Original article
Rosacea is associated with chronic systemic diseases in a skin severity–dependent manner: Results of a case-control study

A portion of this work was presented at the Society for Investigative Dermatology Annual Meeting in Albuquerque, New Mexico, May 7-10, 2014.
https://doi.org/10.1016/j.jaad.2015.07.009Get rights and content

Background

Rosacea is a common chronic inflammatory dermatosis of unclear origin. It has been associated with systemic comorbidities, but methodical studies addressing this association are lacking.

Objective

We evaluated: (1) the association between rosacea and systemic comorbidities; and (2) if the severity of rosacea is impacted by comorbidities.

Methods

This was a case-control study: patients with rosacea were matched (1:1) to rosacea-free control subjects by age, sex, and race. Relative risk estimates were calculated using logistic regression as odds ratios with 95% confidence intervals.

Results

Among 130 participants (65 patients/65 control subjects), we observed a significant association between rosacea and allergies (airborne, food), respiratory diseases, gastroesophageal reflux disease, other gastrointestinal diseases, hypertension, metabolic and urogenital diseases, and female hormone imbalance. Compared with mild rosacea, moderate to severe rosacea was significantly associated with hyperlipidemia, hypertension, metabolic diseases, cardiovascular diseases, and gastroesophageal reflux disease.

Limitations

This was a case-control study with moderate sample size. Associated medical conditions were self-reported and could not always be confirmed by medication use and medical records.

Conclusions

Rosacea is associated with numerous systemic comorbid diseases in a skin severity–dependent manner. Physicians should be aware of these associations to provide comprehensive care to patients with rosacea, especially to those with more severe disease.

Section snippets

Study design

The study was a single-center case-control study with prospective recruitment of patients with rosacea and matched rosacea-free control subjects. The Johns Hopkins Institutional Review Board approved the study (NA_00078020/October 18, 2012). Study procedures were conducted at the Johns Hopkins Department of Dermatology in Baltimore, MD, between November 2012 and August 2013.

Study cohort

Eligible cases were patients 18 years of age or older with a diagnosis of rosacea. Rosacea-free control subjects were

Participant characteristics

A total of 130 participants were recruited for the study, 65 patients and 65 control subjects. Each patient was matched to a control subject by age (P = .6), sex (P = 1.0), and race (P = 1.0). The mean (SD) age of cases was 50.6 (14.1) years, 43 (66.2%) were female, and 62 (95.4%) were Caucasian. Body mass index (P = .1), sun exposure (P = .3), smoking status (P = 1.0), alcohol intake (P = .5), and caffeine intake (P = .3) were comparable between cases and controls. Cases more frequently had a

Discussion

Our case-control study reports significant associations between rosacea and several systemic comorbidities. Patients with rosacea have significantly higher odds of experiencing allergies (airborne and food), respiratory diseases, GERD/other GI diseases, hypertension, metabolic diseases, urogenital diseases, and female hormone imbalance compared with age-, sex-, and race-matched control subjects originating from the same population. Moderate to severe rosacea13 is associated with hyperlipidemia,

References (14)

There are more references available in the full text version of this article.

Cited by (0)

Funding sources: None.

Conflicts of interest: None declared.

View full text