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PubMed2000

Clinical cross-reactivity among foods of the Rosaceae family.

BACKGROUND: Foods from the Rosaceae botanical family have been increasingly reported as causes of allergic reaction. Patients frequently have positive skin tests or radioallergosorbent test results for multiple members of this botanical family. OBJECTIVE: Our purpose was to investigate the clinical cross-reactivity assessed by double-blind, placebo-controlled food challenge (DBPCFC) of Rosaceae foods (apricot, almond, plum, strawberry, apple, peach, and pear). METHODS: Thirty-four consecutive adult patients complaining of adverse reactions to Rosaceae were included in the study. Skin prick tests and CAP System (FEIA) were performed with Rosaceae foods in all patients. Clinical reactivity to Rosaceae was systematically evaluated by open food challenges (OFCs), unless there was a convincing history of a recent severe anaphylaxis. Positive reactions on OFCs were subsequently evaluated by DBPCFCs. RESULTS: Twenty-six and 24 patients had positive skin prick tests and CAP FEIA with Rosaceae, respectively; from these 88% and 100% had positive tests with >/=2. No evidence of clinical reactivity was found in 66% percent of positive skin prick tests and 63% of positive specific IgE determinations to fruits. A total of 226 food challenges (including OFC and DBPCFC) were performed in the 28 patients with positive skin prick tests or CAP System FEIA. Of 182 initial OFCs carried out, 26 (14%) reactions were confirmed by DBPCFCs. Overall, 40 reactions were considered positive in 22 patients with positive skin tests or CAP FEIA. Thirty-eight reactions had been previously reported, the remaining two were detected by systematic challenges. Most reactions were caused by peach (22 patients), apple (6), and apricot (5). Ten patients (46%) were clinically allergic to peach and other Rosaceae. CONCLUSION: Positive skin test and CAP System FEIA should not be taken as the only guide for multi-species dietary restrictions. Nevertheless, the potential clinical allergy to other Rosaceae should not be neglected. If the reported reaction is confirmed, current tolerance to other Rosaceae should be precisely established unless there has been ingestion without symptoms after the reaction.

Adolescent↗
PubMed2004

Interventions for rosacea.

BACKGROUND: Rosacea is a common skin condition affecting the face, characterised by flushing, redness, pimples, pustules and dilated blood vessels. The eyes are often also involved. The cause of rosacea is unclear. It is a chronic disease, which can be controlled in most cases with appropriate treatment. Numerous treatments are in use although it is unclear which are best, and which are most appropriate for the different types of rosacea. OBJECTIVES: To assess and summarise current evidence for the efficacy and safety of treatments for rosacea. SEARCH STRATEGY: We searched the Skin Group Specialised Trials Register (March 2002), Cochrane Central Register of Controlled Trials (CENTRAL, March 2002), MEDLINE (from 1966 to March 2002), EMBASE (from 1980 to March 2002), Biosis (from 1970 to March 2002) and the Science Citation Index (from 1988 to March 2002). Reference lists of trials and key review articles were also searched. Relevant manufacturers and experts were contacted. SELECTION CRITERIA: Randomised controlled trials in people with moderate to severe rosacea were included. Studies judged by the reviewers to have seriously flawed methodology were excluded. DATA COLLECTION AND ANALYSIS: Study selection, assessment of methodological quality, data extraction and analysis were carried out by two independent reviewers. MAIN RESULTS: The evidence provided by twenty-two included studies was generally weak because of poor methodology and reporting. One of our primary outcome measures, 'quality of life', was not assessed in any of the studies. Only two studies of ocular rosacea could be included. Pooled data from two trials involving 174 participants indicated that topical metronidazole is more effective than placebo (odds ratio 5.96, 95% confidence interval 2.95 to 12.06). Data from a between-patient trial (114 patients) and a within-patient trial (33 patients) of azelaic cream versus placebo were not pooled, but both showed good evidence of efficacy. Data pooled from three studies of oral tetracycline versus placebo involving 152 participants showed that, according to physicians' ratings, tetracycline was effective (odds ratio 6.06, 95% confidence interval 2.96 to 12.42). Some evidence of efficacy of oral metronidazole was provided by one small study. REVIEWER'S CONCLUSIONS: The quality of studies evaluating rosacea treatments was generally poor. There is evidence that topical metronidazole and azelaic acid cream have a therapeutic effect. There is some evidence that oral metronidazole and tetracycline are effective. There is insufficient evidence concerning the effectiveness of other treatments. As many of these treatments are used for rosacea, good RCTs are urgently needed.

