Modern concepts of erythematotelangiectatic rosacea pathogenesis and treatment

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Rosacea is a multifactorial chronic pathology characterized by a complex etiopathogenesis. Rosacea is represented by 4 subtypes: erythematotelangiectatic, papulopustular, rhinophyma and ophthalmic rosacea.

Clinical manifestations of erythematotelangiectatic rosacea reduce the quality of human life, which is manifested by disorders of the psychoemotional sphere of varying severity. The erythematotelangiectatic subtype is influenced by two groups of trigger factors ― internal and external.

Mandatory areas of patients management with rosacea in general include the “triad of treatment”: providing proper skin care, health education, a set of therapeutic measures.

Rosacea drug therapy is divided into local and systemic. The main treatment for erythematotelangiectatic rosacea is to eliminate the vascular component and reduce the severity of transient and persistent erythema.

Among the physiotherapeutic methods, the most promising today are considered to be laser therapy and an intense pulsed light system (IPL). The effectiveness of laser medicine in dermatology is due to the ability to selectively build up the laser of the chromophochic layer of the dermis. The mechanism of action of IPL-therapy is associated with the absorption of photons by internal or external chromophores, which are located in different layers of the skin, which can locally increase the temperature and cause destructed target formations.

A review of the literature on pathogenesis, trigger factors, classification and modern treatment of eerythematotelangiectatic rosacea is based on an analysis of articles on the relevant topic 44 presented in information systems electronic library, PubMed, NCBI, Embase. Studies are described demonstrating the convincing effectiveness of the treatment of patients with lasers and the IPL system.

Full Text

Restricted Access

About the authors

Elena S. Snarskaya

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: snarskaya-dok@mail.ru
ORCID iD: 0000-0002-7968-7663
SPIN-code: 3785-7859

MD, Dr. Sci. (Med.), Professor

Russian Federation, 2, building 2, Bolshaya Pirogovskaya st., Moscow, 119992

Tatiana S. Rusina

I.M. Sechenov First Moscow State Medical University (Sechenov University); Central Institute of Dermatocosmetology

