The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology (한방안이비인후피부과학회지)

The Society of Korean Medicine Ophthalmology, Otolaryngology & Dermatology (대한한방안이비인후피부과학회)
권호 표지
DOI QR코드

DOI QR Code

A Review of the Latest Research Trends in Rosacea and Recommendations for More Effective Oriental Medicine Treatments - Focusing on Autonomic Nervous System Regulation -

주사피부염의 최신 연구 동향 및 더욱 효과적인 한방치료를 위한 제언 - 자율신경 기능조절을 중심으로 -

  • EunKyung Lee (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, Kyung Hee University) ;
  • Byunghyun Kim (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, Kyung Hee University) ;
  • YeEun Hong (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, Kyung Hee University) ;
  • Heejae Lee (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, Kyung Hee University) ;
  • Kyuseok Kim (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, Kyung Hee University) ;
  • Haejeong Nam (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, Kyung Hee University) ;
  • YoonBum Kim (Department of Ophthalmology, Otolaryngology and Dermatology of Korean Medicine, Kyung Hee University)
  • 이은경 (경희대학교 한의과대학 안이비인후피부과학교실) ;
  • 김병현 (경희대학교 한의과대학 안이비인후피부과학교실) ;
  • 홍예은 (경희대학교 한의과대학 안이비인후피부과학교실) ;
  • 이희재 (경희대학교 한의과대학 안이비인후피부과학교실) ;
  • 김규석 (경희대학교 한의과대학 안이비인후피부과학교실) ;
  • 남혜정 (경희대학교 한의과대학 안이비인후피부과학교실) ;
  • 김윤범 (경희대학교 한의과대학 안이비인후피부과학교실)
  • Received : 2024.07.05
  • Accepted : 2024.08.02
  • Published : 2024.08.25
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives : The aim of this study is to explore the potential of oriental medicine in managing rosacea through the regulation of the autonomic nervous system. Methods : We reviewed studies on the pathophysiology and medical treatment (both western and oriental medicine) of rosacea, as well as the relationship between rosacea and the autonomic nervous system, using four databases: PubMed, OASIS, RISS, and NDSL. Results : Rosacea is a chronic recurrent inflammatory disease characterized by symptoms such as facial flushing, inflammatory papules, and pustules. In Western medicine, symptomatic treatments like vasoconstrictors, doxycycline, and anti-inflammatory drugs are primarily used. According to the pathophysiological mechanisms of rosacea, the autonomic nervous system is closely related, particularly with sympathetic overactivity causing vasodilation and local inflammation in rosacea patients. Additionally, recent studies report that rosacea patients frequently exhibit neuropsychiatric symptoms such as anxiety, depression, and insomnia, which are closely linked to autonomic dysfunction and contribute to the worsening of skin symptoms. However, current studies on the use of oriental medicine for rosacea focus mainly on anti-inflammatory effects at the local level, similar to conventional treatments. Conclusions : Based on the close involvement of the autonomic nervous system in the pathophysiological mechanisms of rosacea and numerous studies showing that oriental medicine can effectively regulate autonomic function, applying such treatments to rosacea patients may improve not only skin symptoms but also the frequently associated neuropsychiatric symptoms like anxiety, depression and insomnia.

