Acne rosacea.

Rosacea is a multifactorial skin disorder that usually affects middle-aged persons. Little is known about the etiology of rosacea, although the disease most likely represents a vascular anomaly occurring in patients with fair skin. The mainstay of treatment for inflammatory lesions has been oral antibiotics, but topical metronidazole also may be effective. Because recurrences are common after discontinuation of therapy, doses should be tapered as tolerated. Antibiotics are more effective for inflammatory lesions than for erythema and telangiectasia. Isotretinoin may be effective for inflammatory lesions, edema and rhinophyma in some resistant cases, but its use is limited by its side effects and teratogenicity. Ablation of telangiectasia with the tunable dye laser and various surgical approaches to rhinophyma are effective newer treatments but are more expensive and less available than conventional therapy.