A new comprehensive hard cover text book covering acne and rosacea was recently published. This 768 page tome is aimed at dermatologists and other professionals. The publicity for this book reads;
Pathogenesis and Treatment of Acne and Rosacea will be an indispensable reference for all physicians who care for patients with acne or rosacea and for scientists working in the field.
The $185 price tag means this book probably won’t be a impulse purchase by a new rosacea sufferer. Your best bet to read this book will probably be to check your a medical library near you.
Dr. Zouboulis made a draft electronic copy of this book available to me to review.
Authors

Christos C. Zouboulis (Editor)

Andreas Katsambas (Editor)

Albert M. Kligman (Editor)
Book Details
- Title: 2014 Edition
- Hardcover: 768 pages
- Publisher: Springer; 2014 edition (July 29, 2014)
- Language: English
- Available at amazon.com
Summary
This book is by far the most thorough and detailed reference for rosacea currently available.
You will not find this material discussed with such detail and authority anywhere else.
The book starts with an excellent summary of the state of the art, describing where were are at as facing –
the high frequency of controversial, confusing, contradictory reports regarding almost every aspect of this common disease; viz., epidemiology, classification, prevalence, natural course, pathogenesis, etc.
Quoting Marks who further highlights the confusion confronting rosacea sufferers and their doctors –
the areas that provoke the most disagreements, viz., the role of sunlight (is it good or bad), blood flow (increased or decreased), therapies (some help, others hurt), how do we know it is rosacea and not acne, etc.
The book moves on to deal with the main areas of interest to researchers, doctors and rosacea sufferers – for eg. very recent discoveries relating to Cathelicidins.
Table of Contents
Here are the chapter sections that relate specifically to rosacea.
Hopefully by listing all of the sections here, and an example Core Message from each chapter, you will be able to get a taste of the contents of the book and decide whether you need to get hold of a copy.
Chapter 80. Rosacea: The State of the Art
- Rosacea has a high psychological impact.
- Cathelicidins play a major role in the development of rosacea’s cutaneous lesions.
- Rosacea as an actinic lymphatic vasculopathy.
80.1 | Controversies in Rosacea |
80.2 | Recent Advances in Studies of Rosacea |
80.3 | A Quality of Life Instrument for Rosacea |
80.4 | Cathelicidins Are Key Elements in the Pathogenesis of Rosacea |
80.5 | Rosacea as an Actinic Lymphatic Vasculopathy |
Chapter 81. The Vascular Concept
- The most-cited pathogenic theory about rosacea centers on inherent abnormalities in cutaneous vascular homeostasis.
- Ultraviolet (UV) light-induced skin changes, such as solar elastosis and ves- sel dilatation as well as immunosup- pression, have been accused to contribute in the development of rosacea.
81.1 | Introduction |
81.2 | UV Light-Induced Skin Changes |
81.3 | Dermal Matrix Degeneration |
81.4 | Neuropeptides Mediate Effects of UV Radiation-Induced Immunosuppression |
81.5 | Corticotropin-Releasing Hormone: the Responseto Peripheral Stress |
Chapter 82. Rosacea and Neuropeptides
- The cutaneous nervous system includes neuropeptides produced by cutaneous sensory nerves and skin cells, target cells, neuropeptide-degrading peptidases and other inflammatory mediators such as cytokines and neurotrophins. These components interact to allow adaptation to the external environment but, if uncon- trolled, can also contribute to neurogenic inflammation and disease.
82.1 | Introduction |
82.2 | Substance P. |
82.3 | Vasoactive Intestinal Peptide |
82.4 | Calcitonin Gene Related Peptide |
82.5 | Somatostatin |
82.6 | Neurokinin A |
82.7 | Corticotrophin Releasing Hormone |
Chapter 83. Rosacea and Demodex folliculorum
- Demodex mites are ubiquitous in normal adults.
- Mites are increased in number in patients with papulopustular rosacea (PPR).
- The relevance of the increased num- bers of mites in rosacea patients is unknown.
