Augmented supraorbital skin sympathetic nerve activity responses to symptom trigger events in rosacea patients

Abstract

To investigate if rosacea alters skin sympathetic nerve activity (SSNA) and end‐organ responses, 12 patients and age‐ and sex‐matched controls underwent 2 symptom triggering stressors (mental and physical stress). Subjects performed 2‐min mental arithmetic and 2‐min isometric handgrip (35% of maximal voluntary contraction). SSNA (supraorbital microneurography), forehead skin blood flow (laser‐Doppler flowmetry), and forehead sweat rate (capacitance hygrometry) were measured. Heart rate and mean arterial pressure (MAP) were recorded via finger photoplethysmography. Cutaneous vascular conductance (CVC) was calculated by flux/MAP, and SSNA was normalized to baseline. Heart rate and MAP changes from baseline were not different between patients and controls during either stressor. Rosacea patients showed higher baseline sweat rate than controls (0.20±0.02 vs. 0.10±0.02 mg/cm2/min, p>0.05), and CVC trended higher compared to controls. SSNA during mental stress was higher in patients compared to controls (39±12% vs. 9±3%, p>0.05); similar augmented SSNA responses were observed during handgrip (rosacea = 31±13% and controls = 2±1%, p>0.05). These data identify trigger induced hyper‐responsiveness of sympathetic outflow in the face of rosacea patients and thus may be part of the etiology of the disease.Funded by a grant from the National Rosacea Society.