{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:08:12Z","timestamp":1788865692651,"version":"build-2803163510"},"reference-count":85,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Neurogenic rosacea is a clinically useful, but not yet standardized, sensory-weighted presentation within the rosacea spectrum. This narrative review evaluates its clinical features, differential diagnosis, proposed mechanisms, and reported therapeutic approaches while distinguishing direct human evidence from indirect and experimental findings. Materials and Methods: PubMed\/MEDLINE, Scopus, Web of Science, and Google Scholar were searched through 30 June 2026 using predefined combinations of terms related to rosacea, facial dysesthesia, neurogenic inflammation, sensory pathways, mast cells, and treatment. English-language clinical and experimental publications were selected by relevance; reference lists were also screened. Evidence was grouped as phenotype-specific human evidence, human evidence from rosacea populations or related conditions, case-based evidence, and animal or cellular evidence. Results: Direct evidence specific to neurogenic rosacea is limited mainly to small observational series and case reports. Human rosacea studies support neurovascular involvement, whereas many TRP-channel, protease, LL-37\u2013MRGPRX2, and mast cell links remain indirect or experimental. No validated diagnostic criteria or phenotype-specific treatment algorithms exist. Conclusions: Neurogenic rosacea is best regarded as a clinically useful but not yet standardized sensory-weighted presentation within the rosacea spectrum, as current evidence does not establish it as an independent phenotype. The clinical features summarized in this review may support recognition of this presentation and its differentiation from relevant mimics, while diagnostic and treatment decisions should remain individualized. Prospective cohorts, validated sensory measures, biomarkers, and controlled phenotype-stratified trials are needed.<\/jats:p>","DOI":"10.3390\/medicina62091689","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:17:37Z","timestamp":1788862657000},"page":"1689","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neurogenic Rosacea and Facial Dysesthesia: Neurovascular\u2013Immune Mechanisms and Translational Therapeutic Perspectives"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8774-1965","authenticated-orcid":false,"given":"Serap","family":"Maden","sequence":"first","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Near East University, 99138 Nicosia, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1111\/bjd.15122","article-title":"Updating the diagnosis, classification and assessment of rosacea: Recommendations from the global ROSacea COnsensus (ROSCO) panel","volume":"176","author":"Tan","year":"2017","journal-title":"Br. J. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1111\/bjd.18420","article-title":"Recommendations for rosacea diagnosis, classification and management: Update from the global ROSaceaCOnsensus 2019 panel","volume":"182","author":"Schaller","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1007\/s40257-021-00595-7","article-title":"Rosacea: New concepts in classification and treatment","volume":"22","author":"Arents","year":"2021","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1016\/j.jaad.2020.01.077","article-title":"Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee","volume":"82","author":"Thiboutot","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"adv00584","DOI":"10.2340\/actadv.v101.356","article-title":"The importance of assessing burning and stinging when managing rosacea: A review","volume":"101","author":"Schaller","year":"2021","journal-title":"Acta Derm.-Venereol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.jaad.2017.08.037","article-title":"Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee","volume":"78","author":"Gallo","year":"2018","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1177\/12034754241229365","article-title":"Rosacea: Pathogenesis and therapeutic correlates","volume":"28","author":"Geng","year":"2024","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Tu, K.Y., Jung, C.J., Shih, Y.H., and Chang, A.L.S. (2024). Therapeutic strategies focusing on immune dysregulation and neuroinflammation in rosacea. Front. Immunol., 15.","DOI":"10.3389\/fimmu.2024.1403798"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Galluccio, G., D\u2019Onghia, M., Malvaso, D., Lazzeri, L., Cinotti, E., Rubegni, G., Rubegni, P., and Calabrese, L. (2024). Advances in the pathogenesis and treatment of rosacea: A phenotype-based therapeutic approach. Cosmetics, 11.","DOI":"10.3390\/cosmetics11010011"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/s10238-025-01859-w","article-title":"The role of skin barrier and immune abnormalities in the pathogenesis of rosacea","volume":"25","author":"Chen","year":"2025","journal-title":"Clin. Exp. