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    No one really knows the cause of rosacea but there are many theories. "Rosacea is a skin disease with an obscure and complicated pathogenesis." [1]

    The current most popular theory is that rosacea is a disorder of the innate immune system. For over twenty years the vascular theory was held as the most promising. What is interesting is at the heart of the innate immune system theory is that this includes an overproduction of cathelicidin (a killer of microscopic organisms that is at the cellular level found in white blood cells and also found in cells on the skin) which is transported in the vascular system, so we have come full circle. Some consider the nervous system as the root cause of rosacea, and the list goes on with many other theories worth considering (the latest theory is the Trigeminal sensory malfunction theory) but a good place to start your research is our post on Theories Revisited

    End Notes

    [1] Dovepress
    Rosacea and Helicobacter pylori: links and risks
    Elizabeth Lazaridou, Chrysovalantis Korfitis, Christina Kemanetzi, Elena Sotiriou, Zoe Apalla, Efstratios Vakirlis, Christina Fotiadou, Aimilios Lallas, Demetrios Ioannides

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    • Comparative effectiveness of purpuragenic 595 nm pulsed dye laser versus sequential emission of 595 nm pulsed dye laser and 1,064 nm Nd:YAG laser: a double-blind randomized controlled study. Acta Dermatovenerol Alp Pannonica Adriat. 2019 Mar;28(1):1-5 Authors: Campos MA, Sousa AC, Varela P, Baptista A, Menezes N Abstract INTRODUCTION: Erythematotelangiectatic rosacea is a common condition in Caucasians. The most frequently used lasers to treat this condition are pulsed dye laser (PDL) and neodymium:yttrium-aluminum-garnet laser (Nd:YAG). This study compares the treatment efficacy of purpuragenic PDL with that of sequential emission of 595 nm PDL and 1,064 nm Nd:YAG (multiplexed PDL/Nd:YAG). METHODS: We performed a prospective, randomized, and controlled split-face study. Both cheeks were treated, with side randomization to receive treatment with PDL or multiplexed PDL/Nd:YAG. Efficacy was evaluated by spectrophotometric measurement, visual photograph evaluation, the Dermatology Quality of Life Index questionnaire, and a post-treatment questionnaire. RESULTS: Twenty-seven patients completed the study. Treatment was associated with a statistically significant improvement in quality of life (p < 0.001). PDL and multiplexed PDL/Nd:YAG modalities significantly reduced the erythema index (EI; p < 0.05). When comparing the degree of EI reduction, no differences were observed between the two treatment modalities. PDL was associated with a higher degree of pain and a higher percentage of purpura. Multiplexed PDL/Nd:YAG modality was associated with fewer side effects and greater global satisfaction, and 96.3% of the patients would recommend this treatment to a friend. CONCLUSIONS: Both laser modalities are efficacious in the treatment of erythematotelangiectatic rosacea. The multiplexed PDL/Nd:YAG modality was preferred by the patients. PMID: 30901061 [PubMed - in process] {url} = URL to article
    • Logo of the Human Microbiome Project, a program of the NIH Common Fund, National Institutes of Health, image courtesy of Wikimedia Commons This subject of microbiome-based therapeutic strategies for rosacea is one of my favorite subjects which I have done a great deal of research on. You may want to read the latest article I have written on this subject of the human microbiome. 
    • Related Articles Skin diseases are more common than we think: screening results of an unreferred population at the Munich Oktoberfest. J Eur Acad Dermatol Venereol. 2019 Mar 19;: Authors: Tizek L, Schielein MC, Seifert F, Biedermann T, Böhner A, Zink A Abstract BACKGROUND: Skin diseases are ranked as the fourth most common cause of human illness, resulting in an enormous non-fatal burden. Despite this, many affected people do not consult a physician. Accordingly, the actual skin disease burden might be even higher since reported prevalence rates are typically based on secondary data that exclude individuals who do not seek medical care. OBJECTIVE: The aim of the study was to investigate the prevalence of skin diseases in an unreferred population in a real-life setting. METHODS: A cross-sectional study of 9 days duration was performed in 2016 at the 'Bavarian Central Agricultural Festival', which is part of the Munich Oktoberfest. As part of a public health check-up, screening examinations were performed randomly on participating visitors. All participants were 18 years or older and provided written informed consent. RESULTS: A total of 2701 individuals (53.5% women, 46.2% men; mean age 51.9 ± 15.3 years) participated in the study. At least one skin abnormality was observed in 1662 of the participants (64.5%). The most common diagnoses were actinic keratosis (26.6%), rosacea (25.5%) and eczema (11.7%). Skin diseases increased with age and were more frequent in men (72.3%) than in women (58.0%). Clinical examinations showed that nearly two-thirds of the affected participants were unaware of their abnormal skin findings. CONCLUSION: Skin diseases might be more common than previously estimated based on the secondary data of some sub-populations. Further information and awareness campaigns are needed to improve people's knowledge and reduce the global burden associated with skin diseases. PMID: 30891839 [PubMed - as supplied by publisher] {url} = URL to article
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