Clinical and pathogenetic patterns of rosacea development
- Authors: Ayupova K.R.1, Yusupova L.A.1
-
Affiliations:
- Kazan State Medical Academy – Branch Campus of the RMACPE
- Issue: Vol 32, No 5 (2025)
- Pages: 14-20
- Section: Reviews
- URL: https://journal-vniispk.ru/2073-4034/article/view/316487
- DOI: https://doi.org/10.18565/pharmateca.2025.5.14-20
- ID: 316487
Cite item
Abstract
Rosacea (RC) is a chronic facial dermatosis that affects 2 to 10% of the population and is more common in women after the third decade of life. RC has a significant burden on patients, as it has significant consequences for physical and mental health. Both neurovascular and immunological factors play an important role in the pathogenesis. Recurrent clinical symptoms of RC affect appearance, are irritating and negatively affect emotional health. Significant correlations are known between RC and neuropsychiatric diseases that can affect cognitive functions, including depression, dementia, anxiety disorders, and migraine. With a long course of the disease, purulent-septic complications, deterioration of vision, distortion of facial features, and formation of scars on the skin may appear. Modern methods of treating RC with neurogenic changes are limited and reduce satisfaction, patient confidence in therapy, and can also aggravate psychological stress. Early seeking of help and proper treatment will help reduce inflammation and stop the development of the disease. The article describes the pathogenetic features of the development of RC, reveals neurovascular changes and autonomic dysregulation. The relationship between RC and various concomitant mental disorders is described in detail, clinical features and types of the disease are considered. Clinical manifestations of neurogenic RC and its distinctive features in comparison with other subtypes of this dermatosis are given.
Full Text
##article.viewOnOriginalSite##About the authors
Kamila R. Ayupova
Kazan State Medical Academy – Branch Campus of the RMACPE
Author for correspondence.
Email: skinderma@rambler.ru
ORCID iD: 0000-0002-2179-1214
SPIN-code: 3811-5710
PhD Candidate, Department of Dermatovenereology and Cosmetology
Russian Federation, KazanLuiza A. Yusupova
Kazan State Medical Academy – Branch Campus of the RMACPE
Email: yuluizadoc@hotmail.com
ORCID iD: 0000-0001-8937-2158
SPIN-code: 5743-6872
Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenereology and Cosmetology
Russian Federation, KazanReferences
- Manfredini M., Barbieri M., Melandri M. et al. Probiotics and diet for rosacea: current data and future prospects. Biomolecules. 2025;15(3):411. https://dx.doi.org/10.3390/biom15030411
- Ильина И.В., Масюкова С.А., Санакоева Э.Г. и др. Современные аспекты патогенеза и принципы терапии розацеа. Consilium medicum. Дерматология. 2011;2:24–28. [Il’ina I.V., Masyukova S.A., Sanakoeva E.G. et al. Sovremennye aspekty patogeneza i principy terapii rozacea. Consilium medicum. Dermatologiya. 2011;2:24–28. (In Russ.)].
- Аюпова К.Р., Юсупова Л.А. Этиопатогенетические аспекты розацеа. Фарматека. 2024;29(8):43–47. [Ayupova K.R., Yusupova L.A. Modern features of the pathogenetic mechanisms of rosacea. Farmateka. 2024;29(8):43–47. (In Russ.)]. https://dx.doi.org/10.18565/pharmateca.2024.5.61-65
- Rainer B.M., Kang, S., Chien, A.L. Rosacea: epidemiology, pathogenesis and treatment. Dermatocosmetology. 2017;9:e1361574. https://dx.doi.org/10.1080/19381980.2017.1361574
- Kim H.S. Microbiota in Rosacea. Am J Clin Dermatol. 2020;21(Suppl 1):25–35. https://dx.doi.org/10.1007/s40257-020-00546-8
- Medgyesi B., Dajnoki Z., Béke G. et al. Rosacea Is Characterized by a Profoundly Diminished Skin Barrier. J Invest Dermatol. 2020;140(10):1938–1950.e5. https://dx.doi.org/10.1016/j.jid.2020.02.025
- Юсупова Л.А. Современный взгляд на проблему старения кожи. Лечащий врач. 2017;6:75. [Yusupova L.A. Modern view on the problem of skin aging. Lechashchii vrach. 2017;6:75. (In Russ.)].
