Summary
Tympanic (Tty), esophageal (Tes), forehead, and hand skin temperatures, as well as the forehead evaporation rate were recorded in six men (four suffering from rosacea and two healthy controls) before, during, and after 1 h of warm bath (38°–39°C). During the last 30 min of the bath, the subject's face was vigorously fanned (14 m/s). Blood flow was explored with ultrasonic Doppler in the emissary veins of the cranium during normothermia before entering the bath, and during hyperthermia just after leaving it. Under normothermic conditions, Tty was higher than Tes in all subjects. In three patients, no blood flow could be detected in the ophthalmic emissary veins whereas in the fourth patient as well as in both control subjects, blood flowed from the intracranium to the face. During hyperthermia, face fanning decreased Tty by 0.25°±0.05°C (±SEM) below Tes in the control subjects whereas in all patients Tty remained warmer than Tes by 0.1°C. Doppler recordings showed a rapid inward blood flow from the skin to the brain in the controls during hyperthermia. In patients, however, there was no change from normothermia in the blood flow patterns of vena angularis oculi. Their forehead temperature was permanently higher than in control subjects. Venous blood flow from the skin to the brain appears to be suppressed in rosacea, thus inhibiting selective brain cooling in hyperthermic conditions. The importance of this mechanism in the pathogenesis of rosacea and its significance as a means of investigation are discussed.
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References
Baker MA (1982) Brain cooling in endotherms in heat and exercise. Annu Rev Physiol 44:85–96
Baker MA, Hayward JN (1967) Carotid rete and brain temperature of cat. Nature 216:139–141
Bernstein JE (1982) Rosacea flushing. Int J Dermatol 21:24
Bernstein JE (1983) Flushing. In: Goldsmith LA (ed) Biochemistry and physiology of the skin: Neuropeptides and the skin. Oxford University Press, Oxford, pp 1226–1227
Bernstein JE, Soltani K (1982) Alcohol-induced rosacea flushing blocked by naloxone. Br J Dermatol 107:59–62
Borrie P (1955) State of the blood vessels of the face in rosacea. Br J Dermatol 67:5–8, 73–75
Brinnel H, Boy J, Cabanac M (1986) Intracranial temperature during passive heat exposure in humans. Brain Res 363:170–173
Brinnel H, Cabanac M (1987) Hyperthermia and human brain cooling. In: Shiraki K, Youssef MK (eds) Man in stressful environments. Thermal and work physiology. C. C. Thomas, Springfield, pp 87–97
Brinnel H, Cabanac M, Hales JRS (1987) Critical upper limits of body temperature, tissue thermosensitivity and selective brain cooling in hyperthermia. In: Hales JRS, Richardq DAB (eds) Heat stress, physical exertion and environment. Elsevier, Amsterdam, pp 209–240
Brinnel H, Nagasaka T, Cabanac M (1987) Enhanced brain protection during passive hyperthermia in humans. Eur J Appl Physiol 56:540–545
Cabanac M (1983) Face fanning: a possible way to prevent or to cure brain hyperthermia. In: Khogali M, Hales JRS (eds) Heat stroke and temperature regulation. Academic Press, Sydney, pp 213–221
Cabanac M, Brinnel H (1985) Blood flow in the emissary veins of the human head during hyperthermia. Eur J Appl Physiol Occup Phys 54:172–176
Cabanac M, Brinnel H (1987) The pathology of human temperature regulation: “thermiatrics”. Experientia 43: 19–27
Cabanac M, Caputa M (1979) Natural selective cooling of the human brain: evidence of its occurrence and magnitude. J Physiol (Lond) 286:255–264
Cabanac M, Caputa M (1979) Open loop increase in trunk temperature produced by face cooling in working humans. J Physiol (Lond) 289:163–174
Cabanac M, Germain M, Brinnel H (1987) Tympanic temperature during hemiface cooling. Eur J Appl Physiol 56:534–539
Caputa M (1980) Thermal gradients in the oesophagus of man during exercise and passive warming. J Therm Biol 5:248–251
Caputa M (1981) Selective brain cooling: an important component of thermal physiology. In: Selenvi Z, Szekely M (eds) Contributions to thermal physiology. Pergamon Press, Oxford, pp 183–192
Caputa M, Cabanac M (1980) Muscular work as thermal behavior in humans. J Appl Physiol 48:1020–1023
Caputa M, Kadziela W, Narebski J (1976) Significance of cranial circulation for the brain homeothermia in rabbits. II. The role of cranial venous lakes in the defense against hyperthermia. Acta Neurobiol Exp 36:625–638
Caputa M, Perrin G, Cabanac M (1978) Ecoulement sanguin réversible dans la veine ophtalmique: mécanisme de refroidissement sélectif du cerveau humain. CR Acad Sci [III] 287:1011–1014
Cheadle WB (1884) Acne rosacea. Practitioner 13:1–8
Cuntliffe WJ, Tan SG, Tebbs E (1975) Rosacea, migraine and Dixarit. Br J Dermatol [Suppl 11] 93:11–12
Grosshans E (1977) Bilan des notions étiologiques actuelles de la rosacée. J Agrégés 10:427–433
Grosshans E, Friedel J (1987) Physiopathologie de la Rosacée et ses implication thérapeutiques. Actualités Dermatologiques. Séance Académique en l'honneur du Professeur Achten. Bruxelles, 17 October 1987. Nouvelles Dermatologiques 6 [Suppl 4]:466–470
Guarrera AM, Parodi A, Cipriani C, Divano C, Rebora A (1982) Flushing in rosacea: a possible mechanism. Arch Dermatol Res 272:311–316
Haxthausen H (1930) Changes in skin vessels from protracted action of climatic factors and their significance in various skin diseases. Br J Dermatol 42:105
Marks R (1968) Conncepts in the pathogenesis of rosacea. Br J Dermatol 80:170–177
Narebski J (1985) Human brain homeothermy during sleep and wakefulness: an experimental and comparative approach. Acta Neurobiol Exp 45:63–75
Parodi A, Guarrera M, Rebora A (1980) Flushing in rosacea: an experimental approach. Arch Dermatol Res 269:269–273
Rebora A (1987) Rosacea. J Invest Dermatol, 88 [Suppl 3]: 569–605
Søbye P (1950) Aetiology and pathogenesis of rosacea. Acta Derm Venereol (Stockh) 30:137–153
Still J (1982) On the number of subjects used in animal behavior experiments. Anim Behav 30:873–880
Wilkin JK (1979) Heat, not caffeine, induces flushing in erythematotelangiectatic rosacea. J Invest Dermatol 73: 310–312
Wilkin JK (1980) Vasodilator rosacea. Arch Dermatol 116:598
Wilkin JK (1980) Oral thermal induced flushing in erythematotelangiectatic rosacea. J Invest Dermatol 76: 15–18
Wilkin JK (1982) A quantitative, non-invesive method for the characterization of flushing reactions. J Invest Dermatol 78:276–279
Wilkin JK (1983) Rosacea: a review. Int J Dermatol 22:393–400
Wilkin JK (1986) Quantitative assessment of alcohol-provoked flushing. Arch Dermatol 122:63–65
Wilkin JK, Josephs JA (1980) Infrared photographic studies of rosacea. Arch Dermatol 116:676–678
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Brinnel, H., Friedel, J., Caputa, M. et al. Rosacea: disturbed defense against brain overheating. Arch Dermatol Res 281, 66–72 (1989). https://doi.org/10.1007/BF00424276
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DOI: https://doi.org/10.1007/BF00424276