Diagnosis of Rosacea

Rosacea Diagnosis: Book Excerpts

• Differential Diagnosis - Acne
• History and physical examination - Butterfly rash
• History and physical examination - Papular rash
• History and physical examination - Pustular rash
• Diagnosis - Rosacea
• Diagnosis - Acne vulgaris
• History and physical examination - Butterfly rash
• History and physical examination - Papular rash
• History and physical examination - Pustular rash
• Diagnosis - Acne vulgaris
• History - Butterfly rash
• History - Papular rash
• History - Pustular rash
• History and physical examination - Butterfly rash
• History and physical examination - Papular rash
• History and physical examination - Pustular rash

Diagnosis of Rosacea: medical news summaries:

The following medical news items are relevant to diagnosis and misdiagnosis issues for Rosacea:

• New topical oil therapy for rosacea and acne developed
• More news »

Diagnostic Tests for Rosacea: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about diagnostis of Rosacea.

Acne: Differential Diagnosis
(In a Page: Signs and Symptoms)

• Acne vulgaris
  –Common in adolescents, especially boys
  –Most common on face, chest, and upper back
  –Due to hormones, P. acnes, and comedogenic cosmetics
  –May be secondary to or exacerbated by medications (e.g., corticosteroids, phenytoin, lithium, isoniazid) and polycystic ovarian syndrome
• Rosacea
  –Middle-aged to older adults
  –Papules and pustules in middle third of face, telangiectasia, flushing, erythema
  –No comedones
  –Often associated with ingestion of hot beverages, alcohol, or vasodilating medications

• Miliaria (“heat rash”)
  –Burning, pruritic vesicles, papules, or pustules on covered areas, usually trunk and intertriginous areas

• Gram-negative folliculitis
  –Klebsiella, Enterobacter, E. coli –May develop during antibiotic treatment of
  acne

• Acne conglobata
  –Most severe form of acne
  –Deep nodules, cysts, ulcers, abscesses,
  sinus tracks, scars
  –Causes severe scarring and keloid formation if untreated

• Hidradenitis suppurativa
  –Pustules and cysts, often draining and very
  painful
  –Especially in axilla, groin

Workup and Diagnosis

• History and physical examination
  –Examination should include the face, chest, and back
  –Comedones are the hallmark of acne: Open comedones (blackheads) are follicles with dilated, black orifice; closed comedones (whiteheads) are white papules without surrounding erythema
  –Look for evidence of severe acne: Inflammatory papules, pustules, cysts, nodules, scars, pits
  –Document the number of comedones, inflammatory lesions, scars, and cysts
  –Assess acne severity (mild/moderate/severe) based on number, size, and extent of lesions and the presence/ absence of scarring

• Measurement of androgen levels (testosterone, DHEA-S, 17hydroxyprogesterone) for females with resistant acne and evidence of androgen excess (e.g., irregular menses, hirsutism, clitoromegaly)
• Malassezia infection may require biopsy for diagnosis
• Bacterial culture may be necessary to rule out folliculitis

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Butterfly rash: History and physical examination
(Handbook of Signs & Symptoms (Third Edition))

Ask the patient when he first noticed the butterfly rash and if he has recently been exposed to the sun. Has he noticed a rash elsewhere on his body? Also, ask about recent weight or hair loss. Does he have a family history of lupus? Is he taking hydralazine or procainamide (common causes of drug-induced lupus erythematosus [LE])?

Inspect the rash, noting any macules, papules, pustules, or scaling. Is the rash edematous? Are areas of hypopigmentation or hyperpigmentation present? Look for blisters or ulcers in the mouth, and note any inflamed lesions. Check for rashes elsewhere on the body.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Papular rash: History and physical examination
(Handbook of Signs & Symptoms (Third Edition))

Your first step is to fully evaluate the papular rash: Note its color, configuration, and location on the patient’s body. Find out when it erupted. Has the patient noticed changes in the rash since then? Is it itchy or burning, or painful or tender? Has there ever been discharge or drainage from the rash? If so, have the patient describe it. Also, have him describe associated signs and symptoms, such as fevers, headaches, and GI distress.

Next, obtain a medical history, including allergies; previous rashes or skin disorders; infections; childhood diseases; sexual history, including sexually transmitted diseases; and cancers. Has the patient recently been bitten by an insect or rodent or been exposed to anyone with an infectious disease? Finally, obtain a complete drug history.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Pustular rash: History and physical examination
(Handbook of Signs & Symptoms (Third Edition))

Have the patient describe the appearance, location, and onset of the first pustular lesion. Did another type of skin lesion precede the pustule? Find out how the lesions spread. Ask what medications the patient takes and if he has applied topical medication to his rash. If so, what type and when did he last apply it? Find out if he has a family history of a skin disorder.

