title: Association of Rosacea With Risk for Glioma in a Danish Nationwide Cohort Study.
abstract: Rosacea, a common facial skin disorder, has a poorly understood pathogenesis in which increased matrix metalloproteinase activity might play an important role. Glioma accounts for 80% of all primary malignant tumors in the central nervous system, and these tumors also show upregulation of certain matrix metalloproteinases.
  
  
  
  To investigate the association between rosacea and the risk for glioma.
  
  
  
  Nationwide cohort study of the Danish population from individual-level linkage of administrative registers. All Danish citizens 18 years or older from January 1, 1997, to December 31, 2011, were eligible for inclusion. A total of 5 484 910 individuals were eligible for analysis; of these, 68 372 had rosacea and 5 416 538 constituted the reference population. Data were analyzed from July 14 to August 10, 2015.
  
  
  
  The outcome of interest was a diagnosis of glioma. Incidence rates per 10 000 person-years were calculated, and incidence rate ratios adjusted for age, sex, and socioeconomic status were estimated by Poisson regression distribution models.
  
  
  
  Of the 5 484 910 individuals in the study population, 21 118 individuals developed glioma during the study period, including 20 934 of the 5 416 538 individuals in the reference population (50.4% women; mean [SD] age, 40.8 [19.7] years) and 184 of the 68 372 patients with rosacea (67.3% women; mean [SD] age, 42.2 [16.5] years). The incidence rate (95% CI) of glioma was 3.34 (3.30-3.39) in the reference population and 4.99 (4.32-5.76) in patients with rosacea. The adjusted incidence rate ratio (95% CI) of glioma in patients with rosacea was 1.36 (1.18-1.58) in our primary analysis. When analyses were limited to patients with a primary diagnosis of rosacea by a hospital dermatologist (n = 5964), the adjusted incidence rate ratio was 1.82 (1.16-2.86).
  
  
  
  Rosacea was associated with a significantly increased risk for glioma in a nationwide cohort. This association may be mediated, in part, by mechanisms dependent on matrix metalloproteinases. Increased focus on neurologic symptoms in patients with rosacea may be warranted.
authors.affiliation: National Allergy Research Centre, Herlev and Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark2Department of Dermato-Allergology, Herlev and Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark3Department of Ca.
authors.forename: Alexander
authors.initials: A
authors.lastname: Egeberg
authors.affiliation: Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Hansen
authors.affiliation: Department of Cardiology, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark4The Danish Heart Foundation, Copenhagen, Denmark5National Institute of Public Health, University of Southern Denmark, Copenhagen.
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: National Allergy Research Centre, Herlev and Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark2Department of Dermato-Allergology, Herlev and Gentofte University Hospital, University of Copenhagen, Hellerup, Denmark.
authors.forename: Jacob P
authors.initials: JP
authors.lastname: Thyssen
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000201:enzymology / Q000453:epidemiology* / Q000473:pathology; D015331:Cohort Studies; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000201:enzymology / Q000453:epidemiology* / Q000473:pathology; D006801:Humans; D015994:Incidence; D008297:Male; D020782:Matrix Metalloproteinases / Q000378:metabolism*; D008875:Middle Aged; D016012:Poisson Distribution; D012042:Registries; D012307:Risk Factors; D012393:Rosacea / Q000201:enzymology / Q000453:epidemiology* / Q000473:pathology; D015854:Up-Regulation; D055815:Young Adult
chemical_list: D020782:Matrix Metalloproteinases