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Dermatopathology: Practical & Conceptual July - September 2008
7. Hypothesis: The pathogenesis of rosacea keratitis
Almut Böer, M.D.
Review of the literature
It is well known that rosacea often affects not only the skin of the face, but also the eye. For a student of dermatology it is extremely difficult to understand the relationship between a papulopustular infundibulocentric dermatitis characterized histopathologically by inflammatory infiltrates in and around infundibula on one hand and keratitis and conjunctivitis on the other. In current textbooks of dermatology and dermatopathology, no clear concept about the pathogenetic link between both manifestations of the disease is provided. [
Search via Medline reveals more than 1000 articles devoted to rosacea, but most of those articles deal with clinical diagnosis and treatment of the condition, while only few present results of scientific investigations; rarely were pathophysiological, histopathological, immunohistochemical, immunofluorescence, and electronmicroscopic studies undertaken. Fewer than 80 of those articles are dedicated to the problem of involvement of the eye in rosacea: very few of them studied clinical signs and symptoms of ocular rosacea in a bigger group of patients.
This article presents the results of a comprehensive review of articles pertinent to the subject published in journals of ophthalmology and dermatology in the last decades. Then, an attempt is made to integrate all observations on the basis of what is known about anatomy and physiology of the eye and about clinical and histopathologic features of rosacea in the skin.
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