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Annales de Dermatologie et de Vénéréologie
Volume 138, n° S3
pages 172-178 (novembre 2011)
Doi : 10.1016/S0151-9638(11)70086-2
The red face: art, history and medical representations
Histoires de visages rouges : art, culture et représentations médicales

B. Cribier
Clinique Dermatologique, Faculté de Médecine, Université de Strasbourg et Hôpitaux, Universitaires de Strasbourg, 1, place de l’Hôpital 67091 Strasbourg cedex, France 


For millennia, a red face has been a handicap in social relations, mainly because of the associated bias against alcoholics. The color red is also the color of emotion, betrayal of the person who blushes. Since the color red is one of the main characteristics of rosacea, it contributes to the bad reputation this disorder has, which is therefore the subject of a pressing therapeutic demand, principally in women.

Nineteenth-century French novelists such as Balzac and later Proust, admirably described blotchy, red, or sanguine faces, which always announced a difficult, violent temperament, or was simply the mark of the laboring class. The color red remains ambivalent today, on the one hand denoting blood and life and on the other suffering, shame, and death.

The history of dermatology shows that the semiology of rosacea was very well described in the earliest reports, notably those written in the Middle Ages. The term “acne rosacea” appeared in Bateman’s writings, who made it a clinical form of acne. This confusion lasted throughout the nineteenth century. It was not until Hebra in Austria and Darier in France that the differential diagnosis was clearly made between acne and rosacea.

A “couperosis” previously referred to the entire range of the disease, particularly the papules and pustules, and it was not until the twentieth century that the current meaning of rosacea progressively gained ground: this term today designates facial telangiectasia, whether or not it is associated with a characteristic redness.

Rosacea is a conspicuous disease, since the lesions involve the central portion of the face.Among the many manifestations of rosacea, redness is the most characteristic [1].

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Depuis des millénaires, le visage rouge constitue un handicap dans les relations sociales, principalement en raison du préjugé alcoolique qui est attaché. La couleur rouge est aussi celle des émotions, trahissant celui qui rougit. Le rouge étant une des caractéristiques principales de la rosacée, il contribue à la mauvaise réputation de cette affection, qui est donc l’objet d’une demande thérapeutique pressante, principalement chez les femmes.

Les romanciers du XIXe siècle français comme Balzac, mais aussi plus tard Proust, ont fait des descriptions admirables des visages couperosés, rouges ou sanguins, qui annoncent toujours un caractère difficile, violent ou simplement les marques de la classe laborieuse. La couleur rouge est toujours ambivalente, avec d’un côté le sang et la vie, et de l’autre, la souffrance, la honte et la mort.

L’histoire de la dermatologie montre que la séméiologie de la rosacée a été très bien décrite dans les textes les plus anciens notamment ceux du Moyen Âge. Le terme d’acne rosacea apparaît chez Bateman qui en fait une forme clinique de l’acné. Cette confusion va durer pendant tout le XIXe siècle. Il faudra attendre Hebra en Autriche et Darier en France pour faire clairement le diagnostic différentiel entre l’acné et la rosacée. Le mot de couperose désignait autrefois la totalité de la maladie, particulièrement les papulopustules et ce n’est qu’au courant du XXe siècle que la signification actuelle s’est imposée progressivement: ce terme désigne aujourd’hui les télangiectasies faciales, qu’elles soient ou non associées à une rosacée caractéristique.

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Keywords : Rosacea, Erythema, History of medicine

Mots clés : Rosacée, Érythème, Histoire de la médecine

© 2011  Elsevier Masson SAS. All Rights Reserved.
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