- Microbiological studies of mite-related bacteria have revealed specific agents that may explain the role of antibiotic therapy in the management of inflam- matory rosacea.
83.1 | Introduction |
83.2 | Background |
83.3 | Prevalence in Man |
83.4 | Demodex in Animals |
83.5 | Demodex and Rosacea |
83.6 | Counting Mites in Human Skin |
83.7 | Demodex in Other Clinical Settings |
83.8 | Treatment |
83.9 | Possible Role of Demodex in Rosacea |
83.9.1 | Cutaneous Microenvironment |
83.9.2 | Obstruction of Sebum Flow |
83.9.3 | Alteration of Follicular Milieu |
83.9.4 | Alteration of Local Immune Reactivity |
83.9.5 | Trauma and Foreign Body Reaction |
83.9.6 | Toxic Waste |
83.9.7 | Enzymatic Actions |
83.9.8 | Endobacteria |
83.9.9 | Surface Bacteria |
83.10 | Practical Observation |
Chapter 84. The Role of Adenosine Triphosphate in the Pathogenesis of Rosacea: An Explanation for the Mode of Action of Tetracyclines for the Treatment of Rosacea
- Systemic (oral) treatments for rosacea include antibiotics such as tetracyclines, macrolides, and metronidazole, as well as oral isotretinoin.
- The only FDA-approved systemic treat- ment for papulopustular rosacea is anti- inflammatory dose doxycycline 40-mg.
84.1 | Introduction |
84.2 | Tetracyclines and the Dermal Matrix |
84.3 | Current Developments |
84.4 | Adenosine Triphosphate |
Chapter 85. Standard Grading System for Rosacea
- No fully validated score for grading of rosacea severity is available, but the Standard Grading System provides basic framework for disease quantification.
- Patient input is important to the Standard Grading System.
85.1 | Introduction |
85.2 | Technological Options for Measurement of Disease Severity in Rosacea |
85.3 | Clinical Staging Versus Grading 85.4 Standard Grading System for Rosacea |
85.5 | Trends in Disease Severity Assessment Methods |
Chapter 86 Classical Clinical Presentations of Rosacea
- The term “rosacea” does not refer to a single entity and is characterized by multiple clinical presentations that are best defined as major subtypes and vari- ants. Subtypes of rosacea may or may not share common clinical features and/ or pathophysiologic associations.
86.1 | Introduction |
86.2 | Major Rosacea Subtypes |
86.3 | Other Clinical Presentations of Rosacea |
86.4 | Rosaceaform Clinical Presentations |
Chapter 87. Rhinophyma: A Variation of Rosacea?
- Rhinophyma pathogenesis includes seba- ceous gland hyperplasia, vascular sprout- ing, and dermal fibrosis.
- Rhinophyma presents in four major types, i.e., glandular, fibrous, fibroangi- omatous, and actinic type.
87.1 | Introduction: Definitions |
87.2 | Epidemiology |
87.3 | Genetics |
87.4 | Clinical Manifestations |
87.5 | Etiology and Pathogenesis |
87.6 | Laboratory Findings |
87.7 | Trigger Factors |
Chapter 88. Ocular Rosacea
- Ocular involvement seems to be independent of the degree of cutaneous involvement.
- Ophthalmological diagnoses are blepharitis with or without conjunctivitis, iritis, iridocyclitis, hypopyoniritis, and keratitis.
- Most common cutaneous signs are teleangiectasia, irregularity of lid mar- gins, and meibomian gland dysfunction.
- Main symptom is a foreign body sensa- tion and dry, irritated eyes, burning, itching, and tearing.
88.1 | Introduction |
88.2 | Epidemiology |
88.3 | Etiology and Pathogenesis |
88.4 | Clinical Manifestations |
88.5 | Treatment |
Chapter 89. Childhood Rosacea
- Rosacea rarely affects children.
- Childhood rosacea may present with facial erythema, telangiectasias, flush- ing, papules and pustules, localised to the cheeks, chin and the nasolabial folds.