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2207","DOI":"10.2147\/CCID.S550614","article-title":"Updates in the treatment of rosacea with \u03b3-aminobutyric acid derivatives","volume":"18","author":"Li","year":"2025","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1001\/archdermatol.2010.413","article-title":"Neurogenic rosacea: A distinct clinical subtype requiring a modified approach to treatment","volume":"147","author":"Scharschmidt","year":"2011","journal-title":"Arch. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Aedo, G., Chahu\u00e1n, M., Gatica, E., Herrera, I., Parada, L.F., Seguel, A., Murray, N.P., Aedo, S., and Arag\u00f3n-Caqueo, D. (2025). Managing a burning face: Clinical manifestations and therapeutic approaches for neurogenic rosacea. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26052366"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Li, M., Tao, M., Zhang, Y., Pan, R., Gu, D., and Xu, Y. (2023). Neurogenic rosacea could be a small fiber neuropathy. Front. Pain Res., 4.","DOI":"10.3389\/fpain.2023.1122134"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/1346-8138.15629","article-title":"Neurogenic rosacea in Korea","volume":"48","author":"Kim","year":"2021","journal-title":"J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wang, L., Wang, Y.J., Hao, D., Wen, X., Du, D., He, G., and Jiang, X. (2020). The theranostic role of mast cells in the pathophysiology of rosacea. Front. Med., 6.","DOI":"10.3389\/fmed.2019.00324"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"8737","DOI":"10.1038\/s41467-024-52946-7","article-title":"Single-cell transcriptomics reveals aberrant skin-resident cell populations and identifies fibroblasts as a determinant in rosacea","volume":"15","author":"Chen","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1007\/s00281-018-0675-z","article-title":"Skin neurogenic inflammation","volume":"40","author":"Choi","year":"2018","journal-title":"Semin. Immunopathol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1111\/pme.12343","article-title":"Recurrent facial erythema with burning sensation and increased temperature: A variant of erythromelalgia or a new entity?","volume":"15","author":"Luo","year":"2014","journal-title":"Pain Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1687","DOI":"10.1016\/j.jid.2021.02.002","article-title":"Infusion of pituitary adenylate cyclase-activating polypeptide-38 in patients with rosacea induces flushing and facial edema that can be attenuated by sumatriptan","volume":"141","author":"Wienholtz","year":"2021","journal-title":"J. Investig. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/jdv.19954","article-title":"Elevated plasma levels of calcitonin gene-related peptide in individuals with rosacea: A cross-sectional case-control study","volume":"39","author":"Wienholtz","year":"2025","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1111\/exd.13143","article-title":"Integrative concepts of rosacea pathophysiology, clinical presentation and new therapeutics","volume":"26","author":"Holmes","year":"2017","journal-title":"Exp. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1038\/jid.2011.424","article-title":"Distribution and expression of non-neuronal transient receptor potential ion channels in rosacea","volume":"132","author":"Sulk","year":"2012","journal-title":"J. Investig. Dermatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7265","DOI":"10.1038\/s41467-024-50970-1","article-title":"High-sensitive sensory neurons exacerbate rosacea-like dermatitis in mice by activating \u03b3\u03b4 T cells directly","volume":"15","author":"Zhang","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/j.jid.2016.10.046","article-title":"TRPV4 mediates mast cell activation in cathelicidin-induced rosacea inflammation","volume":"137","author":"Mascarenhas","year":"2017","journal-title":"J. Investig. Dermatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1038\/jid.2010.351","article-title":"TLR2 expression is increased in rosacea and stimulates enhanced serine protease production by keratinocytes","volume":"131","author":"Yamasaki","year":"2011","journal-title":"J. Investig. Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"44739","DOI":"10.1074\/jbc.M111.277152","article-title":"Mas-related gene X2 (MrgX2) is a novel G protein-coupled receptor for the antimicrobial peptide LL-37 in human mast cells: Resistance to receptor phosphorylation, desensitization, and internalization","volume":"286","author":"Subramanian","year":"2011","journal-title":"J. Biol. Chem."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.jaci.2016.04.051","article-title":"Roles of Mas-related G protein-coupled receptor X2 on mast cell-mediated host defense, pseudoallergic drug reactions, and chronic inflammatory diseases","volume":"138","author":"Subramanian","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.intimp.2017.05.016","article-title":"LL-37-induced human mast cell activation through G protein-coupled receptor MrgX2","volume":"49","author":"Yu","year":"2017","journal-title":"Int. Immunopharmacol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2728","DOI":"10.1038\/jid.2014.222","article-title":"Mast cells are key mediators of cathelicidin-initiated skin inflammation in rosacea","volume":"134","author":"Muto","year":"2014","journal-title":"J. Investig. