Johannes Flores DAYRIT 医师
皮肤科医师
Rosacea in brown skin: aesthetic concerns and implications
Objectives: To determine the clinical phenotypes of rosacea among patients with Fitzpatrick skin phototypes III-V and to identify primary and secondary features, aggravating factors and extracutaneous manifestations. Aesthetic concerns and implications (treatment and complications) will also be presented.
Introduction: Rosacea was once thought to be a disease of northern European origin and perceived as uncommon in darker skin types. In recent years, more cases of rosacea have been identified in African, Latino, or Asian descents.
Materials / method: This was an observational cross-sectional study conducted among patients at the De La Salle University Medical Center and 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. Reaction from common aesthetic procedures were also elucidated.
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. Heat, sun exposure, emotional stress, and intake of alcoholic beverages were identified as the most common aggravating factors. Majority of patients are unaware of their rosacea prior to undergoing an aesthetic procedure.
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 such as chemical peels, lasers, and facial surgery.
