Rosacea: 244 Tunisian cases
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Abstract
Background: Rosacea is a common, chronic facial dermatosis of uncertain etiology, several well-defined types and variable progression. There is a paucity of epidemiologic studies from North African countries especially in Tunisia.
Aim: to determine epidemiological, clinical, histological features, treatment and outcome of rosacea in a Tunisian study.
Methods: A retrospective study of all rosacea cases diagnosed in the outpatient Dermatology Department of Charles Nicolle hospital of Tunis was conducted between 1990, January and 2003, May.
Results: Our study included 244 patients. The diagnosis of rosacea was made on symptoms and clinical features in 185 cases and on histological findings in 59 patients. The hospital prevalence of rosacea was 0.2%. The sex ratio M/F was 0,4. Patient’s Mean age was of 49 years. Triggered factors mentioned included most often: sun exposure (64%) and thermal stimuli (25%). Mean duration between the onset of symptoms and the first consultation was about 20 months. The rosacea subtypes were: erythematotelangiectatic type (12%), papulopustular rosacea (69%), and rhinophyma (3.7%). Granulomatous rosacea was diagnosed in 8 patients and steroid rosacea in 28 cases. Ocular rosacea was observed in 41 cases. Treatment modalities included: topical treatment (1.6%), systemic
treatment (85%), systemic and topical treatment (5%) and surgical procedures (1.2%).
Conclusions: Rosacea seems to be a frequent dermatosis in Tunisia where most of the population is phenotype IV-V. It affects mostly middle-aged women. Most of our patients present with papulopustular rosacea (69%). More epidemiological and clinical studies in North African countries should be conducted to emphasize these results.
Keywords:
Face, dermatosis, epidemiology##plugins.themes.academic_pro.article.details##
References
- Souissi A, Zeglaoui F, Zouari B, Kamoun MR. A study of skin diseases in Tunis. An analysis of 28,244 dermatological outpatient cases. Acta Dermatovenerol Alp Panonica Adriat 2007;16:111-6.
- Gupta AK, Chaudhry MM. Rosacea and its management: an overview. J Eur Acad Dermatol Venereol 2005;19:273-85.
- Schaefer I, Rustenbach SJ, Zimmer L, Augustin M. Prevalence of skin diseases in a cohort of 48,665 employees in Germany. Dermatology 2008;217:169-72.
- Chalmers DA. Rosacea: recognition and management for the primary care provider. Nurse Pract 1997;22:23-8.
- Kyriakis KP, Palamaras I, Terzoudi S, Emmanuelides S, Michailides C, Pagana G. Epidemiologic aspects of rosacea. J Am Acad Dermatol 2005;53:918-9.
- Feldman SR, Hollar CB, Gupta AK, Fleischer AB Jr. Women commonly seek care for rosacea: dermatologists frequently provide the care. Cutis 2001;68:156-60.
- Berg M, Lidén S. An epidemiological study of rosacea. Acta Derm Venereol. Acta Derm Venereol 1989;69:419-23.
- Rosen T, Stone MS. Acne rosacea in blacks. J Am Acad Dermatol 1987;17:70-3.
- Tan SG, Cunliffe WJ. Rosacea and migraine. Br Med J 1976;1:21.
- Szlachcic A. The link between Helicobacter pylori infection and rosacea. J Eur Acad Dermatol Venereol 2002;16:328-33.
- Zandi S, Shamsadini S, Zahedi MJ, Hyatbaksh M. Helicobacter pylori and rosacea. East Mediterr Health J 2003;9:167-71.
- Diaz C, O'Callaghan CJ, Khan A, Ilchyshyn A. Rosacea: a cutaneous marker of Helicobacter pylori infection? Results of a pilot study. Acta Derm Venereol 2003;83:282-6.
- Jaworek AK, Wojas-Pelc A, Pastuszczak M. Aggravating factors of rosacea. Przegl Lek 2008;65:180-3.
- Wilkin JK. Rosacea. Pathophysiology and treatment. Arch Dermatol 1994;130:359-62.
- Sibenge S, Gawkrodger DJ. Rosacea: a study of clinical patterns, blood flow, and the role of Demodex folliculorum. J Am Acad Dermatol 1992;26:590-3.
- Ramelet AA, Perroulaz G. Rosacea: histopathologic study of 75 cases. Ann Dermatol Venereol 1988;115:801-6.
- Marks R. Concepts in the pathogenesis of rosacea. Br J Dermatol 1968;80:170-7.
- Litt JZ. Steroid-induced rosacea. Am Fam Physician 1993;48:67- 71.
- Jeanmougin M, Civatte J, Cavelier-Balloy B. Rosaceous drug eruption caused by amineptin. Ann Dermatol Venereol 1988;115:1185-6.
- Antille C, Saurat JH, Lübbe J. Induction of rosaceiform dermatitis during treatment of facial inflammatory dermatoses with tacrolimus ointment. Arch Dermatol. 2004;140:457-60.
- Shah P, O'Donnell B, Pochkhanawala F, Tan CY. Severe exacerbation of rosacea by oral acetazolamide. Br J Dermatol 1993;129:647-8.
- Zug KA, Palay DA, Rock B. Dermatologic diagnosis and treatment of itchy red eyelids. Surv Ophthalmol 1996;40:293- 306.
- Browning DJ, Proia AD. Ocular rosacea. Surv Ophthalmol 1986;31:145-58.
- Ramelet AA. Rosacea: a reaction pattern associated with ocular lesions and migraine? Arch Dermatol 1994;130:1448.
- Crawford GH, Pelle MT, James WD. Rosacea: I. Etiology, pathogenesis, and subtype classification. J Am Acad Dermatol 2004;51:327-41.
- Aroni K, Tsagroni E, Lazaris AC, Patsouris E, Agapitos E. Rosacea: a clinicopathological approach. Dermatology 2004;209:177-82.
- Marks R, Harcourt-Webster JN. Histopathology of rosacea. Arch Dermatol 1969;100:683-91.
- Ramelet AA, Perroulaz G. Rosacea: histopathologic study of 75 cases. Ann Dermatol Venereol 1988;115:801-6.
- Aroni K, Tsagroni E, Kavantzas N, Patsouris E, Ioannidis E. A study of the pathogenesis of rosacea: how angiogenesis and mast cells may participate in a complex multifactorial process. Arch Dermatol Res 2008;300:125-31.
- Forton F, Seys B. Density of Demodex folliculorum in rosacea: a case-control study using standardized skin-surface biopsy. Br J Dermatol 1993;128:650-9.
- Georgala S, Katoulis AC, Kylafis GD, Koumantaki-Mathioudaki E, Georgala C, Aroni K. Increased density of Demodex folliculorum and evidence of delayed hypersensitivity reaction in subjects with papulopustular rosacea. J Eur Acad Dermatol Venereol 2001;15:441-4.
- Conde JF, Yelverton CB, Balkrishnan R, Fleischer AB Jr, Feldman SR. Managing rosacea: a review of the use of metronidazole alone and in combination with oral antibiotics. J Drugs Dermatol 2007;6:495-8.
- Laube S, Lanigan SW. Laser treatment of rosacea. J Cosmet Dermatol. 2002;1:188-95.