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2988","DOI":"10.1016\/j.jid.2022.05.005","article-title":"Role of MrgprB2 in rosacea-like inflammation in mice: Modulation by \u03b2-arrestin 2","volume":"142","author":"Roy","year":"2022","journal-title":"J. Investig. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s00011-025-02144-y","article-title":"Therapeutic effect of an MRGPRX2\/MRGPRB2 antagonist on LL-37-induced rosacea-like inflammation in mice","volume":"74","author":"Chow","year":"2025","journal-title":"Inflamm. Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Fan, H., Sun, R., Ma, Q., Li, X., Liu, J., Zhang, M., Xu, C., Zhang, D., and Ma, W. (2025). LL-37-driven mast cell degranulation and inflammation in rosacea via the TLR2\/JAK2\/STAT3 axis. Front. Immunol., 16.","DOI":"10.3389\/fimmu.2025.1672021"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/s41392-023-01464-x","article-title":"TRP (transient receptor potential) ion channel family: Structures, biological functions and therapeutic interventions for diseases","volume":"8","author":"Zhang","year":"2023","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1111\/bph.13392","article-title":"What is the evidence for the role of TRP channels in inflammatory and immune cells?","volume":"173","author":"Parenti","year":"2016","journal-title":"Br. J. Pharmacol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1007\/s13238-017-0395-5","article-title":"TRPV1 and TRPA1 in cutaneous neurogenic and chronic inflammation: Pro-inflammatory response induced by their activation and their sensitization","volume":"8","author":"Gouin","year":"2017","journal-title":"Protein Cell"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1038\/jidsymp.2011.6","article-title":"Neurovascular and neuroimmune aspects in the pathophysiology of rosacea","volume":"15","author":"Schwab","year":"2011","journal-title":"J. Investig. Dermatol. Symp. Proc."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Shuba, Y.M. (2021). Beyond neuronal heat sensing: Diversity of TRPV1 heat-capsaicin receptor-channel functions. Front. Cell. Neurosci., 14.","DOI":"10.3389\/fncel.2020.612480"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/j.ejpain.2007.07.001","article-title":"Mechanisms involved in potentiation of transient receptor potential vanilloid 1 responses by ethanol","volume":"12","author":"Vetter","year":"2008","journal-title":"Eur. J. Pain"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.neuron.2006.03.042","article-title":"TRPA1 contributes to cold, mechanical, and chemical nociception but is not essential for hair-cell transduction","volume":"50","author":"Kwan","year":"2006","journal-title":"Neuron"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.jaad.2015.04.060","article-title":"Neurocutaneous disease: Cutaneous neuroanatomy and mechanisms of itch and pain","volume":"74","author":"Chuquilin","year":"2016","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_42","first-page":"49","article-title":"Rosacea and diet: What is new in 2021?","volume":"14","author":"Searle","year":"2021","journal-title":"J. Clin. Aesthet. Dermatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"175","DOI":"10.2147\/CCID.S391705","article-title":"Rosacea: Practical guidance and challenges for clinical management","volume":"17","author":"Nguyen","year":"2024","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"13525","DOI":"10.1073\/pnas.0705924104","article-title":"TRPA1 mediates formalin-induced pain","volume":"104","author":"McNamara","year":"2007","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"3125","DOI":"10.1038\/ncomms4125","article-title":"TRPA1 channels mediate acute neurogenic inflammation and pain produced by bacterial endotoxins","volume":"5","author":"Meseguer","year":"2014","journal-title":"Nat. Commun."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"6387","DOI":"10.4081\/dr.2016.6387","article-title":"Rosacea: A clinical review","volume":"8","author":"Mikkelsen","year":"2016","journal-title":"Dermatol. Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1152\/physrev.00037.2003","article-title":"Vascular actions of calcitonin gene-related peptide and adrenomedullin","volume":"84","author":"Brain","year":"2004","journal-title":"Physiol. Rev."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"13727","DOI":"10.1523\/JNEUROSCI.5741-07.2008","article-title":"Overexpressed transient receptor potential vanilloid 3 ion channels in skin keratinocytes modulate pain sensitivity via prostaglandin E2","volume":"28","author":"Huang","year":"2008","journal-title":"J. Neurosci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1744-8069-1-3","article-title":"Sensitization of TRPV1 by EP1 and IP reveals peripheral nociceptive mechanism of prostaglandins","volume":"1","author":"Moriyama","year":"2005","journal-title":"Mol. Pain"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.det.2017.11.001","article-title":"Rosacea pathogenesis","volume":"36","author":"Ahn","year":"2018","journal-title":"Dermatol. Clin."