Rosacea

Question 1

Define rosacea

Answer 1

Chronic skin disease
Unknown aetiology
Periods of exacerbation and remission

Question 2

What is the key epidemiology of rosacea?

Answer 2

Peak 40-50yrs
More common in females

Question 3

What is the underlying process of rosacea?

Answer 3

Vascular dysregulation - cutaneous, flushing and telangiectasia
Inflammation - altered innate immune response, increase pro-inflam cytokines etc
Microbial -> changes in normal
UV radiation -> oxidative stress may exacerbate inflammation

Question 4

What are the different types of rosacea?

Answer 4

1. ETR - facial redness, flushing and telangiectasia
2. Papulopustular - ance like, alongisde redness and swelling
3. Phymatous -> thickening of skin, rhinophyma, chin/forehead/ears
4. Ocular - eyes, blepharitis, conjunctivitis and keratitis

Question 5

What are the key clinical features of rosacea?

Answer 5

Nose, cheeks and forehead
Flushing
Telangiectasia
Persistent erythema, papules and pustules
Rhinophyma
Sunlight may exacerbate

Question 6

How should rosacea be diagnosed?

Answer 6

Diagnosis of exclusion
SKin biospy is atypical or unsure

Question 7

How is rosacea managed?

Answer 7

Conservative - high factor sunscreen, camouflage creams
Erythema - Topical brimonidine PRN (alpha adrenergic agonist),
Mod pustules/papules - topical ivermectin
Severe - topic ivermectin and oral doxycycline

Question 8

What cases of rosacea need to be referred to specialist care?

Answer 8

If not resolved with optimal management in primary care.
Laser therapy if prominent telangiectasia
Has a rhinophyma.