Hopp til hovedinnhold

Rosacea

Sist oppdatert: Sist revidert:
Sist revidert av:


Definisjon:
Kronisk hudsykdom i ansiktet karakterisert ved anfall med flushing, etterhvert erytem og ev. papler og pustler. Ukjent årsak
Forekomst:
Debut oftest i 30-50 års alder, prevalens 3-5%
Symptomer:
Flushing, rubor, ev. papler og pustler symmetrisk i ansiktet. Kan også føre til fortykkelse og knuter i huden
Funn:
Erytem, papler, pustler i panne, kinn eller på nesa
Diagnostikk:
Er en klinisk diagnose
Behandling:
Unngå utløsende faktorer. Lokalbehandling med antibiotika eller aknemiddel, ev. antibiotika ved mer uttalte plager. Kirurgisk behandling kan være aktuelt
  1. van Zuuren EJ. Rosacea. N Engl J Med 2017; 377: 1754-64. pmid:29091565 PubMed  
  2. Oge LK, Muncie HL, Phillips-Savoy AR. Rosacea: Diagnosis and treatment. Am Fam Physician. 2015 Aug 1;92(3):187-196.
  3. Barakji YA, Rønnstad ATM, Christensen MO et al. Assessment of Frequency of Rosacea Subtypes in Patients With Rosacea: A Systematic Review and Meta-analysis. JAMA Dermatol. 2022 Apr 6. Epub ahead of print. PMID: 35385049. PubMed  
  4. Helsedirektoratet. Nasjonale faglige retningslinjer for antibiotikabruk i primærhelsetjenesten. Sist faglig oppdatert: 16. november 2021.
  5. Spoendlin J, Voegel JJ, Jick SS, Meier CR. A study on the epidemiology of rosacea in the U.K. Br J Dermatol. 2012;167(3):598–605.
  6. Yang X. Relationship between Helicobacter pylori and Rosacea: review and discussion. BMC Infect Dis. 2018 Jul 11;18(1):318. PMID: 29996790 PubMed  
  7. Gravina AG, Federico A, Ruocco E, et al. Helicobacter pylori infection but not small intestinal overgrowth may play a pathogenetic role in rosacea. United European Gastroenterology Journal 2015; 3: 17-24. doi:10.1177/2050640614559262 DOI  
  8. Yamasaki K, Di Nardo A, Bardan A et al. Increased serine protease activity and cathelicidin promotes skin inflammation in rosacea. Nat Med 2007; 13: 975-81. PubMed  
  9. Whitfeld M, Gunasingam N, Leow JL, et al. Staphylococcus epidermidis: A possible role in the pustules of rosacea. J Am Acad Dermatol 2011; 64(1): 49-52. PMID: 20943287 PubMed  
  10. Aroni K, Tsagroni E, Kavantzas N, et al. Study of the pathogenesis of rosacea: how angiogenesis and mast cells may participate in a complex multifactorial process. Arch Dermatol Res 2008; 300: 125-31. pmid:18071725 PubMed  
  11. Kligman AM. A personal critique on the state of knowledge of rosacea. Dermatology. 2004;208(3):191–197.
  12. Jarell, AD. Rosacea. BMJ Best Practice. Last reviewed 30 Sep, 2020. bestpractice.bmj.com  
  13. Steinhoff M, Schauber J, Leyden JJ. New insights into rosacea pathophysiology: a review of recent findings. J Am Acad Dermatol. 2013;69(6 suppl 1):S15–S26.
  14. Gallo RL, Granstein RD, Kang S, et al. Rosacea comorbidities and future research: The 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2018;78(1):167-170. PMID: 29102687 PubMed  
  15. Zierl S, Hildebrand JA, Guertler A et al. Clinical clues to identify patients with ocular rosacea - a Germany-wide epidemiologic analysis. Int J Dermatol. 2022 Jul;61(7):880-885.Epub 2022 May 17. PMID: 35579395 PubMed  
  16. Su D, Drummond PD. Blushing propensity and psychological distress in people with rosacea. Clin Psychol Psychother. 2012;19(6):488-95. PMID: 21698719 PubMed  
  17. Goldgar C, Keahey DJ, Houchins J. Treatment options for acne rosacea. Am Fam Physician 2009; 80: 461-8. American Family Physician  
  18. Maier LE. Management of rosacea. UpToDate, last updated Feb 24, 2020. UpToDate  
  19. van Zuuren EJ, Fedorowicz Z, Carter B, et al. Interventions for rosacea. Cochrane Database of Systematic Reviews 2015, Issue 4. Art. No.: CD003262. DOI: 10.1002/14651858.CD003262.pub5. DOI  
  20. Taieb A, Khemis A, Ruzicka T, et al. Maintenance of remission following successful treatment of papulopustular rosacea with ivermectin 1% cream vs. metronidazole 0.75% cream: 36-week extension of the ATTRACT randomized study. Journal of the European Academy of Dermatology and Venereology, 2015. PMID: 26691278 PubMed  
  21. Del Rosso JQ, Webster GF, Jackson M, et al. Two randomized phase III clinical trials evaluating anti-inflammatory dose doxycycline (40-mg doxycycline, USP capsules) administered once daily for treatment of rosacea. J Am Acad Dermatol 2007; 56: 791–802. PMID: 17367893 PubMed  
  22. Sanchez J, Somolinos AL, Almodóvar PI, et al. A randomized, double-blind, placebo-controlled trial of the combined effect of doxycycline hyclate 20-mg tablets and metronidazole 0.75% topical lotion in the treatment of rosacea. J Am Acad Dermatol 2005; 53: 791. pmid:16243127 PubMed  
  23. Webster GF. An open-label, community-based, 12-week assessment of the effectiveness and safety of monotherapy with doxycycline 40 mg (30-mg immediate-release and 10-mg delayed-release beads). Cutis 2010; 86: 7. pmid:21229826 PubMed  
  24. Bernstein EF, Schomacker K, Paranjape A, Jones CJ. Pulsed dye laser treatment of rosacea using a novel 15 mm diameter treatment beam. Lasers Surg Med. 2018 Oct;50(8):808-812. Epub 2018 Apr 10. PMID: 29635699 PubMed  
  25. Tanghetti E, Del Rosso JQ, Thiboutot D, et al. Consensus recommendations from the American Acne & Rosacea Society on the management of rosacea, part 4: a status report on physical modalities and devices. Cutis. 2014;93(2):71–76.
  26. Krausz AE, Goldberg DJ, Ciocon DH, Tinklepaugh AJ. Procedural management of rhinophyma: A comprehensive review. J Cosmet Dermatol 2018; 17: 960-7. pmid:30225926 PubMed  
  27. Cuevas P, Angulo J, Giménez-Gallego G. Long term effectiveness of dobesilate in the treatment of papulopustular rosacea. BMJ Case Reports 2012; : doi:10.1136/bcr.08.2011.4579 . DOI  
  28. Hua TC, Chung PI, Chen YJ, et al. Cardiovascular comorbidities in patients with rosacea: A nationwide case-control study from Taiwan. J Am Acad Dermatol 2015; 73: 249-54. DOI: 10.1016/j.jaad.2015.04.028 DOI  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Sylvi Torvund, spesialist i allmennmedisin, Nidarvold legesenter, Trondheim
  • Kristin Ryggen, overlege, Hudavdelingen, Regionsykehuset i Trondheim