Rosacea Flashcards
What is Rosacea?
episodic or persistent facial flushing primarily affecting women aged 30-60 with pale skin.
what are the signs and symptoms of Rosacea?
Erythemato-telangiectatic - facial flushing which can be transient, recurrent or persistent. Telangiectasia may develop over time.
Papulo-pustular - papules and pustules
Rhinophymatois rosacea - more common in men and leads to swollen bulbous nose with enlarged sebaceous glands. Skin becomes thickened and scarred.
Ocular rosea - red, irritated, watery eyes +/- swelling
What are some factors which may exacerbate erythemato-telangiectatic rosacea?
Heat, alcohol, sun exposure, warm baths, stress, spicy foods and irritating cosmetic products
What is the management of predominant erythema Rosacea?
General - camouflage creams, sun protection
Predominant erythema - topical brimonidine (topical alpha-adrenergic agonist)
What is the management of Rosacea with Mild-mod papules and pustules
1st line is topical ivermectin (antiparasitic drug)
2nd line - Topical metronidazole or topical azelaic acid
What is the management of Rosacea with moderate to severe papules and pustules?
Topical ivermetcin and oral doxycyline
Which patients with Rosacea should get a referral to derm?
- If symptoms have not improved with optimal management in primary care
- Laser therapy for prominent telangiectasis
- Rhinophyma (enlarged, red, bumpy, bulbous nose) - surgical or laser debulking
What is the diagnostic criteria for Rosaccea?
One diagnostic or two major clinical features.
Diagnostic feature - Phymatois changes or persistent erythema.
Major - Flushing/transient erythema, papules and pustules, telangiectasia or ocular rosacea
Minor features - Skin burning, stinging sensation, dry skin or oedema.
What are the risk factors for rosacea?
Increasing age,
Photosensitive skin types,
UV exposure,
Spicy foods and hot drinks
Emotional stress and exercise
