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 and Light Therapy

  • Telangiectasias are best treated with light-based and laser therapies
  • Laser and light-based therapies are also used to manage facial erythema secondary to rosacea
  • Indicated in patients with clinically noninflamed phyma
  • 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 and scarring
  • Pulsed Dye Laser (PDL)
    • Targets the visible blood vessels and reduces flushing and erythema
    • Considered as one of the first-line modalities in patients with persistent erythema
    • Indicated in patients with telangiectasia
    • Improvement is not permanent and may cause some temporary bruising
  • Intense Pulsed Light Therapy (IPL)
    • Preferred for larger areas of diffuse redness and may improve flushing
    • Considered as one of the first-line modalities in patients with persistent erythema
    • Indicated in patients with telangiectasia
  • Potassium-titanyl Phosphate Laser (KTP)
    • Ideally used for linear, arborizing and discrete telangiectasia
  • Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) Laser
    • Efficacy found in the treatment of large deep vessels with blue tones
    • Used in the treatment of facial telangiectasia
  • Erbium Laser and 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
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Infectious Diseases - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
01 Dec 2019
Macrolide antibiotics are derived from the Streptomycesspecies. These contain either 14-membered (erythromycin [ERM],clarithromycin [CAM], roxithromycin [RXM]), 15-membered(azithromycin [AZM]) or 16-membered (spiramycin, josamycin,midecamycin) macrocyclic lactone rings. They inhibit proteinsynthesis by reversibly binding to the 23S ribosomal RNA (rRNA)in the 50s subunit of the bacterial ribosome. Traditionally,macrolides are used as first-line agents in respiratory, skin,soft tissue, and urogenital infections, and they are also activeagainst gram-positive cocci and atypical pathogens.
19 Jun 2019
Acquired immunodeficiency syndrome (AIDS) remains as one of the world’s leading causes of mortality in global public health. Dr Charles Hicks shared his insights into the increasing role of dolutegravir (DTG; Tivicay, GSK) – an integrase strand transfer inhibitor (INSTI) – in HIV therapy during the 4th National AIDS Conference 2018 at Swiss Garden International Hotel and Residences, Kuala Lumpur.
21 Sep 2019
Cryptococcosis is more common in nonhuman immunodeficiency virus (HIV) nontransplant (NHNT) patients, and this population tends to have more localized pulmonary cryptococcosis and significantly higher 90-day mortality, reports a study.
Stephen Padilla, 07 May 2019
The risk of HIV transmission is “effectively zero” among gay couples who have condomless anal sex when the HIV viral load is suppressed, according to a new study.