Abstract
Rosacea is a chronic inflammatory skin disorder of a not fully understood pathophysiology. Microbial factors, although not precisely characterized, are speculated to contribute to the development of the condition. The aim of the current review was to summarize the rosacea-associated alterations in the skin, blood, and gut microbiome, investigated using culture-independent, metagenomic techniques. A systematic review of the PubMed, Web of Science, and Scopus databases was performed, according to PRISMA (preferred reporting items for systematic review and meta-analyses) guidelines. Nine out of 185 papers were eligible for analysis. Skin microbiome was investigated in six studies, and in a total number of 115 rosacea patients. Blood microbiome was the subject of one piece of research, conducted in 10 patients with rosacea, and gut microbiome was studied in two papers, and in a total of 23 rosacea subjects. Although all of the studies showed significant alterations in the composition of the skin, blood, or gut microbiome in rosacea, the results were highly inconsistent, or even, in some cases, contradictory. Major limitations included the low number of participants, and different study populations (mainly Asians). Further studies are needed in order to reliably analyze the composition of microbiota in rosacea, and the potential application of microbiome modifications for the treatment of this dermatosis.
Highlights
Rosacea is a chronic inflammatory skin disease that commonly affects white, middle-aged females
The skin microbiome was investigated in 6 papers, in a total number of 115 rosacea subjects and 100 healthy volunteers
One article reported the blood microbiome alterations in 10 rosacea subjects in comparison to 30 healthy volunteers [18], and two studies focused on the gut microbiota in a total of 23 rosacea patients [19,20]
Summary
Rosacea is a chronic inflammatory skin disease that commonly affects white, middle-aged females. The prevalence varies with population, and the disease is infrequently reported in nonwhite patients. The incidence of rosacea was estimated to be 25.6% in the older Finnish population [1], while in China the incidence rate was found to be 3.4% [2]. Rosacea is characterized by the presence of periodically intensifying centrofacial erythema, often associated with teleangiectases (erythematoteleangiectatic rosacea, ETR) or inflammatory papules and pustules (papulopustular rosacea, PPR) [3]. The pathophysiology is not fully understood, and several factors are believed to contribute to the development of the disease, including neurovascular reactivity, genetic susceptibility, dysfunction of the innate immune responses, and comorbid gastrointestinal conditions [3,4,5]. The exact disturbances that lead to the development of the condition remain unknown, which prevents the use of targeted therapy
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