Pathophysiology of rosacea: redness, telangiectasia, and rosacea.

The pathophysiology of rosacea involves a large number of factors that are at times difficult to correlate. There is not a single physiopathological model. Nevertheless, today it seems to have been established that two essential factors are involved: vascular and inflammatory. The disease occurs in individuals with a predisposition, mainly a light phototype subjected to substantial variations in climate. On a background of primary vascular anomaly, external factors (climate, exposure to ultraviolet rays, cutaneous flora, etc.) contribute to the development of abnormal superficial blood vessels, with a low permeability. The edema that results undoubtedly favors the colonization and multiplication of Demodex folliculorum. This parasite creates inflammation, directly and indirectly, which is seen in the papules and pustules as well as granulomas. Inflammation from rosacea is also characterized by innate immune system anomalies, with an increase in the expression of epidermal proteases and production of pro-inflammatory cathelicidin peptides. In addition, facial hypersensitivity exists, even though the cutaneous barrier is not altered. Finally, rhinophyma remains poorly explained; the vascular abnormalities induce local production of transforming growth factor ß1 (TGF-ß1) capable of creating fibrosis and therefore cutaneous thickening.

[Rosacea 2009 : new advances in pathophysiology, clinical staging and therapeutic strategies]. / Rosazea 2009 : Neue Erkenntnisse zur Pathophysiologie, klinische Manifestationsformen und Therapiestrategien.

Rosacea is one of the most common dermatoses of adults. In recent years many studies have contributed to a better understanding of the pathophysiology of rosacea. They suggest that an altered innate immune response is involved in the vascular and inflammatory manifestations seen in rosacea. A good understanding of the disease and its special features is necessary for the differential diagnosis of the many clinical subtypes and for a stage- and phase-specific treatment approach. Topical treatments that are widely accepted are metronidazole and azelaic acid; agents under investigation that show promise include permethrin, calcineurin inhibitors and sulfur compounds. For systemic therapy antibiotics (tetracyclines, macrolides) and recently doxycycline in anti-inflammatory rather than anti-microbial dosages are used, as well as isotretinoin in severe cases. Findings such as rhinophyma and telangiectases can be treated using different laser systems or dermabrasion. This article gives an overview regarding rosacea, a challenging condition with multiple therapeutic options.

Rinofima: revisäo da literatura / Rhinophyma: review of the literature

O rinofima é um tumor benigno reconhecido clinicamente por uma hipertrofia nasal, decorrente de hiperplasia das glândulas sebáceas, com eritema da pele e telangiectasias. O resultado é um desfiguramento podendo ocasionar bloqueio funcional nasal e infecçäo recorrente. O termo é derivado do grego e foi utilizado pela primeira vez por Hebra, em 1845. E 12 vezes mais frequente em homens e atinge caracteristicamente caucasianos brancos, entre 40 e 60 anos. E raro em negros e orientais. Usualmente restrito à metade inferior do nariz, pode ainda desenvolver-se em outros locais, como o mento, pavilhäo auricular, regiäo malar e glabela. Embora a causa seja desconhecida, múltiplos fatores devem estar envolvidos, como a açäo dos hormônios androgênicos, fatores ambientais, alimentares e psicossomáticos. Várias modalidades terapêuticas têm sido reportadas na literatura, como a eletrodissecçäo, a dermoabrasäo, a ressecçäo com laser, bisturi de Shaw, entre outras

Rhinophyma: review of pathophysiology and treatment.

Rhinophyma is an uncommon condition that often results in both functional as well as cosmetic impairment. Different treatment modalities have been devised, with varying degrees of success. A review of the pathophysiology of this condition, together with the authors' experience in managing 76 cases utilizing six different treatment methods, is presented. A simple and atraumatic surgical method has evolved using a Weck blade and argon beam coagulator. The operating time is decreased significantly when compared to other techniques with equal to superior cosmetic results.

El rinofima a través del arte / Rhinophima and the arts

Las artes pictóricas y escultóricas, de siempre, se han interesado por la medicina en general y por la patología en particular. En el presente artículo se detallan exhaustivamente aquellas representaciones artísticas cuyo eje principal es el rinofima