All pimples are not the same: Rosacea is a disease without a
What do the late Princess Diana, former US president Bill Clinton and the 17th-century Dutch painter Rembrandt have in common? The answer is extra rosy cheeks that are symptomatic of a chronic skin disease called rosacea.
Rosacea starts with reddened facial skin (erythema), progresses to fine red lines (telangiectasia) and inflammation, then pus-filled bumps and finally enlargement of the tiny blood vessels that supply blood to the cheeks and nose. Research is now shining the light on how rosacea may be underreported and under-treated in darker-skinned people who may have delayed or less obvious symptoms.

Rosacea in India

Epidemiological studies show that traditionally, the Swedes had the highest prevalence of rosacea (10%), followed by the Americans (approximately 5%) and then the French and Germans (2-3%). This is rapidly changing, though, as inter-racial marriages and migration lead to more mixed populations. Rosacea is now one of the emerging skin diseases among the Indian population, too - 15-40% of patients have a family history of rosacea.

Though the exact mechanism how rosacea occurs and spreads is also unknown, some researchers link it back to dysregulation in the innate (by birth) immune system, overgrowth of commensal skin organisms or aberrant neurovascular signalling to the facial skin. All of these collectively, they feel, may lead to the manifestation of the clinical symptoms.

Telltale signs

HarvardHealth, a magazine published by the Harvard Medical School, described the clinical symptoms of rosacea in four stages: First, flushing and intermittent facial redness. Second, persistent redness on the cheeks, nose, chin or forehead. Third, small red bumps or pus-filled bumps along with red lines and patterns on the face - telangiectasias. In the fourth and final stage, bumps and phymatous rosacea on the nose.

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