| What condition is indicated by a bulbous enlargement of the nose? | rhinophyma | • Photosensitivity • Persistent erythema, telangiectasia ± papules and pustules in absence of comedones • Sites: Convexities of the face (cheeks, forehead, nose, chin) • Bulbous enlargement of nose- rhinophyma • Symptoms: Sensitivity to hot and spicy food, and emotional triggers • History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism- look for polycystic ovarian syndrome • History of premenstrual flare • Persistence or onset/ recurrence after 25 years of age • History of dry and gritty eyes- requires ophthalmologic evaluation for ocular rosacea | 199 | definition | 0.940 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967368_acne_roseacea.pdf | • Photosensitivity • Persistent erythema, telangiectasia ± papules and pustules in absence of comedones • Sites: Convexities of the face (cheeks, forehead, nose, chin) • Bulbous enlargement of nose- rhinophyma • Symptoms: Sensitivity to hot and spicy food, and emotional triggers • History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism- look for polycystic ovarian syndrome • History of premenstrual flare • Persistence or onset/ recurrence after 25 years of age • History of dry and gritty eyes- requires ophthalmologic evaluation for ocular rosacea | 1 | page=1,block=24 | 0.700 | valid |
| What are the recommended topical treatments for mild papulopustular rosacea? | topical Azelaic acid (15%) or Metronidazole (1%) or Ivermectin (1%) | • Avoid triggers (alcohol, caffeine, spicy food, cosmetics, topical steroids) • Photoprotection • Mild papulopustular rosacea: topical Azelaic acid (15%) or Metronidazole (1%) or Ivermectin (1%) • Moderate disease, not controlled with topicals: Cap Doxycycline 100mg OD for minimum of 4-6 weeks • Severe/phymatous/ ocular rosacea: refer to a specialist for low dose Isotretinoin/interventional treatment ACNE EXCORIEE ACNE VULGARIS DRUG INDUCED ACNE NODULOCYSTIC ACNE ROSACEA • Connective tissue diseases like lupus erythematous or dermatomyositis: Photosensitivity, presence of Raynaud’s phenomenon, arthralgia, muscle weakness, dyspnea, dysphagia, oral/ genital ulcers, abdominal pain, frothy urine, seizures, or alopecia • Steroid induced rosacea: Photosensitivity, hypertrichosis, atrophy and pigmentary changes, prior history of topical corticosteroid application for a long time • Seborrheic dermatitis: Predominant involvement of nasolabial folds, eyebrows with erythema and greasy scales • Contact dermatitis or atopic dermatitis: Significant itching, exudation and crusting • ACNE VARIANTS AND DIFFERENTIALS DIFFERENTIALS OF ROSACEA Acne is a common dermatosis of adolescence and often persists into adulthood Rosacea often mimics acne but has distinct management issues | 127 |
| What are the symptoms associated with photosensitivity and persistent erythema in the absence of comedones? | telangiectasia ± papules and pustules | • Photosensitivity • Persistent erythema, telangiectasia ± papules and pustules in absence of comedones • Sites: Convexities of the face (cheeks, forehead, nose, chin) • Bulbous enlargement of nose- rhinophyma • Symptoms: Sensitivity to hot and spicy food, and emotional triggers • History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism- look for polycystic ovarian syndrome • History of premenstrual flare • Persistence or onset/ recurrence after 25 years of age • History of dry and gritty eyes- requires ophthalmologic evaluation for ocular rosacea | 42 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967368_acne_roseacea.pdf | • Photosensitivity • Persistent erythema, telangiectasia ± papules and pustules in absence of comedones • Sites: Convexities of the face (cheeks, forehead, nose, chin) • Bulbous enlargement of nose- rhinophyma • Symptoms: Sensitivity to hot and spicy food, and emotional triggers • History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism- look for polycystic ovarian syndrome • History of premenstrual flare • Persistence or onset/ recurrence after 25 years of age • History of dry and gritty eyes- requires ophthalmologic evaluation for ocular rosacea |
| What is the recommended treatment for mild to moderate acne? | 2.5% Benzoyl peroxide gel or 0.025% Tretinoin cream or 1% Adapalene gel ± Clindamycin gel for local application, at night time | • Stop unsupervised topical corticosteroid and cosmetic use on face • Clean face with soap/ mild cleanser • Mild-moderate acne: 2.5% Benzoyl peroxide gel or 0.025% Tretinoin cream or 1% Adapalene gel ± Clindamycin gel for local application, at night time • Moderate acne, not controlled with topicals: Cap Doxycycline 100mg OD for minimum of 4-6 weeks • Severe nodulocystic acne: Isotretinoin treatment at tertiary level after documentation of normal lipid profile and liver functions • Acne fulminans: start Prednisolone 0.5-1 mg/kg/day and refer to higher center • Hormonal acne: Treatment with anti-androgens