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. 2022 Oct 20:9:1026447.
doi: 10.3389/fmed.2022.1026447. eCollection 2022.

Clinical characteristics of combined rosacea and migraine

Nita K F Wienholtz  1   2 , Casper E Christensen  1 , Ditte G Zhang  3 , Anne-Sofie A Rechnagel  1 , Helene V S Byrnel  1 , Jeanette H Haugaard  2 , Messoud Ashina  1 , Jacob P Thyssen  3 , Alexander Egeberg  3
Affiliations

Clinical characteristics of combined rosacea and migraine

Nita K F Wienholtz et al. Front Med (Lausanne). .

Abstract

Background: An overlap between the skin disease rosacea and the headache disease migraine has been established; however, the magnitude of this overlap and the distribution between subtypes/phenotypes remains unclear.

Objective: The aim was to determine the magnitude of the overlap between rosacea and migraine, and to determine which subtypes/phenotypes were present in patients with concomitant rosacea and migraine.

Methods: In this cross-sectional study, 604 patients with a diagnosis of either rosacea or migraine were phenotyped through a face-to-face interview with clinical examination, to determine prevalence and phenotype of rosacea, and prevalence and subtype of migraine.

Results: We found a prevalence of migraine of 54% in patients with rosacea, and a prevalence of rosacea of 65% in patients with migraine. Concomitant migraine was significantly associated with the rosacea features flushing (odds ratio = 2.6, 95% confidence interval = 1.4-4.7, p = 0.002), ocular symptoms (odds ratio = 2.4, 95% confidence interval = 1.5-3.9, p < 0.001), and burning (odds ratio = 2.1, 95% confidence interval = 1.3-3.4, p = 0.002), whereas papules/pustules were inversely related with concomitant migraine (odds ratio = 0.5, 95% confidence interval = 0.3-0.8, p = 0.006). No association was found between concomitant migraine and centrofacial erythema, rhinophyma, telangiectasia, edema, or dryness. Concomitant rosacea was not associated with any specific migraine subtype in patients with migraine.

Conclusion: This study highlights a substantial overlap between rosacea and migraine, particularly in patients with certain rosacea features. Individuals with rosacea should be asked about concomitant migraine, and comorbidities should be considered when choosing between treatments.

Keywords: interview; migraine; overlap; prevalence; rosacea.

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Conflict of interest statement

NW has acted as an invited speaker for Novartis and received a travel grant from the Kgl Hofbundtmager Aage Bang Foundation. CC has received personal fees from Teva and serves as a consultant for Teva. MA has received consulting fees and advisory boards fees from Alder, Allergan, Amgen, Eli Lilly, Lundbeck, Novartis, and Teva; fees for serving as a principal investigator, paid to his institution, from Alder, Allergan, Amgen, Electro-Core, Eli Lilly, Lundbeck, Novartis, and Teva; and grant support, paid to his institution, from Novo Nordisk Foundation, Novartis, and Lundbeck Foundation. JT has been an advisor, investigator, and speaker for Abbvie, Pfizer, LEO Pharma, Sanofi-Genzyme, Eli Lilly & Co., and Regeneron. He has received grants from Sanofi-Genzyme and Regeneron. AE has received research funding from Pfizer, Eli Lilly, the Danish National Psoriasis Foundation, and the Kgl Hofbundtmager Aage Bang Foundation and honoraria as consultant and/or speaker from Almirall, Leo Pharma, Samsung Bioepis Co., Ltd. Pfizer, Eli Lilly & Co., Novartis, Galderma, Dermavant, Bristol-Myers Squibb, and Janssen Pharmaceuticals. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Prevalence of rosacea and migraine in each cohort. (A) Prevalence of rosacea in COMICO. (B) Prevalence of migraine in COROCO. COMICO, Copenhagen Migraine Cohort; COROCO, Copenhagen Rosacea Cohort.
FIGURE 2
FIGURE 2
Distribution of migraine subtypes in COMICO in patients, (A) with concomitant rosacea; (B) without concomitant rosacea. COMICO, Copenhagen Migraine Cohort.
FIGURE 3
FIGURE 3
Distribution of rosacea subtypes in each cohort. ETR, erythematotelangiectatic rosacea; COROCO, Copenhagen Rosacea Cohort; COMICO, Copenhagen Migraine Cohort; PPR, papulopustular rosacea; OR, ocular rosacea; PR, phymatous rosacea.
See this image and copyright information in PMC

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