Humans↗
PubMed1992

Schirmer testing for dry eyes in patients with rosacea.

BACKGROUND: Dry eyes have been reported in a significantly greater number of patients with ocular rosacea than in control subjects. OBJECTIVE: Our purpose was to assess the incidence of dry eyes in patients with cutaneous rosacea and to compare this with a control population. METHODS: With the use of the Schirmer test without anesthesia, the amount of aqueous tear secretion of 32 consecutive patients (16 women, 16 men) with rosacea was compared with that of 32 psoriasis patients (16 women, 16 men) without rosacea who served as age- and sex-matched controls. Two criteria, 5 mm and 8 mm of strip wetting, were used to indicate the lower limit of normal aqueous tear secretion. RESULTS: Of rosacea patients, 56.3% had less than 8 mm of strip wetting compared with 25% of control patients (p less than 0.02). Of rosacea patients, 40.6% had less than 5 mm of strip wetting compared with 18.75% of controls (p less than 0.10). CONCLUSION: The results of this study suggest that dry eyes occur frequently in rosacea. It is important that dermatologists and ophthalmologists be aware of the frequency of dry eyes in rosacea, so that patients are investigated and appropriate therapy can be provided.

Adult↗
PubMed1993

The Demodex mite population in rosacea.

BACKGROUND: The cause of rosacea is unknown; among other factors a causative role has been postulated for the hair follicle mites Demodex folliculorum and Demodex brevis. OBJECTIVE: Our purpose was to compare the population density of Demodex mites in facial skin of defined categories of patients with rosacea with control subjects. We also assessed the impact of tetracycline therapy on the mite population. METHODS: The population density and distribution of Demodex mites were studied in the facial skin of 42 patients with rosacea and 42 age- and sex-matched control subjects. Mites were counted in measured skin surface biopsy specimens obtained from six standard facial sites with cyanoacrylate glue. RESULTS: The mean mite count was 49.8 (range 2 to 158) in patients with rosacea and 10.8 (range up to 97) in control subjects (p < 0.001); the highest density of mites was found on the cheeks. A statistically significant increase in mites was found in all subgroups of rosacea, being most marked in those with steroid-induced rosacea. Mite counts in patients with rosacea before and after a 1-month course of oral tetracycline showed no significant difference. CONCLUSION: Increased mites may play a part in the pathogenesis of rosacea by provoking inflammatory or allergic reactions, by mechanical blockage of follicles, or by acting as vectors for microorganisms.

Adult↗
PubMed1999

Helicobacter pylori eradication treatment reduces the severity of rosacea.

BACKGROUND: A higher prevalence of Helicobacter pylori infection in rosacea patients than in healthy controls has been reported. OBJECTIVE: The aim of this study was to investigate the effect of H. pylori eradication therapy in patients with rosacea. METHODS: Twenty-five rosacea patients and 87 age- and sex-matched healthy controls were included in this study. We detected IgG and IgA antibodies against H. pylori in both groups. An upper gastrointestinal endoscopy and a rapid urease test were performed on the 13 patients with rosacea who accepted this procedure. Amoxicillin 500 mg 3 times daily, metronidazole 500 mg 3 times daily, and bismuth subcitrate 300 mg 4 times daily were administered to patients positive for H. pylori. The severity of rosacea was scored before and after treatment. RESULTS: There was no statistical difference in seropositivity in either group. In H. pylori-positive rosacea patients there was a significant decrease in the severity of rosacea at the end of the treatment as compared with the initial scores. CONCLUSION: Our findings suggest that H. pylori may be involved in rosacea and that eradication treatment may be beneficial.

