Abstract
Rosacea is a common chronic cutaneous inflammatory disorder. Recently, patients with rosacea were identified as having a higher risk of developing various comorbidities such as cardiovascular disease, psychiatric disorders, neurologic disorders, and gastrointestinal disorders. However, the risks of some comorbidities in patients with rosacea are somewhat contradictory, depending upon the study design. Moreover, pathomechanisms associated with the comorbidities of patients with rosacea remain poorly elucidated. The purpose of this review was to provide the most up-to-date evidence on the risks of neuropsychiatric and gastrointestinal comorbidities in patients with rosacea. Moreover, the molecular pathomechanisms associated with neuropsychiatric and gastrointestinal comorbidities in patients with rosacea were evaluated based on recent studies. This review was also intended to focus more on the role of the gut–brain–skin axis in the association of neuropsychiatric and gastrointestinal comorbidities in rosacea.
Highlights
Rosacea is a common chronic immune-mediated inflammatory cutaneous disorder with an estimated prevalence of about 0.91–8.5% [1]
As a gut–brain–skin axis model has been suggested for several decades [5], and recent progress in microbiome research has solidified this hypothesis about the effect of the gut–brain–skin axis in cutaneous disorders, this review investigated a potential association between the gut–brain–skin axis and the comorbidities of rosacea
Among a variety of gastrointestinal disorders, a high prevalence of celiac disease (HR: 1.46; 95% confidence interval (CI): 1.11–1.93), Crohn’s disease (CD) (HR: 1.45; 95% CI: 1.19–1.77), ulcerative colitis (UC) (HR: 1.19; 95% CI: 1.02–1.39), and inflammatory bowel syndrome (HR: 1.34; 95% CI: 1.19–1.50) was observed in patients with rosacea compared with a control population in a large population-based cohort study conducted in Denmark [60] (Table 2)
Summary
Rosacea is a common chronic immune-mediated inflammatory cutaneous disorder with an estimated prevalence of about 0.91–8.5% [1]. It is characterized by chronic recurrent episodes of flushing and persistent erythema of the central face. A variety of combinations and degrees of clinical signs and symptoms of rosacea can be observed in each individual [1]. Several epidemiological studies have identified the possible association between rosacea and various comorbid disorders. This study was intended to review the most up-to-date epidemiological evidence to more clearly assess the risk of comorbid diseases in rosacea. Identifying the real burden of comorbidities in patients with rosacea might help provide a multidisciplinary approach to the patient and serve as a bridge to the unknown etiological pathogenesis of rosacea
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