The first classification of rosacea was published in 2002, recognising rosacea as a syndrome that is comprehensively depicted by four distinct clinical subtypes defined as erythematotelangiectatic, papulopustular, phymatous, and ocular rosacea: The nose may be enlarged and distorted by rhinophyma.Although the usual areas affected are the nose, cheeks and forehead, other areas, such as the neck, chest and ears, can become involved. Erythema and telangiectasias over the forehead and cheeks are variable.The skin is not greasy as in acne and may be rather dry.The disease tends to be progressive but that does not mean that everyone will develop all features. A few complain of gritty eyes and facial oedema.The symptoms are initially intermittent but progress to a constant flushing with obvious telangiectasia.Patients usually complain of the skin condition but direct enquiry may often reveal a long history of flushing back to early teens or before.For a diagnosis to be confirmed the erythema should have been present for at least three months.Rosacea is primarily a condition of the white population it is three times more common in women than in men and has a peak age of onset between 30 and 60 years.In Europe, there is an increasing prevalence from South to North: in Germany prevalence is 2.2%, in Sweden 10% and in Estonia 22%.Drugs such as calcium-channel blockers (may worsen vasodilatation and flushing) and topical corticosteroids.However variability between studies was high and a causal relationship could not be confirmed.Īdditional factors that may trigger or worsen rosacea include: It is likely to be multifactorial involving genetic and environmental factors.Ī systematic review found that compared with controls, people with rosacea were more likely to be infested with Demodex mites and had significantly higher skin density of Demodex mites than controls. Rhinophyma is an enlarged nose associated with rosacea which occurs almost exclusively in men. Ocular rosacea is usually bilateral and causes a foreign-body sensation. Rosacea is characterised by recurrent episodes of facial flushing with persistent erythema, telangiectasia, papules and pustules. Symptoms present in various combinations and severity, often fluctuating between periods of exacerbation and remission. Rosacea is a chronic relapsing inflammatory skin disease with a high prevalence among adults of Northern European heritage with fair skin.
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