Adult↗
PubMed2003

Critical review of the manner in which the efficacy of therapies for rosacea are evaluated.

BACKGROUND: Rosacea is a relatively common disorder that may affect individuals of all races, particularly those of northern European decent. Its onset generally occurs in individuals between the ages of 20 and 50 years. Rosacea may be classified into four subtypes and one variant. Although individuals with rosacea may not pass through all of the stages, the primary features of the disorder include frequent flushing and blushing, nontransient erythema, the presence of papules and pustules, and telangiectasia. Many agents have been used to treat rosacea stigmata, especially because none of these is uniformly effective. AIM: To identify the parameters that are used to evaluate the response to therapy when different agents are used to treat rosacea. For a given parameter, to determine whether the different trials are consistent in the manner in which this variable is measured. METHODS: The reports on the efficacy and safety of the different drug therapies used to treat rosacea were identified. We searched MEDLINE (1966 to June 2002) for studies where rosacea was treated. The parameters used to evaluate the efficacy of therapy were determined. For each parameter, the ways in which it has been measured were identified. RESULTS: Efficacy of treatment is generally judged by evaluating the effect of the intervention on papules and pustules, erythema, and telangiectasia. Manual lesional counts of papules and pustules are usually performed. There is, however, substantial variation in the methodology chosen for comparison of erythema and telangiectasias. Color scales are popular for erythema and telangiectasia, while grading scales are most commonly used for physician and patient evaluations. CONCLUSIONS: For each of the parameters that are commonly used to measure the efficacy of treatments for rosacea, the different approaches by which it has been measured in the various trials have been highlighted; these dissimilarities can make it problematic to compare between clinical trials. A greater degree of uniformity in the manner in which the various parameters are evaluated would enable a more objective comparison between the studies.

Humans↗
PubMed1993

Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy.

A standardized skin-surface biopsy (1 cm2) of the check was performed in 49 patients with rosacea [13 with erythemato-telangiectatic rosacea (ETR), three with squamous rosacea (SR), 33 with papulopustular rosacea (PPR)], and 45 controls. A mean density of 0.7 Demodex folliculorum/cm2 was found in controls, 98% of whom had less than five Demodex/cm2. When all clinical types of rosacea were considered collectively, the density of Demodex was significantly higher in patients with rosacea than in controls (mean = 10.8/cm2; P < 0.001). When the various clinical types of rosacea were considered separately, Demodex density was statistically significantly higher than in controls only in the PPR patients (mean = 12.8/cm2; P < 0.001). The same type of comparison was also made for three other groups of subjects--patients with isolated inflammatory papules (n = 4), rhinophyma (n = 3), and HIV infection (n = 21), respectively: in these groups, the Demodex density did not differ significantly from controls. The present study demonstrates a high density of D. folliculorum in PPR, and supports its pathogenic role in the papulopustular phase of rosacea. The study suggests that standardized surface biopsy could be a useful diagnostic tool for PPR, with a 98% specificity when Demodex density is higher than 5/cm2.

Adult↗
PubMed1998

A study of the prevalence of Helicobacter pylori infection and other markers of upper gastrointestinal tract disease in patients with rosacea.