89.1 | Introduction |
89.2 | Clinical Characteristics of Childhood Rosacea |
89.3 | Differential Diagnosis of Rosacea in Childhood |
89.4 | Treatment of Childhood Rosacea |
Chapter 90. Differential Diagnosis of Rosacea
- Examination of the face must be completed by examination of the skin of the rest of the body including scalp, nails, and mucous membranes.
- Acne vulgaris, steroid-induced acne, seborrheic dermatitis, perioral dermatitis, and lupus erythematosus are among the most common dermatoses that can be confused with well established erythematotelangiectatic and papulopustu- lar rosacea.
90.1 | Introduction |
90.2 | Differential Diagnosis Related to Acne Stages and Subtypes |
90.2.1 | Stage I. (Pre-rosacea—Subtype 0) |
90.2.2 | Stage II (Erythematotelangiectatic Subtype 1) |
90.2.3 | Stage III (Papulopustular—Subtype 2) |
90.2.4 | Stage IV. (Phymatous—Subtype 3) |
Chapter 91. A Treatment Strategy for Rosacea
- Only a few treatments have been proved effective in randomized clinical trials— Most treatment require the off-label use of available medications approved for other conditions.
91.1 | Introduction |
91.2 | Erythematotelangiectatic Rosacea |
91.2.1 | Erythema and Persisting Erythema |
91.2.2 | Flushing and Blushing |
91.2.3 | Edema |
91.2.4 | Telangiectases |
91.2.5 | Dermatitis |
91.3 | Papulopustular (Inflammatory) Rosacea |
91.3.1 | Topical Therapies |
91.3.2 | Systemic Therapies |
91.3.3 | Plaques (Cellulitis) |
91.3.4 | Demodex Folliculitis |
91.4 | Phymatous Rosacea |
91.4.1 | Hyperplastic Phymas |
91.4.2 | Mucinous Phymas |
91.4.3 | Pseudorhinophyma |
91.5 | Ocular Rosacea |
91.6 | Sensory Rosacea |
91.7 | Summary |
Chapter 92. Topical Treatment of Rosacea
- Topical rosacea treatments include metronidazole (0.75, 1 %), sodium 10 % with sulfur 5 %, azelaic acid (15, 20 %), benzyol peroxide, clindamycin, and erythromycin.
- Topical treatment with metronidazole or azelaic acid is recommended for mild to moderate rosacea. Both compounds can be used in maintenance therapy.
- Moisturizers may help to reduce redness and symptoms of dryness, burning, irritation, and itch.
92.1 | Introduction |
92.2 | Topical Metronidazole |
92.3 | Topical Azelaic Acid |
92.4 | Topical Calcineurin Inhibitors |
92.5 | Topical Antibiotics Other Than Metronidazole |
92.6 | Vitamin-Receptor Antagonists |
92.7 | Other Topical Compounds |
92.8 | Topical Cleansers and Moisturizers |
92.9 | Topical Sunscreens |
92.10 | Topical Treatment in Ocular Rosacea |
Chapter 93. Systemic Treatment
- Systemic (oral) treatments for rosacea include antibiotics such as tetracyclines, macrolides, and metronidazole, as well as oral isotretinoin.
- The only FDA-approved systemic treatment for papulopustular rosacea is antiinflammatory dose doxycycline 40 mg.
- Doxycycline inhibits the activity of matrix metalloproteinases (MMPs) in human skin. So, it prevents the tryptic KLK activation by MMPs and the production of the active antimicrobial peptide LL-37 (cathelicidin).
