Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Letter to the Editor
2009:75:4;405-406
doi: 10.4103/0378-6323.53146
PMID: 19584472

Correlation of the severity of cutaneous rosacea with ocular rosacea

Alireza Keshtcar-Jafari, Maryam Akhyani, Amir H Ehsani, Maryam Ghiasi, Vahide Lajevardi, Oldoos Baradran, Siavash Toosi
 Tehran University of Medical Sciences, Tehran, Iran

Correspondence Address:
Maryam Akhyani
Razi Hospital, Tehran University of Medical Sciences, Vahdat-Eslami Square, Tehran 1199663911
Iran
How to cite this article:
Keshtcar-Jafari A, Akhyani M, Ehsani AH, Ghiasi M, Lajevardi V, Baradran O, Toosi S. Correlation of the severity of cutaneous rosacea with ocular rosacea. Indian J Dermatol Venereol Leprol 2009;75:405-406
Copyright: (C)2009 Indian Journal of Dermatology, Venereology, and Leprology

Sir,

The National Rosacea Society′s Committee identified four subtypes of rosacea: Erythemato-telangiectatic, papulopustular, phymatous and ocular. [1],[2] The diagnosis of ocular rosacea should be considered when the patient′s eyes have one or more of the following signs and symptoms: Watery or bloodshot appearance, foreign body sensation, dryness, itching, light sensitivity, blurred vision, telangiectasia of the conjunctiva and lid margin or lid and periocular erythema. Meibomian gland dysfunction presenting as chalazion or chronic staphylococcal infection are common signs of rosacea-related ocular disease. Some patients may have decreased visual acuity caused by corneal complications (punctate keratitis, corneal infiltrates/ulcer or marginal keratitis). [2] Although the frequency of ocular involvement in patients with rosacea is reported to be somewhere between 3 and 58%, its exact prevalence is not known. [3] In approximately 20% of the patients, eye findings may precede skin changes, making the diagnosis more challenging for both the ophthalmologist and the dermatologist. [4] This study is performed to evaluate the ocular signs and symptoms of rosacea and their relationship with severity of cutaneous lesions.

Sixty-four adult facial rosacea patients (28 men and 36 women) with a mean age of 39.3 (range = 22-56) years attending our clinic from September 2004 to September 2005 were enrolled in this study using simple sequential sampling. A thorough medical history and physical examination including skin manifestations was undertaken and recorded for each patient.

We classified each major sign and symptom of rosacea into three groups: Mild, instant flushing, light red erythema, telangiectasia of up to 10 lines, less than 10 papules or pustules and 1-3 small nodules (plaques); moderate, flushing duration of less than 15 min, red erythema, 10-20 lines of telangiectasia, 10-20 papules or pustules and 4-10 nodules (plaques); severe, more than 15 min of flushing, purple red erythema, more than 20 lines of telangiectasia and more than 10 large inflammatory nodules (plaques).

After skin examination, we referred all the 64 patients to an ophthalmology clinic. The ophthalmologist had performed a thorough examination of the eyelids, conjunctiva and cornea via slit lamps. The fluorecein test was also carried out on all the patients. The common ocular symptoms in rosacea were eye dryness (21.9%), eye strain (14.1%) and tearing (4.7%). Similarly, other studies have reported that the common symptoms were foreign body sensation, burning sensation and eye irritability accompanied by visible reddening of the conjunctivae [3] . It is thought that meibomian gland impaction leads to decreased lipid in the tear film, greater tear evaporation and subsequent irritability of the eyes. [1]

The common ocular signs were meibomian gland plugging (45.3%), blepharitis (23.4%), keratoconjunctivitis (14.1%) and chalazia (14.1%). None of our patients had the less common, but significant, abnormalities like scleritis, episcleritis, iritis, iridocyclitis, hypopyon, corneal thinning, corneal neovascularization, scarring and blindness. Previous studies have demonstrated that meibomian gland dysfunction, chronic conjunctivitis and recurrent chalazia are the common ocular signs in rosacea. [4],[5]

In our series, ocular involvement did not correlate with the severity of papular, pustular, nodular lesions and flushing but, surprisingly, we found a significant relationship between the severity of telangiectasia and ocular involvement. This finding was not in agreement with the previous studies claiming that the ophthalmologic complications of rosacea are completely independent of the severity of facial rosacea. [5] On the other hand, it seems that the significant relationship between the severity of telangiectasia and eye lesions in our study might be an incidental experience. We agree with the general assumption that skin and eye lesions in rosacea are separate al together.

References
1.
Tanzi EL, Weinberg JM. The ocular manifestations of rosacea. Cutis 2001;68:112-4.
[Google Scholar]
2.
Wilkin J, Dahl M, Detmar M, Drake L, Liang MH, Odom R, et al . Standard grading system for rosacea: Report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. J Am Acad Dermatol 2004;50:907-12.
[Google Scholar]
3.
Gessert CE, Bamford JT. Measuring the severity of rosacea: A review. Int J Dermatol 2003;42:444-8.
[Google Scholar]
4.
Wilkin J, Dahl M, Detmar M, Drake L, Feinstein A, Odom R, 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 2002;46:584-7.
[Google Scholar]
5.
Michel JL, Cabibel F. Frequency, severity and treatment of ocular rosacea during cutaneous rosacea. Ann Dermatol Venereol 2003;130:20-4.
[Google Scholar]

Fulltext Views
1,794

PDF downloads
2,101
Show Sections