH, Ju HJ, Bae JM, Cho SH, Lee JD. Systemic Comorbidities in Korean Patients with Rosacea: Results from a Multi-Institutional Case-Control Study. J Clin Med 2020; 9:jcm9103336. [PMID: 33080929 PMCID: PMC7603220 DOI: 10.3390/jcm9103336] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 12/27/2022] Open
Abstract
Recent evidence links rosacea to systemic disease, but there are not enough methodologic studies addressing this association in Asians. Our aim was to identify rosacea comorbidities in Koreans and establish a reference database. A multi-center, case-control study was performed where a total of 12,936 rosacea patients and 12,936 age- and sex-matched control subjects were identified from 2007 to 2018. Logistic regression was performed to find significant association between rosacea and Sjögren syndrome (odds ratio [OR] 2.05; 95% confidence interval, 1.40–3.00), systemic sclerosis (OR 6.56; 95% CI, 1.50–28.7), rheumatoid arthritis (OR 1.72; 95% CI, 1.50–1.98), ankylosing spondylitis (OR 2.32; 95% CI, 1.42–3.84), autoimmune thyroiditis (OR 1.96; 95% CI, 1.40–2.73), alopecia areata (OR 1.77; 95% CI, 1.27–2.45), vitiligo (OR 1.90; 95% CI, 1.30–2.77), lung cancer (OR 1.54; 95% CI, 1.06–2.21), hepatobiliary cancer (OR 1.38; 95% CI, 1.06–1.77), alcohol abuse (OR 1.59; 95% CI, 1.05–2.39), diabetes mellitus (OR 1.11; 95% 1.02–1.19), obesity (OR 1.72; 95% CI, 1.22–2.41), allergic rhinitis (OR 1.65; 95% CI, 1.54–1.76), allergic conjunctivitis (OR 1.57; 95% CI, 1.27–1.94), chronic rhinosinusitis (OR 1.28; 95% CI, 1.14–1.42), herpes infection (OR 1.69; 95% CI, 1.53–1.86), and human papillomavirus infection (OR 2.50; 95% CI, 2.06–3.02). Higher odds for Sjogren syndrome, systemic sclerosis, ankylosing spondylitis, thyroiditis, vitiligo, hepatobiliary cancer, and obesity was exclusive in female subjects with rosacea, whereas increased prevalence of alopecia areata and alcohol abuse was confined to men. Only those who were 50 years and older exhibited higher odds for vitiligo, lung cancer, and gastroesophageal reflux disease while individuals younger than 50 were exclusively associated with hepatobiliary cancer, allergic conjunctivitis, and irritable bowel syndrome. Our study suggests that Koreans with rosacea are more likely to experience systemic comorbidity. Clinicians should acknowledge these interrelations and employ comprehensive care with an individual-based approach.
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Affiliation(s)
- Yu Ri Woo
- Department of Dermatology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea; (Y.R.W.); (H.S.K.); (S.H.L.); (S.H.C.)
| | - Hei Sung Kim
- Department of Dermatology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea; (Y.R.W.); (H.S.K.); (S.H.L.); (S.H.C.)
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery, Miami Itch Center, Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Se Hoon Lee
- Department of Dermatology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea; (Y.R.W.); (H.S.K.); (S.H.L.); (S.H.C.)
| | - Hyun Jeong Ju
- Department of Dermatology, St. Vincent’s Hospital, The Catholic University of Korea, Seoul 06591, Korea; (H.J.J.); (J.M.B.)
| | - Jung Min Bae
- Department of Dermatology, St. Vincent’s Hospital, The Catholic University of Korea, Seoul 06591, Korea; (H.J.J.); (J.M.B.)
- Heal House Skin Clinic, Mesanro 24, Paldal-gu, Suwon 16461, Korea
| | - Sang Hyun Cho
- Department of Dermatology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea; (Y.R.W.); (H.S.K.); (S.H.L.); (S.H.C.)
| | - Jeong Deuk Lee
- Department of Dermatology, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Korea; (Y.R.W.); (H.S.K.); (S.H.L.); (S.H.C.)
