Rosacea (Erythematotelangiectatic type)

Diagnosis: Rosacea (Erythematotelangiectatic type)

Diffuse erythema and telangiectases.

Clinical Presentation

Diffuse erythema and telangiectases.

Clinical History

Submitted by Alaa Saad. Originally posted September 22, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Acne vulgaris • Seborrheic dermatitis • Contact dermatitis • Lupus erythematosus • Perioral dermatitis • Demodex folliculitis • Carcinoid syndrome (flushing)

Key Learnings

• Four subtypes: erythematotelangiectatic (ETR), papulopustular, phymatous, ocular • No comedones — distinguishes from acne • Demodex mites are found in increased density — role in pathogenesis supported by response to anti-parasitic therapy • Rhinophyma (phymatous rosacea) is more common in men • Ocular rosacea can be sight-threatening — evaluate all rosacea patients for eye involvement • Triggers: UV, heat, alcohol, spicy food, stress, exercise — trigger avoidance is key • Topical ivermectin and topical metronidazole are first-line topical therapies • Low-dose doxycycline (40mg modified-release) is anti-inflammatory without antibiotic activity

Tags: rosacea, erythematotelangiectatic, type, alaa saad