177 Rosacea
Salient features
Examination
• Red patch with telangiectasia, acneiform papules and pustules overlying the flush areas of the face: cheeks, chin and nose (Fig. 177.1). (The papules and pustules distinguish it from the rash of SLE.)
• Rhinophyma or ‘whiskey nose’ or ‘rum blossom’ (Fig. 177.2) (irregular thickening of the skin of the nose with enlarged follicular orifices caused by hyperplasia of the sebaceous glands and hyperplasia of connective tissue); although rhinophyma is often referred to as ‘end-stage rosacea’, it may occur in patients with few or no other features of rosacea
• Tell the examiner that you would like to obtain an opthalmological evaluation for chalazion and progressive keratitis, which can lead to scarring and blindness.
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