Rosacea. Pathophysiology and treatment

Wilkin, Jonathan K.

doi:10.1001/archderm.130.3.359

Cited by 135 publications

(158 citation statements)

References 30 publications

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“…In population-based European studies, the prevalence of rosacea was estimated to be between 2 -10% [2 -4]. It is characterized by extremely sensitive skin and persistent flushing, and may be accompanied by acne-like facial papules or pustules, prominent facial capillaries, swelling of sebaceous glands, skin thickening and ocular discomfort [1,5,6].…”

Section: Introductionmentioning

confidence: 99%

Blushing in rosacea sufferers

Drummond

2012

Journal of Psychosomatic Research

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Objective. Rosacea is characterized by extremely sensitive skin and persistent facial flushing, perhaps initiated or exacerbated by frequent or intense blushing. To investigate this, blushing was assessed in rosacea sufferers and controls during embarrassing laboratory tasks.Methods. Changes in forehead blood flow were monitored with laser Doppler fluxmetry in 31 rosacea sufferers (12 with severe symptoms and 19 with mild symptoms) and 86 controls while singing, giving an impromptu speech, and listening to recordings of these activities.Results. Changes in forehead blood flow were similar in rosacea sufferers and controls, and were similar in subgroups with mild and severe rosacea. Even so, rosacea sufferers thought that that they blushed more intensely and were more embarrassed than controls during most of the tasks. Likewise, changes in forehead blood flow were similar in participants with mild and severe rosacea. Nevertheless, ratings of embarrassment and blushing were greater in those with severe than mild symptoms. Within the rosacea group, increases in blood flow while singing were greatest in participants with the highest blushing ratings, whereas increases in blood flow while listening to the speech were greatest in the most embarrassed participants.Conclusions. These findings do not support the hypothesis that blushing is abnormal in rosacea but, nevertheless, suggest that rosacea sufferers are more aware of and embarrassed by blushing than controls. This might contribute to social anxiety in rosacea sufferers.

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Section: Introductionmentioning

confidence: 99%

Blushing in rosacea sufferers

Drummond

2012

Journal of Psychosomatic Research

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“…It shows various manifestations such as intermittent or persistent erythema, telangiectasia, papules and pustules, ocular findings with or without cutaneous symptoms, and phymatous change. Although the pathogenesis of rosacea remains unclear, it has been suggested that recurrent dilatation of cutaneous vessels followed by impairment of their regulatory function, invasion of inflammatory cells, changes in the perivascular tissue and infestation by microorganisms may play critical roles [1][2][3] . Many trigger or aggravating factors have also been reported.…”

Section: Introductionmentioning

confidence: 99%

Clinical Evaluation of 168 Korean Patients with Rosacea: The Sun Exposure Correlates with the Erythematotelangiectatic Subtype

et al. 2009

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Background:Although rosacea is a chronic cutaneous inflammatory disorder that's commonly seen in adults, the etiology and pathogenesis of the illness remain unclear. A well established diagnostic classification and grading system may play a critical role in performing research and it would serve as a diagnostic reference in the clinical field. Objective: We sought to classify the patients with the new standard classification and grading system and we wanted determine the peculiar features and relationships of each subtype. We also analyzed the relationships between the degree of sun exposure and each subtype. Methods: We reviewed the medical records and clinical photos of 168 patients who were diagnosed with rosacea from 2002 to 2007 at our hospital. The standard classification and grading system suggested by the National Rosacea Society (NRS) Expert Committee was adopted to evaluate each patient's subtype and the severity. Results: The male：female ratio was 1： 2.29. The mean age at the time of diagnosis was 47.8 years. The mean duration of disease was 3.5 years. Sun exposure and hot baths/exercise were the two most common precipitating factors, while the majority of patients did not have any specific factor that relieved their symptoms. According to the NRS classification and grading system, the patients were classified into four subtypes. One hundred sixty two (96.4%) patients were diagnosed with the erythematotelangiectatic subtype irrespective of severity.Eighty five (50.6%) patients had the papulopustular subtype and 24 (14.3%) patients had ocular rosacea. Eight (4.8%) patients displayed mild phymatous change. The degree of sun exposure had significant correlation with the development and severity of the erythematotelangiectatic subtype (p<0.05), while it had no correlation with the papulopustular, ocular and phymatous subtypes. Conclusion: Although the erythematotelangiectatic subtype was the most common subtype of rosacea, many patients also had other subtypes of rosacea simultaneously. Based on our results, we proved that ocular rosacea is an extension of the clinical spectrum of erythematotelangiectatic rosacea. In addition, the results of our study particularly suggest that sun exposure has a different influence on each subtype of rosacea. (Ann Dermatol 21(3) 243∼249, 2009)

