ROSACEA

INTRODUCTION

Rosacea is well recognized as a chronic cutaneous disorder primarily of the convexities of the central face (cheeks, chin, nose, and central forehead) Cutaneous signs: flushing, erythema, telangiectasia, edema, papules, pustules, ocular lesions, and rhinophyma.

EPIDEMIOLOGY

Rosacea appears to be quite common It has been most frequently patients with fair skin, In Asians and African Americans can occur. Any sex , any age The onset typically begins at any time after age 30.

Etiology and Pathogenesis

The etiology of rosacea is unknown. Several pathogenesis are:

Vasculature Climatic exposures Dermal matrix degeneration Chemicals and ingested agents Perivascular versus perifollicular inflammation Microbial organisms

Clinical Picture

Cardinal Physical sign are as follower:

Erhytema Telangiectasia Papules Swelling pustules

STAGE IN ROSACEA

Episodic Erythema :the Rosacea diathesis Stage I. Persistent moderate erythema with scattered telangiectases. Stage II. Persistent erythema, numerous telangiectases, papules and pustules Stage III. Persistent deep erythema, dense telangiectases forming sprays (nose) papules, pustules, nodules with variable plaquelike edema

Subtype of Rosacea
Subtype 1: erythematotelangiectatic rosacea Subtype 2: papulopustular rosacea. Subtype 3: phymatous rosacea. Subtype 4: ocular rosacea.

Subtype 1 Erythematotelangiectatic rosacea

Subtype 2: papulopustular rosacea

Subtype 3: phymatous rosacea.

Subtype 4: ocular rosacea

Histopathology

According to the stage Often not diagnostic Demodex folliculorum often found in all type

Diagnostic Criteria

Deferential Diagnostic

Acne vulgaris, Seborrheic dermatitis Sarcoidosis, Lymorphous light eruption, Harbers syndrome

Complication

Rhinophyma Ocular Inflammation Rosacea lymphoedema

Other complication: blepharitis, meibomianitis, trichiasis, episcleritis, chalazion and hordeolum

Treatment

Additional therapy

Use sunscreen SPF 15 or higher Massase facial Diet cigarette, alcohol, coffee, spicy Surgery

Surgery

Laser resurfacing. Laser surgery removes layers of skin. This may help with an enlarged nose (rhinophyma); small, red lines; or lingering redness. Dermabrasion. This procedure may smooth the rough skin and bumps from the nose caused by rhinophyma. Cosmetic surgery. Reconstructive surgery and plastic surgery may reshape or remove bumps from a nose damaged by rhinophyma.