Sebaceous glands participate in the inflammation of rosacea

Lee, S.H.; Lee, S.B.; Heo, Jae-Hyeok; Yoon, Hee Seong; Byun, Ji Won; Choi, Gwang‐Seong; Shin, Jong-Gye

doi:10.1111/jdv.16055

Cited by 9 publications

(11 citation statements)

References 10 publications

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“…Upregulation of inflammation-related genes and infiltration of inflammatory cells are found in all rosacea subtypes, even in those with transient erythema [ 4 ]. The sebaceous glands, abundant in the centrofacial region, were also suggested to participate in the inflammatory process of rosacea, which is consistent with the clinical manifestation of centrofacial distribution [ 5 ].…”

Section: Introductionmentioning

confidence: 89%

[Retracted] Association between Rosacea and Cardiovascular Diseases and Related Risk Factors: A Systematic Review and Meta‐Analysis

Guo

Hao

et al. 2020

BioMed Research International

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Background. Rosacea is a common inflammatory skin disorder. Several studies, but not all, have suggested a high prevalence of cardiovascular diseases (CVDs) in rosacea patients. This study is aimed at investigating the association between rosacea and CVDs and related risk factors. Methods. We performed a literature search through PubMed, Embase, and Web of Science databases, from their respective inception to December 21, 2019. Two reviewers independently screened the articles, extracted data, and performed analysis, following the PRISMA guidelines. Odds ratios (OR) or standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcomes. The included studies’ quality was evaluated using the Newcastle Ottawa Scale (NOS). Results. The final meta-analysis included ten studies. The pooled analysis found no association between rosacea prevalence and the incidence of CVDs (OR 0.97; 95% CI 0.86-1.10). Rosacea was found to be significantly associated with several risk factors for CVDs (OR 1.17; 95% CI 1.05-1.31), including hypertension (OR 1.17; 95% CI 1.02-1.35), dyslipidemia (OR 1.34; 95% CI 1.00-1.79), and metabolic syndrome (OR 1.72; 95% CI 1.09-2.72). However, no association was found between rosacea and diabetes mellitus (OR 0.98; 95% CI 0.82-1.16). Among the biological parameters, a significant association was found between rosacea and total cholesterol (SMD=0.40; 95% CI=−0.00, 0.81; p<0.05), low-density lipoprotein cholesterol (SMD=0.28; 95% CI=0.01, 0.56; p<0.05), and C-reactive protein (CRP) (SMD=0.25; 95% CI=0.10, 0.41; p<0.05). We found no association between rosacea and high-density lipoprotein cholesterol (SMD=0.00; 95% CI=−0.18, 0.18; p=0.968) or triglycerides (SMD=0.10; 95% CI=−0.04, 0.24; p=0.171). Conclusions. Although no significant association was found between rosacea and CVDs, rosacea was found to be associated with several of related risk factors. Patients with rosacea should pay more attention to identifiable CVD risk factors, especially those related to inflammatory and metabolic disorders.

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Section: Introductionmentioning

confidence: 89%

[Retracted] Association between Rosacea and Cardiovascular Diseases and Related Risk Factors: A Systematic Review and Meta‐Analysis

Guo

Hao

et al. 2020

BioMed Research International

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“…Histological and biochemical studies converge to suggest the continuum of this inflammatory process [25][26][27][28][29][30][31][32][33][34][35][36][37][38]. From the early stages of rosacea, all typical characteristics of the disease are present, although not all may be clinically visible [25].…”

Section: Rosacea: An Inflammatory Continuummentioning

confidence: 99%

“…These characteristics include dilation of blood and lymphatic vessels [ 26 ], solar elastosis [ 25 , 27 ], and increased intradermal fibroblasts [ 28 ]. T cell infiltrates are also present from the early stages of rosacea, around intradermal vessels [ 25 , 30 ], pilosebaceous follicles [ 25 , 31 , 32 ], and sebaceous glands [ 33 ]. These infiltrates are essentially composed of Th1 and Th17 type T helper cells (95%) [ 34 – 37 ] and T suppressor cells (5%) [ 35 ], but also of mastocytes [ 33 ], macrophages and plasmocytes [ 25 ], with a CD4 + helper/CD8 + cytotoxic ratio of 2.8, 31% CD4 + CD25 + regulatory cells, and 6% plasmacytoid dendritic cells [ 38 ].…”

Section: Rosacea: An Inflammatory Continuummentioning

confidence: 99%

“…T cell infiltrates are also present from the early stages of rosacea, around intradermal vessels [ 25 , 30 ], pilosebaceous follicles [ 25 , 31 , 32 ], and sebaceous glands [ 33 ]. These infiltrates are essentially composed of Th1 and Th17 type T helper cells (95%) [ 34 – 37 ] and T suppressor cells (5%) [ 35 ], but also of mastocytes [ 33 ], macrophages and plasmocytes [ 25 ], with a CD4 + helper/CD8 + cytotoxic ratio of 2.8, 31% CD4 + CD25 + regulatory cells, and 6% plasmacytoid dendritic cells [ 38 ]. This infiltrate, often associated with Demodex mites [ 34 , 35 , 39 ], invades the follicular wall and forms granulomas, which have been found in all rosacea subtypes [ 25 , 40 , 41 ].…”

Section: Rosacea: An Inflammatory Continuummentioning

confidence: 99%

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The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea?

