Rosacea

Hi I went to my dermatologist today because my face is red on both cheeks. She said that it's rosacea. I have some hair loss which is due to my low thyroid. I had an ANA test which came back negative. My cheeks don't have any pimples on them and the redness is flat and feels warm. I'm scared that it could be a malar rash but my dermatologist said it's not. Also, my eyes are irritated and red. Can somone please help me who knows the difference between the two? Thanks

[Vanessa Lacuesta]

Hi,

The malar rash of lupus is one strong differential for the presentation of rosacea.

The malar rash usually starts at the bridge of the nose as a flat or raised redness that may be itchy and scaling.This may be aggravated by sun exposure. This is usually accompanied by other criteria that will fit the picture of SLE.Lupus rash is also scarring but does not have the heat and flushing sensation associated with rosacea.

Rosacea on the other hand also may present as a butterfly patterned rash over the face.The skin is red and pustules ( small bumps with pus ) and comedones are not present.The lesion has a well defined border making one think that this could be a skin infection when it is not.It has a symmetrical involvement over the brows, chin , cheeks nose and ears. Because of its vascular cause , rosacea is usually associated with heat or flushing sensation in the face. Eye irritation and inflamation (inflammation) is also assoited with rosacea.

Discuss your concerns with your physicians .Your response to treatment will guide your physician in the next step to managing your condition.The malar rash of lupus and rosacea may be difficult to differentiate. Sometimes a skin biopsy may be able to give the definite diagnosis.