Cutaneous and Ocular Signs of Childhood Rosacea

Abstract

To describe the clinical features of cutaneous and ocular manifestations of childhood rosacea, to propose diagnostic criteria, and to emphasize the possible severity of ocular complications in this age group.

Ocular rosacea: a review

“…However, in children, the dermatologic findings are often absent, making the diagnosis even more challenging and the identification of ocular manifestations especially important (15,17,57) . A study revealed ocular symptoms to precede skin features in 55% of children (58) . Ophthalmologists should maintain high suspicion in children with ocular surface disease, with or without cutaneous features, to avoid misdiagnosis and complications (59) .…”

“…The most common ocular signs in pediatric rosacea include meibomian gland dysfunction, telangiectasia, recurrent chalazia, conjunctival hyperemia, superficial punctate epitheliopathy involving the inferior cornea, as well as corneal infiltrates, pannus and neovascularization (16,58) . Phlyctenular keratoconjunctivitis has also been associated with ocular rosacea in children (17) .…”

“…This routine may be difficult to maintain in children; however, the importance of these measures should be reinforced to the parents. Topical erythromycin ointment may also be used on the eyelid margins (58) . Low-dose corticosteroid drops may be necessary to control ocular surface inflammation and treat keratitis, peripheral corneal vascularization and scarring (17) .…”

“…Systemic treatment of ocular childhood rosacea is very similar to that in adults, although one important difference is that tetracyclines are contra-indicated in children younger than 7 years of age (58) . Tetracycline and doxycycline, commonly used for therapy in adults, may result in depressed bone growth and dental staining in this age range (17) .…”

Two Cases of Corneal Ulcer Caused by Ocular Rosacea: Late Versus Prompt Diagnosis and Treatment

“…Alvarenga suggested the use of doxycycline, 100 mg twice daily for 2-3 weeks, then tapering to 100 mg/day and later to 50 and 25 mg per day [3]. Tetracyclines however, are contraindicated for patients under 8 years old [7,8]. Miguel et al suggested the use of erythromycin for patients under 8 years old, and used it on their case series of two patients.…”