Rosacea Flashcards
Clinical Feature. Lesion features
dome-shaped inflammatory papules ± pustules
• flushing, non-transient erythema, and telangiectasia
Clinical Feature. distribution:
typically on central face including forehead, nose, cheeks, and chin; rarely on scalp, neck,
and upper body
Clinical Feature exacerbating factors:
characterized by remissions and exacerbations.
exacerbating factors: heat, cold, wind, sun, stress, drinking hot liquids, alcohol, spices
Course
all forms of rosacea can progress from mild to moderate to severe.
rarely in longstanding rosacea, signs of thickening, induration and lymphedema in the skin can develop
phyma:
a distinct swelling caused by lymphedema and hypertrophy of subcutaneous tissue, particularly
affecting the nose (rhinophyma)
ocular manifestations:
blepharoconjunctivitis, keratitis, iritis
Pathophysiology
unknown
Epidemiology
- although found in all skin types, highest prevalence in fair-skinned people
- 30-50 yr old; F>M
Differential Diagnosis
acne vulgaris, seborrheic dermatitis, perioral dermatitis, contact dermatitis
Management. Avoid. Telangiectasia. Phymas
trigger avoidance and daily sunscreen use for long-term management
• avoid topical corticosteroids
• telangiectasia: treated by physical ablation; electrical hyfrecators, vascular lasers, and intense pulsed
light therapies
• phymas: treated by physical ablation or removal; paring, electrosurgery, cryotherapy, laser therapy (CO2,
argon, Nd:YAG)
Specific Rosacea Treatments
1st Line
Oral tetracyclines Topical metronidazole Oral erythromycin (250-500 mg PO bid) Topical azelaic acid Topical ivermectin
Specific Rosacea Treatments 2nd Line
Topical clindamycin
Topical erythromycin 2% solution
Topical benzoyl peroxide
Oral metronidazole
Specific Rosacea Treatments 3rd Line
Oral retinoids
