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afya
Acne Rosacea
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<<forEachTiddler where 'tiddler.tags.contains(context.inTiddler.title)' sortBy tiddler.title ascending write '"*[["+tiddler.title+"]]\n"'>> <<tiddler AutoRefresh with: force>> Metronidazole gel or azelaic acid 1st, then consider Oxytet, doxy or erythro Brimonidine cream - useful for flushing, can be used prn, causes pruritis, expensive - ? role Needs 2-6/12 to suppress and 2/3 recur, 10% indefinately warn about eye Sx (leratitis with ulceration can be an emergency) and give lubricants and eyelid advice Chronic skin disease of unknown aetiology fair skinned, NOT comedonal more in females, worse in males ''Features'' affects nose, cheeks, forehead flushing is often first Sx (?? after alcohol but not cos of xs alcohol) - not usually responds to Abs - try propranolol or clonidine Telangiectasia are common later - persistent erythema with papules and pustules - no comedones - ?laser Rx - not on NHS rhinophyma (mostly males) blepharitis and conjunctivitis - problems occur in 50% pts - can lead on to corneal ulceration and dec VA - usually lubricants and eyelid care, beware keratitis - refer ''Management'' Topical Metronidazole (mild Sx - few pustules, no plaques) or azelaic acid - need 8/52 to see result systemic abs - Oxytetracycline, Doxycycline or Erythromycin Isotretinoin can be used in 2ndary care high factor sunscreen camouflage cream laser therapy for telangiectasia Brimonidine - alpha agonist, effective against flushing, SE - pruritis and burning, expensive need to withdraw Rx slowly else can get rebound (takes 2-6/12) 2/3 relapse w'in 2 yrs and 10% require indefinate Rx
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