Rosacea

Question 1

What is rosacea?

Answer 1

• common facial race, chronic, resembles acne
• sterile inflammatory papules, pustules and node (no comedones)
• associated with higher numbers of the normal demodex folliculorum mite

Question 2

Epidemiology of rosacea?

Answer 2

• aged 30-50
• mainly females
• “celtic” origin, Irish / Scottish (fair skin, blue eyes)

Question 3

Presentation of rosacea?

Answer 3

• red rash often with inflammatory papules (may begin with a tendency towards flushing)
• face feels hot or “burns”
• cheeks, forehead, nose and chin
• spares peri-oral and peri-orbital areas
• may have; telangiectasia, facial oedema, seborrheic dermatitis, sensitive skin

Question 4

Complications of rosacea?

Answer 4

• blepharitis (eye lid inflammations)
• conjunctivitis
• RHINOPHYMA (large bulbous nose)

Question 5

Differential diagnoses when thinking rosacea?

Answer 5

• acne
• seborrheic dermatitis
• SLE
• periorifical dermatitis

Question 6

Management of rosacea?

Answer 6

• stringent sun protection
• gentle cleansers eg emollient
• avoid oil based; use water based makeup and suncream
• cool packs
• avoid triggers of flushing (heat, wind, alcohol, excessive exercise, hot baths, spicy food, hot drinks)
• laser for telangiectasis
• surgery for RHINOPHYMA
• AVOID topical steroids

MEDS:

• topical METRONIDAZOLE 0.75% BD for 6-12weeks
• next try oral Abx DOXYCYCLINE
• treat menopausal flushing with HRT