-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