Skin nontumor
Other diseases of skin appendages
Rosacea
Last author update: 1 July 2011
Last staff update: 26 February 2024
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PubMed Search: Acne rosacea
Table of Contents
Definition / general | Terminology | Clinical features | Treatment | Clinical images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Additional referencesCite this page: Hamodat M. Rosacea. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skinnontumoracnerosacea.html. Accessed December 25th, 2024.
Definition / general
- Common chronic dermatosis with erythema of central face, acneiform pustules and papules, telangiectasia and blepharitis (Am Fam Physician 2009;80:461)
Terminology
- Also called rhinophyma
Clinical features
- Exists in 5 clinical forms:
- Erythematous, telangiectatic type (70% of cases)
- Papulopustular type
- Granulomatous type
- Hyperplastic glandular type (phymatous rosacea, which results in irregular, bulbous enlargement of the nose; the condition known as rhinophyma)
- Ocular disease
- May be associated with abnormal TLR2 (toll-like receptor 2) expression, which leads to a calcium dependent release of kallikrein 5 from keratinocytes, which may cause rosacea (J Invest Dermatol 2011;131:688)
Treatment
- Topical metronidazole is well tolerated and efficacious for moderate to severe papulopustular rosacea
- Also topical azelaic acid, azithromycin (once daily), minocycline (40 mg dose)
- Pimecrolimus 1% cream is effective and well tolerated treatment for steroid induced rosacea
Clinical images
Images hosted on other servers:
Various images
Microscopic (histologic) description
- Perinfundibular, lymphocytic or granulomatous inflammation
- Occasional plasma cells, an important clue for the diagnosis
- Variable features: mild dermal edema, solar elastosis, mild perifolliculitis
- Sebaceous gland hypertrophy and scattered follicular plugging are present in most cases of rhinophyma
- Papulopustular lesions have a more pronounced inflammatory infiltrate which is both perivascular and peripilar, involving the superficial and mid dermis; infiltrate may include a few neutrophils, as well as lymphocytes and plasma cells; Demodex mites are present in 20 - 50% of cases
- Granulomatous form is usually characterized by a tuberculoid reaction, often in the vicinity of damaged hair follicles; necrosis (resembling caseation) was present in 11% of patients in one series
Microscopic (histologic) images
Images hosted on other servers:
Dermis of a patient with rosacea
Positive stains
- Direct immunofluorescence occasionally shows immunoglobulins and complement at dermoepidermal junction
Additional references
