Are Axon Reflex Responses Altered in Rosacea?

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Medicine and Health Sciences


Sympathetic-like axon reflexes drive the initial increase in blood flow of the biphasic cutaneous vasodilation response of non-glabrous skin to local heating. It is currently unknown whether this process is involved in the etiology or altered in the pathology of facial flushing disorders, such as rosacea. The hypothesis that afferent responses (axon reflexes) to local triggers would be increased in rosacea-affected areas compared to both unaffected areas and control subjects was tested. In this pilot study, skin blood flow (laser-Doppler flowmetry) responses of one healthy subject and one otherwise healthy subject with rosacea to non-noxious local heating (Baseline for 5min, 32°C for 5min, and 42°C for 30 min) induction of axon reflex vasodilation in the forearm and cheek were measured and expressed as a percentage of maximum cutaneous vascular conductance (CVC = flux/mean arterial pressure). Additionally, sensation and thus the axon reflex was blocked in both forearm and cheek (topical lidocaine/prilocaine, 60- 90min) sites and skin blood flow responses were reassessed. Baseline and peak forearm skin blood flow differed between control (base = 12, peak = 89 %CVCmax) and rosacea (base = 2, peak = 80 %CVCmax) during heating without sensory blockade, but cheek skin blood flow values did not differ between subjects. During sensory blockade, peak forearm vasodilation was increased in rosacea (Control = 65, Rosacea = 77 %CVCmax), while cheek vasodilation was decreased (Control = 94, Rosacea = 84 %CVCmax). Additional subjects are needed to gain further insight to the role of sympathetic-like local axon reflexes in facial flushing disorders. Preliminarily, this pilot data suggests that there may be differences in axon reflex control of cutaneous vasodilation in rosacea-affected areas.


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