A 49-year-old woman comes to the physician requesting treatment for "this unattractive redness of my skin." In the past 3 months, she developed blemishes on her nose, cheeks, and chin. She now flushes intensely in response to hot or cold temperatures, emotion, and the consumption of spicy foods or alcohol. She has no history of dermatological problems. Physical examination shows a reddening of the central face, erythematous papules on the nose, and sporadic telangiectasias on the nose and cheeks as shown below. The appropriate action was taken. Which of the following complications is most frequently associated with this condition?

Question

A 49-year-old woman comes to the physician requesting treatment for "this unattractive redness of my skin."  In the past 3 months, she developed blemishes on her nose, cheeks, and chin.  She now flushes intensely in response to hot or cold temperatures, emotion, and the consumption of spicy foods or alcohol.  She has no history of dermatological problems.  Physical examination shows a reddening of the central face, erythematous papules on the nose, and sporadic telangiectasias on the nose and cheeks as shown below.  The appropriate action was taken.  Which of the following complications is most frequently associated with this condition?

Quizplus · Accepted Answer

Explanation: Patients with rosacea often experience ocular symptoms. Manifestations of ocular rosacea may include burning or foreign body sensations, blepharitis, keratitis, conjunctivitis, corneal ulcers, and recurrent chalazion. The chalazion is characterized by a granulomatous inflammation of a meibomian gland and presents as a painless pea-sized nodule within the eyelid. Patients with ocular rosacea should have an ophthalmology consultation to address the risk of more serious complications. chalazion (Choice A) Fistulous tracts, abscesses, sinus tracts, and fibrosis are common manifestations of cervicofacial actinomycosis. Actinomycosis is due to a filamentous, branching gram-positive bacterium. Examination of abscess fluid shows characteristic yellow "sulfur granules." (Choice B) Actinic keratoses are small scaly lesions found in sun-exposed areas and are caused by excessive ultraviolet (UV) light exposure. They are associated with up to a 20% risk of transformation to squamous cell carcinoma. Actinic keratoses (Choice D) Sinus infections can arise when mucosal edema obstructs the ostia, often subsequent to allergic rhinitis or viral upper respiratory tract infections. Sinusitis is not typically associated with rosacea. (Choice E) Cerebral venous thrombosis may be seen as a complication of invasive mucormycosis. It is also seen in patients with thrombotic disorders, advanced malignancy, or severe infections. It is not a complication of rosacea. mucormycosis Educational objective: Patients with rosacea may also experience ocular symptoms. Complications frequently include a burning or foreign body sensation, blepharitis, keratitis, conjunctivitis, episcleritis, and recurrent chalazion. References: Rosacea: a common, yet commonly overlooked, condition. (http://www.ncbi.nlm.nih.gov/pubmed/12182520)

A 49-Year-Old Woman Comes to the Physician Requesting Treatment for "This