Rosacea

Author: Dr Elina Pantelidi

Chief Editor: Dr Daniel Keith

Rosacea is a long-standing inflammatory condition of the skin. It is estimated to affect 1%-
22% of the general population.

The exact pathophysiology is not known and is thought to be multifactorial. Contributing
factors include genetic predisposition, inflammation and neurovascular mechanisms.
Potential triggers include UV exposure, alcohol, inflammation and others.

Typical presentation:
- Redness/erythema
- Telangiectasia
- Papules
- Pustules

As seen in the pictures below, rosacea usually presents with centrofacial involvement.

Rosacea affecting the nose, cheeks, chin and forehead

Subtypes:

Erythematotelangiectatic
Papulopustular
Phymatous
Granulomatous (specific variant of rosacea)
Lupus miliaris disseminatus faciei (LMDF)
Rosacea-like demodicosis

Even though different subtypes of rosacea have been identified, it is important to note that there is overlap between the different types.

Dermoscopic Appearance

Dermoscopy can be utilised to aid in the diagnosis of rosacea.

The main finding of dermoscopy is the presence of polygonal vessels, usually in a reticular arrangement, with a regular or patchy distribution.

Other findings include follicular plugs, follicular pustules, yellow clods, demodex tails and white amorphous areas.

Contrary to the other types of rosacea, in phymatous rosacea, the main dermoscopic findings are follicular findings. Vascular findings are less evident.