Email: rusina@cidk.ru
ORCID iD: 0000-0002-0861-3800

Graduate Student

Russian Federation, Moscow; Moscow

References

  1. Rainer BM, Fischer AH, Luz Felipe da Silva D, et al. Rosacea is associated with chronic systemic diseases in a skin severity-dependent manner: results of a case-control study. J Am Acad Dermatol. 2015;73(4):604–608. doi: 10.1016/j.jaad.2015.07.009
  2. Weinkle AP, Doktor V, Emer J. Update on the management of rosacea. Plast Surg Nurs. 2015;35(4):184–202. doi: 10.1097/PSN.0000000000000111
  3. Chen W, Plewig G. Human demodicosis: revisit and a proposed classification. Br J Dermatol. 2014;170(6):1219–1225. doi: 10.1111/bjd.12850
  4. Samodelkina KA, Korotkiy NG, Mayatskaya TV. Modern concepts of etiology and pathogenesis of rosacea. Clinical Dermatology and Venereology. 2012;10(3):4–8. (In Russ).
  5. Khamaganova IV, Ikonnikova NA, Galkina OA. Trichopol in complex therapy of rosacea. Con med. Application. Dermatology. 2005. Р. 22–25. (In Russ).
  6. Abram K, Silm H, Maaroos HI, Oona M. Risk factors associated with rosacea. J Eur Acad Dermatol Venereol. 2010;24(5):565–571. doi: 10.1111/j.1468-3083.2009.03472.x
  7. Rice WG, Weiss SJ. Regulation of proteolysis at the neutrophilsubstrate interface by secretory leukoprotease inhibitor. Science. 1990;249(4965):178–181. doi: 10.1126/science.2371565
  8. Berg M, Liden S. An epidemiological study of rosacea. Acta Derm Venereol. 1989;69(5):419–423.
  9. Chang AL, Raber I, Xu J, et al. Assessment of the genetic basis of rosacea by genome-wide association study. J Invest Dermatol. 2015;135(6):1548–1555. doi: 10.1038/jid.2015.53
  10. Chosidow O, Cribier B. Epidemiology of rosacea: updated data. Ann Dermatol Venereol. 2011;138(Suppl 3):179–183. doi: 10.1016/S0151-9638(11)70087-4
  11. Michel JL, Cabibel F. Frequency, severity and treatment of ocular rosacea during cutaneous rosacea. Ann Dermatol Venereol. 2003;130(1 Pt 1):20–24.
  12. Spoendlin J, Voegel JJ, Jick SS, Meier CR. A study on the epidemiology of rosacea in the U.K. Br J Dermatol. 2012;167(3):598–605. doi: 10.1111/j.1365-2133.2012.11037.x
  13. Olisova OY, Kochergin NG, Smirnova EA. Modern external therapy of moderate forms of rosacea. Russian Journal of Skin and Venereal Diseases. 2016;19(6):328–334. (In Russ).
  14. Ramelet AA. Rosacea: a reaction pattern associated with ocular lesions and migraine? Arch Dermatol. 1994;130(11):1448. doi: 10.1001/archderm.1994.01690110118022
  15. 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(4):584–587. doi: 10.1067/mjd.2002.120625
  16. Guzman-Sanchez DA, Ishiuji Y, Patel T, et al. Enhanced skin blood flow and sensitivity to noxious heat stimuli in papulopustular rosacea. J Am Acad Dermatol. 2007;57(5):800–805. doi: 10.1016/j.jaad.2007.06.009
  17. Sibenge S, Gawkrodger DJ. Rosacea: a study of clinical patterns, blood flow, and the role of Demodex folliculorum. J Am Acad Dermatol. 1992;26(4):590–593. doi: 10.1016/0190-9622(92)70086-u
  18. Del Rosso JQ, Baldwin H, Webster G, et al. American Acne & Rosacea Society rosacea medical management guidelines. J Drugs Dermatol. 2008;7(6):531–533.
  19. Del Rosso JQ, Thiboutot D, Gallo R, et al. Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 2: a status report on topical agents. Cutis. 2013;92(6):277–284.
  20. Tan J, Berg M. Rosacea: current state of epidemiology. J Am Acad Dermatol. 2013;69(6 Suppl 1):27–35. doi: 10.1016/j.jaad.2013.04.043
  21. Crawford GH, Pelle MT, James WD. Rosacea: I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol. 2004;51(3):327–341. doi: 10.1016/j.jaad.2004.03.030
  22. Del Rosso JQ, Webster GF, Jackson M, et al. Two randomized phase III clinical trials evaluating anti-infl ammatory dose doxycycline (40-mg doxycycline, USP capsules) administered once daily for treatment of rosacea. J Am Acad Dermatol. 2007;56(5):791–802. doi: 10.1016/j.jaad.2006.11.021
  23. Fowler J, Jackson M, Moore A, et al. Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: results of two randomized, double-blind, and vehicle-controlled pivotal studies. J Drugs Dermatol. 2013;12(6):650–656.
  24. Zouboulis CC. The skin as an endocrine organ. Dermatoendocrinol. 2009;1(5):250–252. doi: 10.4161/derm.1.5.9499
