Rosacea

Question 1

What is rosacea?

ref: may 2017 dermatology check

Answer 1

Chronic cutaneous condition characterised by facial flushing and erythema.

persistent erythema centrally for atleast 3 months

More common in flare, skin blue eyed, European/Celtic

Question 2

Aietiology of rosacea?

Answer 2

multifactorial

• increase protease activity
• increase blood vessel density on face
• demodex mites (lives in sebaceous follicles)

Question 3

Types of roacea

Answer 3

Vascular
Inflammatory
Ocular (blepharitis, conjunctivitis)
Phymatous (severe , thickened skin)

Question 4

DDX of rocaea

Answer 4

Dermatitis
- seborrhoeic (usually scaly, rosacea is not scaly)
- facial
Peri-oral dermatitis
Acne
SLE
Keratosis Pilaris (hard to distinguish from rosacea, is a very common form of dry skin characterised by hair follicles plugged by scale ref:dermnetnz) –> pumice

Question 5

Management of Rocea

Answer 5

Non pharmacological

• Avoid Triggers
• use non-alkaline skin cleansing and moisturising routine
• sun protection including avoiding midday sun.
• avoid spicy food/ sun
• laser

Pharmacological 
-Oral Abx 
-Ab creams 
-ivermectin 
Roacutain

Question 6

What is the primary feature of rosacea?

Ref: AFP Check Skin

Answer 6

Persistent erythema of the central portion of the face lasting for at least three months is the primary feature of rosacea.

Question 7

What is a first-line treatment for mild–moderate papulopustular rosacea.

Ref: AFP Check May 2017

Answer 7

Topical metronidazole is a first-line treatment for mild–moderate papulopustular rosacea.

Doxy 100mg daily 4-12 weeks
Erythromycin in pregnancy if tx required

Question 8

Triggers?

Answer 8

Topical - cosmetic products etc
Weather - hot or cold weather, sun exposure
Exercise -
Emotional - Stress
Dietary - hot foods, dairy products, etoh