- Correspondence: ; Tel.: +82-32-280-5100
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Harden JL, Shih YH, Xu J, Li R, Rajendran D, Hofland H, Chang ALS. Paired Transcriptomic and Proteomic Analysis Implicates IL-1β in the Pathogenesis of Papulopustular Rosacea Explants. J Invest Dermatol 2020; 141:800-809. [PMID: 32941918 DOI: 10.1016/j.jid.2020.08.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/30/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
Papulopustular rosacea (PPR) is a chronic inflammatory skin disease with limited treatment options. Although multiple pathways have been described to be upregulated in PPR, a mechanistic understanding of the key drivers and interaction between pathways in PPR pathology is lacking. In this study, we utilized PPR skin biopsy explants to integrate both differentially expressed genes and differentially expressed proteins in paired nonlesional and lesional PPR tissue (n = 5 patients). The results of this study identified 92 differentially expressed genes and 20 differentially expressed proteins between paired PPR lesional and nonlesional explants. MAPK and TNF signaling pathways were the most significantly upregulated pathways in PPR lesional tissue and aligned with differently expressed proteins identified in this study. Both MAPK and TNF signaling pathways highlighted IL-1β as a potential central mediator for PPR pathogenesis. In support of this, stimulation of nonlesional explants with IL-1β resulted in transcriptomic and proteomic profiles similar to those of lesional PPR. In this integrative transcriptomic and quantitative protein analysis, we identified several inflammatory genes, proteins, and pathways, which may be contributing to PPR, as well as highlighted a potential role of IL-1β in driving inflammation in PPR.
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Affiliation(s)
- Jamie L Harden
- Dermira Inc, Menlo Park, California, USA; Evommune Inc, Los Altos, California, USA
| | - Yi-Hsien Shih
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA; Department of Dermatology, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan; Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jin Xu
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA
| | - Rui Li
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA
| | | | - Hans Hofland
- Dermira Inc, Menlo Park, California, USA; Evommune Inc, Los Altos, California, USA
| | - Anne Lynn S Chang
- Department of Dermatology, Stanford University School of Medicine, Redwood City, California, USA.
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Abstract
Rosacea is a complex facial skin condition associated with abnormal inflammation and vascular dysfunction. Next to the known trigger factors, the role of microbiota in the development and aggravation of rosacea continues to raise interest. Demodex folliculorum mites, Helicobacter pylori, Staphylococcus epidermidis, Chlamydia pneumoniae, and the Demodex-associated bacterium, Bacillus oleronius are microbes that have been linked with rosacea. However, the results of studies which assessed their involvement in the disease have been inconsistent and inconclusive. Microbiological research in many different disciplines exploded in recent years as methods to analyze complex microbial communities at the taxonomic and phylogenetic levels became available. Here, we provide an update on the microorganisms implicated in rosacea and review the potential pathogenic role of microbes in the development of rosacea.
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Affiliation(s)
- Hei Sung Kim
- Department of Dermatology and Cutaneous Surgery, Miami Itch Center, Miller School of Medicine, University of Miami, Miami, FL, USA.
- Department of Dermatology, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, 06591, Korea.
- Department of Biomedicine and Health Sciences, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea.
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Wienholtz NKF, Christensen CE, Haugaard JH, Zhang DG, Ashina M, Thyssen JP, Egeberg A. Cohort profile: COpenhagen ROsacea COhort (COROCO) and COpenhagen MIgraine COhort (COMICO). BMJ Open 2020; 10:e039445. [PMID: 32819957 PMCID: PMC7440817 DOI: 10.1136/bmjopen-2020-039445] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Migraine has consistently been connected with rosacea. Commonalities in epidemiology, trigger factors and associated neuropeptides support shared aetiology and pathophysiological pathways, though underlying mechanisms remain unclear. We established two cohorts of patients diagnosed with either migraine and/or rosacea. All patients were phenotyped in regard to migraine and rosacea. In this article, we describe the baseline parameters of the cohorts. In the future, we expect that these cohorts will help uncover potential disease overlaps and allow for prolonged follow-up through national Danish health registers. PARTICIPANTS COpenhagen ROsacea COhort (COROCO) and COpenhagen MIgraine COhort (COMICO) are prospective cohorts based in the Capital region of Denmark. Participants for COROCO were recruited primarily through two tertiary dermatology clinics in Copenhagen, Denmark and patients for COMICO were recruited through a tertiary neurology clinic in Copenhagen, Denmark. FINDINGS TO DATE COROCO: 67.7% women (median age 51 years (interquartile range (IQR) 43.0-61.0)). Family history of migraine: 44.3%. Family history of rosacea: 45%. There were 13% who currently smoked, and 36.6% were former smokers. Regular intake of alcohol was present in 79.3% (median 4 items/week (IQR 1.0-9.0)). Median body mass index (BMI): 25.7 (IQR 23.1-29.0). Median Dermatology Life Quality Index (DLQI): 2 (IQR 1-5). COMICO 88.5% women (median age 41 years (IQR 29.5-51.0)). Family history of migraine: 73.4%. Family history of rosacea: 18.4%. There were 17.1% who currently smoked, and 26.0% former smokers. Regular intake of alcohol was present in 62.2% (median intake: 2 item/week (IQR 1.0-3.0)). Median BMI was 24.6 (IQR 21.5-28.2). Median DLQI was 1 (IQR 0-2). FUTURE PLANS COROCO and COMICO serve as strong data sources that will be used for future studies on rosacea and migraine with focus on risk factors, occurrence, treatment, natural history, complications, comorbidities and prognosis. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03872050).