Examine the entire skin surface, noting if it’s dry, oily, moist, or greasy. Record the exact location and distribution of the skin lesions and their color, shape, and size.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Rosacea: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

CONFIRMING DIAGNOSIS Typical vascular and acneiform lesions — without the comedones characteristically associated with acne vulgaris — and rhinophyma in severe cases confirm rosacea.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Acne vulgaris: Diagnosis
(Professional Guide to Diseases (Eighth Edition))

Confirming diagnosis  The appearance of characteristic acne lesions, especially in an adolescent patient, confirms the presence of acne vulgaris.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Butterfly rash: History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))

Ask the patient when he first noticed the butterfly rash and if he has recently been exposed to the sun. Has he noticed a rash elsewhere on his body? Also, ask about recent weight or hair loss. Does he have a family history of lupus? Is he taking hydralazine or procainamide (common causes of drug-induced lupus erythematosus)?

Inspect the rash, noting any macules, papules, pustules, or scaling. Is the rash edematous? Are areas of hypopigmentation or hyperpigmentation present? Look for blisters or ulcers in the mouth, and note any inflamed lesions. Check for rashes elsewhere on the body. (See Butterfly rash: Causes and associated findings.)

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Papular rash: History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))

Your first step is to fully evaluate the papular rash: Note its color, configuration, and location on the patient’s body. Find out when it erupted. Has the patient noticed any changes in the rash since then? Is it itchy or burning, or painful or tender? Have him describe associated signs and symptoms, such as fever, headache, and GI distress.

Next, obtain a medical history, including allergies, previous rashes or skin disorders, infections, childhood diseases, sexual history, including any sexually transmitted diseases (STDs), and cancers. Has the patient recently been bitten by an insect or rodent or been exposed to anyone with an infectious disease? Finally, obtain a complete drug history.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Pustular rash: History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))

Have the patient describe the appearance, location, and onset of the first pustular lesion. Did another type of skin lesion precede the pustule? Find out how the lesions spread. Ask what medications the patient takes and if he has applied any topical medication to his rash. If so, what type and when did he last apply it? Find out if he has a family history of a skin disorder.

Examine the entire skin surface, noting if it’s dry, oily, moist, or greasy. Record the exact location and distribution of the skin lesions and their color, shape, and size.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Acne vulgaris: Diagnosis
(Handbook of Diseases)

The appearance of characteristic acne lesions, especially in an adolescent parms the presence of acne vulgaris.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Diseases, 2003

Butterfly rash: History
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Ask the patient when he first noticed the butterfly rash and if he has recently been exposed to the sun. Has he noticed a rash elsewhere on his body? Also, ask about recent weight or hair loss. Does he have a family history of lupus? Is he taking hydralazine or procainamide (common causes of drug-induced lupus erythematosus)?

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Papular rash: History
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Find out when the rash erupted. Has the patient noticed any changes in the rash since then? Is it itchy or burning, or painful or tender? Have the patient describe associated signs and symptoms, such as fever, headache, and GI distress.

Obtain a medical history, including allergies, previous rashes or skin disorders, infections, childhood diseases, sexual history, sexually transmitted diseases (STDs), and cancers. Has the patient recently been bitten by an insect or a rodent or been exposed to anyone with an infectious disease? Finally, obtain a complete drug history.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Pustular rash: History
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Have the patient describe the appearance, location, and onset of the first pustular lesion. Did another type of skin lesion precede the pustule? Find out how the lesions spread. Ask what medications the patient takes and if he has applied any topical medication to his rash. If so, what type and when did he last apply it? Find out if he has a family history of a skin disorder.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Butterfly rash: History and physical examination
(Nursing: Interpreting Signs and Symptoms)

Ask the patient when he first noticed the butterfly rash and if he has recently been exposed to the sun. Has he noticed a rash elsewhere on his body? Ask about recent weight or hair loss. Does he have a family history of lupus? Is he taking hydralazine or procainamide (common causes of drug-induced lupus erythematosus)?

Inspect the rash, noting any macules, papules, pustules, or scaling. Is the rash edematous? Are areas of hypopigmentation or hyperpigmentation present? Look for blisters or ulcers in the mouth, and note any inflamed lesions. Check for rashes elsewhere on the body.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

Papular rash: History and physical examination
(Nursing: Interpreting Signs and Symptoms)

Your first step is to fully evaluate the papular rash: note its color, configuration, and location on the patient's body. Find out when it erupted. Has the patient noticed changes in the rash since then? Is it itchy or burning, or painful or tender? Has there ever been discharge or drainage from the rash? If so, have the patient describe it. Also, have him describe associated signs and symptoms, such as fevers, headaches, and GI distress.

Next, obtain a medical history, including allergies; previous rashes or skin disorders; infections; childhood diseases; sexual history, including sexually transmitted diseases; and cancers. Has the patient recently been bitten by an insect or rodent or been exposed to anyone with an infectious disease? Finally, obtain a complete drug history.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

Pustular rash: History and physical examination
(Nursing: Interpreting Signs and Symptoms)

Have the patient describe the appearance, location, and onset of the first pustular lesion. Did another type of skin lesion precede the pustule? Find out how the lesions spread. Ask what medications the patient takes and if he has applied topical medication to his rash. If so, what type and when did he last apply it? Find out if he has a family history of a skin disorder.

Examine the entire skin surface, noting if it's dry, oily, moist, or greasy. Record the exact location and distribution of the skin lesions and their color, shape, and size.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

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