"Zooming" in the association between rosacea and fibromyalgia syndrome: ıs it worth mentioning?

Investigating the relationship between chronic pruritus and fibromyalgia: an evaluation of 200 patients

Pruritus is a common complaint in dermatology outpatient clinics. It is defined as chronic pruritus if the symptoms last 6 weeks or longer. Fibromyalgia is a chronic, extensive pain syndrome that is well-known for its clinical signs, such as exhaustion, sleeping disorders, and some other pain symptoms. In the present study, it was investigated whether chronic pruritus patients were accompanied by fibromyalgia. The study included 100 patients with chronic pruritus and 100 controls without dermatological disease. All of the individuals were first evaluated in the dermatology clinic, and the patients having any musculoskeletal symptoms were then referred to a physiatrist in terms of accompanying fibromyalgia syndrome. Fibromyalgia was detected in 29 (29%) of 100 chronic pruritus patients and 6 (6%) of 100 patients in the control group. There was a statistically significant difference between the two groups regarding accompanying FM (p < 0.001). In the chronic pruritus group, pruritus severity, according to VAS and the four-item itch questionnaire score, was statistically significantly higher in patients with fibromyalgia than in patients without fibromyalgia (p = 0.027, p = 0.002, respectively). In addition, the number of patients with severe/very severe chronic pruritus was statistically significantly higher in the group accompanied by fibromyalgia (p = 0.023). It may be suggested that fibromyalgia is a frequent disease that can accompany chronic pruritus. Clinicians should keep in mind that there is a possibility of the coexistence of both diseases. This study calls attention to the complex relationship between chronic itch and pain.

Health-related Quality of Life of Patients with Rosacea: A Systematic Review and Meta-analysis of Real-world Data

Patients with rosacea commonly experience stigmatization, which induces stress and thereby exacerbates their symptoms. Given the strong effects of rosacea on health-related quality of life (HRQoL), addressing the physical and psychosocial aspects of rosacea is essential. To examine the effects of rosacea on HRQoL, we conducted a systematic review and meta-analysis involving real-world data. PubMed, EMBASE, and the Cochrane Library were searched, and randomized controlled trials (RCTs), cross-sectional studies, and case series evaluating the HRQoL of patients with rosacea were included. HRQoL assessment tools such as the Dermatology Life Quality Index (DLQI) and Rosacea-Specific Quality-of-Life Questionnaire (RosaQoL) were used. Data on 13,453 patients were retrieved from 52 eligible studies: 4 RCTs, 15 case series, and 33 cross-sectional studies. Compared with healthy controls, patients with rosacea had significantly lower DLQI scores (standardized mean difference [SMD] = -1.09, 95% confidence interval [CI] = -0.81 to -1.37). The DLQI scores after treatment were higher than those before treatment (SMD = -1.451, 95% CI = -1.091 to -1.810). The pooled estimates for the overall DLQI and RosaQoL scores were 8.61 and 3.06, respectively. In conclusion, patients with rosacea have lower HRQoL compared with healthy individuals, and treatment for rosacea improves their HRQoL.

Evaluation of Dermatological and Neurological Aspects of the Relationship between Rosacea and Headaches

This study aimed to investigate the relationship between rosacea and headaches, focusing on different subtypes, as well as the associated clinical features and triggering factors. In this prospective study, 300 patients diagnosed with rosacea and 320 control subjects without rosacea or any connected mast cell activation illness were included. Patients with rosacea were assessed by a dermatologist according to the 2019 updated rosacea classification (ROSCO panel). Accordingly, patients were classified based on their predominant rosacea subtype as follows: erythematotelangiectatic (ETR), papulopustular (PPR), or phymatous (RhR). Patients experiencing headaches were assessed using the International Headache Classification. Headaches were categorized as migraine, tension-type headaches (TTHs), secondary types (STHs), and cluster-type headaches (CTHs). The ratio of headache was 30.3% in the rosacea group, which did not show a significant difference compared to the control group (30.3% vs. 25.0%, p = 0.138). In 81.3% of rosacea patients with headaches, headache onset occurred after the diagnosis of rosacea. The rate of patients with headaches was higher in the ETR group compared to the PPR and RhR groups (35.2% vs. 16.2% vs. 23.1%, p = 0.007, respectively). In terms of headache subtypes, the rates of patients with migraine and STHs were higher in the ETR group compared to the PPR and RhR groups, while the rate of patients with TTHs was higher in the RhR group. A positive correlation was found between rosacea severity and migraine severity (r = 0.284, p < 0.05). Among the triggering factors for rosacea, only sunlight was found to be associated with headaches. Lower age, female gender, and moderate to severe rosacea severity were identified as independent factors increasing the likelihood of headaches. A significant portion of rosacea patients experience headaches. Particularly, different subtypes of rosacea may be associated with various types of headaches. This study, highlighting the connection between migraine and ETR, is a pioneering work that demonstrates common pathogenic mechanisms and potential triggers.

Effects of oral isotretinoin treatment for acne vulgaris patients on anger responses and the relationship with temperament

OBJECTIVE

Isotretinoin is the only medication against all the factors involved in acne vulgaris pathogenesis. The aim of our study was to verify whether patients with acne vulgaris receiving isotretinoin therapy exhibit elevated anger levels and to observe the correlation between age, temperament traits, and anger.

METHODS

The study group comprised a sum of 100 cases, involving 50 individuals with acne vulgaris-required high-dose retinol therapy and 50 controls who did not start any medication.

RESULTS

Our study showed that anger levels increased with drug use. A positive correlation between cyclothymic temperament, the anxiety-related behavior subdimension, and the introvert and passive-aggressive subdimension of interpersonal anger reactions has been recognized. In addition, a positive one was observed between hyperthymic temperament and the introvert subdimension, which is one of the anger-related thoughts and interpersonal anger reactions.

CONCLUSION

This study elucidates anger dimensions such as anger-related thoughts, behaviors, and reactions in individuals who received retinol treatment for acne vulgaris. In addition to anger and its dimensions, temperament was also investigated. Although several studies have investigated the relationship between acne vulgaris and psychiatric symptoms, to the best of our knowledge, no research has been reported in the English-language literature regarding the relationship between anger dimensions and temperament after retinol treatment that might make our study an original and valuable contribution to the literature.