Rosacea and Associated Comorbidities: A Google Search Trends Analysis (Preprint)

BACKGROUND Rosacea is a common skin condition that affects millions of individuals across the globe. While the pathogenesis of rosacea remains unclear, there is mounting evidence linking rosacea with systemic conditions. In recent years numerous reports have demonstrated correlations between rosacea and gastrointestinal, neurologic, and psychiatric disease. Given the mounting evidence linking rosacea with systemic disease, we sought to assess whether the general public is aware and seeking information regarding these trends. OBJECTIVE Our aim was to evaluate whether there exists a correlation between Google searches for rosacea and common comorbid conditions over the time period of January 2004 to February 2018. METHODS Using data acquired from Google, we assessed for correlations between search terms involving rosacea and systemic diseases to ascertain whether this is an area of emerging interest in the general public. The search term rosacea along with 24 other search terms for common comorbid conditions were investigated over the time period of January 1, 2004 to February 28, 2018 in the four majority English-speaking countries of US, Canada, UK, and Australia. Search volume index (SVI) data were plotted over time and Pearson correlation coefficients were calculated from search data to assess for correlations between search terms. Statistical analysis was performed using IBM SPSS Statistics version 25.0. RESULTS Interest in rosacea was highest in spring months (March, April, May) and lowest in winter months (December, January, February) in the US, Canada, and UK from January 2004 to February 2018. Search trends for gastrointestinal disorders IBS (R = .399, P < .001) and ulcerative colitis (R = .514, P = .032) correlated significantly with rosacea in Canada and the UK respectively. A significant correlation was found between rosacea and depression SVI in the US (R = .481, P < .001), while no significant correlation was found between the two search terms in the UK, Canada, or Australia. A very strong positive correlation between dementia and rosacea SVI was found in the UK (R= .774, P = .011). A robust correlation was found between rosacea and hypothyroidism SVI (R = .752, P < .001) in the UK, while a significant negative correlation was noted between rosacea and hyperthyroidism SVI in Australia (R= -.180, P = .003). CONCLUSIONS In light of increasing awareness of links between rosacea and systemic disease, our results demonstrate several strong correlations in public interest of rosacea and comorbid disease. These correlations were strongest for gastrointestinal (IBS and UC), neuropsychiatric (depression and dementia), and metabolic conditions (hypothyroidism, diabetes). Overall, our findings indicate growing interest in the general public regarding rosacea and comorbid diseases, which behooves clinicians to take a more comprehensive approach in managing rosacea patients.