ORIGINAL ARTICLES   

Giornale Italiano di Dermatologia e Venereologia 2004 June;139(3):155-64

Copyright © 2004 EDIZIONI MINERVA MEDICA

language: English, Italian

Helicobacter pylori in rosacea. A systematic review of the literature

Repetto M., Rebora A.

Department of Dermatology, University of Genoa, Genoa, Italy

Aim. The possible role of Helicobacter pylori in rosacea has been suggested by the frequent association of rosacea with gastric disorders and the well known activity of oral metronidazole on both rosacea and H. pylori infection. In addition, several antibiotics, as different as tetracyclines and macrolides, are equally effective on both conditions. The possible association has been the object of several papers with contrasting results. The aim of this study was to establish if H. pylori is more frequent in rosacea patients than in the population at large.
Methods. The standard search strategy of the Cochrane Collaboration Group on PubMed MEDLINE® was used and ISITRIAL and hand screening of dermatological journals and Congress proceedings were carried out. Only English–written articles were considered. All studies included a control population. Anecdotal reports and uncontrolled series were excluded. The cases studied were patients with rosacea. The presence of H. pylori infection was indicated by several different assays on gastric biopsy specimens (culture, rapid urease test and histology with Warthin-Starry method), by 13C-urea breath test and serology. Two reviewers assessed eligibility and study quality. Analysis was carried out using Metaview in RevMan 4.1 for random effects. Ten studies were included.
Results. The odds ratio for the absence of H. pylori infection in controls was 2.22 (95% confidence interval 1.74-2.83). Heterogeneity was highly significant, however.
Conclusion. Patients with rosacea are likely to carry a higher risk to bear H. pylori than controls, but future investigators should pay more attention to the homogeneity of the stages of rosacea, of the participants and of the methods used to detect the infection.