Internal Medicine

0521779407-18 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:20

Rocky Mountain Spotted Fever Rosacea 1311

Prognosis

■Mortality≥25% untreated.

■5% mortality with treatment, due to delays in diagnosis and treat-

ment.

ROSACEA

JEFFREY P. CALLEN, MD

history & physical

History

■Common condition in adults

■Facial erythema, papules and pustules

■Potentially exacerbated by hot foods, spicy foods, alcohol, and sun-

light

■Patients most often with Celtic or Northern European background

■Ocular disease (ocular rosacea) has symptoms of burning or redness

of the eyes

Signs & Symptoms

■Erythema and telangiectasia

■Papules and pustules on the central face

■Rare patients develop more fixed swellings known as “phymas,” of

which the most common is rhinophyma.

tests

■Clinical diagnosis

■Biopsy rarely needed

differential diagnosis

■Seborrheic dermatitis

■Acne vulgaris

■Lupus erythematosus

■Contact dermatitis

management

What to Do First

■Establish a diagnosis

General Measures

■Gentle facial cleansers

■Consider dietary alterations

■Ophthalmologic referral for ocular symptoms