at tertiary level • Drug induced acne: Stop offending drugs if feasible; treatment as per severtiy as detailed above | 128 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967368_acne_roseacea.pdf | • Stop unsupervised topical corticosteroid and cosmetic use on face • Clean face with soap/ mild cleanser • Mild-moderate acne: 2.5% Benzoyl peroxide gel or 0.025% Tretinoin cream or 1% Adapalene gel ± Clindamycin gel for local application, at night time • Moderate acne, not controlled with topicals: Cap Doxycycline 100mg OD for minimum of 4-6 weeks • Severe nodulocystic acne: Isotretinoin treatment at tertiary level after documentation of normal lipid profile and liver functions • Acne fulminans: start Prednisolone 0.5-1 mg/kg/day and refer to higher center • Hormonal acne: Treatment with |
| Which areas of the face are typically affected by photosensitivity and persistent erythema? | Convexities of the face (cheeks, forehead, nose, chin) | • Photosensitivity • Persistent erythema, telangiectasia ± papules and pustules in absence of comedones • Sites: Convexities of the face (cheeks, forehead, nose, chin) • Bulbous enlargement of nose- rhinophyma • Symptoms: Sensitivity to hot and spicy food, and emotional triggers • History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism- look for polycystic ovarian syndrome • History of premenstrual flare • Persistence or onset/ recurrence after 25 years of age • History of dry and gritty eyes- requires ophthalmologic evaluation for ocular rosacea | 113 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967368_acne_roseacea.pdf | • Photosensitivity • Persistent erythema, telangiectasia ± papules and pustules in absence of comedones • Sites: Convexities of the face (cheeks, forehead, nose, chin) • Bulbous enlargement of nose- rhinophyma • Symptoms: Sensitivity to hot and spicy food, and emotional triggers • History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism- look for polycystic ovarian syndrome • History of premenstrual flare • Persistence or onset/ recurrence after 25 years of age • History of dry and gritty eyes- requires ophthalmologic evaluation for ocular rosacea |
| What symptoms might suggest polycystic ovarian syndrome? | History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism | • Photosensitivity • Persistent erythema, telangiectasia ± papules and pustules in absence of comedones • Sites: Convexities of the face (cheeks, forehead, nose, chin) • Bulbous enlargement of nose- rhinophyma • Symptoms: Sensitivity to hot and spicy food, and emotional triggers • History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism- look for polycystic ovarian syndrome • History of premenstrual flare • Persistence or onset/ recurrence after 25 years of age • History of dry and gritty eyes- requires ophthalmologic evaluation for ocular rosacea | 282 | list | 0.780 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1725967368_acne_roseacea.pdf | • Photosensitivity • Persistent erythema, telangiectasia ± papules and pustules in absence of comedones • Sites: Convexities of the face (cheeks, forehead, nose, chin) • Bulbous enlargement of nose- rhinophyma • Symptoms: Sensitivity to hot and spicy food, and emotional triggers • History of menstrual irregularities (oligomenorrhea), weight gain and hirsutism- look for polycystic ovarian syndrome • History of premenstrual flare • Persistence or onset/ recurrence after 25 years of age • History of dry and gritty eyes- requires ophthalmologic evaluation for ocular rosacea |
| What are the management options for severe or phymatous rosacea? | low dose Isotretinoin/interventional treatment | • Avoid triggers (alcohol, caffeine, spicy food, cosmetics, topical steroids) • Photoprotection • Mild papulopustular rosacea: topical Azelaic acid (15%) or Metronidazole (1%) or Ivermectin (1%) • Moderate disease, not controlled with topicals: Cap Doxycycline 100mg OD for minimum of 4-6 weeks • Severe/phymatous/ ocular rosacea: refer to a specialist for low dose Isotretinoin/interventional treatment ACNE EXCORIEE ACNE VULGARIS DRUG INDUCED ACNE NODULOCYSTIC ACNE ROSACEA • Connective tissue diseases like lupus erythematous or dermatomyositis: Photosensitivity, presence of Raynaud’s phenomenon, arthralgia, muscle weakness, dyspnea, dysphagia, oral/ genital ulcers, abdominal pain, frothy urine, seizures, or alopecia • Steroid induced rosacea: Photosensitivity, hypertrichosis, atrophy and pigmentary changes, prior history of topical corticosteroid application for a long time • Seborrheic dermatitis: Predominant involvement of nasolabial folds, eyebrows with erythema and greasy scales • Contact dermatitis or atopic dermatitis: Significant itching, exudation and crusting • ACNE VARIANTS AND DIFFERENTIALS DIFFERENTIALS OF ROSACEA Acne is a common dermatosis of adolescence and often persists into adulthood Rosacea often mimics acne but has distinct management issues | 357 | list |