Met rode koontjes: Huidige inzichten van rosacea

Rosacea is a frequent skin disorder of the face occurring mainly in middle-aged women. Its four primary features are flushing, nontransient erythema, papules and pustules, and telangiectasia. The most common patterns or groupings of signs are designated as specific subtypes of rosacea: erythematotelangiectatic rosacea, papulopustular rosacea, phymatous rosacea and ocular rosacea. Ocular changes are seen in half of the rosacea patients, notably blepharitis and kerato-conjunctivitis. The exact cause of rosacea is unknown. Rosacea can be treated successfully - albeit symptomatically - but is rarely curable. Mild forms are treated with metronidazole cream or gel. Alternatives are topical clindamycin, erythromycin and azelaic acid gel. More active rosacea is treated orally, especially with the tetracyclines (tetracycline hydrochloride, doxycycline, minocycline). Isotretinoin is very effective, even at doses as low as 10 mg daily. Erythema and telangiectasias react well to therapy with pulsed dye lasers. Rhinophyma is treated with the CO2 laser, electrocoagulation or with plastic surgery ('decortication').