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Affiliation(s)
- Nita Katarina Frifelt Wienholtz
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Casper Emil Christensen
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Jeanette Halskou Haugaard
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Ditte Georgina Zhang
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Glostrup, Denmark
| | - Jacob Pontoppidan Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; Copenhagen Research Group for Inflammatory Skin (CORGIS), Herlev and Gentofte Hospital, Hellerup, Denmark
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47
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Searle T, Al‐Niaimi F, Ali FR. Rosacea and the cardiovascular system. J Cosmet Dermatol 2020; 19:2182-2187. [DOI: 10.1111/jocd.13587] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 06/24/2020] [Accepted: 06/26/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Tamara Searle
- University of Birmingham Medical School Birmingham UK
| | - Firas Al‐Niaimi
- Department of Dermatology Aalborg University Hospital Aalborg Denmark
| | - Faisal R. Ali
- Vernova Healthcare CIC Macclesfield UK
- Dermatological Surgery & Laser Unit Guy's Hospital Cancer Centre St John's Institute of DermatologyGuy's and St Thomas' NHS Foundation Trust London UK
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48
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Dai Y, Tai Y, Chen C, Chang Y, Chen T, Chen M. Use of proton pump inhibitors and risk of rosacea: A nationwide population‐based study. J Dermatol 2020; 47:1126-1130. [DOI: 10.1111/1346-8138.15478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 05/19/2020] [Accepted: 05/29/2020] [Indexed: 01/20/2023]
Affiliation(s)
- Ying‐Xiu Dai
- Department of Dermatology Taipei Veterans General Hospital TaipeiTaiwan
- School of Medicine National Yang‐Ming University TaipeiTaiwan
| | - Ying‐Hsuan Tai
- School of Medicine National Yang‐Ming University TaipeiTaiwan
- Department of Anesthesiology Shuang Ho HospitalTaipei Medical University New Taipei CityTaiwan
- Department of Anesthesiology School of Medicine College of Medicine Taipei Medical University TaipeiTaiwan
| | - Chih‐Chiang Chen
- Department of Dermatology Taipei Veterans General Hospital TaipeiTaiwan
- School of Medicine National Yang‐Ming University TaipeiTaiwan
- Institute of Clinical Medicine National Yang‐Ming University TaipeiTaiwan
| | - Yun‐Ting Chang
- Department of Dermatology Taipei Veterans General Hospital TaipeiTaiwan
- School of Medicine National Yang‐Ming University TaipeiTaiwan
| | - Tzeng‐Ji Chen
- School of Medicine National Yang‐Ming University TaipeiTaiwan
- Department of Family Medicine Taipei Veterans General Hospital TaipeiTaiwan
| | - Mu‐Hong Chen
- School of Medicine National Yang‐Ming University TaipeiTaiwan
- Department of Psychiatry Taipei Veterans General Hospital Taipei Taiwan
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Jabbehdari S, Memar OM, Caughlin B, Djalilian AR. Update on the pathogenesis and management of ocular rosacea: an interdisciplinary review. Eur J Ophthalmol 2020; 31:22-33. [PMID: 32586107 DOI: 10.1177/1120672120937252] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Rosacea is one of the most common conditions affecting the ocular surface. The purpose of this review is to provide an update on the pathogenesis and treatment of rosacea based on the dermatology and ophthalmology literatures. METHODS Literature searches were conducted for rosacea and ocular rosacea. Preference was given to systematic reviews, meta-analysis, case-controlled studies, and documented case reports while excluding poorly documented case studies and commentaries. The data were examined and independently analyzed by more than two of the authors. RESULTS Rosacea is a complex inflammatory condition involving the pilosebaceous unit. Its underlying mechanism involves an interplay of the microbiome, innate immunity, adaptive immunity, environmental triggers, and neurovascular sensitivity. The latest classification of rosacea includes three dermatologic subgroups and a fourth subgroup, ocular rosacea. Ocular rosacea clinically displays many features that are analogous to the cutaneous disease, such as lid margin telangiectasia and phlyctenulosis. The role of environmental triggers in the exacerbation of ocular rosacea appears to be understudied. While lid hygiene and systemic treatment with tetracycline drugs remain the mainstay of treatment for ocular rosacea, newer dermatologic targets and therapies may have potential application for the eye disease. CONCLUSIONS Ocular rosacea appears to embody many of the manifestation of the dermatologic disease. Hence, the basic pathophysiologic mechanisms of the ocular and cutaneous disease are likely to be shared. Better understanding of the ocular surface microbiome and the immunologic mechanisms, may lead to novel approaches in the management of ocular rosacea.
