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Referral
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Rosacea
Rosacea is a common rash, usually occurring on the face, and which predominantly affects both middle-aged (age range 30 to 60) and fair-skinned people.
This condition can generally be managed in Primary Care.
Referral Criteria:
Only required if:
- Diagnostic uncertainty
- Failure of primary care management
- Severe and tetracycline resistant rosacea for consideration of isotretinoin
Signs and Symptoms
- Bimodal prevalence of 20-30 years of age and a larger peak at 40-50
- Aggravated by anything that predisposes to flushing such as alcohol, spicy foods, hot drinks, temperature changes, sunlight, emotion and drugs that cause vasodilation
Clinical features
- Sited on the central face with sparing of the perioral and periorbital skin
- Telangiectasia
- Papules and pustules on a background erythema
- Facial disfigurement intermittent or permanent
- Rhinophyma
- As opposed to acne vulgaris – no comedones
- Ocular involvement in 50% of cases can cause gritty eyes, conjunctivitis, blepharitis episcleritis and chalazion. Keratitis is a more serious complication
This condition can generally be managed in Primary Care.
Referral is only required if:
- Diagnostic uncertainty
- Failure of primary care management
- Severe and tetracycline resistant rosacea for consideration of isotretinoin
Referral instructions
e-Referral Service selection:
- Specialty: Dermatology
- Clinic Type: Not Otherwise Specified
- Service: DRSS-WC-Dermatology (PCT) (not for patient attendance)-Devon ICB-15N
Referral forms
Evidence
South and West Devon formulary - Skin
The Primary Care Dermatology Society
Pathway Group
This guideline has been signed off on behalf of NHS Devon.
Publication date: 30 January 2017