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“…Although successively attributed to genetic, behavioural, psychogenic, climatic, nutritional, infectious and immunological factors, [18][19][20][21] evidence has accumulated that underneath the diverse clinical settings, there are always vascular abnormalities, as such strengthening Unna`s original view point of rosacea being basically a vascular disorder. 22,23 In fact, a basic microcirculatory disturbance of the facial angular veins (involved in a direct brain cooling mechanism) 23,24 has been said to play a pivotal role. Additionally, Revista SPDV 74 (2) association with migraine and with vasodilator substances (alcohol, foods…) [25][26][27][28] and life circumstances (menopause…) are frequently observed in clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Avaliação Psicológica em Doentes com Rosácea: Um Estudo de Caso-Controlo com Symptom Checklist -90 - Revised

Tavares‐Bello

Torres

2016

SPDV

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RESUMO -Introdução:A rosácea, uma prevalente dermatose facial crónica, é classicamente considerada uma "psicodermatose" já que factores psicológicos são determinantes no seu desencadeamento ou evolução. Os doentes padecendo de rosácea foram descritos como imaturos, ansiosos, com reduzida auto-estima, com sentimentos de vergonha ou culpa, ou como "psiconeuróticos", com configurações histéricas ou obsessivo-compulsivas. Objectivo: Neste estudo foi investigado o distress psicopatológico de doentes com rosácea, comparados com um grupo de dermopatas sofrendo de dermatoses agudas, acidentais, não conspícuas. Um objectivo adicional foi o de avaliar a influência determinada pelos dados demográficos e características clínicas sobre os resultados finais. Material e Métodos: Os participantes foram 53 doentes com rosácea e 190 outros dermopatas, com idades compreendidas entre os 18 e os 72 anos foram recrutados duma consulta externa hospitalar de Dermatologia. A rosácea foi clinicamente avaliada e classificada bem como registada a duração da doença. Foi aplicado a todos os doentes o questionário de auto-resposta SCL-90-R para avaliar o distress psicológico e registar as queixas emocionais e psico-vegetativas. Resultados: As análises estatísticas revelaram uma efectiva influência independente das variáveis rosácea, género, nível escolar/educacional e da Interacção rosácea/género nas variáveis psicométricas. Os doentes com Rosácea revelaram valores superiores aos da população do grupo controlo nas dimensões sensibilidade interpessoal (F[1,241]=3,57, p<0,01). No que concerne às diferenças entre géneros, as doentes com rosácea registaram valores superiores aos dos da população controlo nas dimensões ansiedade, depressão, sensibilidade interpessoal, obsessões e compulsões, ideação paranóide e somatização, ao contrário dos doentes do género masculino em que tal apenas se verificou na sensibilidade interpessoal. No que se refere aos efeitos da duração da doença, os doentes com rosácea com mais de 1 ano de duração registaram scores significativamente mais elevados de ideação paranóide do que os doentes com durações de doença inferiores a um ano (F[2,52]=3,79, p<0,05). Conclusões: Os doentes sofrendo de rosácea -em contraste com outros doentes com outras dermatosesrevelam um distress psicossocial significativo, o qual não se correlaciona no entanto com o sub-tipo clínico da dermatose. PALAVRAS-CHAVE -Psicometria; Rosácea/psicologia; Stress Psicológico. Psychological Evaluation in Rosacea Patients

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Rosacea. Pathophysiology and treatment

Cited by 135 publications

References 30 publications

Blushing in rosacea sufferers

Blushing in rosacea sufferers

Clinical Evaluation of 168 Korean Patients with Rosacea: The Sun Exposure Correlates with the Erythematotelangiectatic Subtype

Avaliação Psicológica em Doentes com Rosácea: Um Estudo de Caso-Controlo com Symptom Checklist -90 - Revised

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