Unusual case of rosacea fulminans in older man

Abstract

Rosacea fulminans (RF) is characterised by the abrupt onset of discomforting and consolidating pustules and nodules, oedema, cysts and erythema. The condition is considered rare, even rarer in men. Controversy exists whether RF should be categorised as rosacea. The aetiopathogenesis of RF remains largely unknown. We present a case of an 87-yr-old man with no previous history of rosacea or acne, admitted for a suspected systemic bacterial infection and who rapidly developed tender ocular, facial and extrafacial lesions. The patient had subfebrile temperatures, leukocytosis and moderate anaemia, but also general fatigue. The features of gender, location and extent of lesions, and biochemical response are all atypical with regards RF. The condition was successfully treated with a combination of antibiotics and oral corticosteroids. Specific management guidelines regarding RF are yet to be established, further warranting the need for continued research to determine RF’s aetiology, natural course and its optimal treatment.