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Classical subtypes - Stage I

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This stage is characterized by flushing (episodic attacks of redness accompanied by a sensation of warmth and burning) and persistent central facial erythema. When asked, most patients typically have a history of flushing. The appearance of telangiectases is common but not essential. Some patients may also develop central facial edema. Stinging and burning may be reported. Roughness or scaling of the skin may occur.
Differential diagnoses that need to be considered in this stage are allergic contact dermatitis, phototoxic dermatitis, erysipelas, lupus erythematosus, dermatomyositis, Sharp syndrome (mixed connective tissue disease), angioedema, scleredema adultorum Buschke, Haber‘s syndrome (rare variant of the Dowling-Degos disease with rosacea-like erythema of the face), flush-inducing drugs (e.g. glyceryl trinitrate, nifedipine, prostaglandin E, nicotinic acid, drugs containing ethanol).

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