Dermatology

Rosacea

A chronic inflammatory facial dermatosis with flushing, persistent erythema, telangiectasia, papules or pustules, phymatous change and/or ocular disease; identify the dominant feature because treatment is feature-directed.

Definition

Rosacea is a chronic relapsing inflammatory facial dermatosis characterised by flushing, persistent erythema, telangiectasia and/or inflammatory papules and pustules, with possible ocular and phymatous involvement. It is diagnosed clinically and managed according to its dominant features.

First principles

Rosacea is a chronic inflammatory and neurovascular disorder, not an infection

Rosacea commonly causes episodic flushing that may progress to persistent central-facial erythema, telangiectasia and inflammatory papules or pustules. Antibiotics can help inflammatory disease through anti-inflammatory effects; their use does not prove that rosacea is a bacterial infection and should follow antimicrobial stewardship.

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