Keywords

References

  1. Clanner-Engelshofen BM, Bernhard D, Dargatz S, Flaig MJ, Gieler U, Kinberger M, et al. S2k guideline: Rosacea. J Dtsch Dermatol Ges. 2022;20(8):1147-65. https://doi.org/10.1111/ddg.14849
  2. Metzler-Wilson K, Toma K, Sammons DL, Mann S, Jurovcik AJ, Demidova O, et al. Augmented supraorbital skin sympathetic nerve activity responses to symptom trigger events in rosacea patients. J Neurophysiol. 2015;114(3):1530-7. https://doi.org/10.1152/jn.00458.2015
  3. Li YW, Li W, Wang ST, Gong YN, Dou BM, Lyu ZX, et al. The autonomic nervous system: A potential link to the efficacy of acupuncture. Front Neurosci. 2022;16:1038945.
  4. Sinikumpu SP, Jokelainen J, Tasanen K, Timonen M, Huilaja L. Association of Rosacea with Depressive and Anxiety Symptoms: A General Population Study. Dermatology. 2024;240(2):189-94. https://doi.org/10.1159/000535034
  5. Hung CT, Chiang CP, Chung CH, Tsao CH, Chien WC, Wang WM. Risk of psychiatric disorders in rosacea: A nationwide, population-based, cohort study in Taiwan. J Dermatol. 2019;46(2):110-6. https://doi.org/10.1111/1346-8138.14705
  6. Yang Z, Zhao W, Hu M, Wu P, Zhang X, Wang T, et al. Quality of life, sleep and anxiety status among patients with rosacea in the Yunnan plateau region: A 2-year retrospective study. Skin Res Technol. 2024;30(3):e13616.
  7. Wang B, Huang Y, Tang Y, Zhao Z, Shi W, Jian D, et al. Paroxetine is an effective treatment for refractory erythema of rosacea: Primary results from the Prospective Rosacea Refractory Erythema Randomized Clinical Trial. Journal of the American Academy of Dermatology. 2023;88(6):1300-7. https://doi.org/10.1016/j.jaad.2023.01.044
  8. van Zuuren EJ, Arents BWM, van der Linden MMD, Vermeulen S, Fedorowicz Z, Tan J. Rosacea: New Concepts in Classification and Treatment. Am J Clin Dermatol. 2021;22(4):457-65. https://doi.org/10.1007/s40257-021-00595-7
  9. Kim JY, Kim YJ, Lim BJ, Sohn HJ, Shin D, Oh SH. Increased Expression of Cathelicidin by Direct Activation of Protease-Activated Receptor 2: Possible Implications on the Pathogenesis of Rosacea. Yonsei Med J. 2014;55(6):1648-55. https://doi.org/10.3349/ymj.2014.55.6.1648
  10. Buddenkotte J, Steinhoff M. Recent advances in understanding and managing rosacea [version 1; peer review: 3 approved]. F1000Research. 2018;7(1885).
  11. Woo YR, Lim JH, Cho DH, Park HJ. Rosacea: Molecular Mechanisms and Management of a Chronic Cutaneous Inflammatory Condition. International Journal of Molecular Sciences. 2016;17(9):1562.
  12. Schwab VD, Sulk M, Seeliger S, Nowak P, Aubert J, Mess C, et al. Neurovascular and neuroimmune aspects in the pathophysiology of rosacea. J Investig Dermatol Symp Proc. 2011;15(1):53-62. https://doi.org/10.1038/jidsymp.2011.6
  13. Piwnica D, Rosignoli C, de Menonville ST, Alvarez T, Schuppli Nollet M, Roye O, et al. Vasoconstriction and anti-inflammatory properties of the selective α-adrenergic receptor agonist brimonidine. J Dermatol Sci. 2014;75(1):49-54.
  14. Hoover RM, Erramouspe J. Role of Topical Oxymetazoline for Management of Erythem atotelangiectatic Rosacea. Ann Pharmacother. 2018;52(3):263-7. https://doi.org/10.1177/1060028017740139
  15. Anderson MS, Nadkarni A, Cardwell LA, Alinia H, Feldman SR. Spotlight on brimonidine topical gel 0.33% for facial erythema of rosacea: safety, efficacy, and patient acceptability. Patient Prefer Adherence. 2017;11:1143-50. https://doi.org/10.2147/PPA.S115708
  16. Patel NU, Shukla S, Zaki J, Feldman SR. Oxymetazoline hydrochloride cream for facial erythema associated with rosacea. Expert Rev Clin Pharmacol. 2017;10(10):1049-54. https://doi.org/10.1080/17512433.2017.1370370
  17. Del Rosso JQ, Kircik LH. Update on the management of rosacea: a status report on the current role and new horizons with topical azelaic acid. J Drugs Dermatol. 2014;13(12):s101-7.
  18. Reinholz M, Ruzicka T, Steinhoff M, Schaller M, Gieler U, Schofer H, et al. Pathogenesis and clinical presentation of rosacea as a key for a symptom-oriented therapy. J Dtsch Dermatol Ges. 2016;14 Suppl 6:4-15. https://doi.org/10.1111/ddg.13139
  19. Baldwin HE. Systemic therapy for rosacea. Skin Therapy Lett. 2007;12(2):1-5,9.
  20. Jansen T, Regele D, Schirren CG, Trautner B, Plewig G. Persistent erythema and edema of the face associated with rosacea and lymph vessel dysplasia. Hautarzt. 1998;49(12):932-5. https://doi.org/10.1007/s001050050851
