177 Rosacea

Instruction

Salient features

History

• Age (typically occurs between the ages of 30 and 50 years)

• Blushing of the face with caffeine, alcohol or spicy foods

• History of unilateral headaches (an increased incidence of migranous headaches accompanying rosacea has been reported).

Examination

• Red patch with telangiectasia, acneiform papules and pustules overlying the flush areas of the face: cheeks, chin and nose (Fig. 177.1). (The papules and pustules distinguish it from the rash of SLE.)

• Comment on the following:

• Rhinophyma or ‘whiskey nose’ or ‘rum blossom’ (Fig. 177.2) (irregular thickening of the skin of the nose with enlarged follicular orifices caused by hyperplasia of the sebaceous glands and hyperplasia of connective tissue); although rhinophyma is often referred to as ‘end-stage rosacea’, it may occur in patients with few or no other features of rosacea