Rozase Hastalarında Antinükleer Antikor ve İnflamatuar Belirteçlerin Değerlendirilmesi

Öz

Amaç: Rosacea, sistemik inflamatuar ve otoimmün hastalıklarla ilişki potansiyeli olan kronik inflamatuar bir cilt hastalığıdır. Bu çalışmada, rosacea hastalarında antinükleer antikor (ANA) ve kompleman düzeyleri dâhil olmak üzere inflamatuar belirteçlerin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Mart 2022 ile Mart 2023 tarihleri arasında rosacea tanısı alan, 18 yaş ve üzeri 178 hasta retrospektif olarak değerlendirildi. Yaş ve cinsiyet açısından eşleştirilmiş 49 sağlıklı birey kontrol grubunu oluşturdu. Katılımcıların demografik bilgileri ile lökosit ve trombosit sayısı, hemoglobin, hematokrit, eritrosit sedimantasyon hızı (ESH), C-reaktif protein (CRP), kompleman C3 ve C4 düzeyleri ve ANA titresi gibi laboratuvar verileri kaydedildi ve analiz edildi. Bulgular: Rosacea hastalarının %7,9’unda (14/178) ANA pozitifliği saptandı. Lökosit (p=0,482), trombosit (p=0,567), hemoglobin (p=0,828), hematokrit (p=0,877), ANA titresi (p=0,946), C3 (p=0,665), ESH (p=0,083) ve CRP (p=0,690) değerleri açısından hasta ve kontrol grupları arasında anlamlı fark bulunmadı. Ancak, rosacea hastalarında serum C4 düzeyleri kontrol grubuna göre anlamlı şekilde düşük bulundu (p=0,029). Sonuç: Rosacea hastalarında serum C4 düzeylerinde azalma gözlenmiş olup, bu durum sistemik inflamatuar veya otoimmün süreçlerle olası bir ilişkiye işaret edebilir. Bulguların klinik öneminin daha iyi anlaşılması için ileriye dönük çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• rosacea
• inflamasyon
• otoimmün hastalık

The Frequency Of Antinuclear Antibody Positivity And Inflammatory Indicators Elevation In Rosacea Patients

Öz

Objective: Rosacea, a chronic inflammatory disease, has been the subject of previous studies due to its potential link with inflammatory and autoimmune diseases. Materials and methods: In this retrospective, case-control study, patients older than 18, diagnosed with rosacea, and gender- and age-matched healthy controls were included in the study between March 2022 and 2023. We thoroughly evaluated the patients' demographic, clinical features, and inflammatory indicator laboratory tests, including leucocyte, platelet, hemoglobin, hematocrit levels, sedimentation (ESR), C-reactive protein (CRP), complement- 3 (C3), complement- 4 (C4) and antinuclear antibody (ANA) titers. Results: 178 patients with rosacea and 49 healthy controls were participated in the study. ANA positivity was 7.9% (14/178) in rosacea patients. There was no statistically significant difference between the two groups in terms of mean total leucocyte, platelet, hemoglobin, hematocrit, ANA, C3, and CRP levels (p=0.771; p=0,835; p=0,216; p=0,193; p=0;945; p=0.511; p= 0.435, respectively). However, ESR levels were significantly higher and serum C4 levels were significantly lower in rosacea patients (p=0.030; p=0.003, respectively). Conclusion: Patients with rosacea may exhibit antinuclear antibody positivity, elevated ESR levels, and decreased serum C4 levels. Further studies are needed to provide more clarity on this issue.

