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| Acne rosacea |
Chronic skin eruption with flushing and dilation of small blood vessels in the face, especially nose and cheeks. Sometimes associated with ocular symptoms (ocular rosacea).
Predominant age: 30-50
Predominant sex: Female > Male
SIGNS AND SYMPTOMS are skin flush - prominent at onset, redness - lower half of nose, sometimes whole nose, forehead, cheeks, chin, conjunctivae red - (sometimes), erythema, dusky - (in advanced cases), blood vessels in involved area collapse under pressure, acne lesions form papules, pustules, and nodules; comedones are rare, telangiectasia, and rhinophyma (sometimes) more common in males
CAUSES:
•No proven cause.
*Possibilities include
•Thyroid and gonadal disturbance
•Alcohol, coffee, tea, spiced food overindulgence (unproven)
•Demodex follicular parasite (suspected)
•Exposure to cold, heat, hot drinks
•Emotional stress
•Dysfunction of the gastrointestinal tract
PATHOLOGICAL FINDINGS:
•Inflammation around hypertrophied sebaceous glands, producing papules, pustules and cysts
•Absence of comedones and blocked ducts
•Vascular dilatation and dermal lymphocytic infiltrate
ACTIVITY:
No restrictions. Support physical fitness.
DIET:
Avoid any food or drink that causes facial flushing, e.g., hot drinks, spiced food, alcohol
Precautions:
•Tetracycline: may cause photosensitivity; sunscreen recommended
Significant possible interactions:
•Tetracycline: avoid concurrent administration with antacids, dairy products, or iron
•Broad-spectrum antibiotics: may reduce the effectiveness of oral contraceptives; barrier
method recommended
ALTERNATIVE DRUGS:
•For severe cases, isotretinoin orally for 4 months.
POSSIBLE COMPLICATIONS:
•Rhinophyma (dilated follicles and thickened bulbous skin on nose), especially in men
•Conjunctivitis
•Blepharitis
•Keratitis
EXPECTED COURSE AND PROGNOSIS:
•Slowly progressive
•Subsides spontaneously (sometimes)
PREGNANCY:
Use of oral isotretinoin contraindicated |
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