$Unique_ID{BRK03418} $Pretitle{} $Title{Acne Rosacea} $Subject{Acne Rosacea Adult Acne Acne Erythematosa Rosacea Hypertrophic Rosacea Rhinophyma Acne Conglobata Acne Vulgaris Acne Fulminans Excoriated Acne of Young Women Chloracne Atypical Acneiform eruptions} $Volume{} $Log{} Copyright (C) 1988, 1989, 1992 National Organization for Rare Disorders, Inc. 527: Acne Rosacea ** IMPORTANT ** It is possible the main title of the article (Acne Rosacea) is not the name you expected. Please check the SYNONYMS listing on the next page to find alternate names and disorder subdivisions covered by this article. Synonyms Adult Acne Acne Erythematosa Rosacea Hypertrophic Rosacea Rhinophyma Information on the following diseases can be found in the Related Disorders section of this report: Acne Conglobata Acne Vulgaris Acne Fulminans Excoriated Acne of Young Women Chloracne Atypical Acneiform eruptions General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Acne Rosacea is a skin disorder limited to the nose, cheeks and forehead, typically beginning during adulthood. The facial skin becomes oily, reddened and bumpy. Small red blood vessels are visible. In extreme cases, the nose may appear very red and bulbous. Symptoms Acne Rosacea affects the skin of the nose, surrounding cheeks and forehead areas. The skin becomes oily and progressively reddened (erythematous) with enlarged blood vessels apparent in the skin (telangiectasias). Typically, small elevated growths (papules), some containing dead skin cells and fluid (pustules) develop over the central area of the face. Scarring usually does not occur. In very severe cases, the skin of the nose becomes extremely red and bulbous (rhinophyma). Causes The exact cause of Acne Rosacea is not known. Scientists believe a genetic predisposition to the disorder may exist. Symptoms can be intensified by hot liquids, spicy foods, alcohol consumption (although this is not always a cause; many cases occur among teetotalers), vigorous exercise, heat, exposure to sun and wind, certain vitamin deficiencies, endocrine disturbances and/or emotional stress. Affected Population Acne Rosacea usually begins between the ages of thirty and fifty years of age, but can occur at any age. The disorder tends to affect females more than males, although cases among males tend to be more severe. Related Disorders Symptoms of the following disorders can be similar to those of Acne Rosacea. Comparisons may be useful for a differential diagnosis: Acne Conglobata may occur alone, or may be part of a symptom complex in conjunction with Hidradenitis Suppurativa and connective tissue inflammation (cellulitis) of the scalp. Lesions usually occur on the neck and upper trunk, but may extend to the upper arms, lower back, buttocks, and thighs. The typical acne skin eruptions are present, but symptoms are chronic with abscesses and the development of connective formations between inflamed skin growths (nodules) and cysts. The cysts contain foul-smelling fluid, and severe scarring is common. Although this form of acne resists treatment with systemic antibiotics, symptoms may be controlled by the use of isotretinoin in some cases. Acne Vulgaris is the most common form of acne which affects many adolescents during puberty. The skin eruptions primarily appear on the face, upper back and/or chest due to overactive oil-secreting (sebaceous) glands related to changes in hormonal activity. Acne Fulminans is a rare variant of acne seen predominately among adolescent males. Mild Acne Vulgaris initially develops but it is unexpectedly followed by markedly inflamed and painful lesions on the upper trunk and occasionally the face. Lesions may bleed and/or crust, and may be accompanied by fever and other systemic abnormalities. Treatment with isotretinoin, with or without systemic corticosteroid drugs and antibiotics, can be effective in most cases. Excoriated Acne of Young Women (Acne Excorie Des Jeunes Filles) is a variant of acne produced by excessive manipulation of acne lesions resulting in increased scarring. Although it is often found among young women, it can be found in any age group and both sexes. Chloracne may develop among workers exposed to chlorinated hydrocarbons. Treatment of the skin lesions should be accompanied by removal of the irritating substance from the environment. Atypical Acneiform eruptions are seen in any age group and are not always limited to oil-secreting (sebaceous) glands. These eruptions may appear as a result of corticosteroid, androgen, or progesterone drug therapy. Occupational problems including ingestion of iodine or bromine salts, or skin contact with machine oils such as insoluble cutting oils, may also cause this type of acne. Additionally, drugs such as diphenylhydantoin and lithium can induce this skin condition. Therapies: Standard Although there is no cure for Acne Rosacea, symptoms can be controlled. Antibiotics can control inflammation, but may cause adverse reactions in some patients. Carbon Dioxide laser and conventional surgery are used to remove excess skin growth (rhinophyma) as a temporary measure. Argon lasers have been effective in reducing redness in the nose area, but only in mild cases which have not progressed to rhinophyma. The orphan drug metronidazole (Metrogel) was approved in 1988 by the FDA for treatment of Acne Rosacea. This drug is manufactured by Curatek Pharmaceuticals of Elk Village, IL. Other treatment is symptomatic and supportive. The orphan drug Sprelin injection was recently approved by the FDA for the treatment of Precocious Puberty. Therapies: Investigational This disease entry is based upon medical information available through February 1992. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Acne Rosacea, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 Acne Research Institute 1236 Somerset Lane Newport Beach, CA 92260 (914) 722-1805 The National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse Box AMS Bethesda, MD 20892 (301) 495-4484 References INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 1379-1381. TOPICAL METRONIDAZOLE THERAPY FOR ROSACEA: P.A. Bleicher, et al.; Arch Dermatol (May 1987, issue 123(5)). Pp. 609-614. TREATMENT OF THE RED NOSE WITH THE ARGON LASER: C.H. Dicken; Mayo Clin Proc (November 1986, issue 61(11)). Pp. 893-895. SURGICAL TREATMENT OF RHINOPHYMA WITH THE SHAW SCALPEL: R.F. Eisen, et al.; Arch Dermatol (March 1986, issue 122(3)). Pp. 307-309. TREATMENT OF ROSACEA WITH ISOTRETINOIN: E. Hoting, et al.; Int J Dermatol (December 1986, issue 25(10)). Pp. 660-663. COMBINED CARBON DIOXIDE LASER EXCISION AND VAPORIZATION IN THE TREATMENT OF RHINOPHYMA: R.G. Wheeland, et al.; R.G. Wheeland, et al.; J Dermatol Surg Oncol (February 1987, issue 13(2)). Pp. 172-177.