Case Series: Underdiagnosis of Ocular and Oculocutaneous Rosacea in an African American Pediatric Population.

Abstract

As the global multiracial population grows, this case series highlights the current underdiagnosis and misdiagnosis of ocular and oculocutaneous rosacea and the importance of properly identifying the condition in a darkly pigmented pediatric population. This series aims to report the clinical presentation of ocular and oculocutaneous rosacea and adverse sequelae of misdiagnosis in two pediatric African American patients. One 11-year-old boy and one 10-year-old girl, both darkly pigmented African American patients, presented with a history of chronic ocular irritation. The male patient was seen by an eye care provider eight times over the past 7 years for recurrent anterior ocular inflammation. The female patient presented to the clinic with chronic anterior segment ocular inflammation for 1 year. Both patients were previously treated for their acute signs and symptoms. The male patient was diagnosed with ocular rosacea, and the female patient was diagnosed with oculocutaneous rosacea. Both patients were subsequently treated for their underlying inflammatory condition, yielding an improvement in their ocular health. These two cases bring attention to the underdiagnosis and misdiagnosis of ocular and oculocutaneous rosacea in pediatric patients with darkly pigmented skin. Timely and accurate diagnosis is critical to minimize the risk of significant visual and dermatological sequelae.