Forton¹

2020

Dermatol Ther (Heidelb)

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Rosacea is an inflammatory continuum, with all characteristics being already present from the onset of the disease, even if not clinically visible. Demodex proliferation also appears to be a continuum process in rosacea, and high Demodex density is beginning to be accepted as an important trigger of the inflammatory cascade and as a marker of rosacea: moreover, papulopustules of rosacea can be treated using acaricides. Immunological studies are providing new hypotheses according to which Demodex may induce tolerogenic dendritic cells and collaborate with VEGF to induce T cell exhaustion favoring its own proliferation. This proliferation may not be clinically visible initially. The interactions among VEGF, Demodex, and immunity need to be explored, and the nosology of rosacea definitions adapted accordingly. The effectiveness of treating any patient who only has visible vascular symptoms with an acaricidal cream needs to be confirmed in prospective controlled clinical trials with long-term follow-up, but it is already important to detect patients with pityriasis folliculorum among those with only vascular symptoms of rosacea in order to treat at least these patients with an acaricidal cream. DIGITAL FEATURES This article is published with digital features to facilitate understanding of the article. You can access the digital features on the article's associated Figshare page. To view digital features for this article go to

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“…The 97 articles included in the quantitative analyses were categorized into 3 different groups, based on available data, as follows: (1) ETR, PPR, PhR, and ocular rosacea (main analysis); (2) ETR, PPR, and PhR; and (3) ETR and PPR. All studies included were given 7 or more stars according to the Newcastle Ottawa Scale, except for 8 studies, which were not considered to be of high quality because they scored less than 7 stars . All included studies were clinical population studies except for 6 that were conducted in the general population …”

Section: Resultsmentioning

confidence: 99%

Assessment of Frequency of Rosacea Subtypes in Patients With Rosacea

et al. 2022

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IMPORTANCEFour distinct rosacea subtypes have traditionally been recognized, but the frequency of these subtypes among patients with rosacea remains unknown.OBJECTIVE To assess the frequency of 4 rosacea subtypes.DATA SOURCES This systemic review and meta-analysis included a search of 2 databases, PubMed and Embase, from inception of the databases to November 2, 2021. The search was filtered to include only studies of human participants published in English, French, and German.STUDY SELECTION Studies were screened independently by 2 of the authors and were included if they were original with a sample size of 25 or more patients and reported absolute numbers or frequency of patients affected by rosacea subtypes. Studies that did not report sufficient data to calculate the proportions of subtypes were excluded. DATA EXTRACTION AND SYNTHESISData extraction was performed independently and in duplicate by 2 of the authors, using the search term rosacea, according to the Preferred Reporting items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search term, objectives, and study protocol methods were defined before the study was initiated. A total of 292 studies were included for full-text assessment. Owing to the heterogeneity of the included studies, a random-effects model was used. MAIN OUTCOME AND MEASURESThe main outcome was the proportion of patients with rosacea in each of the 4 major subtype groups defined by the 2002 National Rosacea Society classification system. Measures were absolute numbers or frequency of patients affected by each of the 4 rosacea subtypes.RESULTS A total of 39 studies examining 9190 patients with rosacea were included. The pooled proportion of erythematotelangiectatic rosacea was 56.7% (95% CI, 51.4%-62.0%), of papulopustular rosacea was 43.2% (95% CI, 38.8%-47.6%), of phymatous rosacea was 7.4% (95% CI, 6.1%-8.9%), and of ocular rosacea was 11.1% (95% CI, 6.7%-16.3%). Subtype distribution occurred equally among men and women except for phymatous rosacea, which was more prevalent in men. Studies from Africa showed the lowest proportion of erythematotelangiectatic rosacea. Differences in frequency of subtypes were observed when stratification by publication year was performed. CONCLUSION AND RELEVANCEIn this systematic review and meta-analysis, differences were found in rosacea subtypes by patient sex and by continent of origin and publication year of included studies. Erythematotelangiectatic and papulopustular rosacea were the most prevalent subtypes, but data should be interpreted with caution. Future studies should use the phenotype-based rosacea approach.

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Sebaceous glands participate in the inflammation of rosacea

Cited by 9 publications

References 10 publications

[Retracted] Association between Rosacea and Cardiovascular Diseases and Related Risk Factors: A Systematic Review and Meta‐Analysis

[Retracted] Association between Rosacea and Cardiovascular Diseases and Related Risk Factors: A Systematic Review and Meta‐Analysis

The Pathogenic Role of Demodex Mites in Rosacea: A Potential Therapeutic Target Already in Erythematotelangiectatic Rosacea?

Assessment of Frequency of Rosacea Subtypes in Patients With Rosacea

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