Rosacea Fulminans

Key Points
Rare skin condition which affects the face
Cause is unknown
Consists of large, red nodules and pustules which may ulcerate or scar and are accompanied by pain

Rosacea fulminans (also known as pyoderma faciale) is a rare skin condition which affects only the face, and may appear similar to acne or rosacea. Symptoms present abruptly, and consist of the formation of large, red nodules, typically on the chin, cheeks, and/or forehead. Lesions are accompanied by pain and may ulcerate into sores and leave behind scars.

The cause of rosacea fulminans is unknown, and factors which it may be related to vary widely, including infection, exposure, and hypersensitivity reactions. The condition only affects women, and typically resolves after approximately one year. Though it appears similar to acne or rosacea, symptoms appear abruptly and are not accompanied by oily skin, flushing, or eye involvement.

Differential Diagnosis (Other conditions with similar appearance)
Acne
Rosacea

Diagnosis
Key Points
Diagnosis based on appearance of the affected area
Skin biopsy may be performed to confirm diagnosis and rule out other conditions

Rosacea fulminans is diagnosed based on the characteristic appearance of the affected area. A skin biopsy may be performed to confirm the diagnosis and to rule out similar appearing conditions.

Treatment
Due to its rarity, no specific treatment that is uniformly effective exists for the condition
*Certain medications may resolve the condition in most cases

Due to its rarity, there is no specific treatment for rosacea fulminans. Certain medications may be prescribed, either singly or in combination, to assist in speeding resolution of the condition. These medications include Antibiotics, Isotretinoin, and Systemic steroids. Treatment with these medications may shorten the span of the condition to 3 to 6 months in most cases.