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| Fig. 21.7 Acne rosacea involving the convex surfaces of the face. |
Acne rosacea is a chronic skin disease that most commonly occurs between the ages of 30 and 50 years, although it can be seen in adolescents and elderly patients. The course is typically chronic with remissions and relapses. It is characterized by flushing, telangiectasia, papules, and pustules, and in severe late-stage disease, patients may develop chronic facial lymphedema and rhinophyma. It is usually symmetrical and is most commonly seen on the convex areas of the face, including the nose, cheeks, forehead, and chin (Fig. 21-7). Blepharitis, conjunctivitis, and keratitis are common associations.
The etiology of rosacea is unknown. Genetic factors seem to play a role in that the disease is more common in persons of Celtic ancestry and less common in blacks. Factors that stimulate flushing, such as hot beverages, alcohol, ultraviolet light exposure, and emotional factors, frequently exacerbate the disease. A rosacea-like eruption can be induced by the topical application of fluorinated corticosteroids and tacrolimus ointment to the face.
Powell FC: Rosacea,
N Engl J Med 352:793–803, 2005.
