Vascular Remodeling in Rosacea: A Study on Microcirculatory Insights Using Oral Capillaroscopy

ABSTRACT Background Rosacea is a chronic inflammatory skin condition characterized by facial erythema, telangiectasia, and papules. Although clinical assessment is essential for diagnosis, objective criteria for evaluating severity are lacking. This study aimed to investigate the relationship between rosacea severity, disease duration, and associated microvascular changes through oral mucosal capillaroscopy. Methods This cross‐sectional case–control study included patients with rosacea and healthy controls. Oral capillaroscopy was performed to evaluate capillary morphology, analyzing parameters such as capillary arrangement (regular or irregular), presence of dot vessels, microhemorrhages, glomerular vessels, megacapillaries, tortuous vessels, areas of discoloration, and hyperkeratosis. Results A total of 100 patients diagnosed with rosacea and 100 healthy controls were included in the study. Oral capillaroscopic findings revealed significantly higher rates of family history of rosacea and tortuous capillaries in the patient group. Patients with microhemorrhages exhibited a longer disease duration. No significant differences in tortuous capillary positivity were found between the papulopustular and erythematotelangiectatic subtypes; however, phymatous rosacea demonstrated no positive findings. Additionally, moderate‐severity patients had lower rates of microhemorrhage positivity, whereas the presence of tortuous capillaries increased with severity. Conclusion Oral mucosal capillaroscopy is a valuable tool for assessing microvascular damage in rosacea and may serve as a diagnostic and prognostic marker for effective management.