OBJECTIVE: Recent reports have suggested that patients with rosacea, a chronic inflammatory skin disorder of unknown etiology, have an increased prevalence of Helicobacter pylori infection. However, no causal relation has been identified. This study was designed to determine the prevalence of H. pylori infection and upper gastrointestinal symptoms in rosacea patients and in subjects without chronic skin disorders. METHODS: Forty-five patients with rosacea and 43 healthy subjects underwent serological testing for H. pylori infection. Demographics, gastrointestinal symptoms, and medication use were recorded using a structured questionnaire. RESULTS: There was no significant difference in the seroprevalence of H. pylori infection between rosacea patients and healthy subjects (26.7% vs 34.9%; p = 0.40). Significantly more patients with rosacea complained of indigestion (66.7% vs 32.6%; p = 0.001) and used antacids (60% vs 32.6; p = 0.01). There was no significant difference in the prevalence of H. pylori infection between symptomatic and asymptomatic rosacea patients, or in those using antacids. There were no differences in the frequency of heartburn, history of peptic ulcer disease, family history of peptic ulcer disease, use of H2-receptor antagonists, or use of nonsteroidal antiinflammatory drugs. CONCLUSIONS: Patients with rosacea have similar rates of H. pylori infection as healthy subjects. Rosacea patients complain significantly more frequently of "indigestion" and use more antacids unrelated to H. pylori infection.

Adult↗
PubMed2006

GSTM1 and GSTT1 null genotypes as possible heritable factors of rosacea.

PURPOSE: Rosacea might be related to an increased activity of reactive oxygen species (ROS) and deficient function of the antioxidant system. Glutathione S-transferases (GSTs) play a primer role in cellular defense against electrophilic chemical species and radical oxygen species. We hypothesized that increased ROS activity or decreased antioxidant potential, possibly induced by GST gene polymorphism, might have a pathogenic role in rosacea. METHODS: The study group consisted of 45 patients with rosacea and 100 control subjects. DNA samples were isolated from blood samples using high pure polymerase chain reaction (PCR) Template preparation Kit. The GSTM1, GSTT1, and P1 polymorphisms were detected using a real-time PCR and fluorescence resonance energy transfer with a Light-Cycler Instrument. Associations between specific genotypes and the development of rosacea were examined using logistic regression analyses to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: GSTM1 and GSTT1 null genotypes were found to be statistically different from control (P=0.005, P=0.009, respectively), and associated with an increased risk of rosacea (OR [95% CI]: 2.84 [1.37-5.89]; OR [95% CI]: 2.68 [1.27-5.67], respectively). There was a statistically significant relationship between both null combination of the GSTM1 and GSTT1 genotype polymorphisms and rosacea (P=0.003, OR [95% CI]: 4.18 [1.57-11.13]). There were no statistically significant differences between patient and control groups for the GSTP1 Ile/Ile, Ile/Val, and Val/Val genotypes (P>0.05). CONCLUSION: We demonstrated a significant association between the GSTT1 and/or GSTM1 null genotypes and rosacea. However, the potential role of GSTs as markers of susceptibility to rosacea needs further studies in larger patient groups.

Adult↗
PubMed2004

Relationship between peach lipid transfer protein specific IgE levels and hypersensitivity to non-Rosaceae vegetable foods in patients allergic to lipid transfer protein.

BACKGROUND: Lipid transfer protein (LTP), the major allergen in Rosaceae in geographic areas where the prevalence of birch pollen allergy is low, is a widely cross-reacting pan-allergen, but the pattern of cross-reactivity to plant-derived foods botanically unrelated to Rosaceae shows much variability. OBJECTIVE: To examine the relationship between peach LTP specific IgE levels and cross-reactivity to several non-Rosaceae, plant-derived foods. METHODS: IgE specific for peach LTP was measured by enzyme-linked immunosorbent assay in serum samples from 40 patients with Rosaceae allergy monosensitized to LTP. Patients were considered monosensitized to this protein in the absence of sensitization to other cross-reacting, plant-derived foods as shown by negative skin prick test (SPT) results with both birch and mugwort pollen. SPTs with commercial extracts of walnut, hazelnut, peanut, celery, maize, rice, tomato, orange, and onion were performed to detect possible immunologic cross-reactivity to these foods. RESULTS: Patients with negative SPT results with non-Rosaceae foods showed significantly lower levels of IgE to peach LTP than patients showing skin reactivity to one or more non-Rosaceae foods (P < .001). A significant difference in specific IgE to peach LTP between patients with positive or negative SPT results was observed with each individual food (P < .001 in all cases). The level of IgE to peach LTP was strongly related to the number of positive SPT results with non-Rosaceae foods (r = 0.78; P < .001). Increasing levels of IgE to peach LTP were associated with skin reactivity to nuts (29/40 [72%]), peanut (27/40 [67%]), maize (16/39 [41%]), rice (14/39 [36%]), onion (13/37 [35%]), orange (9/32 [28%]), celery (11/40 [27%]), and tomato (8/39 [20%]). CONCLUSIONS: This study suggests that all allergenic determinants in LTP from vegetable foods other than peach cross-react with peach LTP determinants, whereas only some peach LTP epitopes cross-react with allergenic determinants on botanically unrelated, plant-derived foods. The high levels of IgE to peach LTP seem to reflect the presence of IgE targeting common allergenic determinants of LTP, causing cross-reactivity to botanically unrelated, vegetable foods. In LTP-allergic patients, increasing levels of IgE to peach LTP are paralleled by an increasing number of foods other than Rosaceae positive on SPT that cause clinical symptoms.

