Rosacea

Abstract

Rosacea is a common, inflammatory facial dermatosis that affects predominantly middle-aged patients. The cause is unclear, but dermal damage from ultraviolet rays may be important in fair-skinned individuals. It is characterized by a mixture of inflammatory papules and pustules along with varying degrees of flushing, vasodilatation and telangiectasia. These features are seen on the convexities of the face such as the forehead, cheeks and nose. Occasionally, other sites such as the scalp and the V of the neck are involved. Symptoms are aggravated by heat, emotion, vasodilator drugs and potent topical corticosteroids. Treatment is with topical metronidazole or oral broad-spectrum antibiotics, usually tetracyclines. The condition is chronic, and treatment is therefore often required long term. Differential diagnoses includes acne vulgaris, facial eczema and lupus erythematosus. Complications include ocular involvement, rhinophyma and lymphoedema. Ocular disease necessitates oral antibiotic treatment, while rhinophyma usually requires surgical correction.