- Morgado-Carrasco D., Granger K., Trullas K. et al. Impact of ultraviolet radiation and exposome on rosacea: key role of photoprotection in optimizing treatment. J Cosmet Dermatol. 2021;20(11):3415–3421. https://dx.doi.org/10.1111/jocd.14020 2021;20:3415
- Аюпова К.Р., Юсупова Л.А. Современные особенности патогенетических механизмов розацеа. Фарматека. 2022;29(8):43–47. [Ayupova K.R., Yusupova L.A. Modern features of the pathogenetic mechanisms of rosacea. Farmateka. 2022;29(8):43–47. (In Russ.)]. https://dx.doi.org/10.18565/pharmateca.2022.8.43-47
- He A., Grandi R., Quatro S.G. Rosacea and the rate of temperature change: real-time data analysis from 2004 to 2016. Ann. Dermatol. 2018;30:739–741. https://dx.doi.org/10.5021/ad.2018.30.6.739
- Gupta M.A., Gupta, A.K. The relationship between neurogenic rosacea and chronic post-traumatic stress disorder (PTSD): a possible role of dysregulation of the autonomic nervous system and high sympathetic tone in PTSD. J Am Acad Dermatol. 2016;74:AB44.
- Аюпова К.Р., Юсупова Л.А. Розацеа: триггерные факторы и сопутствующие заболевания. Фарматека. 2023;29(8):20–26. [Ayupova K.R., Yusupova L.A. Rosacea: trigger factors and associated diseases. Farmateka. 2023;29(8):20–26. (In Russ.)]. https://dx.doi.org/10.18565/pharmateca.2023.8.20-26
- Wu W.H., Geng H., Cho, E. et al. Reproductive and hormonal factors and the risk of rosacea in white women in the United States. J Am Acad Dermatol. 2021;87:138–140. https://dx.doi.org/10.1016/j.jaad.2021.06.865
- Aedo G., Chahuán M., Gatica E., et al. Managing a burning face: clinical manifestations and therapeutic approaches for neurogenic rosacea. Int J Mol Sci. 2025;26(5):2366. https://dx.doi.org/10.3390/ijms26052366
- Scharschmidt T.K., Jost J.M., Truong S.V. et al. Neurogenic rosacea: a separate clinical subtype requiring a special treatment approach. Arch Dermatol. 2011;147(1):123–126. https://dx.doi.org/10.1001/archdermatol.2010.413
- Sulk M., Siliger S., Ober J. et al. Distribution and expression of non-neural ion channels with transient receptor potential (TRPV) in rosacea. J Invest Dermatol. 2012;132(4):1253?1262. https://dx.doi.org/10.1038/jid.2011.424
- Drummond P.D., Su D. Endothelial and axon reflex vasodilation to acetylcholine in rosacea-affected skin. Arch Dermatol Res. 2011;304:133–137. https://dx.doi.org/10.1007/s00403-011-1177-1
- McAleer M.A., Lacey N., Powell F.S. Pathophysiology of rosacea. G Ital Dermatol Venereol. 2009;144:663–671.
- Geng R.S.Q., Bourkas A.N., Mufti A., Sibbald R.G. Rosacea: pathogenesis and therapeutic correlates. J Cutan Med Surg. 2024;28(2):178–189. https://dx.doi.org/10.1177/12034754241229365.
