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Rosacea is a chronic inflammatory skin disease characterised by periods of remission and subsequent relapses typically provoked by environmental factors. Eruptions located on the face are easily visible and may be difficult to conceal, which leads to a decrease in patients' self-esteem, quality of life, and general well-being. Since the aetiology of rosacea is multifactorial and not entirely understood, and the clinical characteristics and course of the disease are heterogeneous, therapy may be challenging. While a complete cure is not possible, in the majority of cases clinical improvement and long-term remission are satisfying both to the patient and physician. In recent years, the therapeutic approach has been significantly modified. Currently, the focus is placed on the need to personalise the treatment process and adapt it to the patients' phenotypic characteristics. Combination therapies and new variants of existing topical and systemic drugs are increasingly being recommended. The mainstays of therapy are antiinflammatory agents. Proper skin care - along with the identification and avoidance of factors known to trigger consecutive episodes of rosacea - are also essential. [ABSTRACT FROM AUTHOR]

Introduction: Topical treatment and daily skin care are the biggest challenges in the treatment of rosacea. The treatment is long lasting and particularly difficult because of poor tolerance to skin care products. Objective: A search for factors that can influence the progress of rosacea among contact allergens, and to find out why are some patients resistant to the therapy. A detailed analysis involved fragrances, antioxidants and preservatives. Material and methods: Patients with complicated rosacea were tested for contact allergies. The testing was performed between 2010 and 2017 in a group of 269 patients. The patients were divided into two groups: tested before and tested after 2014. The reason for this division was a different distribution of positive tests for certain allergens before and after 2014. Results: 62.8% of patients had erythematotelangiectatic rosacea (ETR), 15.6% had papulo-pustular rosacea (PPR), 21.6% had both ETR and PPR. Among fragrances, the fragrance mix and balsam of Peru most frequently gave the positive result. After 2014, among phenolic antioxidants a positive reaction to dodecyl gallate increased from 5.6% to 20.0% in the first reading, and from 12.7% to 46.4% in the second reading. High proportion of positive results were seen for octyl gallate and paraben mix. For preservatives, positive reactions were recorded for 0.02% water solution of methylisothiazolinone (MIT) and methyl-chloroisothiazolinone (MCI), benzyl alcohol and phenoxyethanol. After 2014, reaction caused by propolis was observed. Conclusions: In treatment-resistant cases of rosacea, standard procedures should include testing for contact allergens. The first and the second reading are equally important for the further therapy. [ABSTRACT FROM AUTHOR]

Demodex folliculorum and Demodex brevis are commensal mites residing in hair follicles and sebaceous glands on human skin, primarily in seborrhoeic areas, on the scalp, and in the external auditory canals. Demodex mites feed on exfoliated epidermal cells and substances secreted by sebaceous glands. They cause mechanical blocking of follicles, follicular hyperkeratosis, and local inflammation. The prevalence of Demodex folliculorum colonisation in the population may vary between 20% and 80% of the population, and it increases with age. Demodex infestation is more common in immunocompromised patients, after application of topical glucocorticosteroids or after immunomodulatory agents. The potential role of Demodex folliculorum mites in the pathogenesis of rosacea, perioral dermatitis, blepharitis, folliculitis, and pityriasis folliculorum has been discussed. [ABSTRACT FROM AUTHOR]

Rosacea is a chronic dermatosis, manifesting with erythema, papular or pustular eruptions located in the facial area. The authors present a case of an 84-year-old woman with a long-term history of rosacea who had a mycotic infection of the facial skin imitating aggravation of the underlying disease. The case presented by us can be regarded as a variant of "tinea incognito", i.e., undiagnosed mycosis, misdiagnosed as another dermatosis, which is often aggravated by the patient by using local glucocorticosteroids or other local immunomodulators, which hinders proper diagnosis. It may be diagnostically relevant to consider other comorbidities in elderly patients with rosacea. [ABSTRACT FROM AUTHOR]

Acne rosacea is a chronic inflammatory skin disease that affects the face. The symptoms depend on the stage of the disease. The first stage is characterized by erythema and telangiectasia. This is followed by a papulopustular phase and a phymatous type in the final stages. An ocular type of rosacea is described in the literature as well. In the etiopathogenesis of papulo-pustular and ocular types of rosacea, inflammatory response modulation caused by microorganisms living on the skin play a key role. Binding of bacterial ligands with epidermal receptors leads to induction of the inflammatory cascade. This leads to vasodilation and white blood cell chemotaxis, which causes a change in the microenvironment of the skin that assists in microorganism proliferation. Microorganisms such as Demodex folliculorum, Bacillus oleronius, Staphylococcus epidermidis, Chlamydia pneumoniae and Helicobacter pylori play a crucial role in the pathogenesis of rosacea. [ABSTRACT FROM AUTHOR]

Introduction. The etiology and pathogenesis of rosacea are not fully understood. Among factors suspected of inducing and/or exacerbating the skin changes are UV radiation, hormonal changes, stress, alcohol consumption and Demodex folliculorum or Helicobacter pylori infection There is a general consensus that rosacea is at least a photoaggravated dermatosis. However, several studies in rosacea patients have failed to demonstrate an abnormal reaction to UV radiation. Objective. Retrospective analysis of phototest results in rosacea patients. Material and methods. Retrospective analysis of 102 phototests in rosacea patients with skin types I-III was performed in the Photobiological Laboratory of the Dermatological Department of Warsaw Medical University in the years 2005-2010. As a control results of phototests performed in 56 healthy persons with skin types I-III were used. Results. Decreased MED (⩽ 0.047 J/cm2) was found in 34/102 (33.3%) rosacea patients in comparison to 5% in the control group. In the whole group of rosacea patients in comparison to controls a shift into lowered MED was observed (p < 0.0001). Abnormal reactions to UVB radiation (in dose ⩽ 2 MED) were evident as vivid, persistent erythema or oedema within the irradiated skin in 20/102 (19.6%) patients (95% CI ±7.8%) (p < 0.0001). Conclusions. The results of our work confirm the role of UV radiation in the pathogenesis of rosacea. Thus, future prospective analysis should evaluate the characteristic features of rosacea patients who are most sensitive to UV radiation. [ABSTRACT FROM AUTHOR]