Cutaneous inflammatory biomarkers in rosacea and their association with disease severity

BACKGROUND AND OBJECTIVES: Rosacea is a common chronic disease of the facial region characterized by erythema, flushing, papules, pustules, phymatous changes, and ocular symptoms. Despite its prevalence, the inflammatory pathways underlying rosacea remain poorly understood, and reliable biomarkers for assessing disease severity have not been established. METHODS: In this study, we employed a noninvasive skin tape stripping technique to evaluate levels of certain cutaneous biomarkers in patients with rosacea compared with skin-healthy individuals. RESULTS: Levels of the following biomarkers were increased in patients with rosacea compared with skin-healthy controls: interleukin (IL)-1RA, IL-8, IL12p70, IL-17A, IL-17E, IL-17F, IL-18, IL-22, interferon-gamma inducible protein (IP)-10, vascular endothelial growth factor (VEGF)-a and interferon gamma (IFN-γ). Increasing severity of rosacea (measured by the Rosacea Area and Severity Index) was positively correlated with higher concentrations of IFN-γ, IL-18, IP-10, VEGF-α and IL-17F. CONCLUSIONS: Our data suggest that dysregulation of both innate and adaptive immune responses, particularly involving T-helper (Th)1 and Th17 pathways, plays a critical role in rosacea pathogenesis and severity.