Rosazea 2009

Abstract

Rosacea is one of the most common dermatoses of adults. In recent years many studies have contributed to a better understanding of the pathophysiology of rosacea. They suggest that an altered innate immune response is involved in the vascular and inflammatory manifestations seen in rosacea. A good understanding of the disease and its special features is necessary for the differential diagnosis of the many clinical subtypes and for a stage- and phase-specific treatment approach. Topical treatments that are widely accepted are metronidazole and azelaic acid; agents under investigation that show promise include permethrin, calcineurin inhibitors and sulfur compounds. For systemic therapy antibiotics (tetracyclines, macrolides) and recently doxycycline in anti-inflammatory rather than anti-microbial dosages are used, as well as isotretinoin in severe cases. Findings such as rhinophyma and telangiectases can be treated using different laser systems or dermabrasion. This article gives an overview regarding rosacea, a challenging condition with multiple therapeutic options.

Neurovascular and Neuroimmune Aspects in the Pathophysiology of Rosacea

“…Although statistically not significant, we found a clear tendency of increased nerve density, especially in ETR, followed by a decrease in PhR. Reflecting those morphometrical findings, sensations such as “pricking, burning, or pain” are predominantly known in ETR and PPR, followed by less sensation in PhR (Crawford et al , 2004; Sobottka and Lehmann, 2009). …”

“…The mechanism(s) that induce rapid flushing and erythema in rosacea are still unknown (Sobottka and Lehmann, 2009). Despite the prominent telangiectasia, blood vessels maintain their ability to respond to vasoactive stimuli (Guarrera et al , 1982), suggesting that changes are not structural or due to irreversible damage.…”

Peripheral ulcerative keratitis in a patient with granulomatous rosacea

“…[ 8 ] GR has been associated with inflammation, altered immunity, and dysregulation of the vessel. [ 9 10 ] The epidermis of a patient with rosacea releases IL-37, which activates mast cells releasing proteases such as chymase, tryptase, and MMPs. The MMPs damage the dermal matrix, thereby causing leakage and accumulation of inflammatory cells, leading to granuloma formation.…”

Mushroom keratoplasty in rosacea keratitis complicated by corneal perforation (a clinical case)

“…Точная патофизиология розацеа остается неясной [3]. Считается, что она связана c нарушением регуляции состояния сосудов, измененной реакцией иммунной системы и воспалительными изменениями [4]. Глазные проявления розацеа могут варьировать от незначительного раздражения, ощущения инородного тела, сухости и других симптомов блефароконъюнктивита до серьезного снижения остроты зрения на фоне кератита.…”