Laser Treatment of Rosacea

Lonne-Rahm, Sol-Britt; Nordlind, Klas; Edström, Desirée Wiegleb; Ros, Anne‐Marie; Berg, Mats

doi:10.1001/archderm.140.11.1345

Cited by 56 publications

(10 citation statements)

References 15 publications

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“…So far, suggested communicating neuropeptides involved in rosacea include calcitonin gene-related peptide and substance P ( tachykinin, precursor 1 ; Powell et al , 1993; Lonne-Rahm et al , 2004). Unexpectedly, neither of these neuropeptides nor their receptors was upregulated at the RNA level, but were rather downregulated (Figure 6c).…”

Section: Discussionmentioning

confidence: 99%

Neurovascular and Neuroimmune Aspects in the Pathophysiology of Rosacea

Schwab

Sulk

Seeliger

et al. 2011

Journal of Investigative Dermatology Symposium Proceedings

239

255

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Rosacea is a common skin disease with a high impact on quality of life. Characterized by erythema, edema, burning pain, immune infiltration, and facial skin fibrosis, rosacea has all the characteristics of neurogenic inflammation, a condition induced by sensory nerves via antidromically released neuromediators. To investigate the hypothesis of a central role of neural interactions in the pathophysiology, we analyzed molecular and morphological characteristics in the different subtypes of rosacea by immunohistochemistry, double immunofluorescence, morphometry, real-time PCR, and gene array analysis, and compared the findings with those for lupus erythematosus or healthy skin. Our results showed significantly dilated blood and lymphatic vessels. Signs of angiogenesis were only evident in phymatous rosacea. The number of mast cells and fibroblasts was increased in rosacea, already in subtypes in which fibrosis is not clinically apparent, indicating early activation. Sensory nerves were closely associated with blood vessels and mast cells, and were increased in erythematous rosacea. Gene array studies and qRT-PCR confirmed upregulation of genes involved in vasoregulation and neurogenic inflammation. Thus, dysregulation of mediators and receptors implicated in neurovascular and neuroimmune communication may be crucial at early stages of rosacea. Drugs that function on neurovascular and/or neuroimmune communication may be beneficial for the treatment of rosacea.

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Section: Discussionmentioning

confidence: 99%

Neurovascular and Neuroimmune Aspects in the Pathophysiology of Rosacea

Schwab

Sulk

Seeliger

et al. 2011

Journal of Investigative Dermatology Symposium Proceedings

239

255

View full text Add to dashboard Cite

show abstract

“…Rosacea is also well known to have increased angiogenesis, increases in VEGF [94], and contains vasodilation that could be mediated by autonomic nerve innervation. One study reported increased nerve fiber density and neuropeptides, including substance P in patients with Rosacea [95] and patients with rosacea often complain of more sensitive skin [96, 97] and that their rosacea is exacerbated when they are under stress [98]. …”

Section: Discussionmentioning

confidence: 99%

Cutaneous manipulation of vascular growth factors leads to alterations in immunocytes, blood vessels and nerves: Evidence for a cutaneous neurovascular unit

Ward

Hatala

Wolfram

et al. 2011

Journal of Dermatological Science

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Background Skin cells produce soluble factors which influence keratinocyte proliferation, angiogenesis, nerve innervation and immunocyte response. Objective To test the hypothesis that epidermal-dermal interactions influence neural outgrowth, vascular survival, immunocyte recruitment and keratinocyte proliferation. Methods We genetically manipulated the epidermis to express excess vascular endothelial growth factor (VEGF) and/or angiopoietin-1 (Ang1) and then examined the epidermal and dermal phenotypes. We compared these findings with those occurring following overexpression of the Ang1 receptor Tie2 in endothelial cells or keratinocytes. Results Keratinocyte-overexpression of Ang1 resulted in increased epidermal thickness compared to control littermates. Keratinocyte-specific overexpression of Ang1 or VEGF increased dermal angiogenesis compared to control animals and combined Ang1-VEGF lead to further increases. Cutaneous leukocyte examination revealed increases in CD4+ T cell infiltration in mice with keratinocyte-specific overexpression of Ang1, VEGF and Ang1-VEGF combined; in contrast only keratinocyte-specific Ang1 overexpression increased cutaneous F4/80+ macrophage numbers. Interestingly, combined keratinocyte-derived Ang1-VEGF overexpression reduced significantly the number of F4/80+ and Cd11c+ cells compared to mice overexpressing epidermal Ang1 alone. Endothelial cell-specific Tie2 overexpression increased dermal angiogenesis but failed to influence the epidermal and immune cell phenotypes. Keratinocyte-specific Tie2 expressing mice had the highest levels of CD4+, CD8+ and CD11c+ cell numbers and acanthosis compared to all animals. Finally, increases in the number of cutaneous nerves were found in all transgenic mice compared to littermate controls. Conclusion These findings demonstrate that change to one system (vascular or epidermal) results in change to other cutaneous systems and suggest that individual molecules can exert effects on multiple systems.

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“…PDL is effective for erythema, flushing, telangiectasia and even inflammatory lesions in patients with rosacea 6 7 8 . Biopsy specimens which were taken from patients with rosacea 3 months after PDL therapy showed that nerve fiber density and number of substance P immunoreactive nerve fibers were decreased 9 10 . However, exact relationship between this and the therapeutic effect of PDL has not been demonstrated yet.…”

Section: Introductionmentioning

confidence: 98%

Pulsed Dye Laser Treatment Combined with Oral Minocycline Reduces Recurrence Rate of Rosacea

Suh

Byun

et al. 2017

Ann Dermatol

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BackgroundThe recurrence rate of rosacea was not known very well, but has been reported as 60% in 6 months after withdrawal of the drug. It is not known which treatment can reduce relapses of rosacea effectively.ObjectiveThe objective was to identify whether 595 nm-pulsed dye laser (PDL) treatment reduced recurrence rate among rosacea patients who were treated with oral minocycline.MethodsOne hundred and seven Korean patients with rosacea who started treatment with oral minocycline (100 mg/d) with or without PDL (2∼4 sessions) were evaluated retrospectively. The recurrence rate was estimated using the Kaplan-Meier method, and difference was evaluated using the log-rank test. Cox proportional hazards model was used to estimate hazard ratios and 95% confidence intervals (CIs) of risk factors for the recurrence of rosacea.ResultsThe recurrence-free survival analysis revealed that the group with oral minocycline plus PDL was significantly different compared with the group with oral minocycline alone (p=0.011). Cox proportional hazards model showed that the combined use of PDL with oral minocycline appeared to be a significant protective factor for the hazard of recurrence of rosacea (hazard ratio, 0.492; 95% CI, 0.257∼0.941; p=0.032).ConclusionPDL can be used added to oral minocycline to reduce relapses among rosacea patients who are undergoing oral minocycline treatment.

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Laser Treatment of Rosacea

Cited by 56 publications

References 15 publications

Neurovascular and Neuroimmune Aspects in the Pathophysiology of Rosacea

Neurovascular and Neuroimmune Aspects in the Pathophysiology of Rosacea

Cutaneous manipulation of vascular growth factors leads to alterations in immunocytes, blood vessels and nerves: Evidence for a cutaneous neurovascular unit

Pulsed Dye Laser Treatment Combined with Oral Minocycline Reduces Recurrence Rate of Rosacea

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