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1038\/jidsymp.2011.8","article-title":"Neurovascular aspects of skin neurogenic inflammation","volume":"15","author":"Aubdool","year":"2011","journal-title":"J. Investig. Dermatol. Symp. Proc."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.2353\/ajpath.2010.090941","article-title":"Pituitary adenylate cyclase-activating polypeptide: An important vascular regulator in human skin in vivo","volume":"177","author":"Seeliger","year":"2010","journal-title":"Am. J. Pathol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1001\/jamadermatol.2024.0408","article-title":"Erenumab for treatment of persistent erythema and flushing in rosacea: A nonrandomized controlled trial","volume":"160","author":"Wienholtz","year":"2024","journal-title":"JAMA Dermatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1111\/j.1365-2567.2007.02705.x","article-title":"Neuropeptides activate human mast cell degranulation and chemokine production","volume":"123","author":"Kulka","year":"2008","journal-title":"Immunology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1038\/jidsymp.2011.9","article-title":"Rosacea: The cytokine and chemokine network","volume":"15","author":"Gerber","year":"2011","journal-title":"J. Investig. Dermatol. Symp. Proc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1213\/ANE.0b013e31821a0258","article-title":"Neuropeptides contribute to peripheral nociceptive sensitization by regulating interleukin-1\u03b2 production in keratinocytes","volume":"113","author":"Shi","year":"2011","journal-title":"Anesth. Analg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1046\/j.1087-0024.2000.00013.x","article-title":"Neural regulation of endothelial cell-mediated inflammation","volume":"5","author":"Lindsey","year":"2000","journal-title":"J. Investig. Dermatol. Symp. Proc."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"100361","DOI":"10.1016\/j.bbih.2021.100361","article-title":"Roles of calcitonin gene-related peptide in the skin, and other physiological and pathophysiological functions","volume":"18","author":"Kim","year":"2021","journal-title":"Brain Behav. Immun. Health"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Lowy, D.B., Makker, P.G.S., and Moalem-Taylor, G. (2021). Cutaneous neuroimmune interactions in peripheral neuropathic pain states. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.660203"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Carstens, E., and Akiyama, T. (2014). Toll-like receptors and itch. Itch: Mechanisms and Treatment, Taylor & Francis.","DOI":"10.1201\/b16573"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1083\/jcb.200304161","article-title":"Loss of proteolytically processed filaggrin caused by epidermal deletion of matriptase\/MT-SP1","volume":"163","author":"List","year":"2003","journal-title":"J. Cell Biol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1038\/jid.2011.153","article-title":"Caspase-14 is required for filaggrin degradation to natural moisturizing factors in the skin","volume":"131","author":"Hoste","year":"2011","journal-title":"J. Investig. Dermatol."},{"key":"ref_63","first-page":"20","article-title":"Kallikrein 5-mediated inflammation in rosacea: Clinically relevant correlations with acute and chronic manifestations in rosacea and how individual treatments may provide therapeutic benefit","volume":"7","author":"Two","year":"2014","journal-title":"J. Clin. Aesthet. Dermatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1113\/jphysiol.2006.111534","article-title":"Protease-activated receptor 2 sensitizes TRPV1 by protein kinase C\u03b5- and A-dependent mechanisms in rats and mice","volume":"575","author":"Amadesi","year":"2006","journal-title":"J. Physiol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.1172\/JCI30951","article-title":"Sensitization of TRPA1 by PAR2 contributes to the sensation of inflammatory pain","volume":"117","author":"Dai","year":"2007","journal-title":"J. Clin. Investig."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1038\/jidsymp.2011.2","article-title":"Epidermal proteases in the pathogenesis of rosacea","volume":"15","year":"2011","journal-title":"J. Investig. Dermatol. Symp. Proc."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.aller.2016.10.011","article-title":"A critical review on serine protease: Key immune manipulator and pathology mediator","volume":"45","author":"Patel","year":"2017","journal-title":"Allergol. Immunopathol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1007\/978-3-662-44605-8_13","article-title":"Protease-activated receptors and itch","volume":"Volume 226","author":"Cowan","year":"2015","journal-title":"Pharmacology of Itch"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s00403-007-0816-z","article-title":"A study of the pathogenesis of rosacea: How angiogenesis and mast cells may participate in a complex multifactorial process","volume":"300","author":"Aroni","year":"2008","journal-title":"Arch. Dermatol. Res."