  21. Erdogan FG, Yurtsever P, Aksoy D, Eskioglu F. Efficacy of low-dose isotretinoin in patients with treatment-resistant rosacea. Arch Dermatol. 1998;134(7):884,885.
  22. Loyal J, Carr E, Almukhtar R, Goldman MP. Updates and Best Practices in the Management of Facial Erythema. Clin Cosmet Investig Dermatol. 2021;14:601-14. https://doi.org/10.2147/CCID.S267203
  23. Clark SM, Lanigan SW, Marks R. Laser treatment of erythema and telangiectasia associated with rosacea. Lasers Med Sci. 2002;17(1):26-33. https://doi.org/10.1007/s10103-002-8263-8
  24. Keaney TC, Tanzi E, Alster T. Comparison of 532 nm Potassium Titanyl Phosphate Laser and 595 nm Pulsed Dye Laser in the Treatment of Erythematous Surgical Scars: A Randomized, Controlled, Open-Label Study. Dermatol Surg. 2016;42(1):70-6. https://doi.org/10.1097/DSS.0000000000000582
  25. Chang J, Wang Y, Sun D, Zhang L, Man MQ, Tu Y, et al. Characterization of rosacea in Chinese: An analysis of 254 cases. J Cosmet Dermatol. 2021;20(11):3666-71. https://doi.org/10.1111/jocd.14039
  26. Egeberg A, Hansen PR, Gislason GH, Thyssen JP. Patients with Rosacea Have Increased Risk of Depression and Anxiety Disorders: A Danish Nationwide Cohort Study. Dermatology. 2016;232(2):208-13. https://doi.org/10.1159/000444082
  27. Mao H, Wei G. Clinical efficacy of Rose Yurong decoction in patients with lung meridian wind-heat type of rosacea. Int J Clin Exp Med. 2020;13(9):6916-22.
  28. Lee J, Park M, Hong J, Park J, Jo E. A case report of hot flush-type rosacea improved by baekho-tang. J Korean Med. 2020;41(3):173-9. https://doi.org/10.13048/jkm.20033
  29. Kim H, Yoon H, Ko W. A Case Report of Erythematotelangiectatic Type Rosacea and Peripheral Facial Palsy Improved by Korean Medicine Treatment with Soshioho-tang Gagambang. J Korean Med Ophthalmol Otolaryngol Dermatol. 2022;35(3):123-32. https://doi.org/10.6114/JKOOD.2022.35.3.123
  30. Kang E, Lee H, Kam E, Choi J, Kim J, Park S, et al. A Case Report of Erythemato-telangiectatic Rosacea Patient Treated with Yang dokbaekho-tang and Hwangryunhaedok-Tang Wet dressing. J Korean Med Ophthalmol Otolaryngol Dermatol. 2019;32(3):235-43.
  31. Gao Y, Lin W, Zhou S, Shi G, He J, Chen Y. Treatment of Rosacea using acupuncture for improving the local skin microcirculation: A case report. Medicine (Baltimore). 2018;97(34):e11931.
  32. Yang X, Cai M. New Insights into the Mutual Promotion of Rosacea, Anxiety, and Depression from Neuroendocrine Immune Aspects. Clin Cosmet Investig Dermatol. 2023;16:1363-71. https://doi.org/10.2147/CCID.S413237
  33. Chang HC, Huang YC, Lien YJ, Chang YS. Association of rosacea with depression and anxiety: A systematic review and meta-anal ysis. J Affect Disord. 2022;299:239-45. https://doi.org/10.1016/j.jad.2021.12.008
  34. Gorman JM, Sloan RP. Heart rate variability in depressive and anxiety disorders. Am Heart J. 2000;140(4 Suppl):77-83. https://doi.org/10.1067/mhj.2000.109981
  35. Oliver MD, Baldwin DR, Datta S. The relationship between sleep and autonomic health. J Am Coll Health. 2020;68(5):550-6. https://doi.org/10.1080/07448481.2019.1583652
  36. Hamvas S, Hegyi P, Kiss S, Lohner S, McQueen D, Havasi M. Acupuncture increases parasympathetic tone, modulating HRV - Systematic review and meta-analysis. Complement Ther Med. 2023;72:102905.
  37. Chien TJ, Liu CY, Ko PH, Hsu CH. A Chinese Decoction, Kuan-Sin-Yin, Improves Autonomic Function and Cancer-Related Symptoms of Metastatic Colon Cancer. Integr Cancer Ther. 2016;15(1):113-23. https://doi.org/10.1177/1534735415617282
  38. Yuan C, Wu S, Wu Y, Tian C, Wang Z, Zhang X. Effects of Traditional Chinese Medicine "Fuzheng Qingdu Decoction" on Autonomic Function and Cancer-Related Symptoms in Patients with Advanced Gastric Cancer undergoing Chemotherapy: A Controlled Trial. Integr Cancer Ther. 2024;23.
  39. An HJ, Lee JH, Lee HJ, Yang WM, Park SK, Hong SH, et al. Electroacupuncture protects against CCK-induced acute pancreatitis in r ats. Neuroimmunomodulation. 2007;14(2):112-8. https://doi.org/10.1159/000107793
  40. Kim B, Seo G, Hong Y, Kim K, Nam H, Kim Y. A Statistical Analysis of Outpatients in Dermatology of Korean Medicine at Kyung Hee University Korean Medicine Hospital in 2018-2022. J Korean Med Ophthalmol Otolaryngol Dermatol. 2023;36(3):1-11. https://doi.org/10.6114/jkood.2016.29.3.001