Objectives: To identify and properly classify the clinical phenotypes of rosacea among patients with Fitzpatrick skin phototypes III-V . To identify primary and secondary features, aggravating factors and extracutaneous manifestations. To discuss updates and challenges on the management of rosacea in skin of color.
Introduction: There has always been a erroneous perception that rosacea is rare in skin of color but in recent years, more cases of rosacea have been identified in African, Latino, and Asian population. Because it is difficult to detect erythema in darker skin phototypes, it has been underdiagnosed, misdiagnosed, undertreated and sub-optimally treated.
Materials / method: This was an observational cross-sectional study conducted among patients in a private clinic evaluating clinical features using the rosacea clinical scorecard and the 2017 standard classification by the National Rosacea Society expert committee. The duration of the disease, the subtype, aggravating factors, ocular symptoms, comorbidities , and subtype severity were likewise identified. Appropriate medical treatment and other adjunctive modalities such lasers to address erythema, inflammatory papules and pustules and erythema. Potential complications will be highlighted.
Results: A total of 413 (345 F; 68 M) patients were enrolled . Forty eight percent of patients presented with persistent centrofacial erythema, validated by 3D imaging. Phymas were present in 16% of cases. Transient facial redness with papules, pustules, and nodules were present in 52% of cases. Ocular symptoms constituted 4% of cases. Heat, sun exposure, emotional stress, and intake of alcoholic beverages were identified as the most common aggravating factors. Flushing is generally more pronounced in the papulopustular subtype, during menstruation and pregnancy. Majority of treatments were successful
Conclusion: The clinical characteristics of rosacea among Filipinos were identified. Although previously considered as rare among Asians, the study shows that it is common among Filipinos with brown skin. This seems to be related to Spanish and Chinese racial influence, vascular and sebaceous gland hyperreactivity and natural instrinsic responses to heat and sunlight. The presence of rosacea should always be considered when contemplating on performing aesthetic procedures since most patients are inflammatory and may experience potential complications such as burns and hyperpigmentation
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