Baldwin Hilary E
SUNY Downstate Medical Center, New York, NY 11203, USA.
J Drugs Dermatol. 2012 Jun;11(6):725-30.
Rosacea is a common disorder that is both under recognized and undertreated. Prevalence figures indicate that it may be present in 1 of every 10 adults in a primary care waiting room. Untreated, patients with rosacea can suffer significant emotional, workplace, and social impairments. While rosacea has been recognized since ancient times, only recently have investigators begun to identify the pathophysiologic elements responsible for the characteristic erythema, flushing, dysesthesias, and papulopustular manifestations of the disease. Although the etiology of rosacea is unclear, inflammation appears to be a central element. Experimental evidence suggests that abnormalities of the skin's innate and adaptive immune responses may play pivotal roles. Once recognized, effective topical and systemic therapies can be prescribed to lessen the impact of the disease on the patient's life. Although initially administered in an empiric fashion, it now seems clear that the role of antibiotics in patients with rosacea depends upon their anti-inflammatory rather than their antimicrobial properties. Consequently, practitioners have the opportunity to practice good antibiotic stewardship when treating the disease, particularly with systemic therapies. Therapy with subantimicrobial dosing and with topical treatments can modulate the inflammation of rosacea without exerting antibiotic pressure responsible for the emergence of antibiotic resistance.
酒渣鼻是一种常见的疾病，既未得到充分认识，也未得到充分治疗。患病率数据表明，在初级保健候诊室中，每10名成年人中可能就有1人患有此病。若不治疗，酒渣鼻患者可能会遭受严重的情绪、工作场所和社交方面的损害。虽然酒渣鼻自古以来就已被认识到，但直到最近，研究人员才开始确定导致该疾病特征性红斑、潮红、感觉异常和丘疹脓疱表现的病理生理因素。尽管酒渣鼻的病因尚不清楚，但炎症似乎是一个核心因素。实验证据表明，皮肤先天性和适应性免疫反应的异常可能起关键作用。一旦确诊，就可以开出有效的局部和全身治疗方案，以减轻该疾病对患者生活的影响。尽管最初是以经验性方式给药，但现在似乎很清楚，抗生素在酒渣鼻患者中的作用取决于其抗炎特性而非抗菌特性。因此，从业者在治疗该疾病时，尤其是采用全身治疗时，有机会践行良好的抗生素管理。采用亚抗菌剂量治疗和局部治疗可以调节酒渣鼻的炎症，而不会产生导致抗生素耐药性出现的抗生素压力。
