Rosacea

Question 1

Rosacea

Answer 1

• auto-inflammatory skin condition
• central face most common
• can be mistake for sunburn or acne
• rosacea and acne can co-exist
• more common in women
• Age of onset: 30-50s
• Affected person flushes easily
• Patients often report very sensitive skin

Question 2

Characteristics

Answer 2

facial erythema (redness), flushing, and acne-like pimples, papules, and pustules (NO COMEDONES)

Question 3

Exacerbating Factors

Answer 3

• Alcohol
• Sunlight
• Heat
• Hot, spicy food
• Emotional stress
• unlike acne vulgaris, rosacea is not related to androgens

Question 4

Stage 1

Answer 4

episodic/persistent erythema, telangiectasia

Question 5

Stage 2

Answer 5

erythematous papules and pustules

Question 6

Stage 3

Answer 6

the apex of rosacea, rhinophyma (a large, bulbous,, ruddy nose)

Question 7

Common treatments

Answer 7

• topicals (antibiotics, anti-inflammatory, others)
• oral antibiotics
• Avoiding precipitating factors
• Green tinted make-up
• Laser for telangiectatic and erythematous component
• Surgery for rhinophyma

Question 8

Topical Treatment

Answer 8

• Indicated for erythema and mild to moderate rosacea
• Topical antibiotics: Metronidazole (Metrogel, Metrocream, Metrolotion)
• anti-inflammatory: Azelaic acid (Azelex, Finacea)
• other topical medications, such as benzoyl peroxide, retinoids, and sulfur lotions are sometimes used

Question 9

Oral Antibiotics

Answer 9

• indicated for: moderate-severe inflammatory rasacea
• Tetracycline, minocycline, doxycycline, bactrim
• Metronidazole: 250mg/day 4-6 weeks