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Several comorbidities have been found to be associated with rosacea, including cardiovascular diseases, depression, gastrointestinal disorders, malignancies, neurologic diseases, and autoimmune conditions.
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Although the exact etiologic factors of rosacea remain to be elucidated, the physiopathology of rosacea is multifactorial, and numerous cell and molecular mechanisms may contribute to the development of rosacea and its comorbidities.
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A chronic inflammatory state may be the underlying mechanism
Rosacea Comorbidities
Section snippets
Key points
Methods
A review of English-language articles was performed using PubMed and Google Scholar. Search terms included rosacea, comorbidities, depression, CVD, autoimmune disease, malignancy, and neurologic disorders. Results were categorized by the comorbidity associated with rosacea or by pathophysiologic relationship linking rosacea to a comorbid condition. Results included information since the first description of the association between migraines and rosacea in 1976, as well as more contemporary
Cardiovascular Diseases
Inflammation plays a key role in the pathogenesis of rosacea and is an established risk factor in the development of atherosclerosis and its complications. Rosacea and atherosclerosis share the upregulation of cathelicidin in inflammatory cells and low serum paraoxonase-1 (PON-1) activity.1, 8, 9, 10 In the skin and vasculature, apart from its antimicrobial activity, cathelicidin functions as an immune modulator, inducing expression of inflammatory genes, leading to cytokine and chemokine
Summary
A growing body of literature exists that links rosacea to multiple comorbidities. However, the strength and interpretation of these associations remains to be clearly delineated. Existing literature seems to implicate the potential for underlying pathogenic mechanisms responsible for multiple disease states. Neural dysregulation, aberrant immune activation, systemic inflammation, in addition to genetic and environmental factors, are all potential contributors to a seemingly multifactorial
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Consensus on the therapeutic management of rosacea – Brazilian Society of Dermatology
2020, Anais Brasileiros de DermatologiaCitation Excerpt :RosalQol has already been translated and validated for Brazilian Portuguese, and should be considered as a measure of effectiveness in future clinical studies.223 Once considered a limited skin disorder, rosacea has been described in association with systemic diseases.224–226 In 2015, Hua et al. published an important study, describing rosacea as a “systemic inflammatory disease,” showing similarities with psoriasis in relation to the risk of cardiovascular (CV) disease, possibly because both diseases have altered innate immunity, increased cathelicidin and C-reactive protein, in addition to decreased paraoxonase activity, which are predictors of CV events.
Comorbidities in Dermatology: What's Real and What's Not
2019, Dermatologic ClinicsCitation Excerpt :Understanding of comorbidities is of significant importance for treatment algorithms, because they can influence treatment choice and may lead to the identification of novel therapeutic targets through elucidating common underlying pathophysiologic mechanisms. In terms of comorbidities, several dermatologic diseases extensively studied include acne, psoriasis, and rosacea.1,4,5 This present article, however, seeks to highlight newer associations drawn from the current literature studying diseases that have emerging work in the area of comorbidities.
Evaluation of inflammatory status in blood in patients with rosacea
2023, Scientific ReportsRole of the skin microbiota and intestinal microbiome in rosacea
2023, Frontiers in Microbiology
Disclosure Statement: Nora Vera, Nupur U. Patel and Lucia Seminario-Vidal have no conflicts to disclose.