Table of contents
- 1. Rosacea
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Rosacea
- Skin condition affecting primarily the face, proposed theory is that skin mites plug pores.
- Initially: Intermittent redness or blushing. Over time, redness may become persistent and more visible.
- Most common sites are cheeks, nose, chin, and forehead.
- In over half of patients, can affect eyes (blood shot eyes that feel gritty)
- Bumps, tiny pus-filled pimples, and enlarged blood vessels can also appear, giving skin a rough, uneven appearance.
- No known cure for rosacea, although it can be managed with appropriate treatment and lifestyle changes.
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- Avoid hot/cold changes
- Rarely, can be severe enough (esp if untreated) that the skin tissue of the nose becomes thick, swollen, and bumpy (rhinophyma) - occurs when oil-producing glands and surrounding connective tissues becoming enlarged
- Rhinophyma develops in some men , and very rarely in women with rosacea.
- Can be mistaken for acne (but worsens with benzoyl peroxide etc..)
- Epi: usually age 30-50y, F>M but more severe in M; tendency for fair skin and eastern European
- RF:
- Fair skin (Irish, Scottish, English or Eastern/Northern European descent)
- Family history
- Chronic sun exposure
- Skin mite (?blocks glands)
- H Pylori
- S/S:
- Frequent flushing or blushing on cheeks, nose, chin, forehead
- Persistent redness
- Red lines, due to enlarged blood vessels becoming visible
- Dry skin
- Burning, stinging, or itching
- Pimple-like bumps without blackheads or whiteheads
- Graded based on severity
- Mild - facial flushing/redness intermittently. Can also have swelling, burning/stinging, roughness and visible blood vessels
- Moderate - persistent redness and pimple like bumps with burning and stinging
- Severe - thickening of skin with bumpy and enlarged appearance
- Ocular - eyes and eyelid involvement; can cause redness to surrounding skin tissue and also burning or stinging, dryness, light sensitivity, blurred vision and watery bloodshot eyes
- Triggers
- Hot/cool weather, sun (UV exposure)
- Stress
- Hot/spicy food/drinks
- Intense exercise
- Medications: vasodilatory, ACEI
- Treatment - not self-resolving --> NEED TREATMENT
- NEEDS TREATMENT - can thicken skin permanently
- 1st Line -> Metronidazole CREAM- gold standard; gel, cream or lotion form
- Antibiotics - topical or oral (tetracycline, minocycline, erythromycin, clindamycin
- Steroid creams - mild topical; short term use only
- Isotretinoin - for severe
- Tretinoin - mild rosacea
- Sodium sulfacetamide and sulphur - treat redness and inflammation
- Laser therapy - later
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