Abstract

A55-year-oldmanpresentedwitha longhistoryofETRrosacea manifesting with prolonged facial flushing provoked by multiple stimuli including heat, exercise, sun exposure, and the consumption of alcoholic beverages. He confided thathewasparticularlydisturbedthat,formanyyears,people frequently asked him: “Why is your face so red?” His condition had progressed over the last 15 years to include persistent facial erythema. In addition to his usual triggers, he had noted that during his workday in an air conditioned office the erythema worsened, usually peaking in early afternoon,sometimeswithconcurrentfacialstingingorburning. He had previously been treated with several oral antibiotics, multiple topical therapies including metronidazole, and most recently azelaic acid gel, with no effect. He asked if there was anything that might help the erythema and symptoms.

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