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RosaceaPerioral Dermatitis (Periorificial Dermatitis)

Rosacea (continued)

  • Pathogenesis
    • This is not at all understood.  Since antibiotics (particularly tetracyclines) are effective therapy, a microbial contribution to pathogenesis has been considered but not proven. 
    • Similarly, agents triggering flushing (for example, alcohol) have been thought to at least aggravate rosacea, but it is not clear that this is the case.

  • Diagnosis
    • As discussed previously, the presence of red papules and pustules in the central third of the face in the absence of comedones should suggest rosacea.

  • Differential Diagnosis of Rosacea (see Table):
    • The rosacea variants are likely to cause most trouble. 
    • The telangiectatic variant may be confused with photo damage, and the often described but rarely seen "butterfly" rash of lupus.


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