Rosacea clinical features and diagnosis

Rosacea clinical features and diagnosis

Rosacea clinical features and diagnosis

Clinical features The disease begins as prominent flush. Initially it is limited to lower half of the nose and then extends to involve the blush area of the face, chin, and central forehead. With time the intermittent episodes become long lasting. Residual erythema may persist. This is accompanied by telangiectasia, blanching on diascopy. This is followed by the greasy appearance over the face and formation of papules, pustules, nodules, and cysts localized to the central one third of the face. Comedones are conspicuous by their absence. rhinophyma may develop, especially in men in consequence to hyperplasia of the sebaceous glands over the nose. the ocular lesions are often benign and restricted to blepharitis and conjunctivitis.

Diagnosis The diagnosis is primarily clinical. However, it may be supplemented by histopathology. Hematoxylin and eosin stained section reveals the folllowing

Lymphohistiocytic inflammatory infiltrate around upper dermal blood vessels

Dermal edema

Dermal elastosis

telangiectasia

Loss of archiectecture of upper dermis

Hypertrophy and hyperplasia of sebaceous glands

Rosacea needs to be differentiated from the Acne, periorificial dermatitis, seborrheic dermatitis, and photodermatitis.

Treatment Rosacea being a progressive disorder should be intercepted with systemic and topical measures similar to that of acne vulgaris. the drugs erythromycin 250 mg four times a day, till the symptoms subside. 200 mg of metronidazole thrice a day, till symptoms subside. 0.5 mg/kg/day of isotretinoin for 20 weeks. Topical application of 2 percent erythromycin, preferably at night time.

Unani herbal treatment Decoction musaffi khoon, Majoon Ushba 10 gm twice daily, Majoon chochini 10 gm two times daily till symptoms subsides. Marham hina for local applicant at bed time.

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