Rosacea - External and Internal Eye
The etiology of rosacea is poorly understood. Cutaneous vascular changes, inappropriate activation of the immune system, UV and microbial exposure (ie, Demodex mites), and disruption of the epidermal barrier have all been implicated as playing a role in the pathogenesis in this condition. There have been reports of familial rosacea, so an underlying genetic predisposition has not been ruled out.
Rosacea primarily affects individuals with lighter skin phototypes, and females tend to present at a younger age than males. The disease is reported less commonly in skin types IV-VI, perhaps because darker skin types are less prone to photodamage, and flushing and telangiectasias are harder to visualize.
There are 4 main subtypes of the disease: erythematotelangiectatic, papulopustular, phymatous, and ocular rosacea.
Ocular rosacea presents with conjunctivitis, blepharitis, and hyperemia. Patients complain of dry, irritated, itchy eyes. Keratitis, scleritis, and iritis are potential but infrequent complications. Ocular rosacea can occur in patients with or without cutaneous findings.
A rare consequence of chronic rosacea and certain other facial disorders is solid facial edema, sometimes called Morbihan disease.
Since rosacea manifests on the face, it is important to recognize that this disease can have psychosocial consequences, which may affect quality of life.
L71.9 – Rosacea, unspecified
398909004 – Rosacea
- Chronic blepharitis (allergic, bacterial, viral)
- Hordeolum or chalazion
- Dry eye syndrome
- Keratitis (bacterial, herpetic, atopic, sicca)
- Corneal ulceration
- Mucous membrane pemphigoid
- Acne vulgaris
- Perioral dermatitis (periorificial dermatitis)
- Lupus miliaris disseminatus faciei
- Menopause, "hot flashes"
- Cellulitis (usually unilateral)
- Erysipelas (usually unilateral)
- Lupus erythematosus
- Seborrheic dermatitis
- Photosensitive or photoallergic drug eruption