Rosacea

Clinical features[1]Gallo RL, Granstein RD, Kang S, et al. Standard classification and pathophysiology of rosacea: the 2017 update by the National Rosacea Society Expert Committee. J Am Acad Dermatol. 2018 Jan;78(1):148-55. http://www.ncbi.nlm.nih.gov/pubmed/29089180?tool=bestpractice.com

Diagnostic phenotype:

• Fixed centrofacial erythema

• Phymatous changes.

Major phenotypes:

• Without a diagnostic phenotype, the presence of 2 or more major features may be considered diagnostic.

• Major phenotypes include:

  • Papules and pustules

  • Flushing

  • Telangiectasia

  • Ocular manifestations.​[Figure caption and citation for the preceding image starts]: Rosacea with erythema, papules, and pustulesCourtesy of Dr Richard Allen Johnson (MD, CM. Harvard Medical School); used with permission [Citation ends].

Secondary signs and symptoms

• Secondary signs and symptoms may appear with 1 or more diagnostic or major phenotypes and may include the following.

  • Burning or stinging. May occur typically on erythematous skin without scales, although scaling may also occur, especially on malar skin.

  • Edema. Facial edema may accompany or follow prolonged erythema or flushing.

  • Dry appearance. Central facial skin may be rough and scaly so as to resemble dry skin and suggest an eczematous dermatitis, and rosacea may often include the coexistence of seborrheic dermatitis.