Which Type of Rosacea Do You Have?

The National Rosacea Society has developed a standard classification system that can serve which type of rosacea you have. The classification systems defines 4 subtypes and 1 variant of rosacea.

Subtype 1: Erythematotelangiectatin rosacea – It is mainly characterized by flushing and persistent central facial erythema. The appearance is not essential for diagnosis. Central facial edema, stinging and burning sensations and roughness or scaling may be present. A history of flushing alone is common in patients with erythematotelangiectatin rosacea.

Subtype 2: Papulopustular rosacea – It is characterized by persistent central facial erythema with transient papules or pustules or both in a central facial distribution. However, Papules and pustules can also occur periorificially that is in the perioral, perinasal or periocular areas. This subtype resembles acne vulgaris except that comedones are absent. Rosacea and acne can occur concomitantly and in such patients comedones as well as papules and pustules of rosacea are present.

Burning and stinging sensations may be present. This subtype can be present in combination with subtype 1 including telangiectases. The telangiectases results in persistent erythema, papules and pustules.

Subtype 3: Phymatous rosacea – It includes thickening of skin, irregular surface nodularities and enlargement. Rhinophyma is the most common but it may occur in other locations including chin, forehead, cheeks and ears. Patients may also have patulous expressive follicles in the phymatous area and telangiectases may be present.

This subtype has been seen in combination with subtype 1 or 2 including persistent erythema, telangiectases, papules and pustules. In rhinophyma stigmata is more pronounced [90].

Subtype 4 : Ocular rosacea – it is diagnosed when a patient’s eyes have one or more of following signs and symptoms – watery or blood shot appearance, foreign body sensation, burning or stinging, dryness, itching, light sensitivity, blurred vision, telangiectases of the conjunctiva and lid margin or lid and periocular erythema [37].

Blepharitis, conjunctivitis may occur. Meiobomiam gland dysfunctions as chronic staphylococcal infection are common signs. Reduced visual acuity caused by corneal complication. Approximately half of the patients experience skin lesion first and a minority may have both manifestations simultaneously [31].

Variant 1: Granulomatous rosacea – this is a hard, yellow, brown or red cutaneous papules or nodules that may be severe and lead to scarring. These are less inflamed than papules and pustules. They can vary in size and appear on cheeks and periorificial areas.

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