Medical scientists from around the world heard updated reports on advances in the understanding of the potential causes and other key aspects of rosacea at the National Rosacea Society (NRS) research workshop held in conjunction with the annual meeting of the Society for Investigative Dermatology in St. Louis. The NRS conducts the annual workshop to promote interest in rosacea research and to share new information from ongoing studies.
In a recently completed clinical study, Dr. Joel Bamford, associate professor of family practice, University of Minnesota-Duluth, and colleagues found that individuals who had styes as children were significantly more likely to have rosacea as adults.
In the study, 5.5 percent of those who had had styes as children developed rosacea as adults, while just 1.5 percent of those who had not had styes later developed the skin disorder. Styes are an inflamed swelling of the sebaceous gland, called the Meibomian gland, at the margin of the eyelid.
"These findings suggest new avenues for investigation of the causes of rosacea, as well as an informal diagnostic marker to consider in patient histories," Dr. Bamford said.
Dr. Richard Gallo, chief of the division of dermatology, University of California-San Diego, reported that new research by his group shows that a particular antimicrobial peptide that acts as a natural antibiotic could be the cause of certain signs of rosacea.
"Biopsy samples from all rosacea patients in the study showed increased levels of cathelicidins, one of the tools the body uses to protect itself against infection," Dr. Gallo said. He noted that cathelicidins are vasoactive (expand blood vessels) and inflammatory (cause irritation), potentially producing the telangiectasia (visible blood vessels) as well as the papules (bumps) and pustules (pimples) often associated with rosacea. They also observed that certain microorganisms like Helicobacter pylori, which have been linked to rosacea, are better able to stimulate an increase in cathelicidins than other skin organisms.
Dr. Richard Granstein, chairman of dermatology at Cornell University, reported on his group's research into the role of neurochemicals in the development of rosacea. They found that adenosine triphosphate (ATP), a neurotransmitter and carrier of chemical energy that is widespread throughout the body, induced the release of a variety of substances linked to inflammation, and hypothesize that rosacea triggers such as stress, alcohol and sunlight may initiate a cascade of events that contribute to producing the bumps and pimples of rosacea.
Tracy Stoudemayer reported results of an NRS-funded study conducted by Dr. YaXian Zhen and Dr. Albert Kligman, professor, University of Pennsylvania, exploring similarities between acne vulgaris and rosacea. The researchers noted that in studies of more than 100 women with rosacea, about 40 percent reported having adolescent acne. Moreover, about 30 percent to 40 percent of the women who experienced acne during adolescence exhibited moderate flushing responses to common rosacea triggers.
In a further investigation of 15 female rosacea patients and five women without rosacea as controls, the researchers found that the rosacea patients had more characteristics common to acne than the control subjects. Facial oil production was about 40 percent greater; microcomedones, precursor to visible comedones (blackheads), were twice as numerous and larger in the rosacea patients than in the controls; and the density of the acne bacterium, Propionibacterium acnes, was nearly twice that of controls.