Diagnosing a Patient with Facial Erythema is Challenging

[Guide]

Image courtesy of Contact Dermatitis 

A recent paper reports of a "A 62‐year‐old man without a history of atopy had been experiencing episodic facial erythema for 30 years." [1] Over this period of thirty years he had been diagnosed with seborrheic dermatitis, rosacea, and finally allergic contact dermatitis (ACD). 

This paper highlights that "To diagnose a patient with facial erythema is challenging." Furthermore, misdiagnosis is not uncommon when it comes to diagnosing rosacea. Especially is this true when differentiating rosacea from sensitive skin. 

"This report highlights the significance of multiple causes of facial erythema in individuals, which may change over time. Patients with sudden flares, and where treatments only seem to give worse symptoms, should be referred for patch testing, since a damaged skin barrier may bring about polysensitization to the treatment. Once contact allergies have been found, the patientʼs original dermatitis can be investigated correctly. Patch testing with higher concentrations of brimonidine and a ROAT could be helpful in suspected cases of ACD." [1]

Etcetera

ROAT or PATCH Test

Diagnosing Rosacea

End Notes

[1] Contact Dermatitis. 2021 Feb; 84(2): 121–122.
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