- Yamasaki K., Schauber J., Koda A. et al. Kallikrein-dependent proteolysis regulates the antimicrobial action of cathelicidins in the skin. FASEB J. 2006;20:2068–2080. https://dx.doi.org/ 10.1096/fj.06-6075com
- Searle T., Ali F.R., Karolides S. et al. Rosacea and the gastrointestinal tract. Australas J Dermatology. 2020;61:307–311. https://dx.doi.org/10.1111/ajd.13401
- Shvab V.D., Sulk M., Siliger S. et al. Neurovascular and neuroimmune aspects in the pathophysiology of rosacea. J Investig Dermatol Symp Proc. 2011;15:53–62. https://dx.doi.org/10.1038/jidsymp.2011.6
- Guzman-Sanchez D.A., Ishiuji Y., Patel T. et al. Increased blood flow in the skin and sensitivity to harmful thermal effects in papular pustular rosacea. J Am Acad Dermatol. 2007;57:800–805. https://dx.doi.org/10.1016/j.jaad.2007.06.009
- Botchkarev V.A., Yaar M., Peters E.M.J. et al. Neurotrophins in biology and pathology of the skin. J Invest Dermatol. 2006;126:1719–1727. https://dx.doi.org/ 10.1038/sj.jid.5700270
- Roosterman D., Goerge T., Schneider S.W., et al. Neuronal control of skin function: the skin as a neuroimmunoendocrine organ. Physiol Rev. 2006;86(4):1309–1379. https://dx.doi.org 10.1152/physrev.00026.2005
- Slominski A.T., Slominski R.M., Raman K. et al. Neuroendocrine signaling in the skin with special attention to epidermal neuropeptides. Am J Physiol Cell Physiol. 2022;323:C1757–C1776. https://dx.doi.org/10.1152/ajpcell.00147.2022
- Choi J.E., di Nardo A. Neurogenic inflammation of the skin. Semin Immunopathol. 2018;40:249–259. https://dx.doi.org/10.1007/s00281-018-0675-z
- Marek-Josefovich L., Nedoshitka B., Grohotska M. et al. Molecular mechanisms of neurogenic skin inflammation. Int J Mol Sci. 2023;24:5001. https://dx.doi.org 10.3390/ijms24055001
- Li M., Tao M., Zhang Y. et al. Neurogenic rosacea may be a small-focal neuropathy. Front Pain Res. (Lausanne). 2023;4:1122134. https://dx.doi.org/10.3389/fpain.2023.1122134
- Eskeland S., Halvorsen J., Tanum L. Antidepressants have anti-inflammatory effects that may be relevant for dermatology: a systematic review. Acta Derm Venereol. 2017;97:897–905. https://dx.doi.org/10.2340/00015555-2702
- Liu Y, Shi W. Associations between rosacea, anxiety, and depression: a bidirectional two-sample Mendelian randomization study. Arch Dermatol Res. 2025;317(1):431. https://dx.doi.org/10.1007/s00403-025-03800-3
- Юсупова Л.А. Современное состояние проблемы эксфолиативного дерматита. Лечащий врач. 2019;11:6–8 [Yusupova L.A. The current state of the problem of exfoliative dermatitis. Lechashchii vrach. 2019;11:6–8. (In Russ.)]. https://dx.doi.org/10.26295/OS.2019.43.24.001
- Gallo R.L., Granstein R.D., Kang S. et al. Standard Classification and Pathophysiology of rosacea: 2017 update from the Expert Committee of the National Rosacea Society. J Am Acad Dermatology. 2018;78:148–155. https://dx.doi.org/10.1016/j.jaad.2017.08.037
- Wilkin J., Dahl M., Dettmar M. et al. Standard classification of rosacea: report of the Expert Committee of the National Rosacea Society on classification and staging of rosacea. J Am Acad Dermatol. 2002;46:584–587. https://dx.doi.org/10.1067/mjd.2002.120625
- Redd T.K., Seitzman G.D. Ocular rosacea. Curr Opin Ophthalmol. 2020;31:503–507. https://dx.doi.org/10.1097/ICU.0000000000000706
- Parkins G.J., Maan A., Don G. Neurogenic rosacea: a rare and poorly studied disease? Clin Exp Dermatol. 2015;40:930–931. https://dx.doi.org/10.1111/ced.12630
- Kim H.O., Kang S.Y., Kim K.E. et al. Neurogenic rosacea in Korea. J Dermatol. 2020;48:49–55. https://dx.doi.org/10.1111/1346-8138.15629
- Tu K.Y., Jung K.J., Shi Y.H., et al. Therapeutic strategies aimed at eliminating immune dysregulation and neuroinflammation in rosacea. Front Immunol. 2024;15:1403798. https://dx.doi.org/10.3389/fimmu.2024.1403798
Supplementary files
