Use of permethrin in the treatment of rosacea fulminans during pregnancy: One case report

Abstract

Rosacea fulminans (RF) is a rare dermatological condition which occurs exclusively in women and it is characterized by a sudden onset of painful papules, pustules, cysts, and nodules on the face. A 28‐year‐old woman was referred to our clinic due to a painful facial eruption within the 13th week of her second pregnancy. After physical examination, the diagnosis of RF during pregnancy was established. Several treatments were used: mupirocin ointment, topical zinc oxide, topical erythromycin, oral erythromycin, metronidazole gel, oral metronidazole, oral amoxiciline, and oral prednisone. Finally, the patient was started on 5% permethrin cream with complete clearing of the lesions. Nowadays, a wide range of treatments for rosacea is available: topical metronidazole, oral metronidazole, topical ivermectin, oral tetracyclines, oral isotretinoin, systemic steroids, photodynamic therapy, or pulsed dye laser. However, in pregnant patients, the treatment alternatives are limited. We consider that 5% permethrin cream could be an effective, cheap, and safe treatment not only in regular patients with rosacea but also in pregnant women, representing an important alternative in the context of pregnancy when therapeutic options are limited. To our knowledge, this is the first case of rosacea treated with 5% permethrin cream in monotherapy during pregnancy.

Topical calcineurin inhibitors as a double‐edged sword in rosacea: A systematic review

“…Granulomatous rosacea is characterized by hard cutaneous papules or nodules 7 . Rosacea fulminans, also known as pyoderma faciale or rosacea conglobata, is characterized by inflammatory and purulent papules, pustules, cysts, and nodules 9 . The relationship between rosacea fulminans and rosacea remains controversial 7 .…”

A case of rosacea fulminans during pregnancy

“…Including our case, 27 cases of RF during pregnancy have been reported to date [1][2][3][4][5][6][7][8][9] (Table 1): Median age at diagnosis was 31 years (range: 26-33) and 54% of the patients developed RF during the first trimester. Of those whose medical history was investigated, 58% had a history of acne or rosacea and 45% of the patients had RF during their first pregnancy.…”