Rosacea

Abstract

Rosacea, a common disease in adults, has an extremely variable presentation. Severity is also highly variable and, to some degree, the location of mild end of the rosacea spectrum is in the eye of the beholder. Rosacea has been noted since at least the Middle Ages. The red-faced drunk and the swollen nose of the self-indulgent are images from Shakespeare and Chaucer that have been used in modern political cartoons as well. This association with alcohol and excess is unfortunate since most patients are neither alcoholic nor dissipated.

Blushing in rosacea sufferers

“…As perceptions of blushing were associated with the degree of embarrassment, these findings suggest that blushing heightened embarrassment. In particular, rosacea sufferers could worry that blushing might draw attention to their persistently flushed face, or that the erythema of rosacea might be misinterpreted as an intense emotional response [13] or a sign of alcoholism [39].…”

“…The differential diagnosis of rosacea is challenging, as seborrhoeic dermatitis and diseases such as keratosis pilaris and lupus may co-exist with or mimic features of rosacea [1,11,39]. Although each patient in our sample had been diagnosed with rosacea by a general practitioner, only some of them had attended a dermatologist.…”

Acne Rosacea

“…A lymphohistiocytic infiltrate with perivascular and perifollicular distribution is observed in papulopustular form [17]. Solar elastosis is invariably found in histopathologic examination of biopsy specimens.…”

“…Seborrheic dermatitis often coexists with rosacea [17]. Scaling and erythema of the scalp, eyebrows, external auditory canals, and retroauricular folds serve as clues to the presence of seborrheic dermatitis [4].…”

“…Clinically, papules pustules and ocular symptoms are mostly absent in lupus [17]. Severe Demodex infection (demodicosis) may present with rosacea-like features, but flushing and telangiectasia are absent [4].…”