To critically evaluate whether the observed convergences between atopic dermatitis (AD) and rosacea represent true mechanistic overlap or parallel but independent responses.
Key Findings:
Both AD and rosacea share an upstream innate immune activation platform involving TLR2/TLR4 signaling, NLRP3 inflammasome activation, mast cell degranulation, and neurovascular dysregulation.
AD is characterized by Th2/ILC2 skewing and IgE sensitization, while rosacea is dominated by Th1/Th17 involvement and LL-37 overproduction.
Dupilumab-induced rosacea-like dermatitis suggests competition between the immune polarization states of AD and rosacea.
Interpretation:
The duality of immune responses in AD and rosacea challenges simplistic models of mechanistic overlap.
Limitations:
No formal risk-of-bias assessment was performed due to the narrative nature of the review.
The review may not encompass all relevant studies published after April 2026, which could affect the comprehensiveness of the findings.
Conclusion:
Future research should utilize multi-omics approaches and prospective comorbidity cohorts to clarify causal pathways.
