Acne Rosacea

Snapshot

• A 45-year-old woman complains of facial flushing in her forehead and cheeks. She has no other symptoms and denies any history of autoimmune diseases. She notices that the redness is worse after eating spicy foods. On exam, she has multiple pustules and papules on her cheeks.

Introduction

• Common inflammatory facial dermatosis
• Epidemiology
  • most commonly in adults
  • can occur in children, though rare
• Cause is unknown
• Exacerbated by 
  • hot foods and drinks
  • spicy foods
  • alcohol
  • heat
• sun

Presentation

• Skin findings
  • facial eruption
    • forehead
    • cheeks
    • nose
    • around the eyes
  • erythema with telangiectasias
  • flushing
• papules and pustules may appear

Evaluation

• Diagnosis is usually based on clinical exam and history

Differential Diagnosis

• Acne vulgaris
• Pustular tinea
• Folliculitis
• Lupus erythematosus

Treatment

• Lifestyle modifications
  • avoid spicy foods
  • avoid hot food/drinks
  • avoid sun exposure and use sunscreen
• Pharmacologic
  • topical metronidazole 
• topical sulfacetamid

Prognosis, Prevention, and Complications

• Disease course varies
  • chronic condition
• Complications
  • recurrence of disease or resistant disease