{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T18:11:17Z","timestamp":1757614277699,"version":"3.44.0"},"reference-count":38,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Derm Venereol"],"abstract":"<jats:p>COVID-19 can affect the skin, with rosacea flare-ups reported after infection or vaccination. This study compared rosacea patients with and without post-COVID-19 exacerbation to identify contributing factors. A customized electronic questionnaire was administered to rosacea patients, gathering COVID-19 infection\/vaccination status, demographics, and rosacea features. Participants were classified by post-COVID-19 rosacea exacerbation vs none. Multivariable logistic regression identified risk factors. Finally, a total of 104 patients were analysed; 15.4% experienced rosacea exacerbation after COVID-19 vaccination and 28.8% after infection. Comorbidities such as metabolic diseases or allergic diseases were associated with a higher risk of rosacea exacerbation after vaccination or infection (OR\u2009=\u200911.083, 95% CI: 1.136\u2013108.135). Burning and stinging symptoms predicted higher exacerbation risk after vaccination (OR\u2009=\u20098.978, 95% CI 1.968\u201340.969). Papulopustular rosacea was associated with lower risk (OR\u2009=\u20090.276, 95% CI: 0.066\u20131.160). Higher body mass index (BMI) was associated with lower exacerbation risk after vaccination (OR\u2009=\u20090.646, 95% CI 0.450\u20130.928) and infection (OR\u2009=\u20090.731, 95% CI: 0.572\u20130.933). Frequent rosacea episodes increased exacerbation risk after infection (OR\u2009=\u20098.288, 95% CI: 2.044\u201333.608). In conclusion, lower BMI was associated with higher risk of rosacea exacerbation after COVID-19 vaccination or infection. Patients with burning and stinging symptoms or a non-papulopustular subtype were more likely to experience exacerbation after vaccination.<\/jats:p>","DOI":"10.2340\/actadv.v105.43615","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T06:04:10Z","timestamp":1757052250000},"page":"adv43615","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the Risk Factors of Rosacea Exacerbation Associated with COVID-19 Infection or Vaccination: A Cross-sectional Study"],"prefix":"10.2340","volume":"105","author":[{"given":"Xidie","family":"Yin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiting","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liyuan","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shu Zhan","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qihang","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yajing","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiuli","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peiru","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"doi-asserted-by":"crossref","unstructured":"van Zuuren EJ, Arents BWM, van der Linden MMD, Vermeulen S, Fedorowicz Z, Tan J. Rosacea: new concepts in classification and treatment. Am J Clin Dermatol 2021; 22: 457\u2013465.","key":"125818","DOI":"10.1007\/s40257-021-00595-7"},{"doi-asserted-by":"crossref","unstructured":"Schaller M, Dirschka T, Lonne-Rahm SB, Micali G, Stein Gold LF, Tan J, et al. The importance of assessing burning and stinging when managing rosacea: a review. Acta Derm Venereol 2021; 101: adv00584.","key":"125819","DOI":"10.2340\/actadv.v101.356"},{"doi-asserted-by":"crossref","unstructured":"Zhang H, Zhang Y, Li Y, Wang Y, Yan S, Xu S, et al. Bioinformatics and network pharmacology identify the therapeutic role and potential mechanism of melatonin in AD and rosacea. Front Immunol 2021; 12: 756550.","key":"125820","DOI":"10.3389\/fimmu.2021.756550"},{"doi-asserted-by":"crossref","unstructured":"Novak N, Peng W, Naegeli MC, Galvan C, Kolm-Djamei I, Br\u00fcggen C, et al. SARS-CoV-2, COVID-19, skin and immunology: what do we know so far? Allergy 2021; 76: 698\u2013713.","key":"125821","DOI":"10.1111\/all.14498"},{"doi-asserted-by":"crossref","unstructured":"Ozaras R, Berk A, Ucar DH, Duman H, Kaya F, Mutlu H. Covid-19 and exacerbation of psoriasis. Dermatol Ther 2020; 33: e13632.","key":"125822","DOI":"10.1111\/dth.13632"},{"doi-asserted-by":"crossref","unstructured":"Cosansu NC, Yuksekal G, Kutlu O, Umaroglu M, Yald\u0131z M, Dikicier BS. The change in the frequency and severity of facial dermatoses and complaints in healthcare workers during the COVID-19. J Cosmet Dermatol 2022; 21: 3200\u20133205.","key":"125823","DOI":"10.1111\/jocd.15044"},{"doi-asserted-by":"crossref","unstructured":"Damiani G, Gironi LC, Grada A, Kridin K, Finelli R, Buja A, et al. COVID-19 related masks increase severity of both acne (maskne) and rosacea (mask rosacea): multi-center, real-life, telemedical, and observational prospective study. 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Demographic and clinical feature disparity between progress and non-progress patients with vitiligo after COVID-19 vaccination: a cross-sectional study. Exp Dermatol 2023; 32: 1344\u20131349.","key":"125836","DOI":"10.1111\/exd.14825"},{"doi-asserted-by":"crossref","unstructured":"Lowy DB, Makker PGS, Moalem-Taylor G. Cutaneous neuroimmune interactions in peripheral neuropathic pain states. Front Immunol 2021; 12: 660203.","key":"125837","DOI":"10.3389\/fimmu.2021.660203"},{"doi-asserted-by":"crossref","unstructured":"Duan YW, Chen SX, Li QY, Zang Y. Neuroimmune mechanisms underlying neuropathic pain: the potential role of TNF-\u03b1-necroptosis pathway. Int J Mol Sci 2022; 23: 7191.","key":"125838","DOI":"10.3390\/ijms23137191"},{"doi-asserted-by":"crossref","unstructured":"Khan S, Shafiei MS, Longoria C, Schoggins JW, Savani RC, Zaki H. SARS-CoV-2 spike protein induces inflammation via TLR2-dependent activation of the NF-\u03baB pathway. 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Association of acne with face mask in healthcare workers amidst the COVID-19 outbreak in Karachi, Pakistan. Clin Cosmet Investig Dermatol 2021; 14: 1427\u20131433.","key":"125851","DOI":"10.2147\/CCID.S333221"},{"doi-asserted-by":"crossref","unstructured":"Shah PM, Md UR, Porter C, Feldman SR. Associations between different mask wearing patterns and rosacea severity. Dermatol Online J 2023; 29.","key":"125852","DOI":"10.5070\/D329562420"},{"doi-asserted-by":"crossref","unstructured":"Abduljabbar M, Kalthoum DE, Bakarman M, Wahby Salem I, Alsulaimani Z, Alharbi W, et al. The correlation between wearing face masks and skin damage in adults during the COVID-19 pandemic: a cross-sectional study in Jeddah, Saudi Arabia. Cureus 2022; 14: e31521.","key":"125853","DOI":"10.7759\/cureus.31521"},{"doi-asserted-by":"crossref","unstructured":"Watanabe M, Balena A, Masi D, Tozzi R, Risi R, Caputi A, et al. 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