Rosacea

Question 1

Features of rosacea

Answer 1

• flushing
• telangiectasia
• persistent erythema with papules and pustules
• rhinophyma
• ocular involvement: blepharitis

Question 2

What areas does rosacea commonly affect?

Answer 2

nose
cheeks
forehead

Question 3

What may worsen rosacea?

Answer 3

Sun exposure

Question 4

Management of rosacea which is predominantly erythema/flushing

Answer 4

• topical brimonidine gel
  it typically reduces redness within 30 minutes, reaching peak action at 3-6 hours, after which the redness returns to the baseline
  mild-to-moderate papules and/or pustules CKS

Question 5

Management of rosacea with papules/pustules

Answer 5

Mild-Mod:
- topical ivermectin
- topical metronidazole
- topical azelaic acid

Mod-severe
- topical ivermectin + oral doxycycline

Question 6

When should patients with rosacea be referred?

Answer 6

• symptoms not improved with optimal management in primary care
• laser therapy for patients with prominent telangiectasia
• rhinophyma