  25. Wilkin JK. Oral thermal-induced flushing in erythematotelangiectatic rosacea. J Invest Derm. 1981;76(1):15–18. doi: 10.1111/1523-1747.ep12524458
  26. West JB, Mathieu-Costello O. Stress failure of pulmonary capillaries: role in lung and heart disease. Lancet. 1992;340(8822):762–767. doi: 10.1016/0140-6736(92)92301-u
  27. Motley RJ, Barton S, Marks R. The signifi cance of telangiectasia in rosacea. In: Acne and Related Disorders: An International Symposium. Wales: Martin Dunitz: Cardiff; 1989. Р. 339–344.
  28. Olisova OY, Dodina MI, Kushlinskiy NE. The role of vascular endothelial growth factor in rosacea pathogenesis and it’s medical correction. Russian Journal of Clinical Dermatology and Venereology. 2012;10(1):49–55. (In Russ).
  29. Dermatovenerology. Ed. by Y.S. Butova, O.K. Skripkina, O.L. Ivanova. Moscow: GEOTAR-Media; 2013. 896 p. (In Russ).
  30. Katkhanova OA, Stenin AV. Complex therapy of acneform dermatoses. Experimental and Clinical Dermatocosmetology. 2014;(2):1–6. (In Russ).
  31. Svirshchevskaya EV, Matushevskaya EV, Matushevskaya YI. Actual issues of pathogenesis and therapy of rosacea. Clinical Dermatology and Venereology. 2017;16(4):4–12. (In Russ). doi: 10.17116/klinderma20171644-13
  32. Zuuren EJ, Graber MA, Hollis S, et al. Interventions for rosacea. Cochrane Database Syst Res. 2005;(3):CD003262. doi: 10.1002/14651858.CD003262.pub3
  33. Borovaya A, Olisova O, Ruzicka T, Sardy M. Does isotretinoin therapy of acne cure or cause depression? Int J Dermatology. 2013;52(9):1040–1052. doi: 10.1111/ijd.12169
  34. Pankina ES. Violations of microcirculation of the skin of the face with rosacea and methods of their correction [dissertation abstract]. Saint Petersburg; 2008. 20 р. (In Russ).
  35. Elewski BE, Draelos Z, Dréno B, et al. Rosacea ― global diversity and optimized outcome: proposed international consensus from the Rosacea International Expert Group. J Eur Acad Dermatol Venereol. 2011;25(2):188–200. doi: 10.1111/j.1468-3083.2010.03751.x
  36. Draelos ZD. Cosmetics in acne and rosacea. Semin Cutan Med Surg. 2001;20(3):209–214. doi: 10.1053/sder.2001.27556
  37. Babilas P, Schreml S, Szeimies RM, et al. Intense pulsed light (IPL): a review. Lasers Surg Med. 2010;42(2):93–104. doi: 10.1002/lsm.20877
  38. Chen Y, Moore CD, Zhang JY, et al. TRPV4 moves toward center-fold in rosacea pathogenesis. J Invest Dermatol. 2017;137(4):801–804. doi: 10.1016/j.jid.2016.12.013
  39. Dorofeeva TG, Komarovsky VS. Technologies based on light, radio frequency and plasma effects in aesthetic medicine. Almanac of CLinical Medicine. 2008;(17-2):184–185. (In Russ).
  40. Schoenewolf NL, Barysch MJ, Dummer R. Basics in dermatological laser applications. In: Current problems in dermatology. Editors: Bogdan-Allemann I, Goldberg DJ. Basel: Karger; 2011. Р. 42.
  41. Kovalchuk LA, Goncharuk VY. Experience of treatment of patients with rosacea. Innovative technologies in the diagnosis and treatment of skin diseases and infections of the urogenital tract. In: Abstracts of the regional scientific and practical conference with international participation. Grodno; 2012. Р. 64–67. (In Russ).
  42. Gao L, Gao N, Song W, et al. A retrospective study on efficacy of pulsed dye laser and intense pulsed light for the treatment of facial telangiectasia. J Drugs Dermatol. 2017;16(11):1112–1116.
  43. Kruglova LS, Kotenko KV, Orlova EN. Laser therapy and ultrasound therapy in the treatment of patients with rosacea. Bulletin of New Medical Technologies. 2014;(1):96. (In Russ).
  44. Papageorgiou P, Clayton W, Norwood S, et al. Treatment of rosacea with intense pulsed light: significant improvement and long-lasting results. Br J Dermatol. 2008;159(3):628–632. doi: 10.1111/j.1365-2133.2008.08702.x
  45. Kenneth AM, Sparacio MR, Voigt A, Objective and quantitative improvement of rosacea-associated erythema after intense pulsed light treatment. Dermatol Surg. 2003;29(6):600–604. doi: 10.1046/j.1524-4725.2003.29141.x

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2021 Eco-Vector


СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 86501 от 11.12.2023 г. 
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ЭЛ № ФС 77 - 80653 от 15.03.2021 г.


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies