-IBIS-1.5.0-
tx
cutaneous system
rosacea
diagnoses
definition and etiology
definition: chronic acneiform eruption in the central region of the face, typically beginning in middle age or older and recognized by facial flushing and telangiectasia; aka acne rosacea
etiology: The disease is more common in women than men (3:1), but in men, the disease presents in a more severe form. The disease is idiopathic, and occurs mostly from age 30-50. There are usually no comedones associated with the disease; instead erythema, papules, pustules, seborrhea, and rhinophyma may develop. The disease is symmetrical. Implicating factors include: alcoholism, hypochlorhydria, vitamin B deficiency, vasomotor neurosis, and seborrheic tendency.
signs and symptoms
signs and symptoms:
skin symptoms as described above
blushing and flushing: vasomotor reactions
ocular symptoms (in 30-50% of patients): blepharoconjunctivitis, chalazion, iritis, keratitis, scleritis
migraine headaches
lab findings:
(+) Heidelberg analysis for hypochlorhydria
(+) blood analysis for vitamin B deficiency
course and prognosis
The course varies in patients, but tends to be chronic. Rhinophyma may be the worst outcome. There is a higher incidence of basal cell carcinoma in acne rosacea patients than in the general population. The ocular symptoms may eventually lead to corneal clouding, ulcerations or blindness.
differential diagnosis
drug eruptions: esp. iodides and bromides
cutaneous LE
granuloma of the skin
seborrheic dermatitis
atopic dermatitis
acne vulgaris
footnotes