American Journal of Clinical Dermatology

, Volume 7, Issue 2, pp 141–144 | Cite as

Rosacea Fulminans in Pregnancy

Case Report and Review of the Literature
  • Ayten Ferahbas
  • Serap Utas
  • Selcuk Mistik
  • Umit Uksal
  • Dilek Peker
Case Report

Abstract

Rosacea fulminans is a rare disease of unknown cause which occurs exclusively in women years after adolescence. Although the etiology is unknown, immunologic, hormonal, and vascular factors have been suggested. When rosacea fulminans occurs during pregnancy and in women taking oral contraceptive pills, hormonal factors may be a trigger. Rosacea fulminans is localized specifically to the face, with the chin, cheeks, and forehead bearing the brunt of the attack. A dull red, cyanotic erythema of all involved facial areas, extending beyond the inflammatory nodules, is typical.

We present the case of a 31-year-old pregnant woman who had rosacea fulminans during the first trimester of her second pregnancy. She had multiple erythematous papules, pustules, nodules, and purulent discharging cysts on the face. Conventional therapeutic approaches with systemic corticosteroids were associated with clear improvement within 2 months, and subsequently only 0.75% metronidazole topical cream was used during the second trimester.

Keywords

Acne Isotretinoin Systemic Corticosteroid Dapsone Oral Contraceptive Pill 

Notes

Acknowledgements

The authors have no financial or proprietary interest in any instrument or products used in this case report, and no other conflicts of interest that are directly relevant to the content of this case report.

References

  1. 1.
    Plewig G, Jansen T. Rosacea. Disorders of epidermal appendages and related disorders. In: Fitzpatrick TB, Freedberg IM, Eisen AZ, et al., editors. Dermatology in general medicine. 5th ed. New York (NY): McGraw-Hill, 1999: 785-92Google Scholar
  2. 2.
    Plewig G, Jansen T, Kligman AM. Pyoderma faciale: a review and report of 20 additional cases: is it rosacea? Arch Dermatol 1992; 128: 1611-7PubMedCrossRefGoogle Scholar
  3. 3.
    Firooz A, Firooabadi MR, Dowlati Y. Rosacea fulminans (pyoderma faciale): successful treatment of a 3-year-old girl with oral isotretinoin. Int J Dermatol 2001; 40: 203-5PubMedCrossRefGoogle Scholar
  4. 4.
    Lewis VJ, Holme SA, Wright A, et al. Rosacea fulminans in pregnancy. Br J Dermatol 2004; 151 (4): 917-9PubMedCrossRefGoogle Scholar
  5. 5.
    Jansen T, Plewig G. An historical note on pyoderma faciale. Br J Dermatol 1993; 129: 594-6PubMedCrossRefGoogle Scholar
  6. 6.
    Bormann G, Gaber G, Fischer M, et al. Dapsone in rosacea fulminans. J Fur Acad Dermatol Venereol 2001; 15: 465-7CrossRefGoogle Scholar
  7. 7.
    Massa MC, Su WP. Pyoderma faciale: a clinical study of twenty-nine patients. J Am Acad Dermatol 1982; 6: 84-91PubMedCrossRefGoogle Scholar
  8. 8.
    Haugstvedt A, Bjerke JR. Rosacea fulminans with extrafacial lesions. Acta Derm Venereol 1998; 78: 70-1PubMedCrossRefGoogle Scholar
  9. 9.
    Gob CL. Clinician’s photo guide to recognizing and treating skin diseases in women. Part 1: dermatoses not linked to pregnancy. Medscape Women’s Health 1997; 2: 3Google Scholar
  10. 10.
    Jansen T, Plewig G. Fulminating rosacea conglobata (rosacea fulminans) and ulcerative colitis. Br J Dermatol 1997; 137: 830-1PubMedCrossRefGoogle Scholar
  11. 11.
    Romiti R, Jansen T, Heldwein W, et al. Rosacea fulminans in a patient with Crohn’s disease: a case report and review of the literature. Acta Derm Venereol 2000; 80: 127-9PubMedGoogle Scholar
  12. 12.
    Jansen T, Romiti R, Kreuter A, et al. Rosacea fulminans triggered by high-dose vitamins B6 and B12. J Fur Acad Dermatol Venereol 2001; 15: 484-5CrossRefGoogle Scholar
  13. 13.
    Jensen SL, Holmes R. Rosacea fulminans associated with pegylated interferon alpha-2B and ribavirin therapy. J Drugs Dermatol 2003; 2: 554-6PubMedGoogle Scholar
  14. 14.
    Rebora A, Drago F, Parodi A. May Helicobacter pylori be important for dermatologists? Dermatology 1995; 191: 6-8PubMedCrossRefGoogle Scholar
  15. 15.
    Manna V, Marks R, Holt P. Involvement of immune mechanisms in the pathogenesis of rosacea. Br J Dermatol 1982; 107: 203-8PubMedCrossRefGoogle Scholar
  16. 16.
    Mirtschink S, Barth J, Hubner U. Case report of the facial pyoderma disease picture [in German] Dermatol Monatsschr 1986; 172 (5): 290-293Google Scholar
  17. 17.
    Jansen T, Plewig G, Kligman AM. Diagnosis and treatment of rosacea fulminans. Dermatology 1994; 188: 251-4PubMedCrossRefGoogle Scholar
  18. 18.
    Utas S, Ozean H. Etiology, clinical findings and recent treatment modalities in acne rosacea [in Turkish]. Turkderm 1998; 32: 195-200Google Scholar

Copyright information

© Adis Data Information BV 2006

Authors and Affiliations

  • Ayten Ferahbas
    • 1
  • Serap Utas
    • 1
  • Selcuk Mistik
    • 2
  • Umit Uksal
    • 1
  • Dilek Peker
    • 1
  1. 1.Department of DermatologyErciyes University Medical FacultyKayseriTurkey
  2. 2.Department of Family MedicineErciyes University Medical FacultyKayseriTurkey

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