eMedicine Specialties > Ophthalmology > Dermatologic Disorders
Ocular Rosacea: Differential Diagnoses & Workup
Updated: Feb 20, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
- Multimedia
Differential Diagnoses
Workup
Laboratory Studies
- The diagnosis of ocular rosacea is established clinically and is often aided by dermatologic findings. Laboratory studies are not indicated.
Imaging Studies
- Imaging studies are not indicated.
Other Tests
- Other tests are not indicated.
Histologic Findings
The conjunctiva in ocular rosacea is infiltrated by inflammatory cells, T-helper/T-suppressor (CD4) cells, phagocytic cells, and antigen-presenting cells. In addition, increased vascular dilation and occasionally granulomatous changes are present. None of these changes are specific for rosacea.
Patients with rosacea typically have a mean increase of nearly all cell types, but especially T-helper cells.
Hoang-Xuan et al demonstrated a 3.5-fold increase in the ratio of CD4 cells to CD8 cells in the conjunctiva of patients with rosacea, most resembling a type IV hypersensitivity reaction.13
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| Overview: Ocular Rosacea |
Differential Diagnoses & Workup: Ocular Rosacea |
| Treatment & Medication: Ocular Rosacea |
| Follow-up: Ocular Rosacea |
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References
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Knox CM, Smolin G. Rosacea. Int Ophthalmol Clin. Spring 1997;37(2):29-40. [Medline].
Powell FC. Clinical practice. Rosacea. N Engl J Med. Feb 24 2005;352(8):793-803. [Medline].
Wilkin J, Dahl M, Detmar M, et al. Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. J Am Acad Dermatol. Apr 2002;46(4):584-7. [Medline].
Akpek EK, Merchant A, Pinar V, Foster CS. Ocular rosacea: patient characteristics and follow-up. Ophthalmology. Nov 1997;104(11):1863-7. [Medline].
Browning DJ, Proia AD. Ocular rosacea. Surv Ophthalmol. Nov-Dec 1986;31(3):145-58. [Medline].
Wilkin JK. Rosacea. Pathophysiology and treatment. Arch Dermatol. Mar 1994;130(3):359-62. [Medline].
Tisma VS, Basta-Juzbasic A, Jaganjac M, et al. Oxidative stress and ferritin expression in the skin of patients with rosacea. J Am Acad Dermatol. Feb 2009;60(2):270-6. [Medline].
Chamaillard M, Mortemousque B, Boralevi F, et al. Cutaneous and ocular signs of childhood rosacea. Arch Dermatol. Feb 2008;144(2):167-71. [Medline].
Viso E, Rodriguez-Ares MT, Gude F. Prevalence of and associated factors for dry eye in a Spanish adult population (the Salnes Eye Study). Ophthalmic Epidemiol. Jan-Feb 2009;16(1):15-21. [Medline].
Icasiano E, Latkany R, Speaker M. Chronic epiphora secondary to ocular rosacea. Ophthal Plast Reconstr Surg. May-Jun 2008;24(3):249. [Medline].
Frucht-Pery J, Sagi E, Hemo I, Ever-Hadani P. Efficacy of doxycycline and tetracycline in ocular rosacea. Am J Ophthalmol. Jul 15 1993;116(1):88-92. [Medline].
Modi S, Harting M, Rosen T. Azithromycin as an alternative rosacea therapy when tetracyclines prove problematic. J Drugs Dermatol. Sep 2008;7(9):898-9. [Medline].
Torresani C. Clarithromycin: a new perspective in rosacea treatment. Int J Dermatol. May 1998;37(5):347-9. [Medline].
Barnhorst DA Jr, Foster JA, Chern KC, Meisler DM. The efficacy of topical metronidazole in the treatment of ocular rosacea. Ophthalmology. Nov 1996;103(11):1880-3. [Medline].
Further Reading
Keywords
ocular rosacea, rosacea, adult acne, inflammatory keratitis, corneal ulceration, corneal perforation
Differential Diagnoses & Workup: Ocular Rosacea