Modern view on rosacea: Topical issues of epidemiology, pathogenesis and therapy. Literature review

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Rosacea is a multifactorial dermatological disease that is widespread throughout the world, initially manifested as a cosmetic defect, and in the absence of systemic and topical therapy leads to a change in the structure and functions of the facial skin.

Patients with rosacea often seek medical attention, as these aesthetic problems impair their quality of life and contribute to the development of social and psychological problems. Chronic stress is often the cause of the development of social maladaptation, which occurs because of a constant feeling of self-doubt, own inferiority, and anxiety. Anxiety and chronic depression can cause even minor manifestations of rosacea, as it is localized on the skin of the face. Dermatosis often manifests itself in women older than 30 years, under the influence of multiple trigger factors, has a chronic relapsing course.

Understanding the pathophysiology and the use of combined therapies can improve the effectiveness of therapy in patients with rosacea, achieve and prolong clinical remission, identify trigger factors and possible prevention. This explains the need to study rosacea not as an independent dermatosis, but as a sign of more significant disorders that can lead not only to social and aesthetic problems, but also affect the general health of the patient.

作者简介

Olga Aleksandrova

Tver State Medical University

编辑信件的主要联系方式.
Email: olgaalexandrova@live.com
ORCID iD: 0000-0001-8281-3619
SPIN 代码: 8080-0721

