Interventions for rosacea

Zuuren, Esther J van; Fedorowicz, Zbys; Carter, Ben; Linden, M.M.D. van der; Charland, Louis C.

doi:10.1002/14651858.cd003262.pub5

Cited by 117 publications

(95 citation statements)

References 174 publications

(7 reference statements)

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“…Increased MMPs contribute substantially to connective tissue damage that occurs during photoageing. [2,6,7] UVB has been shown to stimulate the generation of reactive oxygen species (ROS), which subsequently results in the activation of various intracellular signalling pathways and regulation of gene expression by activating transcription factors, leading to cellular oxidative stress. [8][9][10] These transcription factors are regulated by mitogen-activated protein kinases (MAPKs), which increase MMP expression.…”

Section: Backg Rou N Dmentioning

confidence: 99%

Characterization of the facial microbiome in twins discordant for rosacea

Zaidi

Spaunhurst

Sprockett

et al. 2018

Experimental Dermatology

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Previously, we determined that genetic and environmental factors contributed equally towards rosacea in twins. To assess an environmental factor, we characterized the malar cheek bacterial microbiome from twins discordant for rosacea. We found no significant difference in facial microbiome alpha and beta diversity between related twins discordant for rosacea. However, the relative percentage abundance of Gordonia and Geobacillus, low-abundant genera, was positively and negatively associated with rosacea severity, respectively. Our data demonstrate a significant correlation between facial microbiome and severity of rosacea in genetically matched twins and importantly that overall microbiome composition is largely unchanged. | BACKG ROU N DRosacea is a chronic inflammatory disease of the facial skin and eyes that affects ~16 million individuals in the United States alone.Although its aetiology is unknown, we previously determined that both genetic and environmental factors contribute equally towards disease using identical (monozygotic) and fraternal (dizygotic) twins. [1] Previous studies have implicated microbial colonization and the cognate immune response as the critical driver of rosacea. [2,3] Increased levels of Demodex mites and associated bacteria (bacillus), antimicrobial peptides (eg cathelicidin/LL37), host immune variables (eg Tolllike receptor (TLR)-2) and nutrients (eg vitamin D3) are reported to alter the innate immune response and cause chronic inflammation and the facial skin sensitivity in rosacea. [2,3] In addition, the recent studies suggest significant associations between the severity of rosacea and systemic comorbidities (eg cardiovascular, allergic, respiratory, metabolic and gastrointestinal diseases) that are linked with chronic inflammation. [4,5] Rosacea and its reported comorbidities share involvement with barrier tissues that are colonized with a wide variety of microflora that constitute the microbiome. | QUE S TION ADDRE SS EDThe beneficial use of therapeutic drugs for rosacea including oral and topical antibiotics, sulphur compounds and ivermectin that alter the facial microbiome, [6] suggests that altering the resident skin microbiome may play a role in the disease. However, no conclusive evidence has been established.Microbial dysbiosis could be one of the factors associated with the pathogenesis of rosacea as well as its comorbidities. Harnessing the genetic and environmental control inherent in a twin study, we performed next-generation sequencing of the 16S rRNA gene to evaluate the hypothesis that facial bacterial microbiome dysbiosis will associate with the severity of rosacea in twins discordant for rosacea. | E XPERIMENTAL DE S I G NSee Appendix S1. | RE SULTS | Comparable overall facial skin microbiome composition across subjectsWe estimated the relative percentage abundance (RPA) of facial bacterial microbiome at the phylum level in twins with and without rosacea. The top four abundant phyla were Firmicutes (mean ± SD; 42.98% ± 1.05%), Proteobacteria (39.29% ± 1...

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Section: Backg Rou N Dmentioning

confidence: 99%

Characterization of the facial microbiome in twins discordant for rosacea

Zaidi

Spaunhurst

Sprockett

et al. 2018

Experimental Dermatology

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“…The exact cause of rosacea remains unclear. It may contain hereditary components, and has been hypothesized to be associated with disorders of the innate immune system, dysfunction of facial vascular regulation, neurogenic inflammation, and elevated levels of Demodex mites, among others (Gibson, 2004; Yamasaki & Gallo, 2009; Abram et al, 2010; Steinhoff et al, 2011; Van Zuuren et al, 2015; Margalit et al, 2016). Morbidity of rosacea varies greatly among different ethnic populations, with a higher prevalence amongst fair-skinned individuals of northern European or Celtic ancestry (Spoendlin et al, 2012; Tuzun et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

An observational descriptive survey of rosacea in the Chinese population: clinical features based on the affected locations

