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Rivista di Dermatologia e Malattie Sessualmente Trasmesse
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 2016 Feb 18
Etiopathogenesis of rosacea: a prospective study with a three-year follow-up
Arianna F. AGNOLETTI 1, Elena DE COL 1, Aurora PARODI 1, Irene SCHIAVETTI 2, Vincenzo SAVARINO 3, Alfredo REBORA 1, Stefania PAOLINO 1, Emanuele COZZANI 1, Francesco DRAGO 1
1 DISSAL Section of Dermatology IRCCS University of Genoa, San Martino, IST Hospital, Genoa, Italy; 2 DISSAL Biostatistics Unit, University of Genoa, Genoa, Italy; 3 Department of Internal Medicine and Medical Specialities, University of Genoa, Genoa, Italy
BACKGROUND: To assess the role of Demodex folliculorum (DF), Helicobacter pylori (HP) small intestinal bacterial overgrowth (SIBO) in rosacea development and maintenance.
METHODS: A case-control study including 60 patients with rosacea and 40 healthy controls was performed. All the patients underwent standardised skin surface biopsy to investigate DF, Urea breath test for HP and lactulose breath test and glucose breath test for SIBO. Etiological therapy was started in the following order: acaricidal treatment, antibiotics for SIBO and HP. These exams were repeated after 3 years. Statistical analysis was performed.
RESULTS: As regards the 88 patients who completed the entire follow-up, DF positivity was found in the 47.7%, SIBO in the 25.0% and HP in the 21.6%. SIBO significantly prevailed
in papulopustular rosacea, while HP in erythrosis. At the 6-month follow up, the 61% of patients were in remission. After 3 years the 18% dropped out, the remaining patients repeated all the investigations. The majority of patients were still in remission and negative for HP while only 5 were positive for DF and 4 for SIBO.
CONCLUSIONS: SIBO was the most relevant factor in papulopustular rosacea. Its treatment was crucial in improvement and in maintaining the clinical remission.