Rosacea
Rosacea: Excerpt from Professional Guide to Diseases (Eighth Edition)
A chronic skin eruption, rosacea produces flushing and dilation of the small blood vessels in the face, especially the nose and cheeks. Papules and pustules may also occur, but without the characteristic comedones of acne vulgaris. Ocular involvement may result in blepharitis, conjunctivitis, uveitis, or keratitis. Rosacea usually spreads slowly and rarely subsides spontaneously.
Causes and incidence
Although the cause of rosacea is unknown, stress, infection, vitamin deficiency, menopause, and endocrine abnormalities can aggravate this condition. Anything that produces flushing — for example, hot beverages, such as tea or coffee; tobacco; alcohol; spicy foods; physical activity; sunlight; and extreme heat or cold — can also aggravate rosacea.
Rosacea is most common in white women between ages 30 and 50. When it occurs in men, however, it’s usually more severe and often associated with rhinophyma, which is characterized by dilated follicles and thickened, bulbous skin on the nose.
Signs and symptoms
Rosacea generally begins with periodic flushing across the central oval of the face, accompanied later by telangiectasia, papules, pustules, and nodules. Rhinophyma is commonly associated with severe untreated rosacea but may occur alone. Rhinophyma usually appears first on the lower half of the nose, and produces red, thickened skin and follicular enlargement. It’s found almost exclusively in men older than age 40. Related ocular lesions are uncommon.
Diagnosis
CONFIRMING DIAGNOSIS Typical vascular and acneiform lesions — without the comedones characteristically associated with acne vulgaris — and rhinophyma in severe cases confirm rosacea.
Treatment
Treatment for the acneiform component of rosacea consists of oral tetracycline or erythromycin in gradually decreasing doses over 1 to 2 months as symptoms subside. Resistant cases can be treated with oral minocycline or doxycycline. Isotretinoin is also effective, but its use is limited to those with severe disease. Topical metronidazole gel helps the papules, pustules, and erythema. Sulfacet-R lotion, available in flesh tones, controls pustules and hides redness. It can be used alone or together with oral antibiotics. Other treatments include electrolysis to destroy large, dilated blood vessels and removal of excess tissue in patients with rhinophyma. Topical hydrocortisone preparations worsen the condition.
Special considerations
❑ Instruct the patient to avoid spicy foods, hot beverages, alcohol, extended sun exposure, and other possible causes of flushing.
❑ Assess the effect of rosacea on body image. Because it’s always apparent on the face, support is essential.
❑ Encourage the use of sunscreen.
Book Source Details
- Book Title: Professional Guide to Diseases (Eighth Edition)
- Author(s): Springhouse
- Year of Publication: 2005
- Copyright Details: Professional Guide to Diseases (Eighth Edition), Copyright © 2005 Lippincott Williams & Wilkins.
More About Rosacea
More Medical Textbooks Online about Rosacea
Review other book chapters online related to Rosacea:
Medical Books Excerpts
- Acne
- "In a Page: Signs and Symptoms" (2004)
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- Rosacea
- "Professional Guide to Diseases (Eighth Edition)" (2005)
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- Papular rash
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
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- Pustular rash
- "Professional Guide to Signs & Symptoms (Fifth Edition)" (2006)
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- Acne
- "The 5-Minute Pediatric Consult" (2008)
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
» Next page: Acne vulgaris (Professional Guide to Diseases (Eighth Edition))
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