Nelson Jessie M, Rizzo Jason M, Greene Rachel K, Fahlstrom Kathryn, Troost Jonathan P, Helfrich Yolanda R, Nakamura Mio
Dermatology, University of Michigan, Ann Arbor, USA.
Dermatology, The Woodruff Institute for Dermatology, Bonita Springs, USA.
Cureus. 2024 Oct 25;16(10):e72363. doi: 10.7759/cureus.72363. eCollection 2024 Oct.
Systemic abnormalities in the immune system may contribute to rosacea pathogenesis. Several studies have found a higher prevalence of abnormal bacterial growth, such as () and small intestinal bacterial overgrowth (SIBO) in rosacea subjects. However, discrepancies remain in the literature, likely perpetuated by inconsistent testing methods and incomplete controlling for potential confounders.
We aimed to evaluate the prevalence of and SIBO in rosacea subjects after controlling for several potential confounders.
This cross-sectional study evaluated subjects with papulopustular or erythematotelangiectatic rosacea. Subjects with previous or existing gastrointestinal (GI) disease, GI surgery, autoimmune disorders, immunosuppression, or significant comorbidities were excluded. Certain medication use (antibiotics, steroids, GI-modulating medications, anti-inflammatories) required an appropriate washout period. Rosacea history and severity were assessed. Subjects answered questions regarding their rosacea and GI health. andSIBO were evaluated by C-urea breath test and glucose-breath test methods, respectively.
Of 27 subjects, 14.8% (N=4) tested positive for and 33.3% (N=9) tested positive for SIBO. Compared to the general population prevalence, the proportion of in the rosacea cohort was significantly less (p=0.02). Though the estimated population prevalence of SIBO had a wider range, compared to midrange, the prevalence of SIBO in the rosacea cohort was greater (p<0.001). There were no significant associations between demographics, rosacea characteristics, or GI symptoms and or SIBO positivity. Conclusion: When eliminating several potential confounders, SIBO is more prevalent in subjects with rosacea compared to the general population. Thus, SIBO may be associated with rosacea, though it remains incompletely understood whether SIBO itself contributes to rosacea pathophysiology or rather SIBO prevalence and rosacea are both downstream effects of abnormalities in systemic immunity. Future studies are warranted to elucidate this relationship further, though this observed association may be promising for novel therapeutic targets in rosacea treatment.
免疫系统的全身异常可能与玫瑰痤疮的发病机制有关。多项研究发现，玫瑰痤疮患者中异常细菌生长的患病率较高，如（此处原文缺失具体细菌名称）和小肠细菌过度生长（SIBO）。然而，文献中仍存在差异，这可能是由于检测方法不一致以及对潜在混杂因素的控制不完整所致。
我们旨在评估在控制了多个潜在混杂因素后，玫瑰痤疮患者中（此处原文缺失具体细菌名称）和SIBO的患病率。
这项横断面研究评估了丘疹脓疱型或红斑毛细血管扩张型玫瑰痤疮患者。排除既往或现有胃肠道疾病、胃肠道手术、自身免疫性疾病、免疫抑制或严重合并症的患者。某些药物使用（抗生素、类固醇、胃肠道调节药物、抗炎药）需要适当的洗脱期。评估玫瑰痤疮病史和严重程度。受试者回答有关其玫瑰痤疮和胃肠道健康的问题。分别通过C -尿素呼气试验和葡萄糖呼气试验方法评估（此处原文缺失具体细菌名称）和SIBO。
27名受试者中，14.8%（N = 4）的（此处原文缺失具体细菌名称）检测呈阳性，33.3%（N = 9）的SIBO检测呈阳性。与一般人群患病率相比，玫瑰痤疮队列中（此处原文缺失具体细菌名称）的比例显著较低（p = 0.02）。尽管估计的SIBO人群患病率范围更广，但与中间范围相比，玫瑰痤疮队列中SIBO的患病率更高（p < 0.001）。人口统计学、玫瑰痤疮特征或胃肠道症状与（此处原文缺失具体细菌名称）或SIBO阳性之间无显著关联。
在排除多个潜在混杂因素后，与一般人群相比，玫瑰痤疮患者中SIBO更为普遍。因此，SIBO可能与玫瑰痤疮有关，尽管SIBO本身是否导致玫瑰痤疮病理生理变化，或者SIBO患病率和玫瑰痤疮是否都是全身免疫异常的下游效应，仍不完全清楚。尽管这种观察到的关联可能为玫瑰痤疮治疗中的新治疗靶点带来希望，但未来仍需进一步研究以阐明这种关系。
