[Rosacea].

Abstract

Rosacea should no longer be considered a follicular skin disease. It is a vascular disease of the face characterized by a significant evolution towards local complications such as telangiectasias, papular and aseptic pustular lesions, lupoid granulomas, chronic facial oedema and seboglandular hyperplasia. The basic abnormality seems to be a microcirculatory disturbance of the function of the facial angular veins directly involved in the brain-cooling vascular mechanism. The first clinic hallmark of this dysfunction is the occurrence of flushing, which may be spontaneous or induced by alcohol, intake of hot food, emotional stress and sudden variations in temperature. Tetracycline, metronidazole and isotretinoin are very useful for therapy but they only influence the cutaneous and ocular complications and do not act upon the basic vascular trouble. Current therapeutic research is directed towards drugs having an alpha-sympathomimetic activity and inhibiting the endogenous opioid mediators of flushing such as naloxone or clonidine.