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AT-A-GLANCE

AT-A-GLANCE

  • Rosacea is a common facial skin disease in many countries.

  • Signs and symptoms for rosacea include flushing, transient erythema, persistent erythema, telangiectasia, papules, pustules, phymata, edema, pain, stinging or burning, and (very rarely) pruritus.

  • The pathophysiology of rosacea is poorly understood; however, a genetic predisposition along with trigger factors activate a dysregulated neurovascular, innate immune, and adaptive immune system.

  • Taking a thorough family and patient history and performing a clinical examination are crucial to diagnose rosacea.

  • All clinical features have to be considered with severity scores for a proper treatment, combined with assessing patient’s quality of life.

  • Approved topical or systemic drugs exist for various, but not all, features of rosacea and should be used on the basis of pathophysiology and while considering efficacy and side effect profiles.

  • Knowledge about the beneficial use of physical therapies and their limitations is important for best medical practice in patients with rosacea.

  • Education about disease progress, general skin care, cosmetic usage and medication effects and potential adverse events is mandatory; teaching of proper topical use guarantees better treatment results.

  • Education to prevent exacerbating “trigger factors” is critical for successful management of patients with rosacea.

INTRODUCTION

Rosacea is a common chronic inflammatory skin disease that almost exclusively affects the central facial skin and rarely affects the extrafacial (neck, forehead) skin. Rosacea derives from the Greek word meaning “rose-like,” which describes the main symptomatology of repeated flushing alone or in combination with transient or persistent erythema. Clinically, the condition is characterized by prolonged flushing (transient erythema), persistent erythema, telangiectasia, papules, pustules, and phymatous changes, often accompanied by burning, stinging, or even migraine-like pain (cutaneous rosacea). Eyes can be also involved (ocular rosacea). Because of their different pathophysiologies, the terms acne rosacea and adult acne are no longer used to describe this disorder.1,2

Worldwide, more than 20 million patients are estimated to have rosacea, although reliable statistics are lacking.3 Because of its obvious facial location, rosacea is associated with a significant disease burden and impaired quality of life.4 The etiology and pathophysiology of rosacea are poorly understood, so the therapy of rosacea is still unsatisfactory; currently used treatment modalities mainly aim to control the clinical signs and symptoms rather than target causes or prevent disease.5-9

EPIDEMIOLOGY AND DISEASE BURDEN

In many countries, rosacea is more prevalent than asthma or diabetes. Depending on the country, rosacea affects at least 2% to 18% of individuals, with the highest level reported in Celtic populations. A Swedish study described a prevalence of 10% for rosacea,10 and a German study found 12.3% of the population to be affected.11 In 2010, an epidemiologic study from Ireland reported a prevalence of 13.9% for rosacea.12 The prevalence of rosacea probably depends on the genetic make-up of the population being studied. The condition affects women more often than men (3:1) ...

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