Journal Mobile Options
Table of Contents
Vol. 210, No. 2, 2005
Issue release date: 2005

Rosacea: An Update

Buechner S.A.
To view the fulltext, log in and/or choose pay-per-view option

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in

Abstract

Rosacea is a common chronic cutaneous disorder of unknown etiology which occurs most commonly in middle-aged individuals. Cutaneous manifestations include transient or persistent facial erythema, telangiectasia, edema, papules and pustules that are usually confined to the central portion of the face. The National Rosacea Society’s Expert Committee on the Classification and Staging of Rosacea identified four subtypes of rosacea: erythematotelangiectatic, papulopustular, phymatous and ocular. Recently, a standard grading system for assessing gradations of the severity of rosacea has been reported. Little is known about the cause of rosacea. Genetic, environmental, vascular, inflammatory factors and microorganisms such as Demodex folliculorum and Helicobacter pylori have been considered. Topical metronidazole and azelaic acid have been demonstrated to be effective treatments for rosacea. Severer or persistent cases may be treated with oral metronidazole, tetracyclines or isotretinoin.



Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Bamford J: Rosacea: Current thoughts on origin. Sem Cutan Med Surg 2001;20:199–206.
  2. Plewig G, Jansen T: Rosacea; in Freedberg I, Eisen A, Wolff K, Austen K, Goldsmith L, Katz S (eds): Fitzpatrick’s Dermatology in General Medicine. New York, McGraw-Hill, 2003, pp 688–696.
  3. Berg M, Liden S: An epidemiological study of rosacea. Acta Derm Venereol 1989;69:419–423.
  4. Millikan L: Rosacea as an inflammatory disorder: A unifying theory? Cutis 2004;73:5–8.
  5. Zug K, Palay D, Rock B: Dermatologic diagnosis and treatment of itchy red eyelids. Surv Ophthalmol 1996;40:293–306.
  6. Valanconny C, Michel J-L, Gain P, et al: Rosacée oculaire. Ann Dermatol Vénéréol 1999;126:450–454.
  7. Jansen T, Plewig G: Pathogenese der Rosazea: Fakten und Mythen. Z Hautkr 1996;71:8–14.
  8. Crawford G, Pelle M, James W: Rosacea. I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol 2004;51:327–341.
  9. Wilkin J: Rosacea: Pathophysiology and treatment. Arch Dermatol 1994;130:359–362.
  10. Powell FC: The histopathology of rosacea: ‘Where’s the beef?’ Dermatology 2004;209:173–174.
  11. Rebora A: The red face: Rosacea. Clin Dermatol 1993;11:225–234.
  12. Wilkin J: The red face: Flushing disorders. Clin Dermatol 1993;11:211–223.
  13. Wilkin J: Oral thermal-induced flushing in erythematotelangiectatic rosacea. J Invest Dermatol 1981;76:15–18.
  14. Sibenge S, Gawkrodger D: Rosacea: A study of clinical patterns, blood flow, and the role of Demodex folliculorum. J Am Acad Dermatol 1992;26:590–593.
  15. Findlay G, Simson I: Leonine hypertrophic rosacea associated with a benign bronchial carcinoid tumor. Clin Exp Dermatol 1977;2:175–176.
  16. Brinnel H, Friedel J, Caputa M, Cabanac M, Grosshans E: Rosacea: Disturbed defense against brain overheating. Arch Dermatol Res 1989;281:66–72.
  17. Grosshans E: Gesichtsdurchblutung und Pathogenese der Gesichtsdermatosen. Akt Dermatol 1993;19:342–346.
  18. Dupont C: The role of sunshine in rosacea. J Am Acad Dermatol 1986;15:713–714.
  19. Aroni K, Tsagroni E, Lazaris AC, Patsouris E, Agapitos E: Rosacea: a clinicopathological approach. Dermatology 2004;209:177–182.
  20. Öztas M, Balk M, Ögüs E, Bozkurt M, Ögüs I, Özer N: The role of free oxygen radicals in the aetiopathogenesis of rosacea. Clin Exp Dermatol 2003;28:188–192.
  21. Rufli T, Mumcuoglu Y: The hair follicle mites Demodex folliculorum and Demodex brevis: Biology and medical importance. Dermatologica 1981;162:1–11.
