Rosacea is a chronic inflammatory skin disease characterized by central facial erythema with or without ocular involvement. It is often difficult to distinguish rosacea from other malar rashes, one of which is acute cutaneous lupus erythematosus (CLE), particularly when there is an increase in antinuclear antibody (ANA) level. We report the case of a 16-year old woman with facial erythematous plaque accompanied by papules and pustules, reddened eyes, and swollen eyelids since the last one year. Dermoscopic examination revealed telangiectasia, and skin scraping examination with 20% potassium hydroxide identified the presence of<i> Demodex folliculorum</i>. Further ocular examination also revealed blepharitis, dysfunction of Meibomian gland, cicatrix, and corneal neovascularization. The ANA titer was positive (1:320), while the anti-dsDNA was negative. The patient was treated according to standard treatment for rosacea. The patient showed a satisfactory response following 2 weeks of therapy. Signs of recurring red patches with papules, pustules, telangiectasia, and identification of <i>D. folliculorum</i> on skin scraping examination led to the diagnosis of papulopustular rosacea. A positive ANA test may also be present in other diseases, e.g. acute CLE. Therefore, the diagnosis of rosacea remains a challenge. Thorough observation and examination must be done in order to yield an accurate diagnosis of rosacea.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.