Assessment of Frequency of Rosacea Subtypes in Patients With Rosacea

Barakji, Yousef A; Rønnstad, Amalie Thorsti Møller; Christensen, Maria O.; Zachariae, Claus; Wienholtz, Nita Katarina Frifelt; Halling, Anne‐Sofie; Maul, Julia‐Tatjana; Thomsen, Simon Francis; Egeberg, Alexander; Thyssen, Jacob P.

doi:10.1001/jamadermatol.2022.0526

Cited by 22 publications

(12 citation statements)

References 78 publications

(107 reference statements)

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“…Phyma is the less frequent phenotype—around 7.4% (95% CI: 6.1–8.9%) with higher prevalence among men 43 . Phyma usually is characterized by soft tissue hypertrophy and hyperplasia and fibrosis of sebaceous glands, mainly in the nose.…”

Section: Discussionmentioning

confidence: 99%

Long‐term maintenance treatment of rosacea: experts' opinion

Almeida,

Ianhez,

Dal'Forno

et al. 2023

Int J Dermatology

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BackgroundRosacea is a chronic inflammatory dermatosis characterized by remissions and flares. Although the rosacea active treatment phase is well established, the long‐term maintenance phase is still challenging.ObjectiveTo discuss and make recommendations on how to treat patients during the long‐term maintenance phase for the main rosacea phenotypes.MethodsA panel of six board‐certified Brazilian dermatologists and one American dermatologist gathered to compose a consensus based upon an initial statement on how to treat rosacea during the long‐term maintenance phase based on the methodology Nominal Group Technique. The experts discussed each factor based upon an initial statement on how to treat rosacea patients in the long‐term maintenance phase. A sequence of comprehensive narrative reviews was performed; a questionnaire preparation about the definition of the maintenance phase and its management was presented; an interpersonal discussion and ranking of the ideas were conducted. Recommendations were made if the specialists had 75% agreement.ResultsThe maintenance treatment phase, which starts by achieving IGA 0 or 1 grades at the active phase, should be considered at least during the 9‐month period after remission. The recommendations of all treatments target this period. Daily skincare regimen and sunscreen are crucial. Active treatment phase should be recommended if signs or symptoms reappear or worsen.ConclusionMaintenance phase success depends on patient's adherence to daily skin care, appropriate treatments, continued follow‐up with dermatologist, and self‐assessment to identify new signs and symptoms indicating disease relapse.

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Section: Discussionmentioning

confidence: 99%

Long‐term maintenance treatment of rosacea: experts' opinion

Almeida,

Ianhez,

Dal'Forno

et al. 2023

Int J Dermatology

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“…Almost 1/3 of the patients were currently being treated (either locally or systemically) for their rosacea which may have also "masked" current features. A recent meta-analysis looked at the distribution of subtypes in patients with rosacea and found the most common subtype to be ETR (pooled proportion = 56.7%, 95% CI, 51.4-62.0%), followed by papulopustular rosacea (pooled proportion = 32.2%, 95% CI, 38.8-47.6%), ocular rosacea (pooled proportion = 11.1%, 95% CI, 6.7-16.3%) and phymatous rosacea (pooled proportion = 7.4%, 95% CI, 6.1-8.9%) (36). Migraine has been consistently associated with dry eye disease in population-based studies (37)(38)(39)(40)(41)(42), although it has not been explored whether this dry eye disease might in fact be ocular rosacea.…”

Section: Rosacea Phenotypementioning

confidence: 99%

Clinical characteristics of combined rosacea and migraine

Wienholtz

Christensen²,

Zhang³

et al. 2022

Front. Med.

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BackgroundAn overlap between the skin disease rosacea and the headache disease migraine has been established; however, the magnitude of this overlap and the distribution between subtypes/phenotypes remains unclear.ObjectiveThe aim was to determine the magnitude of the overlap between rosacea and migraine, and to determine which subtypes/phenotypes were present in patients with concomitant rosacea and migraine.MethodsIn this cross-sectional study, 604 patients with a diagnosis of either rosacea or migraine were phenotyped through a face-to-face interview with clinical examination, to determine prevalence and phenotype of rosacea, and prevalence and subtype of migraine.ResultsWe found a prevalence of migraine of 54% in patients with rosacea, and a prevalence of rosacea of 65% in patients with migraine. Concomitant migraine was significantly associated with the rosacea features flushing (odds ratio = 2.6, 95% confidence interval = 1.4–4.7, p = 0.002), ocular symptoms (odds ratio = 2.4, 95% confidence interval = 1.5–3.9, p < 0.001), and burning (odds ratio = 2.1, 95% confidence interval = 1.3–3.4, p = 0.002), whereas papules/pustules were inversely related with concomitant migraine (odds ratio = 0.5, 95% confidence interval = 0.3–0.8, p = 0.006). No association was found between concomitant migraine and centrofacial erythema, rhinophyma, telangiectasia, edema, or dryness. Concomitant rosacea was not associated with any specific migraine subtype in patients with migraine.ConclusionThis study highlights a substantial overlap between rosacea and migraine, particularly in patients with certain rosacea features. Individuals with rosacea should be asked about concomitant migraine, and comorbidities should be considered when choosing between treatments.

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“…On this basis, with current knowledge of its pathophysiology, the national rosacea society (NRS) published in 2017 a new standard classification system ( Gallo et al, 2018 ). The previous 2002 classification yet identified the main signs and symptoms of rosacea and categorized them into four subtypes: erythematotelangiectatic (ETR), papulopustular (PPR), phymatous, and ocular rosacea, being ETR and PPR the top phenotypes diagnosed ( Barakji et al, 2022 ). The problem with this system was that it did not consider the frequent coexistence of phenotypes and progression from one subtype to another.…”

Section: Introductionmentioning

confidence: 99%

Rosacea, microbiome and probiotics: the gut-skin axis

Sánchez-Pellicer,

Eguren-Michelena,

García-Gavín

et al. 2024

Front. Microbiol.

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Rosacea is an inflammatory skin disease involving diverse symptoms with a variable clinical progress which can severely impact the patient’s quality of life as well as their mental health. The pathophysiological model of rosacea involves an unbalanced immune system predisposed to excessive inflammation, in addition to vascular and nervous alterations, being certain cutaneous microorganisms’ triggers of the symptoms onset. The gut-skin axis explains a bidirectional interaction between skin and gut microbiota in some inflammatory skin diseases such as atopic dermatitis, psoriasis, or rosacea. The introduction and consolidation of the next-generation sequencing in recent years has provided unprecedented information about the microbiome. However, the characterization of the gut and skin microbiota and the impact of the gut-skin axis in patients with rosacea has been little explored, in contrast to other inflammatory skin diseases such as atopic dermatitis or psoriasis. Furthermore, the clinical evolution of patients with rosacea is not always adequate and it is common for them to present a sustained symptomatology with frequent flare-ups. In this context, probiotic supplementation could improve the clinical evolution of these patients as happens in other pathologies. Through this review we aim to establish and compile the basics and directions of current knowledge to understand the mechanisms by which the microbiome influences the pathogenesis of rosacea, and how modulation of the skin and gut microbiota could benefit these patients.

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Assessment of Frequency of Rosacea Subtypes in Patients With Rosacea

Cited by 22 publications

References 78 publications

Long‐term maintenance treatment of rosacea: experts' opinion

Long‐term maintenance treatment of rosacea: experts' opinion

Clinical characteristics of combined rosacea and migraine

Rosacea, microbiome and probiotics: the gut-skin axis

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