Systemic Comorbidities in Korean Patients with Rosacea: Results from a Multi-Institutional Case-Control Study

Abstract

Recent evidence links rosacea to systemic disease, but there are not enough methodologic studies addressing this association in Asians. Our aim was to identify rosacea comorbidities in Koreans and establish a reference database. A multi-center, case-control study was performed where a total of 12,936 rosacea patients and 12,936 age- and sex-matched control subjects were identified from 2007 to 2018. Logistic regression was performed to find significant association between rosacea and Sjögren syndrome (odds ratio [OR] 2.05; 95% confidence interval, 1.40–3.00), systemic sclerosis (OR 6.56; 95% CI, 1.50–28.7), rheumatoid arthritis (OR 1.72; 95% CI, 1.50–1.98), ankylosing spondylitis (OR 2.32; 95% CI, 1.42–3.84), autoimmune thyroiditis (OR 1.96; 95% CI, 1.40–2.73), alopecia areata (OR 1.77; 95% CI, 1.27–2.45), vitiligo (OR 1.90; 95% CI, 1.30–2.77), lung cancer (OR 1.54; 95% CI, 1.06–2.21), hepatobiliary cancer (OR 1.38; 95% CI, 1.06–1.77), alcohol abuse (OR 1.59; 95% CI, 1.05–2.39), diabetes mellitus (OR 1.11; 95% 1.02–1.19), obesity (OR 1.72; 95% CI, 1.22–2.41), allergic rhinitis (OR 1.65; 95% CI, 1.54–1.76), allergic conjunctivitis (OR 1.57; 95% CI, 1.27–1.94), chronic rhinosinusitis (OR 1.28; 95% CI, 1.14–1.42), herpes infection (OR 1.69; 95% CI, 1.53–1.86), and human papillomavirus infection (OR 2.50; 95% CI, 2.06–3.02). Higher odds for Sjogren syndrome, systemic sclerosis, ankylosing spondylitis, thyroiditis, vitiligo, hepatobiliary cancer, and obesity was exclusive in female subjects with rosacea, whereas increased prevalence of alopecia areata and alcohol abuse was confined to men. Only those who were 50 years and older exhibited higher odds for vitiligo, lung cancer, and gastroesophageal reflux disease while individuals younger than 50 were exclusively associated with hepatobiliary cancer, allergic conjunctivitis, and irritable bowel syndrome. Our study suggests that Koreans with rosacea are more likely to experience systemic comorbidity. Clinicians should acknowledge these interrelations and employ comprehensive care with an individual-based approach.

Investigation of thyroid blood tests and thyroid ultrasound findings of patients with rosacea

“…In a Korean study, Woo et al investigated the potential association of rosacea with autoimmune disorders, including Sjögren syndrome, systemic sclerosis, rheumatoid arthritis, ankylosing spondylitis, autoimmune thyroiditis, alopecia areata, and vitiligo. 13 They concluded that the risk of autoimmune thyroiditis increased solely in female patients with rosacea. Our study included female patients only and found that the anti-TPO antibody levels decreased as the severity of rosacea increased.…”

“…This finding implies that serum anti‐TPO levels can be used as a marker in determining the severity of rosacea and may help the clinician predict the course of the disease. In a Korean study, Woo et al investigated the potential association of rosacea with autoimmune disorders, including Sjögren syndrome, systemic sclerosis, rheumatoid arthritis, ankylosing spondylitis, autoimmune thyroiditis, alopecia areata, and vitiligo 13 . They concluded that the risk of autoimmune thyroiditis increased solely in female patients with rosacea.…”

Dermatology: how to manage atopic dermatitis in patients with skin of colour

“… 60 – 64 Phase III trials of dupilumab consisted of 20–27% Asian individuals and 5–7% Black individuals; thus, the efficacy of dupilumab is consistent in diverse ethnic groups. 62 – 65 A subgroup analysis by race demonstrated comparable results between white, Black and Asian patients, although the number of Black individuals was limited. 63 , 65 For moderate-to-severe AD in patients 12 years and older, dupilumab is the only approved biologic.…”

“… 62 – 65 A subgroup analysis by race demonstrated comparable results between white, Black and Asian patients, although the number of Black individuals was limited. 63 , 65 For moderate-to-severe AD in patients 12 years and older, dupilumab is the only approved biologic. 66 A recent study demonstrated the effectiveness of dupilumab in improving QOL of patients with AD amongst various racial subgroups (i.e.…”

“… 2 Finally, further research must look for specific molecular targets in Black, Asians and Hispanic populations to assist with treatment development for diverse populations. 9 , 31 , 37 , 42 , 65 …”