  22. Rufli T, Mumcuoglu Y, Cajacob A, Buechner S: Dermatologische Entomologie. 22. Demodicidae/Haarbalgmilben. Schweiz Rundsch Med (Praxis) 1981;70:622–630.
  23. Ramelet A: Rosacea: Disease or reaction pattern? Dermatologica 1986;173:53–56.
  24. Aylesworth R, Vance J: Demodex folliculorum and Demodex brevis in cutaneous biopsies. J Am Acad Dermatol 1982;7:583–589.
  25. Forton F, Seys B: Density of Demodex folliculorum in rosacea: A case-control study using standardized skin-surface biopsy. Br J Dermatol 1993;128:650–659.
  26. Rufli T, Mumcuoglu Y, Cajacob A, Buechner S: Demodex folliculorum: Zur Aetiopathogenese und Therapie der Rosazea und der perioralen Dermatitis. Dermatologica 1981;162:12–26.
  27. Bonnar E, Eustace P, Powell F: The Demodex mite population in rosacea. J Am Acad Dermatol 1993;28:443–448.
  28. Georgala S, Katoulis A, Kylafis G, Koumantaki-Mathioudaki E, Georgala C, Aroni K: Increased density of Demodex folliculorum and evidence of delayed hypersensitivity reaction in subjects with papulopustular rosacea. J Eur Acad Dermatol Venereol 2001;15:441–445.
  29. Forton F: Demodex et inflammation périfolliculaire chez l’homme: revue et observation de 69 biopsies. Ann Dermatol Vénéréol 1986;113:1047–1058.
  30. Ramelet AA, Perroulaz G: Rosacea: Histopathologic study of 75 cases. Ann Dermatol Vénéréol 1988;115:801–806.
  31. Helm K, Menz J, Gibson L, Dicken C: A clinical and histopathologic study of granulomatous rosacea. J Am Acad Dermatol 1991;25:1038–1043.
  32. Rufli T, Buechner S: T-cell subsets in acne rosacea lesions and the possible role of Demodex folliculorum. Dermatologica 1984;169:1–5.
  33. Grosshans E, Kremer M, Maleville J: Demodex folliculorum und die Histogenese der granulomatösen Rosacea. Hautarzt 1974;25:166–177.
  34. Hoekzema R, Hulsebosch H, Bos J: Demodicidosis or rosacea: What did we treat? Br J Dermatol 1995;133:294–299.
  35. Amichai B, Grunwald M, Avinoach I, Halevy S: Granulomatous rosacea associated with Demodex folliculorum. Int J Dermatol 1992;31:718–719.
  36. Ayres SJ: Rosacea and rosacea-like demodicidosis. Int J Dermatol 1987;26:198–199.
  37. Baima B, Sticherling M: Demodicidosis revisited. Acta Derm Venereol 2002;82:3–6.
  38. Vin-Christian K, Maurer T, Berger T: Acne rosacea as a cutaneous manifestation of HIV infection. J Am Acad Dermatol 1994;30:139–140.
  39. Jansen T, Kastner U, Kreuter A, Altmeyer P: Rosacea-like demodicidosis associated with acquired immunodeficiency syndrome. Br J Dermatol 2001;144:139–142.
  40. Lübbe J, Stucky L, Saurat J-H: Rosaceiform dermatitis with follicular Demodex after treatment of facial atopic dermatitis with 1% pimecrolimus cream. Dermatology 2003;207:204–205.
  41. Bernard L, Cunningham B, Al-Suwaidan S, Friedlander S, Eichenfield L: A rosacea-like granulomatous eruption in a patient using tacrolimus ointment for atopic dermatitis. Arch Dermatol 2003;139:229–231.
  42. Rebora A, Drago F, Picciotto A: Helicobacter pylori in patients with rosacea. Am J Gastroenterol 1994;89:1603–1604.
  43. Utas S, Özbakir Ö, Turasan A, Utas C: Helicobacter pylori eradication treatment reduces the severity of rosacea. J Am Acad Dermatol 1999;40:433–435.
  44. Szlachcic A: The link between Helicobacter pylori infection and rosacea. J Eur Acad Dermatol Venereol 2002;16:328–333.
  45. Argenziano G, Donnarumma G, Iovene MR, Arnese P, Baldassarre A, Baroni A: Incidence of anti-Helicobacter pylori and anti-CagA antibodies in rosacea patients. Int J Dermatol 2003;42:601–604.
  46. Gürer MA, Erel A, Erbas D, Caglar K, Atahan C: The seroprevalence of Helicobacter pylori and nitric oxide in acne rosacea. Int J Dermatol 2002;41:768–770.
