Chapter 38 - Rosacea and Related Disorders Flashcards Preview

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Flashcards in Chapter 38 - Rosacea and Related Disorders Deck (16):
1

Which laser is used to recontour fibrotic rhinophyma?

CO2 laser; it's the only established method of improving fibrotic rhinophyma

2

Are the effects of isotretinoin on rosacea long lasting the way they are in acne patients?

No; most patients require longterm oral tetracyclines to maintain remission after treatment with isotretinoin

3

Pediatric patients with childhood granulomatous periorificial dermatitis can't be treated with tetracycline due to the risk of teeth staining. What oral antibiotic should be used instead?

Erythromycin

4

Is topical tretnoin (a comedolytic) helpful in treating rosacea?

Yes, even though there are no comedones in rosacea. It may work through its effects on the elastolysis seen in chronic rosacea

5

Is azelaic acid cream as effective as topical metronidazole for treating rosacea?

Yes, it appears to be as effective as topical metronidazole

6

What's the name for the eponymously named syndrome, presumed to be AD, where patients develop early-onset rosacea-like facial dermatosis, plus comedones, pitted atrophy, and small papules?

Haber syndrome
*In some patients there's an overlap with Dowling-Degos disease

7

What's the name of the rosacea that often clinically overlaps with granulomatous rosacea, has a predilection for the periorbital region, and is characterized histologically by granulomas with central caseation necrosis?

Lupus miliaris disseminatus faciei
*Despite the granulomas with central caseation, there's no relationship to Mycobacterium tuberculosis

8

What is the other name for ulerythema ophryogenes?

Keratosis pilaris atrophicans faciei
*Follicular atrophy and scarring alopecia of the eyebrows is typical

9

What is the pathogenesis of rosacea?

Multifactorial. Vasodilation, hyperirrtability, organisms (Demodex folliculorum, Propionibacterium acnes), neurologic diseases, drugs, ?UV light, ?photodamage, vasoactive tumors/disorders

10

What are the 4 subtypes of rosacea?

1) erythematotelangiectatic, 2) papulopustular, 3) phymatous, 4) ocular

11

What are the primary features of rosacea?

Flushing, non transient erythema, papules/pustules/ telangiectasia

12

What is the diagnostic criteria for rosacea?

1 or more primary features

13

What is the pathogenesis for ocular rosacea?

Meibomian gland impaction leads to decreased lipid in the tear film, greater tear evaporation, and subsequent irritability of the eye. ?Elevated epithelium-derived protease activity

14

What are some ocular symptoms of rosacea?

Symptoms range from a sensation of dryness or tired eyes to edema, tearing, pain, blurry vision, styes, chalazia and corneal damage

15

What might you see on physical examination of the eyes in a patient with ocular rosacea?

Blepharitis, conjunctivitis, chronic edema, meibomian impaction, styes, keratitis, corneal neovascularization, corneal ulceration, rupture, ectropion

16

What are the first line treatment options for patients for rosacea?

Topical metronidazole, sodium sulfacetamide with sulfur, azelaic acid, benzoyl peroxide/clindamycin. Oral tetracycline, minocycline. All are of Level 1 evidence