This patient had rosacea, an inflammatory condition of the face and eyes that mostly affects adults (women more often than men). Patients’ cheeks and noses become reddened, and they develop telangiectasias and papulopustular eruptions. Rosacea is common in fair-skinned people of Celtic and northern European heritage.
In this case, the FP counseled the patient about the diagnosis of rosacea and the factors that can worsen it, including exposure to the sun, alcohol, hot beverages, and spicy foods. The FP started the patient on doxycycline 100 mg twice daily with the intent to taper it to once daily in the future. In addition, he wrote a prescription for metronidazole gel to be used once daily.
The patient agreed to wear a hat and stay out of the sun during the middle of the day. She also promised to look for a sunscreen she could tolerate. A follow-up appointment was arranged for the following month.
Photo and text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Usatine R. Rosacea. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:659-664.
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