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Rosacea: understand better what are the four subtypes of this skin problem

Rosacea: understand better what are the four subtypes of this skin problem

Rosacea is a chronic disease that affects mainly women in their 30s and 50s. It is not contagious and has unknown origin. Rosacea appears as a reddish area, with papules and pustules that appear on the face and may compromise the eyes and nose. The disease can be classified into four types: erythematous telangiectasia (the most common), pustular, ocular and ocular papules.

The types vary according to how it manifests. In the first case, in erythematous telangiectasia, the skin becomes very red and full of vessels (telangectasias). This is very evident mainly in the facial center region. The redness can be aggravated by several factors, among them: alcohol, sun, stress, physical exercises and heat. Whoever has rosacea has the sensation of being pinched or burning. In this case, the affected person is sensitive to any cream.

The rosacea pustular papule is characterized by redness and the appearance of papule-pustular lesions in outbreaks, as if they were pimples. In this type, rosacea resembles acne - so much so that it has long been called acne rosacea. The pustular papule type is quite common in men, with periods of alternating worsening and improvement.

The least frequent type is the rosacea, which causes an inflammation of the skin, making it thicker and redder. The third type of rosacea (phoratosa) is characterized by the increase and infiltration of areas such as the sebaceous glands of the nose and is common in men over 40 years. Over time, the nose can even double in size. Chin, face, eyes and ears can be compromised.

Eye rosacea strikes the eye region. Approximately 20% of cases are discovered while visiting an ophthalmologist. The indication for the disease is an inflammation (called blepharitis) with redness and scaling on the eyelash area. This type is the most serious of all, and can progress to loss of vision.

There is another rarer subtype of rosacea, called granulomatous. Its main characteristic is the appearance of brown nodules on the face. About 15% of patients with the disease may have lesions elsewhere. It is a type that has difficult treatment.

Rosacea can also mix. There may be, for example, the combination of fimatosa with pustular papule type and also with the most common form, telangiectatic erythematous. The association of fulminant rosacea with the ocular is also very common.

The treatment of chronic diseases that do not have a known origin is a challenge for the dermatologist. In the case of rosacea, the most common type of treatment is topical products such as 0.75% metronidazole, 0.75% azelaic acid, benzoyl peroxide and topical retinoids. The main goal of treatment is to decrease the patient's inflammation by using the substances mentioned about 1 to 2 times a day.

Another alternative is the use of oxymetozoline and brimonidine. Both decrease and control flushing. It is good to remember that they do not cure rosacea, but they reduce redness. Calcineurin inhibitors also ameliorate inflammation.

For rosacea, ocular and pharyngeal pustular papules, the cyclin antibiotic tetracycline and minicicline must be used. They are used until the clinical control of the disease and, over time, the dose of the medicine is gradually falling.

Isotretinoin can be used in all four types of rosacea. The treatment lasts around 3 to 4 months. In all these situations, there may be an association of the drugs with the laser.

Is rosacea surgical correction indicated in cases of fimatosa? the fourth type. And to treat ocular rosacea, a specific approach is often necessary, such as the use of local eye drops (with antibiotics) and also immunosuppressants, such as cyclosporine.Also important is the use of laser or pulsed light for vessels. The laser light hits the vessels, promotes their destruction and brightens the region. The most widely used types of laser are Pulsed Dye Laser and NdYag.


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