A study on the epidemiology of rosacea

摘要: Pharmacoepidemiology is the science of use and effects drugs in large human populations. Although its original role was confined to post-marketing surveillance rare or long-latency adverse drug events, gaining increasing importance across different stages development, where it has been applied assess utilization patterns cost-effectiveness, characterize target populations evaluate undiscovered beneficial detrimental effects, provide evidence effectiveness when randomized controlled trials face ethical practical barriers. Rosacea a common but under-investigated inflammatory skin disease, characterized by relapses remissions. The exact pathomechanism disease remains be elucidated, recent findings indicate key etiologic innate immune system. Evidence-based treatment options for are sparse greatly needed. The aim comprehensive rosacea project presented within this thesis contribute general understanding thereby focusing on impact diseases incident rosacea. comprises six individual studies, set up case-control study design, using data from General Practice Research Database (GPRD). This United Kingdom (UK)-based database contains longitudinal primary-care records millions patients, representative UK population. Information recorded practitioners including demographics, lifestyle factors, medical diagnoses, referrals secondary care, laboratory diagnostic results, complete history prescriptions. population consisted 53,927 patients with an diagnosis between 1995 2009 same number rosacea-free controls, matched age, sex, index date, practice, database. Study 3.1 builds basis project, describes terms characteristics, ocular symptoms. An overall incidence rate diagnosed 1.65 / 1,000 person-years calculated, stratified gender, calendar time, geographic region. While cigarette smoking seemed prevent developing rosacea, alcohol consumption yielded marginal risk increase. Studies 3.2 3.5 fathom insufficiently supported notion regarding association migraine (Study 3.2) psychiatric 3.5). Drug triptans psychotropic 3.5) were also studied. In contrast previous findings, pre-existing not generally associated post-menopausal women severe may at slightly increased mechanistically conceivable, did alter Neither depression nor other affective disorders affected relative schizophrenia less frequently. latter finding intriguing, requires further investigation, as bias cannot ruled out. Of all drugs, current lithium exposure protect disease. Topical proven effective seborrheic dermatitis, might interesting approach therapy. Two studies effect diuretics (focus spironolactone, 3.3) antihypertensive (including β-blockers calcium channel blockers, 3.6) line one study, spironolactone significantly decreased risk, whereas no diuretic class showed effect. Despite assumed blockers 3.6 reveal users class. β-blockers, which have suggested off-label erythematotelangiectatic revealed small decrease, probably larger alone. Especially abundantly used therapeutics, such sound required order healthcare professionals make right decisions clinical practice. Finally, 3.4 reports previously uninvestigated diabetes advanced stage, potentially due impaired vasodilation. It clarified whether insulin enhances effect. In summary, these population-based yielding important raising new hypotheses. some results directly support clinicians their daily treatment, yet others spark follow-up projects potential approaches well pathomechanistic aspects