Rosacea is a chronic inflammatory skin condition that often presents with flushing and erythema on the chin, nose, cheeks and forehead. It may present with transient or persistent diffuse centrofacial erythema, telangiectasia, inflammatory papules and pustules.1,2 Secondary features include skin sensitivity (such as a burning or stinging sensation particularly associated with flushing), plaques, dry and oedematous skin, and extra-facial involvement.1 Persistent erythema and telangiectasia might also be seen with chronic photodamage.1
Rosacea may progress and patients can develop phymatous changes caused by overgrowth of the sebaceous gland.3,4 Exacerbations may be unpredictable or related to sun exposure, spicy foods, alcohol intake, physical exercise, emotional state or extremes of temperature.3,4 Rosacea affects both sexes equally over the age of 30, with the greatest incidence between 40 and 59 years.4 It is more common in Caucasians. Four rosacea subtypes are recognised - erythema-telangiectatic, papulopustular, phymatous and ocular.2
Up to 72% of patients present with ocular involvement, such as blepharitis, scleritis and conjunctivitis.4 In a fifth of cases, ocular rosacea may precede cutaneous rosacea.1 Any history of redness, photophobia, discomfort or grittiness of the eyes should be determined.
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