A link to this paper was recently posted recently by Brian to rosacea-support.
SKINmed. 2003 Jan-Feb;2(1):43-7.
The proposed inflammatory pathophysiology of rosacea: implications for treatment.
Millikan L. The Department of Dermatology, Tulane University School of Medicine, 1430 Tulane Avenue TB36, New Orleans, LA 70112, USA.
Abstract and Introduction: The pathophysiology of the vascular and inflammatory stages of facial rosacea and proposes an underlying cause is reviewed. It can be argued that all the stigmata of rosacea are manifestations of an inflammatory process: neutrophilic dermatosis. For this reason, treatments that block neutrophil involvement in the development of rosacea, such as topical metronidazole and systemic antibodies, should be considered first-line therapy for all stages of the disease.
Conclusion: The pathophysiology of rosacea is still a subject of controversy. Research suggests that various immune cells and inflammatory mediators play a role in the vascular, inflammatory, and hyperplasia stages of this disorder. Neutrophils, in particular, may be implicated in the disorder, with the stigmata of the rosacea manifestations of neutrophilic dermatosis. Treatments such as topical metronidazole and certain systemic tetracyclines and macrolides inhibit inflammatory mediator release from these leukocytes. Thus, these agents should be considered first-line therapy for all stages of rosacea.
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