Abstract
Background: The multifactorial nature of rosacea and chronic spontaneous urticaria (CSU) pathogenesis complicates the achievement of satisfactory treatment outcomes. 13C urea breath test (UBT) has been identified as an accurate, non-invasive, and quick procedure to detect the presence of Helicobacter pylori (H. pylori) with high sensitivity and specificity.Objective: In this study, we aim to assess the correlation between H. pylori infection and rosacea and CSU patients.Methods: A cross-sectional, observational study was conducted on patients with rosacea and CSU in the dermatology clinic at King Khalid University Hospital in Riyadh, Saudi Arabia. History and physical examination were performed by a dermatologist. H. pylori 13C-UBT detection was performed in all subjects.Results: In total, 114 patients were included in this current study, with 41 rosacea and 73 urticaria patients. The vast majority of our subjects were females (96.5%). The mean (±SD) age was 42.3 (±12.7). More than half (58.8%) of the examined samples were positive for 13C-UBT; however, positive results were significantly higher in the rosacea patients (73.2%) compared to the urticaria group (50.7%), with a p-value of 0.019.Conclusion: Our findings underline the significant association of H. pylori with rosacea and CSU regardless of the presence or absence of gastrointestinal symptoms. We thus recommend the inclusion of H. pylori testing in the routine workup of CSU and rosacea patients.
Highlights
Rosacea has been defined as a chronic inflammatory relapsing disease of unknown etiology affecting mostly middle-aged adults, especially females more than males [1]
More than half (58.8%) of the examined samples were positive for 13C-urea breath test (UBT); positive results were significantly higher in the rosacea patients (73.2%) compared to the urticaria group (50.7%), with a p-value of 0.019
114 patients were included in this study, of which 41 patients had rosacea and 73 patients had chronic spontaneous urticaria
Summary
Rosacea has been defined as a chronic inflammatory relapsing disease of unknown etiology affecting mostly middle-aged adults, especially females more than males [1]. According to the American National Rosacea Society Expert Committee, there are four subtypes of rosacea, i.e., erythematotelangiectatic rosacea (ETR), papulopustular rosacea (PPR), phymatous rosacea, and ocular rosacea [3,4] The pathogenesis of this disease remains to be unclear; it has been suggested that it may be the result of multifactorial chronic inflammation that is dominated by innate immunity as well as abnormal vasomotor function [5]. CSU affects up to 1% of the general population, with variable duration of the disease that typically lasts for several months, but it may occasionally persist for decades [9] This condition can affect both children and adults; it starts in the third to fifth decades of life and affects females almost twice as often as males [10,11]. The multifactorial nature of rosacea and chronic spontaneous urticaria (CSU) pathogenesis complicates the achievement of satisfactory treatment outcomes. 13C urea breath test (UBT) has been identified as an accurate, non-invasive, and quick procedure to detect the presence of Helicobacter pylori (H. pylori) with high sensitivity and specificity
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