93.1 | Introduction |
93.2 | Overview of the Treatment Principles |
93.3 | Systemic Therapies for Rosacea |
93.3.1 | Antibiotics: Tetracyclines, Macrolides, Metronidazole |
93.4 | Isotretinoin |
93.5 | Oral Zinc Sulfate |
93.6 | Other Oral Therapies |
93.7 | Systemic Therapies for Rosacea: Where Do We Stand? |
93.8 | Future Perspectives |
Chapter 94. Laser and Light Therapy of Rosacea
- Faster and more complete symptom resolution can be achieved by laser and IPL when they are paralleled with topical and oral rosacea treatment agents. Though high cost is a practical problem in clinics, these non-ablative lasers are well tolerated and have little side effects. In addition to erythema, these laser therapies may induce remodeling of abnormal dermal connective tissue by thermally induced fibroblast or endothelial damage.
94.1 | Vascular Laser |
94.2 | Intense Pulsed Light |
94.3 | Other Laser Therapies in Rosacea |
Chapter 95. Nonclassical Treatments
- Emerging treatments results from anti- inflammatory activity of certain compounds like zinc, neurophysiological activity like oxymetazoline or ondansetrone, or probably from antifibrotic compounds in the future.
95.1 | Introduction |
95.2 | Treatment of Flushing |
95.3 | Treatment of Teleangiectasias and Vascular Sprouts |
95.4 | Treatment of Papulopustules (Inflammatory Rosacea) |
95.5 | Treatment of Phymas |
95.6 | Treatment of Ocular Rosacea |
Chapter 96. Cosmetics in Rosacea
- Skin care products and cosmetics can be valuable in the rosacea patient to complement prescription therapies and provide redness camouflage.
- Cleansers for rosacea patients should preserve the intercellular lipids while maintaining a healthy biofilm.
- Moisturizers for rosacea patients should assist in barrier repair and provide broad-spectrum photoprotection.
- Cosmeceuticals with anti-inflammatory properties may be a useful adjunct to traditional therapy in some rosacea patients.
96.1 | Introduction |
96.2 | Sensitive Skin and Rosacea |
96.3 | Facial Product Testing for Sensitive Skin |
96.4 | Facial Cleansers |
96.5 | Facial Moisturizers |
96.6 | Facial Cosmeceuticals |
96.7 | Facial Camouflaging Cosmetics |
96.8 | Facial Cosmetics and Skin Care in the Problem Patient |
96.9 | Summary |
Chapter 97. Treatment of Rhinophyma
- The cornerstone of drug therapy of rhinophyma in milder cases is systemic isotretinoin.
- The more advanced cases of rhinophyma need a surgical approach. Healing by secondary intention is the gold standard with superior cosmetic outcome.
97.1 | Introduction |
97.2 | Retinoid Therapy |
97.3 | Antifibrotic Treatment |
97.4 | Ablative Treatment |
Chapter 98. The Future of Rosacea Treatment
- Some complementary and alternative medicines have effects, such as anti-inflammatory and antimicrobial actions, that may impact on rosacea.
- Low-dose antimicrobial agents, topical benzoyl peroxide, trichloroacetic acid skin peels and photodynamic therapy have been shown to be effective in papulopustular rosacea (PPR).
- The development of drugs directed at sebaceous gland hypertrophy may aid patients with phymatous rosacea.
98.1 | Introduction |
98.2 | Classification of Rosacea |
98.3 | Present Treatmentand Future Options |
98.3.1 | ErythematotelangiectatiRosacea (Subtype 1) |
98.3.2 | Papulopustular Rosacea (Subtype2) |
98.3.3 | Phymatous Rosacea (Subtype 3) |
98.3.4 | Ocular Rosacea (Subtype 4) |
Chapter 99. Impact of Rosacea on Quality of Life
- The impact of rosacea may extend far beyond the physical lesions into the psyche of patients.
- Low self esteem, low self confidence, social anxiety, depression and social avoidance behaviour are important ways in which a rosacea patient’s quality of life may be impacted.
- Emotional distress can both be a triggering factor as well as a consequence of rosacea.
- The magnitude of quality of life impact may vary with different types of rosacea.
99.1 | Introduction |
99.2 | Quality of Life Impact of Rosacea |
99.3 | Measurement of Quality of Life in Rosacea Patients |
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This book certainly sounds comprehensive. Thanks so much for this (& all your other) helpful & informative posts.