Antigens, Plant↗
PubMed2005

[Rosacea. Clinical features, pathogenesis and therapy].

Rosacea is a common facial dermatosis, which may have detrimental effects on the patient's psychological and social interactions. It is a disease of the middle aged, skin types I and II are more often affected than darker skin types. Clinically, pre-rosacea, and rosacea grade I-III may be distinguished. Pre-rosacea is characterized by flushing and blushing, grade I to III by erythemato-teleangiectasies, papulopustules, and inflammatory nodules. Especially severe subtypes include rosacea conglobata and rosacea fulminans. Hyperglandular subtypes lead to different forms of phyma, of which Rhinophyma is the most frequent. Pathogenetically destruction of the dermal vessels and connective tissue seems to be decisive for the development of a chronic inflammation, which leads to the phenotype of the various forms of rosacea. Mild forms can be treated exclusively by topical medication. Antibiotics (erythromycin, clindamycin, tetracyclin), metronidazol, azelaic acid, and the retinoid adapalene have been shown to be effective in well controlled randomized studies. The best evaluated topical medication is metronidazol. In severe forms systemic therapy must be applied. Systemic antibiotics are effective and especially isotretinoin has shown a very good response even in low dose regimens. Rhinophyma must be treated surgically.

Anti-Bacterial Agents↗
PubMed2004

Temperature regulates bacterial protein production: possible role in rosacea.

Facial skin temperature is higher for patients with rosacea. Papules and pustules might arise because bacteria behave differently at these warmer temperatures. We sought to: (1) compare bacteria from facial skin of patients with rosacea with that of control subjects; and (2) grow these bacteria at 30 degrees C and 37 degrees C to compare growth curves and secreted proteins. Bacteria isolated from pustules/skin surfaces of patients with rosacea and skin surfaces of control subjects were identified and cultured at 37 degrees C and 30 degrees C. Secreted proteins were separated by electrophoresis. We found that Staphylococcus epidermidis isolated from patients with rosacea was consistently beta-hemolytic, whereas that from control subjects were nonhemolytic. Bacteria from patients with rosacea grew at the same rate and to the same stationary phase whether cultured at 37 degrees C or 30 degrees C. Isolates from patients with rosacea secreted more proteins, and generally more of each protein at 37 degrees C compared with 30 degrees C. In conclusion, bacteria isolated from patients with rosacea secrete different proteins and different amounts of protein at different temperatures.

Bacterial Proteins↗
PubMed2004

Rosacea: II. Therapy.

Despite an incomplete understanding of the pathogenesis of rosacea, therapeutic modalities continue to expand. The principal subtypes of rosacea include erythematotelangiectatic rosacea, papulopustular rosacea, phymatous rosacea, and ocular rosacea. These phenotypic expressions are probably caused by divergent pathogenic factors and consequently respond to different therapeutic regimens. A subtype-directed approach to therapy is discussed in part II of this review. We provide an overview of the available topical, oral, laser, and light therapies in the context of these cutaneous subtypes, review the evidence that supports their use, and outline their therapeutic approach. Suggestions for future areas of study also are provided. Learning objective At the completion of this learning activity, participants should be familiar with the subtype-directed approach to therapy for rosacea including available topical, oral, laser, and light therapies.