Anahtar Kelimeler

• rosacea
• inflammation
• autoimmune disease

Kaynakça

1. 1. van Zuuren EJ, Fedorowicz Z, Tan J, van der Linden MMD, Arents BWM, Carter B. et al. Interventions for rosacea based on the phenotype approach: an updated systematic review including GRADE assessments. Br J Dermatol 2019;181(1):65-79.
2. 2. Wollina U. Recent advances in the understanding and management of rosacea. Prime Rep 2014;6:50.
3. 3. Thiboutot D, Anderson R, Cook-Bolden F, Draelos Z, Gallo RL, Granstein RD. et al. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol 2020;82(6):1501-10.
4. 4. Sitohang IBS, Parrol F, Fitri EM, Nora RD. Papulopustular and Ocular Rosacea with an Alleged Coincidence of Cutaneous Lupus Erythematosus: A Case Report. Case Rep Dermatol. 2021;13(1):62-8.
5. 5. Egeberg A, Hansen PR, Gislason GH, Thyssen JP. Clustering of autoimmune diseases in patients with rosacea. J Am Acad Dermatol 2016;74(4):667-72.e1.
6. 6. Rainer BM, Fischer AH, Luz Felipe da Silva D, Kang S, Chien AL. Rosacea is associated with chronic systemic diseases in a skin severity-dependent manner: results of a case-control study. J Am Acad Dermatol 2015; 73: 604-8.
7. 7. Chang ALS, Raber I, Xu J, Li R, Spitale R, Chen J. et al. Assessment of the genetic basis of rosacea by genome-wide association study. J Invest Dermatol 2015;135(6):1548-55.
8. 8. Sinikumpu SP, Huilaja L, Auvinen J, Jokelainen J, Puukka K, Ruokonen A. The Association Between Low Grade Systemic Inflammation and Skin Diseases: A Cross-sectional Survey in the Northern Finland Birth Cohort 1966. Acta Derm Venereol. 2018;98(1):65-9.

9. 9. Lazaridou E, Apalla Z, Sotiraki S, Ziakas NG, Fotiadou C, Ioannides D. Clinical and laboratory study of rosacea in northern Greece. J Eur Acad Dermatol Venereol 2010;24(4):410-4.
10. 10. Woźniacka A, Salamon M, McCauliffe D, Sysa-Jędrzejowska A. Antinuclear antibodies in rosacea patients. Postepy Dermatol Alergol 2013;30(1):1-5.
11. 11. Nunzi E, Rebora A, Hamerlinck F, Cormane RH. Immunopathological studies on rosacea. Br J Dermatol 1980;103(5):543-51.
12. 12. Andersen P. Correlation of smooth-muscle and nuclear antibodies in normal subjects. Clin Exp Immunol 1977;27(1):74-7.
13. 13. Fanouriakis A, Kostopoulou M, Alunno A, Aringer M, Bajema I, Boletis JN. et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis. 2019;78(6):736–45.
14. 14. Haber R, El Gemayel M. Comorbidities in rosacea: A systematic review and update. J Am Acad Dermatol 2018;78(4):786-92.e8.
15. 15. Chen Q, Shi X, Tang Y, Wang B, Xie HF, Shi W. et al. Association between rosacea and cardiometabolic disease: A systematic review and meta-analysis. J Am Acad Dermatol 2020;83(5):1331-40.
16. 16. Caf N, Özkök Akbulut T, Can MM, Sarı M, Atsü AN, Türkoğlu Z. Evaluation of subclinical atherosclerosis in rosacea patients by flow-mediated dilatation method. J Cosmet Dermatol 2023;22(3):1001-10.
17. 17. Karaosmanoglu N, Ozdemir Cetinkaya P, Orenay OM. Evaluation of inflammatory status in blood in patients with rosacea. Sci Rep. 2023;13(1):9068.
18. 18. Aksoy B, Ekiz Ö, Unal E, Ozaydin Yavuz G, Gonul M, Kulcu Cakmak S. et al. Systemic comorbidities associated with rosacea: a multicentric retrospective observational study. Int J Dermatol 2019;58(6):722-8.
19. 19. Woo YR, Kim HS, Lee SH, Ju HJ, Bae JM, Cho SH., et al. Systemic Comorbidities in Korean Patients with Rosacea: Results from a Multi-Institutional Case-Control Study. J Clin Med 2020;9(10):3336.