Rosacea: pathophysiology and therapeutics

Rosacea is a chronic, multifactorial inflammatory dermatosis involving immune dysregulation, neurovascular alterations, and microbial imbalance. Overexpression of TLR2, activation of TRP channels, and increased LL-37 cathelicidin are central to its pathophysiology. Therapeutic management includes behavioral strategies, topical treatments (metronidazole, ivermectin, azelaic acid, brimonidine), systemic agents (doxycycline, isotretinoin), and procedures such as laser and intense pulsed light. A personalized, multifaceted approach combining trigger control, pharmacologic therapy, and physical interventions is crucial for reducing symptoms and improving patient quality of life.

Keywords: Rosacea; Innate immunity; Cathelicidins; Botulinum toxin type A; Tetracyclines; Technology