A 54-year-old male from Peru was referred for consultation due to the development of a sudden onset skin condition accompanied by myalgias and chills of 2 weeks of evolution located in the facial region.
The patient was previously diagnosed in another center of papulopustular type mild rosacea and referred application of topical corticoid (0.25% prednicarbate cream) once a day for six months.
Physical examination revealed fever, erythema and facial edema together with inflammatory skin lesions consisting of papules, pustules and without comedones.
She also suffered from ocular symptoms with sectoral ocular injection, telangiectasia, tearing and photophobia due to episcleritis.
The emergency laboratory showed mild leukocytosis with left shift without any other relevant findings added.
1.
With the diagnosis of rosacea fulminans with ocular involvement, oral treatment with metronidazole 250 mg/day, prednisone 30 mg/day, isotretinoin 40 mg/day (0.7 mg/kg/day) was initiated.
In one week the blood count was normalized and after clinical improvement, me-tronidazole and prednisone were removed (the latter after progressive decrease).
The isotretinoin dose was progressively reduced for 5 months until withdrawal with complete resolution.
After six months of medication withdrawal, the patient has not presented any new lesions.
