Characterization of rosacea patients in Tohoku area of Japan: Retrospective study of 340 rosacea cases

Abstract

Rosacea is a chronic inflammatory skin disease with facial redness and acne‐like papules and pustules. The characteristics and background of rosacea patients in Japan have not been well documented. In this study, we retrospectively collected the medical information of rosacea patients, and investigated the background, complications, exacerbating factors, and status of allergy. Between January 2010 and December 2020, 431 cases were diagnosed as rosacea or rosacea‐like dermatitis. We selected 340 patients, in which we could confirm telangiectasia on facial skin. Females and males numbered 266 and 74, respectively. The average age of the first visit was 51.5 years, and the youngest and oldest were 11 and 88 years old. Among 340 cases, 323 had erythematotelangiectatic rosacea, 97 papulopustular rosacea, 20 phymatous rosacea presenting as rhinophyma, and four had symptoms of ocular rosacea. The most common complication was hay fever (93 individuals, 27.4%), and 66 (19.4%) had a medical history of contact dermatitis. Temperature differences (141 individuals, 41.5%) were the most common exacerbating factor followed by sunlight exposure (60 individuals, 17.6%). Seventy‐eight individuals received allergen‐specific immunoglobulin (Ig)E tests, and IgE for cedar was the most frequently observed (46 individuals, 59.0%). High frequencies of IgE for Dermatophagoides pteronyssinus or D. farinae (33 individuals, 42.3%) and house dust I (31 individuals, 39.7%) suggested that environmental conditions at home would affect rosacea symptoms. Since the facial skin is exposed to environmental stimuli every moment, this retrospective observation suggested the importance of the daily lifestyle guidance as well as medical treatments.

Perspectives on rosacea patient characteristics and quality of life using baseline data from a phase 3 clinical study conducted in Japan

“…Interestingly, the recent retrospective study conducted at Tohoku University also reported that temperature differences were the most frequent external exacerbating factor for rosacea. 19 Conversely, sun exposure was reported as an exacerbating factor by only 39.2% of Japanese patients in our study compared with 81% in the US NRS study. Since differences in exacerbating factors according to degree of skin pigmentation have been reported, 36 , 37 it appears likely that skin type or pigmentation may influence the degree of importance of specific exacerbating factors in Japan.…”

“…34,35 In contrast, the most frequently reported exacerbating factor in the current study was temperature changes (53.8%). Interestingly, the recent retrospective study conducted at Tohoku University also reported that temperature differences were the most frequent external exacerbating factor for rosacea 19 . Conversely, sun exposure was reported as an exacerbating factor by only 39.2% of Japanese patients in our study compared with 81% in the US NRS study.…”

“… 39 Among patients with rosacea in the Tohoku University study who received allergy tests, 59% were found to have IgE specific to the pollen of Japanese cedar trees, and a further 20% of patients had allergies to the pollen of Japanese cypress, orchard grass, and timothy grass. 19 Although our study did not address individual pollen types, to our knowledge, it is the first report of pollen as a direct trigger for rosacea worsening, and further investigation will be needed to determine whether this is a factor specific to Japanese or Asian patients. The coexistence of rosacea and pollen allergies has implications for treatment since rosacea symptoms may not fully improve unless the complicating allergic condition is also addressed.…”

“…Patients with rosacea have a significantly greater likelihood of sensitivity to airborne and other allergens, 38 and a dysfunctional immune response has been implicated in the development of rosacea 39 . Among patients with rosacea in the Tohoku University study who received allergy tests, 59% were found to have IgE specific to the pollen of Japanese cedar trees, and a further 20% of patients had allergies to the pollen of Japanese cypress, orchard grass, and timothy grass 19 . Although our study did not address individual pollen types, to our knowledge, it is the first report of pollen as a direct trigger for rosacea worsening, and further investigation will be needed to determine whether this is a factor specific to Japanese or Asian patients.…”

“… 18 In order to achieve the best outcomes for Japanese patients, it is first necessary to understand the current parameters of the disease within the Japanese population with rosacea. Although a recent single‐center, retrospective analysis reported on the background characteristics of 340 Japanese patients with rosacea, 19 prospectively collected data from across Japan are still needed as a basis from which to develop national guidelines and treatment recommendations.…”