Anti-Infective Agents↗
PubMed2005

Videocapillaroscopic alterations in erythematotelangiectatic rosacea.

BACKGROUND: Rosacea is a common chronic dermatosis that involves the cutaneous microvasculature of the face. There are no objective measures for assessing the severity of erythematotelangiectatic rosacea. OBJECTIVE: Our purpose was to characterize and provide objective measures of vessel changes in erythematotelangiectatic rosacea by videocapillaroscopy. METHODS: We compared 30 patients with erythematotelangiectatic rosacea with 30 age- and sex-matched patients with facial seborrheic dermatitis and 30 healthy control subjects. Videocapillaroscopy was performed both on the cheeks and on the nailfold region. The analyzed parameters of the face were morphological (background color, vessel irregularities) and quantitative (polygonal net perimeter, telangiectasia, and vessel diameters). RESULTS: Characteristic alterations of skin vessels were observed in facial rosacea, with a pattern distinct from that of facial seborrheic dermatitis. In particular, rosacea showed neoangiogenesis and significantly larger polygons (13.21 +/- 3 vs 7.8 +/- 3 mm; mean +/- standard deviation, P < .001), more prominent telangiectases (267.8 +/- 108 vs 118.2 +/- 35 microm; P < .001) and larger mean vessel diameter (46.71 +/- 9 vs 24 +/- 10 microm; P < .001) compared with seborrheic dermatitis. Seborrheic dermatitis displayed more polygon irregularities and vessel tortuosity. In contrast, no differences were found in the nailfold region. LIMITATIONS: Vessel irregularities and overall erythema may be difficult to quantify. CONCLUSIONS: Videocapillaroscopy may represent a valid adjunctive method in the early diagnosis and measurement of erythematotelangiectatic rosacea.

Adult↗
PubMed1997

Inflammatory cytokines in the tears of patients with ocular rosacea.

OBJECTIVE: The purpose of the study is to compare tear fluid concentrations of interleukin-1alpha (IL-1alpha), tumor necrosis factor-alpha (TNF-alpha), and epidermal growth factor (EGF) in ocular rosacea with those in control subjects and to examine the relation between tear functions, such as production and clearance rate, and the concentrations of cytokines in tear fluid. PARTICIPANTS AND INTERVENTION: Fourteen patients with severe meibomian gland disease, facial rosacea, and symptoms of ocular irritation were examined for ocular surface disease, tear production, and tear clearance rate (TCR). Twelve control subjects, frequency-matched for age, and 15 ideal normal subjects with no ocular symptoms and normal tear function were assessed using the same parameters. Minimally stimulated tear samples (20 microl) were drawn from each subject and analyzed using a sandwich enzyme-linked immunosorbent assay to detect IL-1alpha, TNF-alpha, and EGF. RESULTS: Tear IL-1alpha concentration was significantly higher in patients with rosacea than in age-matched (P = 0.003) and ideal control subjects (P < 0.001). Tumor necrosis factor-alpha was not detected in patients or control subjects, indicating levels of less than 10 pg/ml. Epidermal growth factor was not significantly higher in patients with rosacea than in age-matched control subjects. Tear turnover LN(TCR) was lower in patients with rosacea than in both age-matched (P = 0.048) and ideal control subjects (P = 0.002). Schirmer I scores were statistically lower in patients with rosacea than in ideal control subjects (P = 0.013), but not age-matched control subjects. Interleukin-1alpha was correlated inversely with LN(TCR) (r= -0.58, P < 0.0001) and Schirmer I (r = -0.39, P = 0.012). 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. The reduced tear turnover, LN(TCR), its inverse correlation with IL-1alpha, and the absence of TNF-alpha in the tears of these patients suggest that the increased concentration of IL-1alpha observed may be largely because of clearance failure of cytokine normally produced at the ocular surface.

