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Introduction to Clinical Rosacea

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Rosacea

Part of the book series: Updates in Clinical Dermatology ((UCD))

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Abstract

Rosacea is a syndrome and not a pathogenically defined disease. Currently, there is no well-established basic mechanism of disease established for rosacea. The classification of rosacea began with the distinction from acne, and by the last half of the twentieth century, the classifications of experts in different countries had become aligned around the notion of rosacea having four or more phenotypic subtypes with some versions allowing for possible, but not obligatory, progression of these phenotypic subtypes as “stages.” While these classifications from different authors consistently recognized similar phenotypic subtypes, there were differences in their precise definitions. In 2002 a consensus committee of the National Rosacea Society (NRS) sought to develop definitions which would provide for a more standardized classification system. These four classic phenotypic subtypes of rosacea have important utilities, including the increased awareness that use of products demonstrated to improve only papulopustular rosacea may lead to disappointment in physicians and their patients with only erythematotelangiectatic rosacea.

In addition to providing a better understanding of the current classification system, this chapter will serve as an introduction to rosacea and its epidemiology, genetic association, comorbidities, clinical/histological findings, and common mimickers. Rosacea is a common inflammatory dermatosis, considered most prevalent in fair-skinned individuals. There are no diagnostic or histologic criteria to diagnose rosacea. Therefore, obtaining a complete and thorough history, along with a pertinent review of systems, is essential not only in diagnosing rosacea but also in correctly assigning clinical subtype (s) (a patient may have more than one). Screening the medication history is necessary, as certain vasoactive agents can enhance flushing in rosacea patients. Assessing modifiable lifestyle factors should also be a part of a complete history-taking, as smoking and alcohol have long been implicated in the development and/or exacerbation of the disease. Lastly, rosacea mimickers should be carefully considered in differential diagnoses through recognizing the subtleties in the physical findings and occasionally obtaining histological information.

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Authors and Affiliations

  1. Retired, George Town, Grand Cayman, The Cayman Islands, UK

    Jonathan K. Wilkin

  2. Beth Israel Deaconess Medical Center, Harvard Medical School, Department of Dermatology, Boston, MA, USA

    Jean S. McGee

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  1. Jonathan K. Wilkin
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Editors and Affiliations

  1. Louisiana State University, New Orleans, LA, USA

    John Havens Cary

  2. Dermatology Clinic, University of California San Francisco, San Francisco, CA, USA

    Howard I. Maibach

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Wilkin, J.K., McGee, J.S. (2020). Introduction to Clinical Rosacea. In: Cary, J.H., Maibach, H.I. (eds) Rosacea. Updates in Clinical Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-030-52097-7_1

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  • DOI: https://doi.org/10.1007/978-3-030-52097-7_1

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