Rosacea all alone

Question 1

Rosacea

- appearance

Answer 1

• acne look-alike
• mostly fair skinned people
• peaks in 3rd and 4th decade
• MC in males

Question 2

Rosacea

- pathophys

Answer 2

• vascular hypersensitivity
• related to food, temperature, neurology
• can be inflammatory response to demodex mites
• other triggers: sun, alcohol, physical exertion, stress, spicy food

Question 3

Rosacea

- Clinical presentation

Answer 3

- several subtypes
MC: 
- central erythema
- flushing
- telangiectasias
- red papules
- pustules and nodules (NO COMEDONES)
- rhynophyma
- sebaceous hyperplasia
- Possibly injected conjunctiva

Question 4

Rosacea

- perioral/ocular dermatitis

Answer 4

• Small pink papules and pustules that recur over weeks and is exacerbated once topical steroids are discontinued
• History is really important for dx
• Often tingly

Question 5

Three treatment options for Rosacea

Answer 5

1. Topical
2. Oral
3. Surgical

Question 6

Rosacea

- topical treatment

Answer 6

Metronidazole
azelaic acid
sulfur
pimecrolimus
tacrolimus
ivermectin (targets the mites, new treatment).
Avoid steroids.

Question 7

Rosacea

- oral treatment

Answer 7

• Doxycycline, minocycline, metronidazole, Bactrim, isotretinoin.
• Tetracycline family works by decreasing the chemotactic response of neutrophils, inhibit granuloma formation, and inhibit protein kinase C.

Question 8

Rosacea

- surgical treatments

Answer 8

• Pulsed dye laser for vascular rosacea (flushing and telangiectasia)
• CO2 laser for rhynophyma.