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Stage I
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Stage III
Persistent edema of rosacea
Rosacea conglobata and rosacea fulminans
Lupoid or granulomatous rosacea
Steroid rosacea
Eye involvement
Rhinophyma
Non-approved therapies


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Treatment - Rosacea conglobata and rosacea fulminans

Topical

In general, topical steroids should not be used in rosacea. The only exception is rosacea fulminans.
High-potency corticosteroids such as clobetasol-17-propionate may be useful by reducing the inflammation when applied in addition to the systemic treatment.


Systemic

A combination regimen including isotretinoin (0,5 - 1 mg/kg body weight daily)and oral corticosteroids such as prednisone (0,5 – 1 mg/kg body weight daily) is recommended. In women, oral contraceptives with antiandrogen properties may be added.
Note: For female patients of childbearing age, the use of effective birth control is mandatory because of this drug’s teratogenic potential. Regular monitoring of cholesterine and triglyceride levels as well as liver enzymes is required during treatment. Simultaneous treatment with isotretinoin and oral tetracyclines is not indicated, as this could cause an increase in cranial pressure. Isotretinoin may worsen ophthalmic rosacea.

Other

In rosacea conglobata, draining sinuses can be treated by intralesional injection of corticosteroids (such as triamcinolone acetonide), although sometimes, complete excision of the lesion is mandatory.


related information:

Rosacea conglobata



This progressive and chronic form mainly affects women and is characterized by indurated plaques and hemorrhagic nodular abscesses on erythematous skin.
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