Contributor: Johannes K. Kristinsson
Rosacea (acne rosacea) is a common acneiform chronic inflammatory disorder of midline facial skin and cheeks, often accompanied by ocular involvement. The condition is more common in females than males. Affected individuals flush easily. The histopathologic abnormalies include telangiectasia, follicular pustules, and abscesses. Papules may develop in association with diffuse erythema and a non-granulomatous inflammation or granulomatous inflammation. Late in the disease, hyperplasia of the glands of the skin may develop, often in conjunction with rhinophyma. Rosacea affects sun-exposed areas of face, and, less commonly, the neck and chest. The facial skin develops a ruddy complexion. The disease is gradual in onset, with intermittent flushing of midline facial skin and cheeks, which represents vascular dilatation, sometimes with edema. This gives eventually way to permanent dilatation and tortuosity of the vessels, or telangiectasia. The patients also develop papules, pustules and, occasionally, nodules. In later stages, the nose may characteristically enlarge and become erythematous and violaceous, or classical rhinophyma. Ocular involvement occurs in ~50% of patients with rosacea.The eyes are frequently dry and appear red from conjunctival hyperemia and telangiectasia. Manifestations of ocular rosacea may antedate skin involvement and include chronic conjunctivitis [conjunctivitis - chronic], a follicular reaction in the fornices Meibomian gland dysfunction, eyelid margin telangiectasias, chalazia [chalazion] that are often recurrent, blepharitis, marginal corneal infiltrates, peripheral corneal neovascularization [neovascularization - cornea], superficial punctate keratopathy [keratopathy - superficial punctate], ulcerative keratitis [keratitis - ulcerative].