Rosacea

Question 1

what is it?

Answer 1

prominent (recurring) facial flushing exacerbated by sudden change in temperature, stress, tetracyclines, alcohol, spicy food, UV light and dietary vasodilators can trigger it - very common

Question 2

pathogenesis

Answer 2

vascular ectasia
patchy inflammation with plasma cells, pustules, perifollicular granulomas, follicular demodex mites - allergic reaction to mites

Question 3

who gets it?

Answer 3

usually in 30-60 year olds affecting nose, chin, cheeks and forehead

Question 4

how does it present?

Answer 4

facial flushing
papules, pustules, cysts, swelling, erythema
visibile blood vessels - telangiecetasia
conjunctivitis/gritty eyes
enlarged/unshapely nose
NO comedones - not a sebaceous gland issue - this can be a differentiation between rosacea and acne

Question 5

how is it managed?

Answer 5

reduce aggravating factors e.g. avoid topical steroids, wear suncream
topical therapies - metrondiazole, ivermectin - reduce demodex mite associated with rosacea
oral therapies - long-term oral doxycycline, low does isotretinoin if severe
vascular laser for telangiectasia
surgery/laser shaving for rhinophyma