Acne Rosacea Disease
BASICS
DESCRIPTION
Chronic skin eruption with flushing and dilation of small blood vessels in the face, especially nose and cheeks. Sometimes associated with ocular symptoms (ocular rosacea).
- System(s) affected: Skin/Exocrine
- Genetics: People of Northern European and Celtic background commonly afflicted
- Incidence/Prevalence in USA: Common
- Predominant age: 30-50
- Predominant sex: Female > Male
SIGNS AND SYMPTOMS
- Skin flush - prominent at onset
- Redness - lower half of nose, sometimes whole nose, forehead, cheeks, chin
- Conjunctivae red - (sometimes)
- Erythema, dusky - (in advanced cases)
- Blood vessels in involved area collapse under pressure
- Acne lesions form papules, pustules, and nodules; comedones are rare
- Telangiectasia
- Rhinophyma (sometimes) more common in males
CAUSES
- No proven cause. Possibilities include:
- Thyroid and gonadal disturbance
- Alcohol, coffee, tea, spiced food overindulgence (unproven)
- Demodex follicular parasite (suspected)
- Exposure to cold, heat, hot drinks
- Emotional stress
- Dysfunction of the gastrointestinal tract
RISK FACTORS
N/A
DIAGNOSIS
LABORATORY
N/A
- Drugs that may alter lab results: N/A
- Disorders that may alter lab results: N/A
PATHOLOGICAL FINDINGS
- Inflammation around hypertrophied sebaceous glands, producing papules, pustules and cysts
- Absence of comedones and blocked ducts
- Vascular dilatation and dermal lymphocytic infiltrate
SPECIAL TESTS
N/A
IMAGING
N/A
DIAGNOSTIC PROCEDURES
N/A
TREATMENT
APPROPRIATE HEALTH CARE
Outpatient
GENERAL MEASURES
- Reassurance
- Treat psychological stress if present
- Avoid oil based cosmetics. Others are acceptable and may help women tolerate the symptoms.
- Electrodesiccation of permanently dilated blood vessels
SURGICAL MEASURES
Surgical treatment of rhinophyma
ACTIVITY
No restrictions. Support physical fitness.
DIET
Avoid any food or drink that causes facial flushing, e.g., hot drinks, spiced food, alcohol
PATIENT EDUCATION
American Academy of Dermatology (708) 330-0230
FOLLOW UP
PREVENTION/AVOIDANCE
No preventive measure known
COMPLICATIONS
- Rhinophyma (dilated follicles and thickened bulbous skin on nose), especially in men
- Conjunctivitis
- Blepharitis
- Keratitis
EXPECTED COURSE AND PROGNOSIS
- Slowly progressive
- Subsides spontaneously (sometimes)
MISCELLANEOUS
ASSOCIATED CONDITIONS
- Seborrheic dermatitis of scalp and eyelids
- Keratitis with photophobia, lacrimation, visual disturbance
- Corneal lesions
- Blepharitis
- Uveitis
AGE-RELATED FACTORS
- Pediatric: Unlikely in this age group
- Geriatric: Uncommon after age 60
- Others: N/A
PREGNANCY
Use of oral isotretinoin contraindicated
OTHER NOTES
N/A
ABBREVIATIONS
N/A
Clinical Investigations
- Cardiology
- Dermatology
- General Destistry
- Cardiology
- Dermatology
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