Rosacea

Front 1

What are the steps in a CHRONIC VASCULAR RESPONSE?

Back 1

-Body has numerous primary sensory neurons that responds to ROSACEA TRIGGERS
-Transient Receptor Potential Vanillloid(1), which are linked to ERYTHEMATOTELANGIECTATIC ROSACEA, are activated by rosacea triggers and cause a vasodilation response followed by a rapid recovery.
-A pathological response leads to release neuropeptides.
-The neuropeptides act as vasodilators, causing prolonged dilation of the blood vessels.
-Resulting in warmth on skin, sustained flushing and facial erythema.

Hint 1

CHRONIC VASCULAR RESPONSE.

Front 2

What are the steps in the CHRONIC INFLAMMATORY RESPONSE?

Back 2

-In rosacea affected skin toll-like receptors(2) are triggered and a chemical cascade occurs.
-White blood cells are sent to the pilosebaceous unit causing inflammation.
-Then a proteases called kallikrein-5 is produced.
-Kallikrein-5 break apart an antimicrobial peptide called cathelicidin LL-37 to create LL-37 peptide fragments.
-Causing increase of white blood cells to pilosebaceous unit and increase of inflammation.

Hint 2

CHRONIC INFLAMMATORY RESPONSE

Front 3

WHAT ARE THE STEPS OF A HISTOPATHOLOGICAL CHANGES?

Back 3

Once inflammation in facial skin is chronic
-Neutrophils leak into the dermis and destroy skin tissue.
-Neutrophils then release destructive compounds: matrix-metalloproteinases, nitric-oxide, and reactive oxygen species.
-Nitric Oxide causes vasodilation, which contributes to both chronic and inflammatory response in rosacea.
-matrix-metalloproteinases and reactive oxygen species work in a chronic inflammatory response by weakening skin elements of collagen and elastin.
-Causing skin elasticity of stratum corneum barrier.
-Resulting in dry, scaling, flaking.

Hint 3

Histopathological Response.

Front 4

WHAT IS THE PATHOLOGY OF ROSACEA?

Back 4

-Pathothology is not fully understood.
-Hyperactivity in skin neuronal sensory systems=vasodilation
-Overactivity of the skins innate immune system=inflammation
-Development of permanent vascular changes
Resulting in complex dysregulation of inflammatory, neuronal, and vascular systems.

Front 5

WHAT ARE THE SIGNS OF "OCULAR" ROSACEA

Back 5

-Burning eyes and stinging eyes.
-Watery blood shot eyes.
-Dryness and Itching eyes.
-Telangiectasia of conjunctiva.
-Conjunctiva.
-Blepharitis.

Front 6

WHAT ARE THE SIGNS OF PHYMATOUS ROSACEA?

Back 6

-Thickening of skin and large pores.
-Rynophyma.
-Also occur on the chin, cheeks, forehead, and ears.
-Has been seen after or in combination with subtypes (1) and (2).

Front 7

WHAT ARE THE SIGNS OF "PAPULOPUSTULAR" ROSACEA?

Back 7

-Persistent facial erythema.
-Popules and/or pustules in a central facial distribution.
-Resembles acne however no comedones are present.
-Secondary stinging or burning may occur.
-May work with Erythematotelangiectasia.

Front 8

WHAT ARE THE SIGNS OF "ERYTHEMATOTELANGIECTATIC " ROSACEA?

Back 8

PRIMARY
-Flushing 10 or more times.
-Telangiectasia.
-Persistent facial redness.

SECONDARY
-Dryness and Scaling.
-Edema.
-Stinging and burning.

Front 9

ACCORDING TO THE NATIONAL ROSACEA SOCIETY, WHAT ARE PHYCHOSOCIAL IMPACT OF ROSACEA AND PERCENTAGES?

Back 9

-Adversely affected professional interaction (88%)
-Missed work (51%)
-Denied promotion (41%)
-Denied new job (39%)

Front 10

WHAT ARE THE PRIMARY AND SECONDARY SIGNS OF ROSACEA?

Back 10

PRIMARY
-Transient erythema.
-Non - Transient Erythema.
-Popules and pustules
-Telangiectasia

SECONDARY
-Edema
-Dryness and Scaling
-Burning and Stinging
-Plagues

Front 11

ACCORDING TO THE NATIONAL ROSACEA SOCIETY, WHAT ARE THE (4) MOST COMMON TRIGGERS OF ROSACEA?

Back 11

-Sun exposure (81%)
-Emotional (79%)
-Hot Weather (75%)
-Wind (57%)

Front 12

WHAT ARE THE TWO TYPES OF ROSACEA TRIGGERS?

Back 12

-Environmental
-Ingested and Introgenic

Front 13

WHAT ARE THE FOUR TYPES OF ENVIRONMENTAL TRIGGERS?

Back 13

-Weather
-Activity
-Emotional
-Temperature

Front 14

WHAT ARE THE INGESTED AND INTROGENIC TRIGGERS?

Back 14

-Beverages
-Food
-Drugs
-Topical agents

Front 15

WHAT IS ROSACEA?

Back 15

-Rosacea is a chronic inflammatory disease that affects the pilosebaceous unit.
-Blood vessels.
-Causing facilities redness, Popules and pustules.

Front 16

WHAT IS THE EPITIOLOGY OF ROSACEA?

Back 16

-16 million
-30's and 50's
-4% African, Asia, Latino
-Fitzpatrick phenotype 1 and 2
-Celtic, Northern European, Welsh

Front 17

WHAT ARE THE PRIMARY FUNCTION OF "TOLL-LIKE RECEPTORS(2)"

Back 17

-Activation of TOLL-LIKE RECEPTORS ( 2 ) attract white blood cells to the pilosebaceous unit, causing inflammation.
-Activation of TOLL-LIKE RECEPTORS ( 2 ) increases production of proteases called kallikrein -5, which break apart cathelicidin LL-37 into inflammation triggering LL-37 fragments.

Front 18

WHAT ROLES DO NEUROPEPTIDES PLAY IN THE PATHOLOGY OF ROSACEA?

Back 18

Neuropeptides act a vasodilators, causing prolonged dilation of blood vessels.

Front 19

WHAT ARE CATHELICIDIN LL-37?

Back 19

-Important molecule of innate immunity of the skin.
-CATHELICIDIN LL-37 splits into LL-37 fragments.
-Affected skin is perceived as pathological.
-Resulting in more inflammation.

Front 20

WHAT ARE PRIMARY SENSORY NEURONS?

Back 20

-Primary sensory neurons can effect vascular change.
-TRANSIENT RECEPTOR POTENTIAL VANILLLOID are abundant.
-Respond to temperature change,mechanical stimuli, and chemical stimuli.

Front 21

WHAT IS THE ROLE OF NITRIC OXIDE?
WHAT IS THE ROLE OF MATRIX-METALLOPROTEINASES?
WHAT IS THE ROLE OF REACTIVE OXYGEN SPECIES?

Back 21

-Nitric Oxide promotes vasodilation contributing to chronic response.
-Matrix-metalloproteinases and reactive oxygen species weaken skin's structure elastin and collagen.
-Play a role in chronic inflammatory response.

Front 22

WHAT ARE FOUR ROSACEA TRIGGERS?

Back 22

-Stress
-Dairy products
-Strong wind
-Hot baths

Front 23

WHAT HAPPENS WHEN TRANSIENT RECEPTOR POTENTIAL VANILLLOID (1) IS ACTIVATED IN HEALTHY SKIN?

Back 23

Transient dilation of the skin's blood vessels,followed by rapid recovery .