Rosacea is essentially a cutaneous vascular disorder, as recently demonstrated by Wilkin1 in the March 1994 issue of the Archives. The origin of rosacea as it relates to migraine and ocular symptoms warrants further comments.
The skin alterations in all four stages of rosacea (flushing, erythema-telangiectasia, papulopustules, and rhynophyma) as well as histopathologic investigations2 demonstrate rosacea to be essentially a cutaneous vascular disorder. The origin of these vascular abnormalities is, however, still unclear. Rosacea may result from a microcirculatory disturbance of the facial angular veins involved in the brain-cooling vascular mechanism,3,4 which is suggested by the topography of rosacea, which exactly corresponds to the cutaneous area of drainage by the tributary veins of the venae angularis.
Is rosacea associated with migraine? As this vascular disorder affects 15% to 25% of whites, its association with rosacea should not be exceptional. Forty-four percent of 137 patients suffering from rosacea
Ramelet AA. Rosacea: A Reaction Pattern Associated With Ocular Lesions and Migraine?. Arch Dermatol. 1994;130(11):1448. doi:10.1001/archderm.1994.01690110118022