  47. Sharma V, Lynn A, Kaminski M, Vasudeva R, Howden C: A study of the prevalence of Helicobacter pylori infection and other markers of upper gastrointestinal tract disease in patients with rosacea. Am J Gastroenterol 1998;93:220–222.
  48. Bamford J, Tilden R, Blankush J, Gangeness D: Effect of treatment of Helicobacter pylori infection on rosacea. Arch Dermatol 1999;135:659–663.
  49. Plewig G, Kligman A: Acne and Rosacea, ed 2. Berlin, Springer, 1993.
  50. Wilkin J, Dahl M, Detmar M, et al: Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 2002;46:584–587.
  51. Wilkin J, Dahl M, Detmar M, et al: Standard grading system for rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 2004;50:907–912.
  52. Chen D, Crosby D: Periorbital edema as an initial presentation of rosacea. J Am Acad Dermatol 1997;37:346–348.
  53. Jansen T, Plewig G: Rosacea: Classification and treatment. J R Soc Med 1997;90:144–150.
  54. Michel J-L, Caribel F: Fréquence, gravité et traitement de la rosacée oculaire au cours de la rosacée cutanée. Ann Dermatol Vénéréol 2003;130:20–24.
  55. Borrie P: Rosacea with special reference to its ocular manifestations. Br J Dermatol 1953;65:458–463.
  56. Quarterman M, Johnson D, Abele D, Lesher JJ, Hull D, Davis L: Ocular rosacea. Arch Dermatol 1997;133:49–54.
  57. Akpek E, Merchant A, Pinar V, Foster C: Ocular rosacea: Patient characteristics and follow-up. Ophthalmology 1997;104:1863–1867.
  58. Starr P, Macdonald A: Oculocutaneous aspects of rosacea. Proc R Soc Med 1969;62:9–11.
  59. O’Leary P, Kierland R: Pyoderma faciale. Arch Dermatol Syphilol 1940;41:451–462.
  60. Plewig G, Jansen T, Kligman A: Pyoderma faciale – A review and report of 20 additional cases: Is it rosacea? Arch Dermatol 1992;128:1611–1617.
  61. Massa M, Su W: Pyoderma faciale: A clinical study of twenty-nine patients. J Am Acad Dermatol 1982;6:84–91.
  62. Jansen T, Plewig G: Rosacea fulminans: Therapie mit Kortikosteroiden und Isotretinoin. Akt Dermatol 1994;20:212–216.
  63. Ackerman A, Chongchitnant N, Sanchez J, Guo Y: Histologic Diagnosis of Inflammatory Skin Diseases, ed 2. Baltimore, Williams & Wilkins, 1997.
  64. Aloi F, Tomasini C, Soro E, Pippione M: The clinicopathologic spectrum of rhinophyma. J Am Acad Dermatol 2000;42:468–472.
  65. Koçak M, Yağlı S, Vahapoğlu G, Ekşioğlu M: Permethrin 5% cream versus metronidazole 0.75% gel for the treatment of papulopustular rosacea. A randomized double-blind placebo-controlled study. Dermatology 2002;205:265–270.
  66. McClellan K, Noble S: Topical metronidazole. Am J Clin Dermatol 2000;1:191–199.
  67. Wolf J: The role of topical metronidazole in the treatment of rosacea. Cutis 2004;73:19–28.
  68. Bleicher P, Charles J, Sober A: Topical metronidazole therapy for rosacea. Arch Dermatol 1987;123:609–614.
  69. Dahl M, Jarratt M, Kaplan D, Tuley M, Baker M: Once-daily topical metronidazole cream formulations in the treatment of the papules and pustules of rosacea. J Am Acad Dermatol 2001;45:723–730.
  70. Jorizzo J, Lebwohl M, Tobey R: The efficacy of metronidazole 1% cream once daily compared with metronidazole 1% cream twice daily and their vehicles in rosacea: A double-blind study. J Am Acad Dermatol 1998;39:502–504.
  71. Nielsen P: A double-blind study of 1% metronidazole cream versus systemic oxytetracycline therapy for rosacea. Br J Dermatol 1983;109:63–65.
  72. Dahl M, Katz I, Krueger G, et al: Topical metronidazole maintains remissions of rosacea. Arch Dermatol 1998;134:679–683.
  73. Frampton J, Wagstaff A: Azelaic acid 15% gel in the treatment of papulopustular rosacea. Am J Clin Dermatol 2004;5:57–64.
  74. Carmichael A, Marks R, Graupe K, Zaumseil R: Topical azelaic acid in the treatment of rosacea. J Dermatol Treat 1993;4:S19-S22.

