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Whether or not you've heard the word rosacea, you most probably know or have met someone with this very common skin condition. It is characterized by redness (erythema), persistent enlarged capillaries (telangiectasia), and in some cases, little pimple-like pustules and small red bumps called papules. It is often confused with acne and the term acne rosacea is used interchangeably.

It is commonly associated with people of European descent, particularly northern Europe. While it is nicknamed the "Curse of the Celts," rosacea can also be found to a lesser extent in people of darker complexions. The infrequency of it found in the latter group often leads to misdiagnosis and then an inappropriate treatment, resulting in an exacerbation of the rosacea.

Rosacea falls into 4 categories:

1) Erythematotelangiectatic rosacea (ETR) - A sensitive skin that is characterized by persistent redness. Patients with this type will feel dry, taut, itchy, burning, and stinging sensations. The blood vessels are always dilated. This condition can also be found on the scalp, neck, chest, upper back, and ears. The skin often is flaky and dry. People with this type flush and redden very readily.

2) Papulopustular rosacea- This type also has the redness, sensitivity, stinging, and dilated blood vessels like ETR above, but the skin can be oily and have papules and pustules giving an acneic appearance. Symptoms can persist for several days with flare-ups from time to time. Because this can often be misdiagnosed as regular acne vulgaris, treatments such as benzoyl peroxide and Retin A can further irritate an already inflamed skin condition.

3) Phymatous rosacea- Phyma (growth in Greek). Fortunately, this form is rarer than the others. It can lead to disfigurement if not treated early. The most commonly seen form involves the nose. It is called rhinophyma. It mainly affects men. You've seen W.C. Fields bulbous nose. Contrary to popular belief, drinking alcohol does not cause rosacea, but rather exacerbates it by causing more flushing and inflammation. What happens in this type of rosacea is the progressive thickening of the sebaceous glands of the nose. The hypertrophy is fibrous and has a lobed appearance. This is often preceded by another form of rosacea and if treated early enough, disfigurement can be avoided.

4) Ocular rosacea- Yes! Even the eyes can be affected. The eyes are red, can either be dry or watery, and can have a gritty feel. Cysts in the eyelids are not uncommon. Eyes feel stinging, burning, and can be light sensitive. About 50 percent of all rosacea patients will have some eye symptoms. Vision problems such as blurriness and loss of vision can be possible.

We will continue this article of rosacea in the next News Bite. The causes and treatment of rosacea will be addressed.

Nutritional Nugget of this News Bite:

Cracks Around the Corners of the Mouth

Those cracks or fissures that form in the corners of the mouth can be quite uncomfortable. The condition is called angular cheilitis. This condition can indicate a deficiency in iron, and vitamins in the B family. When the tongue is purplish-red with vertical fissuring of the lips, it is usually due to a riboflavin deficiency. To be sure, a culture should be done to rule out the possibility of a fungal or bacterial infection.

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