Assistant

俄罗斯联邦, Tver

Valeriy Dubenskiy

Tver State Medical University

Email: valerydubensky@yandex.ru
ORCID iD: 0000-0002-1671-461X
SPIN 代码: 3577-7335

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

俄罗斯联邦, Tver

Ekaterina Muraveva

Tver State Medical University

Email: katerisha87@yandex.ru
ORCID iD: 0000-0001-5326-4876
SPIN 代码: 3332-8424

Assistant

俄罗斯联邦, Tver

Maksim Tenyaev

Tver State Medical University

Email: maksonten@yandex.ru
ORCID iD: 0009-0009-4963-3814

Student

俄罗斯联邦, Tver

参考

  1. Olisova OY, Kochergin NG, Smirnova EA. Innovations in external therapy of rosacea. Russ J Skin Venereal Dis. 2017;20(5):270–274. (In Russ). doi: 10.18821/1560-9588-2017-20-5-270-274
  2. Gorbakova EV, Masyukova SA, Ilyina IV, et al. Pathophysiology of inflammation and directions of therapy for rosacea. Bulletin Med Institute Continuing Education. 2022;(3):44–47. (In Russ). doi: 10.46393/27821714-2022-3-44
  3. Kubanova AA, Makhakova YB. Rosacea: Prevalence, pathogenesis, features of clinical manifestations. Bulletin Dermatol Venereol. 2015;(3):36–45. (In Russ).
  4. Evseeva AL, Ryabova VV, Koshkin SV. Clinical case of papulopustular rosacea. Bulletin Dermatol Venereol. 2021;97(3):73–79. (In Russ). doi: 10.25208/vdv1228
  5. 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
  6. Two AM, Del Rosso JQ. Kallikrein 5-mediated inflammation in rosacea: Clinically relevant correlations with acute and chronic manifestations in rosacea and how individual treatments may provide therapeutic benefit. J Clin Aesthet Dermatol. 2014;7(1):20–25.
  7. Yamasaki K, Kanada K, Macleod DT, et al. TLR2 expression is increased in rosacea and stimulates enhanced serine protease production by keratinocytes. J Invest Dermatol. 2011; 131(3):688–697. doi: 10.1038/ jid.2010.351
  8. Sulk M, Seeliger S, Aubert J, et al. Distribution and expression of nonneuronal transient receptor potential (TRPV) ion channels in rosacea. J Invest Dermatol. 2012;132(4):1253–1262. doi: 10.1038/jid.2011.424
  9. Gerber PA, Buhren BA, Steinhoff M, Homey B. Rosacea: The cytokine and chemokine network. J Investig Dermatol Symp Proc. 2011;15(1):407. doi: 10.1038/jidsymp.2011.9
  10. Ryabova VV, Koshkin SV, Chermnykh TV. Rosacea. Seborrhea. Acne. Illustrated textbook for doctors. Kirov: Kirovskaya gosudarstvennaya meditsinskaya akademiya; 2011. Р. 103–106. (In Russ).
  11. Adaskevich VP. Classical subtypes of rosacea and rare clinical forms: Features of patient management. Smolensk Medical Almanac. 2020;(4):150–151. (In Russ). doi: 10.37963/ SMA.2020.4.150
  12. Mikhneva EN. Treatment of rosacea. Dermatol Venereol. 2012;(4):90–95. (In Russ).
  13. Butov YS. Dermatovenerology. National leadership. Short edition. Ed. by Yu.S. Butov, Yu.K. Skripkin, O.L. Ivanov. Moscow: GEOTAR-Media; 2020. Р. 668–680. (In Russ).
  14. Chauhan N, Ellis DA. Rosacea: Patophyziology and management principles. Facsial Plast Surg Clin North Am. 2013;21(l):127–136. doi: 10.1016/j.fsc.2012.11.004
  15. Kubanova AA, Dubenskiy VV, Dubenskiy VlV. Basic principles of treatment of skin diseases. In: Skripkin Yu.K., Butov Yu.S., Ivanov O.L., ed. Dermatovenerology. National Leadership. Moscow: GEOTAR-Media; 2011. Р. 197–207. (In Russ).
  16. Mimov AV. Combined use of pulsed laser radiation and ultrasound exposure in the treatment of rosacea patients. Bulletin New Med Technol. 2013;(1):1–3. (In Russ).
  17. Kubanova AA, Makhakova YB. Rosacea: Diagnosis and treatment. Bulletin Dermatol Venereol. 2015;(4):27–35. (In Russ).

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2. Fig. 1. Patient S., 42 years old, erythematous-telangiectatic form of rosacea. The process is characterized by damage to the skin of the cheeks and nose. There is a long-existing erythema with numerous telangiectasias. During dermatoscopy, dilated capillaries are determined.

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3. Fig. 2. Patient A., 51 years old, papular-pustular form of rosacea. The process is located in the T-zone of the face, cheeks. There are separate miliary and lenticular papules, bright pink in color, of a dense consistency, located against the background of erythema. There are grouped papulo-pustular elements in the cheeks and chin area; there are separate purulent hemorrhagic crusts in the folds.

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4. Fig. 3. Patient L., 54 years old, pustular-nodular form of rosacea. The initial form of rhinophyma. The process is represented by persistent erythema, multiple telangiectasias, papules, pustules and nodules. Papules form plaques when they merge. Tumor-like growths in the nose, cheeks, forehead, frontal surface of the auricles, chin. The face is puffy and pasty.

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5. Fig. 4. Patient K., 38 years old, the steroid form of rosacea. The process is located on the skin of the forehead, cheeks and chin, is represented by erythema of a red-cyanotic color, with clear boundaries; on its surface there are multiple papular-pustular elements and telangiectasia.

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6. Fig. 5. Patient M., 42 years old, granulomatous form of rosacea. The process is located mainly on the skin of the cheeks, back and wings of the nose, chin. It is represented by small dense papules and nodules on the background of erythema with a cyanotic tinge. Individual lenticular papules are gray-yellow and pink in color, located on the skin of the forehead.

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7. Fig. 6. Patient Yu., 29 years old, conglobate form of rosacea. The process is represented by erythema on the skin of the cheeks, nose, chin, against which there are nodules; when palpation of individual ones, fluctuation is determined.

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版权所有 © Aleksandrova O.A., Dubenskiy V.V., Muraveva E.S., Tenyaev M.A., 2023

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