ABSTRACT
BACKGROUND: Rosacea is characterized by erythema of the central face that persists for several months or longer. Reports of the histological changes in rosacea are scarce, and few attempts have been made to correlate such changes with clinical findings and pathophysiology. OBJECTIVE: This study aimed to elucidate the clinical manifestations of rosacea and investigate its histological features. METHODS: We performed a retrospective analysis of 278 patients with histologically confirmed rosacea who visited the Department of Dermatology at the Catholic Medical Center between January 2008 and May 2013. Clinical subtypes, disease severity, and precipitating factors were evaluated. In 115 randomly selected patients, histopathological features were evaluated as well. RESULTS: The ratio of males to females was 1:1.8. The age distribution showed a peak incidence in the fifth decade. The most common subtype was papulopustular rosacea (52.9%) followed by erythematotelangiectatic rosacea (34.9%), ocular rosacea (4.0%), and phymatous rosacea (2.9%). Granulomatous rosacea accounted for 5.4% of rosacea cases. Precipitating factors included hot weather (54.7%), stress (51.8%), sun exposure (37.4%), alcohol (37.4%), and hot baths (33.1%). Histological analysis of skin biopsies from 115 patients revealed solar elastosis in 62 patients (53.9%) and telangiectasia in 85 patients (73.9%). CONCLUSION: In this study, Korean rosacea patients were predominantly female with a peak age in the fifth decade and the majority suffered from the papulopustular and erythematotelangiectatic types of rosacea. Histological observations pertaining to each rosacea type were also discussed.
Subject(s)
Female , Humans , Male , Age Distribution , Baths , Biopsy , Dermatology , Erythema , Incidence , Korea , Precipitating Factors , Retrospective Studies , Rosacea , Skin , Solar System , Telangiectasis , WeatherABSTRACT
BACKGROUND: Lupus miliaris disseminatus faciei (LMDF) is a rare granulomatous disease characterized by eruption of discrete red-brown, dome-shaped papules, predominantly in the lower eyelid. Histopathologically, LMDF could present as caseous necrosis in the central area with granulomas composed of epithelioid cells and giant cells. The pathogenesis of LMDF remains controversial. Some suspect LMDF as a kind of cutanoeus tuberculosis, but others believe LMDF to be a variant of granulomatous rosacea or sarcoidosis. OBJECTIVE: This study aimed to investigate the clinical and histopathologic features of LMDF. METHODS: We reviewed the medical records, clinical photographs, and histopathologic slides of 30 cases of LMDF that were evaluated in our department between February 1991 and May 2009. RESULTS: The average age of the affected patient was 34.6+/-10.9 years and the ratio of male-to-female patients was 3.3 : 1. The most common sites of involvement with LMDF was the eyelid (86.7%). cheek (76.7%), philtrum (60.0%), and glabella (56.7%). On histopathologic examination, the epithelioid granulomas had a connection to pilosebaceous structures in 66.7% of the cases. Follicular rupture (33.3%), perifollicular granulomas composed of naked tubercles (53.2%), and sarcoidal granulomas with abscesses (23.3%) were noted. Characteristic caseous necrosis occurred in 7 cases (23.3%). The duration of LMDF was 2 years in 26 cases (86.7%) and the lesion improved leaving scar in 21 cases (70%). CONCLUSION: We identified the histopathologic changes of LMDF as a function of disease duration. Connections of pilosebaceous units with granulomas were commonly observed. It will be helpful to understand the pathophysiology of LMDF.
Subject(s)
Humans , Abscess , Cheek , Cicatrix , Epithelioid Cells , Eyelids , Giant Cells , Granuloma , Lip , Medical Records , Necrosis , Rosacea , Rupture , TuberculosisABSTRACT
Granulomatous rosacea is considered as the only true rosacea variant. Granuloma formation is a histologic feature of this condition. The clinical features of granulomatous rosacea include yellow-brown or red papules or nodules that are monomorphic and located on the cheeks and periorificial facial skin. The background facial skin is otherwise normal. Other signs and symptoms of rosacea are not required to make a diagnosis of granulomatous rosacea. We report on a case of granulomatous rosacea that was localized on the both eyelids as an unusual clinical presentation.