Ipoh, Malaysia
A 37 year old restaurant waitress had these rashes on the face for several years, but worse recently since her pregnancy. She is G2P1 at the end of her first trimester. The rash was described as itching, burning. She had seen a dermatologist in Japan and was diagnosed as rosacea. There was no fever or polyarthralgia. Family history was insignificant. Drug history nil.
She feels very uncomfortable. Examination was unremarkable except facial flushing with for bilateral and symmetrical erythematous papules on both cheeks with a mild involvement of the bridge of nose. There was no comedones. Her scalp was normal.
What do you think of the diagnosis? Do you think this is rosacea? What other differentials would you consider - lupus erythematosus, seborrheic dermatitis? How would you manage her remembering that she 3 months pregnant? Would you use topical metrondazole?
What do you think of the diagnosis? Do you think this is rosacea? What other differentials would you consider - lupus erythematosus, seborrheic dermatitis? How would you manage her remembering that she 3 months pregnant? Would you use topical metrondazole?
In Asia, many women routeinly use a facial mask patch for their facial care. Does she use any facial products last a few years? Just thought.
ReplyDeleteAsian women like to use facial mask to exfoliate and smoothen their complexion. She finds her skin of oily type and she could not tolerate any oil based skin care products. She did not use any facial mask so far, and she use only oil-free moisturisers and sunblock.
ReplyDeleteHer serology for ANA is negative.
I would also consider an allergic or a photoallergic contact dermatitis to the sunscreen.
ReplyDelete