Synonyms: Acne rosacea; Gutta rosea; Telangiectasis faciei.
In the earliest stage there appear at intervals patches of redness and vascular dilatation which last for a few hours or days. After a time the vessels lose much of their power to contract, the redness becomes permanent though it continues to fluctuate in intensity, and the dilated venules form a network across the surface of the lesion. The redness may be uniform or blotchy and varies from pink to scarlet-purple. The skin looks warm but feels cool and oily. Acne papules and pustules develop in the affected region, the skin grows thick and coarse, and the orifices of the sebaceous glands become exposed and often plugged with thick, yellow sebum. In most cases the disorder does not advance beyond this stage, but endures with little change for many years and finally disappears.
In many instances however papules and nodes, first soft but later firm and elastic, develop in the engorged area, especially on the nose. Their surface resembles orange peel and their color is red or purplish. Very slowly the nodes increase in size and coalesce to form large sessile lobulated protuberances studded with the crater-like openings of abnormally large sebaceous glands. The nose may become converted into an irregular pendulous tumor like a turkey cock's comb (Rhinophyma).