A 29-year-old male, born in Brazil, with a personal history of seborrheic dermatitis and subacute cutaneous lupus, was referred to our center due to the development of an abrupt cutaneous condition of one week onset in the region.
The patient had applied a topical corticosteroid (mometasone 0.1%) furoate twice a day for 1 month to try to control the lesions.
He described a history of isolated pustular lesions on occasional faces and episodes of facial flushing with heat and alcohol.
Clinically he showed facial erythema and papulopustular lesions located in front, cheeks, perioral region and thorax.
He also had absence of comedones and ocular involvement with conjunctival injection accompanied by photophobia and tears.
He had no fever or other systemic symptoms.
Blood tests with general biochemistry and blood count were normal.
With the clinical judgment of rosacea fulminans with ocular involvement initiated oral treatment with prednisone 40 mg/day, metronidazole 500 mg/12 hours, isotretinoin 50 mg/day (0.7 mg/kg/day),
Metronidazole and prednisone were discontinued after one month of treatment (the latter on a descending regimen).
Finally, oral isotretinoin was discontinued after three months of treatment with progressive dose reduction.
The patient recovered well after three months of treatment.
The patient had no relapses of the disease in the following six months.
