Acne rosacea

Question 1

What is acne rosacea?

Answer 1

A skin condition characterised by episodic or persistent facial flushing

Question 2

What is the presentation of acne rosacea?

Answer 2

Facial flushing
Telengiectasia
Papules and pustules
Rhinophyma (enlarged, red and bumpy nose)
Blepharitis

Question 3

What are the differentials of acne rosacea?

Answer 3

Seborrhoeic dermatitis
Acne vulgaris
Lupus erythematous

Question 4

What can worsen the symptoms of acne rosacea?

Answer 4

Sunlight

Question 5

What is the management of erythema/flushing in acne rosacea?

Answer 5

Topical brimonidine
Oral propranolol

Question 6

What is the management of telangiectasia in acne rosacea?

Answer 6

Laser therapy

Question 7

What is the management of papulopustular acne rosacea?

Answer 7

First line - topical ivermectin
Second line - topical metronidazole or topical azelaic acid

Question 8

What is the management of severe papulopustular acne rosacea?

Answer 8

Oral doxycycline and topical ivermectin

Question 9

When should patients with acne rosacea be referred to secondary care?

Answer 9

Patients with a rhinophyma
When symptoms have not improved despite optimal management in primary care