ROSACEA MEDICAL APPENDIX DEFINITION 1. Rosacea is a chronic inflammatory skin disorder characterized by recurrent or persistent facial redness which may be associated in varying degree with papules, pustules and overgrowth of sweat glands. CLINICAL MANIFESTATIONS 2. In the early stages, intermittent flushing of the face is noticeable affecting especially the nose, cheeks, the centre of the forehead and the chin. The flushing or erythema soon become permanent and is the characteristic feature of the disease with papules and pustules often being associated. 3. The course is variable, the erythema sometimes subsiding spontaneously but, more commonly, it persists with recurrent exacerbations. 4. Occasionally, the disease is complicated by enormous overgrowth of the sebaceous glands of the nose, leading to the condition known as rhinophyma or “strawberry nose”. This complication is more common in men than women. Other common complications are blepharitis, conjunctivitis and keratitis. AETIOLOGY 5. Rosacea is a common condition which appears to affect females more than males. However, different studies have arrived at different conclusions with regard to this aspect and it seems probable that the female-to-male ratio depends on the relative awareness by the sexes of cosmetic disability in the particular part of the world. 6. The condition is commonest in the third to fourth decades of life but it not uncommonly occurs in both the elderly and the adolescent. 7. Despite many unsupportable hypotheses as to the cause of the condition and much investigation of the gastro-intestinal tract, psychological aspects, infective possibilities and climatic effects, no cause has been identified nor has any statistical relationship with any factor been established. 8. Certain factors, which tend to cause vasodilation in normal individuals, exacerbate rosacea. Among these are heat (applied either externally or internally as with hot drinks and foods), alcohol, emotional stress and over-exposure to sunlight. CONCLUSION 9. Rosacea is a disease of unknown cause. Factors which can adversely affect its course are listed at paragraph 8 above.
REFERENCE Marks R. Rosacea, Flushing and Perioral Dermatitis - Rosacea. In: (Eds) Champion R H, Burton J L and Ebling F J G. Textbook of Dermatology. Oxford. Blackwell Scientific Publications. 5th Ed. 1992. p1851-1858. December 1992