What treatments would you recommend for rosacea patients with persistent, soft/non-fibrotic cysts on the dorsal nose recalcitrant to chronic doxycycline and topical therapies?
Can consider a trial of a different oral antibiotic (such as a macrolide), or intralesional triamcinolone if lesions are discrete. However, I would likely proceed with a course of oral isotretinoin if there are no contraindications, given the recalcitrant nature of the disease. Doses usually range b...
Join for free or sign in to see the full answer
I have seen several similar patients. A central aspect of chronic inflammation on the nose in rosacea is sebaceous gland hyperplasia-most likely due to chronic UVA photodamage. My approach has been isotretinoin 0.5mg/kg till maximal improvement. The inflammation and thickness and coarseness of the n...
Join for free or sign in to see the full answer
While the diagnosis may certainly be cysts, it may be worth biopsying one as papular keloidal scars are very common on the nose after acne or rosacea. I see them frequently on the nose. Injection with very precise tiny aliquots of intralesional kenalog, and following with subsequent resurfacing lase...
Join for free or sign in to see the full answer