Rosacea in black South Africans with skin phototypes V and VI

Abstract

Rosacea is a chronic facial dermatosis considered to affect primarily white patients with light phototype skin, and is poorly documented in black patients. The aim of this study was to document the clinical features of rosacea in patients with phototypes V and VI. An 8-year retrospective chart review of patients with a clinical and histological diagnosis of rosacea or acne rosacea was undertaken. Of 6700 patients, 15 (0.2%) had rosacea. All were of African descent with skin phototype V or VI. Mean age was 47 years, and female : male ratio was 14 : 1. Of the 15 patients, 5 (33%) were positive for human immunodeficiency virus; 5 (33%) had used topical steroids to treat the roseacea; 6 (40%) had phototype V and presented with erythema, telangiectasia and erythematous papules, while 9 (60%) had phototype VI skin and presented with skin-coloured papules; and 10 (67%) had histology showing granulomatous rosacea, while 5 (33%) declined a facial skin biopsy. A high index of suspicion is required to diagnose rosacea in black patients as the classic signs of erythema and telangiectasia are difficult to discern.

Epidemiological features of rosacea in Changsha, China: A population‐based, cross‐sectional study

“…According to worldwide data, Caucasian populations showed higher rosacea prevalence rates (Russia, 5.0%; Germany, 12.3%; Estonia, 22%), much higher than those seen in African countries (South Africa, 0.2%; Tunisia, 0.2%). [9][10][11][12] Prevalence differences of rosacea around the world have been mainly attributed to skin phototypes and environmental factors (climate, ultraviolet [UV] exposure and lifestyle). 13 Regardless of racial differences in prevalence, sampling methodology and case criteria may also influence prevalence findings.…”

Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee

“…[1][2][3][4] Although it has been most frequently observed in patients with fair skin, rosacea has also been diagnosed in Asians, Latin Americans, African-Americans, and Africans (Figs 1 to 4). [5][6][7][8] The disorder is identified more often in women than in men, and although it may occur at any age, the onset typically occurs at any time after age 30. 1,2 In 2002, the National Rosacea Society (NRS) assembled an expert committee to develop a classification system to provide standard criteria essential for performing research, analyzing results, and comparing data from different sources, as well as to serve as a diagnostic reference in clinical practice.…”

Acne and rosacea in skin of colour

“…Delayed diagnosis can lead to greater morbidity and disease progression 3 . For example, over an 8‐year period in a South African dermatology clinic, only 15 cases of rosacea were identified in 6700 attendees with skin phototypes V and VI 17 . In this small cohort, the majority of patients presented with skin‐coloured papules and phymatous changes, which were confirmed to be granulomatous rosacea on histology.…”