Rosacea is a chronic inflammatory skin disease that centers on the pilosebaceous units and presents with at least one of the following features:
Centrofacial erythema with telangiectatic mats and flushing;
Inflammatory lesions (papules, pustules, cysts);
Phymatous changes (skin hypertrophy and fibrosis), usually affecting the nose; and/or
Ocular inflammation (conjunctivitis, blepharitis, chalazion).
The cardinal symptoms of rosacea are stinging, burning, and itching. The National Rosacea Society Expert Committee delineates four subtypes of rosacea—erythematotelangiectatic, papulopustular, phymatous, and ocular—although these patterns overlap in clinical practice[1,2] (Figure). Although rosacea classically presents during adulthood, there are rarer pediatric and granulomatous presentations.
Figure. The four rosacea subtypes. Top left: . Erythematotelangiectatic rosacea. Top right: Papulopustular rosacea. Bottom left: Phymatous rosacea. Bottom right: Ocular rosacea.
Rosacea affects all ethnicities, but light-skinned people of European descent are the most prone, with one Swedish study[3] showing a prevalence of 10% (women 14%, men 5%; 81% erythematotelangiectatic type, 19% papulopustular type). The global prevalence of rosacea is 5.41% in women and 3.9% in men, and the condition primarily affects adults between 45 and 60 years of age.[4]
Here are five things to know about rosacea.
1. It's Not Just a Skin Disease
Rosacea is associated with hyperreactivity of the innate immune system, which protects epithelial barriers against infection, and chemical or physical (eg, ultraviolet radiation, extreme heat or cold) injury.
