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Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

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Nội dung chi tiết: Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2ons, including ocular involvement. It is, however, precisely because of such variability in presentation that a set of specific diagnostic criteria ha

s long been elusive. Such pervasive confusion complicates not only clinical diagnosis and eventual choice of treatment modalities, but also research s Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

tudies and investigations into the pathophysiology of this disease. A relatively recent consensus by a panel of expens established a new classificatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

n system based on relatively specific clinical features (Wilkin er al. 2002). Though not without its shortcomings, such a system represents an extreme

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2kinned individuals, especially of Northern and Eastern European descent, and IS estimated to occur in 2.1-10% in this population (Bamford el al. 2006;

Berg Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

teria that define this disease.Only a handful of studies have carefully examined the prevalence of rosacea by gender and age. In a frcqucntly-clted st

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

udy of Swedish office employees, rosacea was found to be nearly three times more common in women than in men (Beig&r Liden 1989). However, because of

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2s have noted an overall equal prevalence in both genders, with a tendency toward earlier presentation in females compared to males (Kyrtakts el al. 20

05). Gender predisposition also depends on the individual rosacea subtype, with rhynophyma occurring predominantly in male patients (Kyriakis etal. 20 Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

05).Overall, rosacea IS most frequently diagnosed tn patients between the ages of 30 and 50 years; however, presentation tn the seventh, eighth, and e

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

ven tn the ninth decade in not unusual (Kyriakis ft al. 2005). Childhood rosacea cases, though rare, have been documented in the literature (Chamailla

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2em of signs and symptoms must be utilized to define this disease. As per the expert committee consensus, rosacea may be diagnosed W'hcn one or more of

the primary features are present, most commonly on the convex surfaces of the central face. The primary features Include flushing (or transient eryth Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

ema), persistent erythema, papules and pustules, and tclangiectasias (Wilkin el al. 2002). Additional secondary features may Include burning or stingi

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

ng, rough and scaly appearance likely as a result of local Irritation, edema, elevated red plaques, peripheral localization, ocular manifestations, an

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2ntrofacial erythema lasting at least 3 months with a tendency toward penocular sparing Is most characteristic of rosacea (Crawford et al. 2004).Awaren

ess of the potential rosacea mimickers is Important. These Include erythema and tclanglectasias frequently noted in lupus erythematosus, demiatomyoslt Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

ls. and other connective tissue diseases. Hushing associated with the carcinoid syndrome and mastocytosis, and plethora seen tn polycythemia vera. Fin

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

ally, if suspected, allergic contact dermatitis and photosensitivity can be excluded with the help of patch testing and phototesting, respectively.ROS

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2btypePapulopustular subtypePhymatous subtypeOcular subtypeGranulomatous variant*•currently not recognized as a separate subtypeTable 6 Rosacea classif

icationThis Is an essential part of the diagnosis, as it has a direct impact on the choice of treatment modalities and the prognosis. The subtype Is d Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

etermined based on the predominant features present in a given patient. According to the expert committee, rosacea may be subdivided into erythcmatotc

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

langiectatic (ET), papulopusnilar (PP). phymatous, and ocular subtypes, with granulomatous rosacea considered a special variant of the disease (W)lkin

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2es. These include rosacea fulmlnans. also known as pyoderma faciale, steroid-induced acnelform eruption, and perioral dermatitis. It should, however,

be noted that some authors consider rosacea to be a much more polymorphic disease with many more subtypes than those recognized by the expert panel (K Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

ligman 2006). Still, the following discussion will focus on the latter, more widely-accepted classification system.Erythematotelangiectatic subtypePat

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

ients who belong to this subtype typically present with persistent ccntrofacial erythema and an extensive history of prolonged flushing in response to

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2(55). Flushing may affect not only the central portions of the face, but also the cars, neck, and chest (Marks & Jones 1969). Unlike physiologic flush

ing, or blushing, prolonged facial vasodilation (lasting 10 minutes or longer and often accompanied by burning or stinging) is typically observed m su Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

ch patients. It Is important to note.ROSACEA - EPIDEMIOLOGY AND PATHOPHYSIOLOGY5353Erythematotelangicctatic subtype of rosacea.54E’rythematotelangiect

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2

atie subtype of rosacea resembling the stigmata of alcoholism.55Extensive telangieetasias in eiythcmatotclangiectatic rosacea.however, that Hushing as

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

Ebook Acne and rosacea: Epidemiology, diagnosis and treatment - Part 2enopausal flushing should not automatically evoke the diagnosis of rosacea, unless other symptoms and signs are present In a given patient.

515ROSACEA - EPIDEMIOLOGYAND PATHOPHYSIOLOGYINTRODUCTIONRosacea Is a common cutaneous disorder thatmay present with a variety of clinical manifestatio

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