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Affiliation(s)
- Sayena Jabbehdari
- Department of Ophthalmology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Benjamin Caughlin
- Department of Surgery/Division of Otolaryngology, Jr. Hospital of Cook County, Chicago, IL, USA.,Hospital of Cook County, Chicago, IL, USA.,Division of Facial Plastic and Reconstructive Surgery, Jesse Brown VA Medical Center, Chicago, IL, USA.,Division of Facial Plastic and Reconstructive Surgery, University of Illinois Health Hospital System, Chicago, IL, USA
| | - Ali R Djalilian
- Department of Ophthalmology, University of Illinois at Chicago, Chicago, IL, USA
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Li Y, Guo L, Hao D, Li X, Wang Y, Jiang X. Association between Rosacea and Cardiovascular Diseases and Related Risk Factors: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:7015249. [PMID: 32685519 PMCID: PMC7320285 DOI: 10.1155/2020/7015249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Rosacea is a common inflammatory skin disorder. Several studies, but not all, have suggested a high prevalence of cardiovascular diseases (CVDs) in rosacea patients. This study is aimed at investigating the association between rosacea and CVDs and related risk factors. METHODS We performed a literature search through PubMed, Embase, and Web of Science databases, from their respective inception to December 21, 2019. Two reviewers independently screened the articles, extracted data, and performed analysis, following the PRISMA guidelines. Odds ratios (OR) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes. The included studies' quality was evaluated using the Newcastle Ottawa Scale (NOS). RESULTS The final meta-analysis included ten studies. The pooled analysis found no association between rosacea prevalence and the incidence of CVDs (OR 0.97; 95% CI 0.86-1.10). Rosacea was found to be significantly associated with several risk factors for CVDs (OR 1.17; 95% CI 1.05-1.31), including hypertension (OR 1.17; 95% CI 1.02-1.35), dyslipidemia (OR 1.34; 95% CI 1.00-1.79), and metabolic syndrome (OR 1.72; 95% CI 1.09-2.72). However, no association was found between rosacea and diabetes mellitus (OR 0.98; 95% CI 0.82-1.16). Among the biological parameters, a significant association was found between rosacea and total cholesterol (SMD = 0.40; 95% CI = -0.00, 0.81; p < 0.05), low-density lipoprotein cholesterol (SMD = 0.28; 95% CI = 0.01, 0.56; p < 0.05), and C-reactive protein (CRP) (SMD = 0.25; 95% CI = 0.10, 0.41; p < 0.05). We found no association between rosacea and high-density lipoprotein cholesterol (SMD = 0.00; 95% CI = -0.18, 0.18; p = 0.968) or triglycerides (SMD = 0.10; 95% CI = -0.04, 0.24; p = 0.171). CONCLUSIONS Although no significant association was found between rosacea and CVDs, rosacea was found to be associated with several of related risk factors. Patients with rosacea should pay more attention to identifiable CVD risk factors, especially those related to inflammatory and metabolic disorders.
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Affiliation(s)
- Yanmei Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Linghong Guo
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Dan Hao
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiaoxue Li
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yujia Wang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xian Jiang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China
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