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    Default Remission of rosacea induced by reduction of gut transit time

    Rosacea is a chronic disorder characterized by hypersensitivity of the facial vascu-lature, presenting with intense flushing eventually leading to chronic erythema andtelangiectasia. Although the precise aetiology of rosacea is not known, numerousassociations with inflammatory gastrointestinal tract disorders have been reported.Furthermore, substance P-immunoreactive neurones occur in considerably greaternumbers in tissue surrounding affected blood vessels suggesting involvement ofneurogenic inflammation and moreover plasma kallikrein–kinin activation isconsistently found in patients. In this report, a patient without digestive tract diseaseis described, who experienced complete remission of rosacea symptoms followingingestion of a material intended to sweep through the digestive tract and reduce transittime below 30 h. It is possible that intestinal bacteria are capable of plasma kallikrein–kinin activation and that flushing symptoms and the development of othercharacteristic features of rosacea result from frequent episodes of neurogenicinflammation caused by bradykinin-induced hypersensitization of facial afferentneurones. The possible relevance of this hypothesis to other conditions featuringafferent hypersensitivity, such as fibromyalgia, is considered.
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