dermatologic disorders
Rosacea
Symptoms and Signs of Rosacea
Rosacea is limited to the face and scalp and manifests in 4 phases: Pre-rosacea Vascular Inflammatory Late In thepre-rosacea phase,patients describe embarrassing flushing and blushing, often accompanied by uncomfortable stinging. Common reported triggers for these flares include sun exposure, emotional stress, cold or hot weather, alcohol, spicy foods, exercise, wind, cosmetics, and hot baths or hot drinks. These symptoms persist throughout other phases of the disorder. In thevascular phase,patients develop facial erythema and edema with multiple telangiectases, possibly as a result of persistent vasomotor instability. Aninflammatory phaseoften follows, in which sterile papules and pustules (leading to the designation of rosacea as adult acne) develop. Thelate phase(developing in some patients), is characterized by coarse tissue hyperplasia of the cheeks and nose (rhinophyma) caused by tissue inflammation, collagen deposition, and sebaceous gland hyperplasia. The phases of rosacea are usually sequential. Some patients go directly into the inflammatory stage, bypassing the earlier stages. Treatment may cause rosacea to return to an earlier stage. Progression to the late stage is not inevitable. Ocular rosaceaoften precedes or accompanies facial rosacea and manifests as some combination of blepharoconjunctivitis, iritis, scleritis, and keratitis, causing itching, foreign body sensation, erythema, and edema of the eye. 