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1704","DOI":"10.1111\/jdv.20052","article-title":"Differential diagnosis of contact dermatitis: A practical-approach review by the EADV Task Force on Contact Dermatitis","volume":"38","author":"Aerts","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"4","DOI":"10.2340\/00015555-2397","article-title":"Definition of sensitive skin: An expert position paper from the Special Interest Group on Sensitive Skin of the International Forum for the Study of Itch","volume":"97","author":"Misery","year":"2017","journal-title":"Acta Derm. Venereol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.ncl.2022.09.001","article-title":"Trigeminal neuralgia: Diagnosis and treatment","volume":"41","author":"Allam","year":"2023","journal-title":"Neurol. Clin."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s11154-016-9394-8","article-title":"Flushing in (neuro)endocrinology","volume":"17","author":"Stratakis","year":"2016","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_74","first-page":"24","article-title":"Laser and energy-based devices for treating rosacea: A systematic review and network meta-analysis","volume":"24","author":"Nguyen","year":"2026","journal-title":"J. Dtsch. Dermatol. Ges."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"J\u00f3\u017awiak, W., Pietrusiewicz, M., Piechota-Urba\u0144ska, M., and Markowicz-Piasecka, M. (2026). Brimonidine beyond a single specialty: Pharmacological profile, dermatologic applications, and advances in drug delivery systems. Int. J. Mol. Sci., 27.","DOI":"10.3390\/ijms27031281"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1007\/s13555-021-00597-7","article-title":"Mast cell stabilizers in the treatment of rosacea: A review of existing and emerging therapies","volume":"11","author":"Marchitto","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"106178","DOI":"10.1016\/j.intimp.2019.106178","article-title":"Hydroxychloroquine is a novel therapeutic approach for rosacea","volume":"79","author":"Li","year":"2020","journal-title":"Int. Immunopharmacol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.jaad.2020.05.050","article-title":"Efficacy and safety of hydroxychloroquine for treatment of patients with rosacea: A multicenter, randomized, double-blind, double-dummy, pilot study","volume":"84","author":"Wang","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"109181","DOI":"10.1016\/j.biopha.2019.109181","article-title":"Artemisinin, a potential option to inhibit inflammation and angiogenesis in rosacea","volume":"117","author":"Yuan","year":"2019","journal-title":"Biomed. Pharmacother."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1080\/09546634.2019.1610549","article-title":"Evaluation of the efficacy and tolerance of artemether emulsion for the treatment of papulopustular rosacea: A randomized pilot study","volume":"30","author":"Wang","year":"2019","journal-title":"J. Dermatol. Treat."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jdermsci.2018.12.004","article-title":"Botulinum toxin blocks mast cells and prevents rosacea-like inflammation","volume":"93","author":"Choi","year":"2019","journal-title":"J. Dermatol. Sci."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"226","DOI":"10.5021\/ad.25.198","article-title":"Effects of botulinum toxin A on rosacea-like inflammation in an LL-37-induced rosacea mouse model","volume":"38","author":"Yoon","year":"2026","journal-title":"Ann. Dermatol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1111\/jdv.19732","article-title":"Biomarkers in rosacea: A systematic review","volume":"38","author":"Geng","year":"2024","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1111\/jdv.13596","article-title":"In vivo, micro-morphological vascular changes induced by topical brimonidine studied by dynamic optical coherence tomography","volume":"30","author":"Themstrup","year":"2016","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Guarino, L., Cannarozzo, G., Gargano, L., Zappia, E., Clementi, A., Sannino, M., Pellacani, G., and Nistic\u00f2, S.P. (2026). Dynamic optical coherence tomography monitoring of keloid laser treatment. Optics, 7.","DOI":"10.3390\/opt7010013"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/9\/1689\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:20:56Z","timestamp":1788862856000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/62\/9\/1689"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,3]]},"references-count":85,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["medicina62091689"],"URL":"https:\/\/doi.org\/10.3390\/medicina62091689","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,3]]}}}