Types of Rosacea
Rosacea is classified into four types, depending on its symptoms:
Persistent redness, burning sensation and visible blood vessels. Transient reddening appears on the tip of the nose and on the cheeks, glabella (the skin between the eyebrows and above the nose) and chin. It progresses gradually becoming persistent and is then accompanied by telangiectasia and seborrhea. The skin of fine texture may have a roughness and scaling of the affected central facial areas and is easily irritated. Cold and warm weather, sunlight and alcohol consumption aggravate it.
Persistent redness, pustules and spots. The history of flushing is also present in most patients, but usually, symptoms of irritancy are not prominent. At times a slightly, sebaceous quality and edema of the affected sites may be present. Such edema may dominate the clinical presentation, with the forehead, eyelids, and cheeks variably affected. This has been termed ‘Morbihan’s’ disease.
Rhinophyma is a rare type of rosacea and usually affects predominantly men with thick sebaceous skin. The papules aggregate and coalesce (merge) to become oedematous (fluid-filled tissue). The surface of the nose becomes rough and a reddish purple. This soft tissue overgrowth can rarely affect the chin, ears, or forehead. The histological features are pilosebaceous gland hyperplasia with fibrosis, inflammation, and telangiectasia.
Ocular rosacea, an incurable eye disorder results in the inflammation of the eyelids and ocular surface causing eye dryness, lacrimation (shedding tears) and itching, the swelling of eyelids, recurrent chalazion and possible vision loss due to corneal damage. It occurs equally in men and women and may occur before the skin disease. Since these symptoms have therapeutic implications and patients will not always complain of them to their dermatologist, they should be actively examined when evaluating rosacea patients.
Although rosacea may not progress from one type to another, each of its symptoms may affect it clinically, from mild to moderate or even severe. This is why timely diagnosis and treatment of rosacea are of utmost importance.
PHOTOGRAPHS OF CASES