rosacea
ROSACEA
Rosacea is a chronic cutaneous disease of the convexities of the central face (cheeks, chin, nose and central forehead) w/ periorbital and perioral skin sparing. This condition is attributed to chronic vasodilation.
Remissions and exacerbations are common.
It typically appears after 30 years of age but may occur at any age.  It commonly affects fair-skinned individuals.
The common presenting symptoms are facial flushing, stinging/burning erythema, telangiectasia, edema, papules, pustules, ocular lesions, and hypertrophy of the sebaceous glands of the nose with fibrosis.
A history of episodic flushing often heralds onset of rosacea.

Surgical Intervention

Surgical/Laser Therapy

  • Telangiectasias are best treated w/ light-based & laser therapies
  • Some reports show that moderate to severe rhinophyma respond well initially to surgical excision, electrocautery, cryosurgery or carbon dioxide-laser therapy
  • Side effects: Temporary bruising, redness, swelling, darker or lighter spots on the skin & scarring
  • Pulsed Dye Laser (PDL)
    • Targets the visible blood vessels & reduces flushing & erythema
    • Improvement is not permanent & may cause some temporary bruising
  • Intense Pulsed Light Therapy (IPL)
    • Preferred for larger areas of diffuse redness & may improve flushing
  • Potassium-titanyl Phosphate Laser (KTP)
    • Ideally used for linear, arborizing & discrete telangiectasia
  • Erbium Laser & Fractional Photothermolysis
    • Used to smoothen the nose in rhinophyma without significant removal of the top layer of skin
  • Dermabrasion
    • Surgical resurfacing technique to remove thickened skin 
  • Electrocautery
    • The top layers of excess skin are scraped off using the hot tip of an electrode
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