4.3 Article

Rosacea: The eyes have it

Journal

CLINICS IN DERMATOLOGY
Volume 41, Issue 4, Pages 528-536

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.clindermatol.2023.08.009

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Rosacea is a chronic inflammatory skin disease that has a significant psychological impact on patients and can cause eye damage. Ocular involvement in rosacea includes inflammation of the eyelids and conjunctiva, and in severe cases, it can lead to blindness. Early diagnosis and treatment, through interdisciplinary collaboration between dermatologists and ophthalmologists, is crucial for preventing permanent eye impairment in rosacea patients.
Rosacea is a chronic inflammatory dermatosis typically affecting the facial skin but also the eyes. With its chronic course with fluctuating episodes of flashing, redness, papulopustules, and nodules it poses a severe psychologic burden to the affected individuals. In addition to the facial changes, more than half of the patients have ocular involvement ranging from blepharitis and conjunctival hyperemia to more severe ophthalmic damage, and even blindness. Clinically, the ocular involvement in rosacea includes meibomian gland dysfunction with relapsing hordeola and chalazia, diffuse hyperemic conjunctivitis, photophobia, episcleritis, or kerato-conjunctivitis, and in rare cases, corneal ulcers. These are mainly observed in adult patients but can also occur in children. Depending on the degree of cutaneous or ocular findings, patients with rosacea may present first to the dermatologist or to the ophthalmologist. Both specialists should be aware of the potential oculocutaneous involvement. Any ocular complaints expressed by the patient in the setting of a dermatologist's office should be referred promptly for an ophthalmologic examination. Conversely, signs suggestive of rosacea in the eye should lead the ophthalmologist to consider underlying skin disease. A timely interdisciplinary collaboration is paramount for the earlier diagnosis and treatment, thus preventing permanent eye impairment in this chronic dermatosis. (c) 2023 Elsevier Inc. All rights reserved.

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