Adult↗
PubMed2002

The seroprevalence of Helicobacter pylori and nitric oxide in acne rosacea.

BACKGROUND: Acne rosacea is a dermatosis with unknown etiology. Some studies have reported a high prevalence of Helicobacter pylori infection in acne rosacea. Other studies have reported a decrease in the severity of the lesions of acne rosacea after eradication of H. pylori. H. pylori is a Gram-negative bacterium which colonizes the gastric mucosa and increases the synthesis of oxygen radicals, such as superoxide and proinflammatory cytokines. These cytokines have been demonstrated to stimulate the synthesis of the inflammatory species nitric oxide (NO). In this study, we examined the role of NO in the possible effect of H. pylori in acne rosacea. METHODS: Thirty-three acne rosacea patients were included in the study and the control group comprised 20 healthy individuals. The levels of immunoglobulin G antibodies against H. pylori in the serum samples were measured using the enzyme-linked immunoabsorbent assay method. Measurement of nitrate was performed using chemiluminescence in accordance with the method described by Braman and Hendrix (Braman RS, Hendrix SA. Nanogram nitrite and nitrate determination in environmental and biological materials by vanadium(iii) reduction with chemiluminescence detection. Anal Chem 1989; 61: 2715-2718). For statistical analysis, the t-test was used. RESULTS: The seropositivity of H. pylori in acne rosacea patients was found to be high; however, the serum nitrate levels were found to be normal. CONCLUSIONS: The results of the study indicate that the inflammatory species NO, which has been hypothesized to be associated with H. pylori, has no role in the inflammatory mechanism of acne rosacea.

Antibodies, Bacterial↗
PubMed2003

Measuring the severity of rosacea: a review.

BACKGROUND: Assessment of severity is essential in the clinical care of rosacea patients and in the research on rosacea. OBJECTIVE: To determine the range of methods used to assess rosacea severity in clinical trials. METHODS: The medical literature from 1965 through 2001 was searched for rosacea clinical trials using MEDLINE and published citations. Forty-seven articles were reviewed. RESULTS: The most frequently assessed signs of rosacea were papules/pustules (43 studies), erythema (35), and telangiectasia (24). Other signs and symptoms of rosacea and adverse reactions to therapies were assessed in 27 studies. Counts of papules/pustules were conducted in 34 studies. Four-point scales were the most frequently used assessment tools for erythema (17) and telangiectasia (11). Other frequently used techniques included global assessment by clinicians (29) and by patients (21), and photography (13). CONCLUSIONS: At present, there are no standard validated tools for assessing the severity of rosacea or its signs or symptoms.

Humans↗
PubMed2003

Incidence of anti-Helicobacter pylori and anti-CagA antibodies in rosacea patients.

In recent years some authors have reported a possible correlation between Helicobacter pylori (Hp) and dermatological diseases such as rosacea. In this study we evaluated serum IgG and IgA anti-Hp in a group of 48 patients with rosacea. IgG antibodies were present in 81% of the rosacea patients with dyspepsia and 16% of the rosacea patients without dyspeptic symptoms. Serum IgG and IgA anti-Hp were detected by means of an enzymatic immunoabsorption test (enzyme-linked immunosorbent assay: ELISA). In addition, an evaluation of the anti-CagA antibodies by means of an immunoenzymatic method was carried out (ELISA, RADIM). IgA anti-Hp was present in 62% of patients with dyspepsia and in 6% of patients with no upper gastrointestinal symptoms. Anti-CagA antibodies were seen to be present in 75% of patients with both rosacea and gastric symptomatology, and were prevalent in patients affected by rosacea with papular symptoms in respect to rosacea with erythematous symptoms. The data that emerge from our case studies appear to confirm the hypothesis put forward by scientists who propose a correlation between the two clinical presentations rather than an inverse hypothesis of total independence.

Adult↗