Clinical Characteristics and Serum <scp>CGRP</scp> Level Differences Between Neurogenic Rosacea and Non‐Neurogenic Rosacea

BACKGROUND: There are limited reports on neurogenic rosacea (NR), and further clarifications are needed regarding its clinical manifestations, serological indicators, and treatment response. OBJECTIVE: Our aim was to explore the clinical features and potential serological biomarkers of NR. METHODS: We collected and analyzed the clinical characteristics, triggers, psychological burden, and treatment of 251 rosacea patients. According to the 2017 International Diagnostic Criteria for Rosacea, key clinical symptoms, and response to conventional treatment, the cohort was divided into 32 NR patients and 219 non-neurogenic rosacea (NNR) patients. Serum neuropeptide levels were detected in 20 NR patients and 20 matched NNR controls. Clinical characteristics, serum neuropeptide differences, and correlations were assessed. RESULTS: NR patients exhibited more severe and more frequent flushing. Besides, neuroinflammatory-related symptoms, such as burning, occur more frequently in NR patients. The serum calcitonin gene-related peptide (CGRP) levels were significantly elevated in NR patients and correlated with clinical severity, flushing severity of rosacea, and treatment outcome. CONCLUSION: NR patients experienced more severe flushing and other neuroinflammatory-related symptoms. The increased serum CGRP level was positively correlated with the severity of NR, suggesting its potential as an adjunct biomarker to screen for NR in rosacea patients and guide treatment.