    External Resources

  75. Bjerke R, Fyrand O, Graupe K: Double-blind comparison of azelaic acid 20% cream and its vehicle in the treatment of papulopustular rosacea. Acta Derm Venereol 1999;79:456–459.
  76. Thiboutot D, Thieroff-Ekerdt R, Graupe K: Efficacy and safety of azelaic acid (15%) gel as a new treatment for papulopustular rosacea: Results from two vehicle-controlled, randomized phase III studies. J Am Acad Dermatol 2003;48:836–845.
  77. Maddin S: A comparison of topical azelaic acid 20% cream and topical metronidazole 0.75% cream in the treatment of patients with papulopustular rosacea. J Am Acad Dermatol 1999;40:961–965.
  78. Del Rosso J: Evaluating the role of topical therapies in the management of rosacea: Focus on combination sodium sulfacetamide and sulfur formulations. Cutis 2004;73:29–33.
  79. Fernandez-Obregon A: Oral use of azithromycin for the treatment of acne rosacea. Arch Dermatol 2004;140:489–490.
  80. Stone D, Chodosh J: Oral tetracyclines for ocular rosacea: An evidence-based review of the literature. Cornea 2004;23:106–109.
  81. van Zuuren E, Graber M, Hollis S, Chaudhry M, Gupta A: Interventions for rosacea. Cochrane Database Syst Rev 2004:CD003262.
  82. Nikolowski J, Plewig G: Orale Behandlung der Rosazea mit 13-cis-Retinsäure. Hautarzt 1981;32:575–584.
  83. Jansen T, Plewig G: Orale Behandlung der Rosazea mit Isotretinoin. Dtsch Med Wochenschr 1995;120:1745–1747.
  84. Ertl G, Levine N, Kligman A: A comparison of the efficacy of topical tretinoin and low-dose oral isotretinoin in rosacea. Arch Dermatol 1994;130:319–324.
  85. Erdogan F, Yurtsever P, Aksoy D, Eskioglu F: Efficacy of low-dose isotretinoin in patients with treatment-resistant rosacea. Arch Dermatol 1998;134:884–885.
  86. Hofer T: Continuous ‘microdose’ isotretinoin in adult recalcitrant rosacea. Clin Exp Dermatol 2004;29:204–205.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50