Acne Rosacea
Acne rosacea is a chronic relapsing and remitting facial inflammatory disorder where flushing will be a common presentation. It rarely affects people less than 30 years old. So far, the etiology is unknown. It is triggered by alcohol, spicy food, etc. Acne rosacea might be wrongly diagnosed by your physician because it sometimes looks alike to acne vulgaris. It usually affects fair-skinned people.
Signs and symptoms
- Fixed erythema (redness) often seen over the cheeks, chin, nose and forehead.
- Telangiectasia
- Papules
- Pustules
- Rhynophyma may occur. (Well, don’t get confused with rhinoceros, rhynophyma is a condition where there is swelling and soft tissue overgrowth of the nose. Unfortunately, it only occurs in males. Hmm, perhaps that is how rhinoceros get its name, they do have similarities…)
- Lympoedema – this will develop after there is recurrent of severe flares
- Eye problems commonly associated – conjunctivitis, keratitis (rarely) and blepharitis (scaling and irritation at base of eyelashes)
Management and treatment
- Oral Tetracycline (250 – 1000 mg per day) – mainstay of treatment. It also can be used in acne vulgaris. Antibiotics can be discontinued after the skin settled. It can be started if any recurrence of acne rosacea
- Avoid irritants
- Avoid excessive sun exposure
- Topical metronidazole – effectively control mild to moderate disease
- Topical non-fluorinated glucocorticoids
Reference:
- Oxford handbook of clinical specialties. 5th edition. 2001.
- Harrison’s Manual of Medicine. 16th edition. 2005.
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Tags: acne, acne vulgaris, alcohol, health, metronidazoles, non-fluorinated glucocorticoids, rhynophyma. tetracyscline, rosacea, skin, telangiectasia
