WHAT FOLLOWS cannot possibly live up to the title of this editorial, since such is the state of our current understanding of rosacea. My temerity will further extend the reader beyond the short list of real facts (a lapidarist would have no difficulty describing what we really know about rosacea) to consider theories about how rosacea might develop. For me, the most compelling view is a synthesis of selected insights of Ryan, Marks, and several Scandinavian workers, especially Sobye and Haxthausen.
However, to directly pursue these theories would be premature without a brief note on what rosacea really is (and is not). Rosacea is not a disease. Rosacea is a typology, namely, a cluster of persons with a characteristic combination of cutaneous stigmata. Given the typologic model, the epicenter of rosacea is occupied by a few unfortunate patients with flushing, erythema, telangiectasia, facial edema, papules, pustules, ocular lesions, and rhinophyma.
Wilkin JK. RosaceaPathophysiology and Treatment. Arch Dermatol. 1994;130(3):359-362. doi:10.1001/archderm.1994.01690030091015