Disease relevance of Rosacea

• Isotretinoin is used clinically for oral therapy of severe acne, but is also recommended for severe Gram-negative folliculitis and rosacea not responding to traditional therapy [1].
• Steroid rosacea is a facial dermatitis clinically resembling acne rosacea [2].
• Systemic associations included two patients with rheumatoid arthritis, one patient with asymptomatic Sjogren's syndrome, and two with rosacea [3].
• CONCLUSION: Use of 15% azelaic acid gel twice daily for 15 weeks demonstrated significant superiority over using 0.75% metronidazole gel in improving principal signs of rosacea (inflammatory lesions and erythema) [4].
• It is suggested that rosacea patients with keratitis should receive early and prolonged tetracycline medication [5].

Psychiatry related information on Rosacea

• Tuberous sclerosis is an inherited syndrome with mental retardation, epilepsy, and acne rosacea being the classic triad of manifestations [6].

High impact information on Rosacea

• Treatment of rosacea by metronidazole [7].
• MMP-3 was detected exclusively in the tear fluid of patients with ocular rosacea who had corneal epithelial disease [8].
• Elevated gelatinase B activity in ocular rosacea may be involved in the pathogenesis of the irritation symptoms, recurrent epithelial erosions, vascularization, and epithelial basement membrane dystrophy that develops in the corneas of patients with this condition [9].
• PURPOSE: To correlate tear fluorescein clearance with interleukin-1alpha (IL-1alpha) concentration and gelatinase B (matrix metalloproteinase [MMP]-9) activity in the tear fluid of patients with ocular rosacea and normal control subjects [9].
• Tear fluid gelatinase B activity correlates with IL-1alpha concentration and fluorescein clearance in ocular rosacea [9].

Chemical compound and disease context of Rosacea

• RESULTS: Compared with normal control subjects, patients with ocular rosacea had a greater delay of tear fluorescein clearance (P < 0.001), a higher tear IL-1alpha concentration (P < 0.001), and a greater pro-gelatinase B (92 kDa) activity (P < 0.001) in their tear fluid [9].
• The effects of caffeine and coffee, agents widely alleged to provoke flushing in patients with erythematotelangiectatic rosacea, were investigated [10].
• Eighteen patients with ocular rosacea were treated with oral tetracycline which resulted in marked improvement in all patients [11].
• Steroid rosacea in children [2].
• PURPOSE: Minocycline is a commonly used drug in the management of acne and rosacea [12].

Biological context of Rosacea

• BACKGROUND: Telangiectasias develop on the face secondary to genetic predisposition, chronic actinic damage, collagen vascular disease, topical steroid application, and disorders of vascular regulation including acne rosacea [13].
• ABC of dermatology. Acne and rosacea [14].
• Visits for skin cancer, not otherwise specified (skin cancer NOS), atopic dermatitis, cysts, common wart, wart, not otherwise specified (wart NOS), rosacea, contact dermatitis, and benign tumors showed no significant seasonal variations or trends [15].

Anatomical context of Rosacea

• The percentage of goblet cells was significantly decreased in rosacea patients and in dry eye patients compared with the normal group with a significant negative correlation with both HLA DR and ICAM-1 markers [16].
• Sunlight exposure was positively associated with localized hypomelanism, localized hypermelanism, seborrheic keratoses, senile lentigines, freckles, acne rosacea, spider nevi, varicose veins, venus star, dry skin, wrinkled skin, pterygia, arcus senilis, and a variety of minor oral lesions of the tongue, palate, and buccal mucosa [17].
• The presence of Factor XIIIa+ dermal fibroblasts may portend the evolution of fibrosis in rosacea and other inflammatory dermatoses [18].
• For this reason, treatments that block neutrophil involvement in the development of rosacea, such as topical metronidazole and systemic antibodies, should be considered first-line therapy for all stages of the disease [19].

Gene context of Rosacea

• The 84-kDa active form of gelatinase B was observed in 46% of the rosacea tear samples and none of the controls [9].
• CONCLUSIONS: Concentrations of IL-1alpha are present in normal tears but are elevated in ocular rosacea, whereas TNF-alpha is not present in either case [20].
• There also was a 3.5-fold increase of the CD4/CD8 ratio in the rosacea conjunctival stroma compared with the normal specimens [21].
• From these results we suggest that, (a) ligands of the VIP-R may contribute to vascular and dermal alterations in rosacea and (b) immature sebocytes show an unusual antigen expression of S100A and glandular keratin [22].
• Retinoids may modulate VEGF in skin and this may be related to an effect on rosacea [23].
• In mice, injection of the cathelicidin peptides found in rosacea, addition of SCTE, and increasing protease activity by targeted deletion of the serine protease inhibitor gene Spink5 each increases inflammation in mouse skin [24].

Analytical, diagnostic and therapeutic context of Rosacea

• Treatment of rosacea with i% metronidazole cream. A double-blind study [25].
• The relapse rate for rosacea after treatment with either oral tetracycline or metronidazole cream [26].
• METHODS: Penetrating keratoplasty specimens were selected from cases of herpes simplex keratitis, herpes zoster ophthalmicus, rheumatoid arthritis ulceration, bacterial keratitis, rosacea keratitis, interstitial keratitis, and previous surgery so as to encompass varying degrees of active and chronic inflammation and scarring [27].
• We suggest that in addition to tear function tests, rose Bengal staining and impression cytology can be successfully used in the early diagnosis of dry eye and in monitoring medical treatment in ocular rosacea [28].
• Differential diagnoses included ocular rosacea with cicatrizing conjunctivitis and 5-FU-induced ectropion [29].

References