Xie

Huang

Yang

et al. 2017

PeerJ

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BackgroundThere is currently no study that has evaluated the differences in epidemiological and clinical characteristics among rosacea patients according to different facial sites.MethodsClinical and demographic data were obtained from 586 rosacea patients. The patients were divided into four groups based on the main sites involved with the rosacea lesions (full-face, cheeks, nose, or perioral involvement). Clinical signs were measured through self-reported, dermatologist-evaluated grading of symptoms, and physiological indicators of epidermal barrier function.ResultsThere were 471 (80.4%), 49 (8.4%), 52 (8.9%), and 14 (2.4%) cases in the full-face, cheek, nasal and perioral groups, respectively. Compared with the healthy control, the full-face group had lower water content and higher transepidermal water loss (TEWL) in the cheeks, and chin; the perioral group had lower water content and higher TEWL in the chin; while the nasal group had the normal water content and TEWL. Compared with the full-face group, the nasal group had more severe phymatous changes, less severe self-reported and dermatologist-evaluated grading of symptoms. All the patients in the perioral or the nasal group had their first rosacea lesions start and remain at the chin or on the nose. In the full-face group, 55.8% of patients had their lesions start with the full face, 40.1% on the cheek, and the rest (4.1%) on the nose.ConclusionSignificant differences in clinical features were observed among rosacea patients with lesions at four different sites. The lesion localization of each group was relatively stable and barely transferred to other locations.

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“…W ostatnim podsumowaniu danych z badań nad stosowaniem poszczególnych leków w rosacea w 2015 roku van Zuuren i wsp. stwierdzili większą skuteczność kwasu azelainowego niż metronidazolu, jednak potwierdzili również korzystne działanie tego ostatniego leku [44].…”

Section: Metronidazol I Kwas Azelainowyunclassified

“…Zbiorcze opracowania z ostatnich lat przedstawiające wskazówki do prawidłowej terapii rosacea nie zawsze są przydatne dla polskiego czytelnika ze względu na różną dostępność poszczególnych leków w naszym kraju [37,44].…”

Section: Leczenie Ogólneunclassified

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Rosacea – new data on pathogenesis and treatment

Placek¹,

Wolska²

2016

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StreSzczenieTrądzik różowaty jest częstą dermatozą, występującą przeważnie u kobiet i mającą istotny niekorzystny wpływ na jakość życia pacjentów. Obecnie przyjmuje się, że w jego przebiegu mogą przeważać zmiany rumieniowe lub zapalne, a w niektórych przypadkach przerostowe, niekoniecznie stanowiące kolejne etapy nasilenia choroby. Badania ostatnich lat wskazują, że podstawową rolę w rozwoju rosacea odgrywają zaburzona wrodzona odpowiedź immunologiczna i patologie w obrębie ukła-du naczyniowego skóry. Uwzględnia się również podłoże genetyczne i rolę skórnych, ale nie tylko, patogenów (np. Helicobacter pylori, Demodex). W związku z powyższym zalecane metody terapii uwzględniają działanie zarówno przeciwzapalne, jak i ukierunkowane na pasożyty skórne. Podstawowymi preparatami w terapii miejscowej są metronidazol, kwas azelainowy, antybiotyki, leki przeciwpasożytnicze, takie jak iwermektyna, oraz leki oddziałujące wybiórczo na zmiany naczyniowe. W cięższych przypadkach za leki z wyboru uznaje się obecnie tetracykliny, alternatywnie makrolidy, a w skrajnie ciężkich postaciach izotretynoinę. W związku z bezsprzeczną, co najmniej pogarszającą chorobę rolą promieniowania ultrafioletowego (UV) zaleca się rygorystyczną ochronę przed UV, a także -co również wynika z obserwacji klinicznych -odpowiednią dietę. Wraz z postępem techniki coraz większe znaczenie w leczeniu rosacea mają różnego typu terapie świetlne. AbStrActRosacea is a common dermatosis more prevalent in females, significantly impairing quality of life. Currently erythematous, papulo-pustular and phymatous subtypes are distinguished, which do not necessarily represent consecutive stages. Recent findings indicate in the pathogenesis of rosacea the role of the impaired innate immune system and vascular abnormalities. Additionally, the role of genetic and infectious factors is suggested. The therapy of rosacea is directed not only against inflammatory changes but also anti-parasitic. In topical treatment the most commonly used are metronidazole and azelaic acid. Other drugs are topical antibiotics, antiparasitic agents such as ivermectin and preparations directly influencing erythema. In more severe cases tetracyclines or macrolides are used, and in the most severe cases, isotretinoine. As ultraviolet light is a recognized trigger for rosacea, regular sunscreen use is necessary. Also, proper diet is indicated. Presently in the treatment of rosacea more and more techniques using different lights are employed.

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Interventions for rosacea

Cited by 117 publications

References 174 publications

Characterization of the facial microbiome in twins discordant for rosacea

Characterization of the facial microbiome in twins discordant for rosacea

An observational descriptive survey of rosacea in the Chinese population: clinical features based on the affected locations

Rosacea – new data on pathogenesis and treatment

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