Preferred practice patterns and review on rosacea

Abstract

Rosacea is a chronic, inflammatory facial dermatosis commonly found in fair skin tone population. Recent studies have shown the increasing prevalence in the dark skin tone population as well. Ocular involvement is very common and can occur without cutaneous features. Common ocular features are chronic blepharoconjunctivitis with eyelid margin inflammation and meibomian gland dysfunction. Corneal complications include corneal vascularization, ulceration, scarring, and rarely, perforation. Diagnosis is largely based on clinical signs, although it is often delayed in the absence of cutaneous changes, particularly in children. The management ranges from local therapy to systemic treatment, depending on the severity of the disease. There is a positive association between demodicosis and rosacea; however, causality is always argued. In this review, we describe the epidemiology, clinical features, and treatment of rosacea and ocular rosacea.

Keywords: Blepharokeratoconjunctivitis; Demodex; ivermectin; rosacea; tea tree oil.

Figure 1

(a) Right eye of a patient with history of chronic red eye with exacerbations and remission for ten years. Facial lesions were suggestive of papulopustular rosacea. (b) 6 weeks after treatment with a tapering dose of topical steroid drops, twice daily tea tree oil lid scrubs at home, and a course of oral ivermectin (12 mg) one week apart

Figure 2

Flowchart showing management of Rosacea