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1、ROSACEAKeyPoints·Rosaceahasfourdifferentclinicalpresentations:erythemato-telangiectatic,papulo-pustular,phymatous,andocular.Itisessentialtocorrectlyidentifythesubtypeofrosaceainordertoselecttheappropriatemedicalorsurgicaltherapy.·Rosaceatreatmentshouldbetailoredtotheclinicalsubtypeandd
2、iseaseseveritytooptimizetherapy.·Facialerythemaistheprimaryfeatureofrosaceaandpresentsubiquitouslyinallsubtypes.Persistentfacialerythemahassignificantimpactonqualityoflife.·Erythemato-telangiectaticrosaceamustbedifferentiatedfromchronicsundamage.·Papulo-pustularrosaceamustbedistinguish
3、edfromacnevulgaris,seborrheicdermatitis,perioraldermatitis,andDemodexfolliculitis/demodicidosis.Rosaceacanbedistinguishedfromacnevulgarisbythelackofcomedones,identificationoftriggersforflushing,absenceofscarring,thepresenceofphymatouschanges,andthepredilectiontoaffectolderadultsrathert
4、hanteenageadults.·Rosaceapatientsoftenhavesensitiveskinandsufferfromintolerancetoskinproductsandcosmetics.·Patientswithrosaceaflush,havefacialerythema,telangectasia,papulesandpustules,sebaceoushyperplasiaofthenose(rhinophyma),and/orocularsymptoms.Triggersforflushingincludealcohol,sunex
5、posure,hotweather,exercise,ingestionofhotorspicyfoods/drinkoramedication,andemotionalstress.Eliminatingthetriggersofflushingcanalleviaterosaceasymptoms.·Newertopicaltreatmentsprovideeffectiveoptionsfortreatingrosaceasubtypes.Thealphaadrenergicagonistbrimonidine(Mirvaso)effectivelyreduc
6、eserythemainerythemato-telangiectacticrosacea,aswellasinothersubtypes.Ivermectincream(Soolantra)ishighlyeffectiveinreducinginflammatorylesionsofpapulo-pustularrosacea.·Ocularrosacearequiressystemicantibiotics.·Phymatousrosaceamayrequirelasertreatmentorothersurgicalintervention.InitialE
7、valuationErythemato-telangiectatic(E-T)subtype: Characterizedbydiffuseerythemaandtelangiectasiasonthecheeks,forehead,dorsalnose,orentireface.Papulo-pustularsubtype: Characterizedbypapulesandpustulesoftenonablushoferythemaprimarilyaffectingthenose,cheeks,andforehead.Predilectionoflesi
