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PATHOLOGY

Histopathologic changes in erythematous and telangiectatic rosacea may be subtle and are often limited to vascular ectasia and mild edema (Fig. 37.11A). In the inflammatory papules and pustules, a more prominent perivascular and perifollicular lymphohistiocytic infiltrate appears (Fig. 37.11B). Sebaceous hyperplasia may be prominent in some patients. Comedo formation is notably lacking. In the granulomatous form of rosacea, non-caseating epithelioid granulomas are seen within the dermis (Fig. 37.11C). Phymatous rosacea shows dilated hair follicles, marked hyperplasia of sebaceous glands, and a variably dense lymphohistiocytic inflammatory infiltrate.