Rosacea May Be Misdiagnosed An Editorial by the Webmaster Please read the first page on the subject

Please note: In my book, Rosacea 101, I wrote a chapter What is Rosacea? and discuss how important it is to get an accurate diagnosis from a physician since there is much confusion with rosacea. Another chapter discusses Rosacea Mimics. In Appendix A, Rosacea Variants, you will find more information and Appendix B, lists other skin conditions. Rosacea 101 is a comprehensive, 373 page book, covering the conventional and alternative treatments for rosacea and covers basic rosacea 101 knowledge for rosacea newbies. It is a must have book for those who need in one book what they need to know about rosacea. Below is some information which helped formed the basis for my comprehensive list of other skin conditions that mimic rosacea in Appendix B which lists 54 skin conditions that looks like rosacea.

 

Rosacea May Be Misdiagnosed As Another Disease

I have written below what should be re-written but I haven't the time to do this. When I do, I will re-write this editorial to bring some coherence to this subject since if you read below it gets very frustrating to rosaceans that rosacea can be misdiagnosed for so many other rosacea-like diseases. This confusion has been somewhat standarized by the new classification system proposed by the NRS. There have been some proposals to list even further this new classification system with even more subtypes and variants. However, you may still obtain some helpful information by reading below and I assure you I will come back and re-write this page so that it makes much more sense when I have the time.

For a long time there has been no test for rosacea. See this url >

http://www.postgradmed.com/issues/1999/02_99/millikan.htm

And for a long time there was no "No Standard Validated Tools For Assessing the Severity of Rosacea or its Signs or Symptoms" See this url > http://tinyurl.com/5c8uu

The NRS has now come up with the four sub types and four variants of rosacea which has been one of the good things the NRS has done. Now everyone is supposed to be on the same page when discussing certain subtypes. However, most rosaceans haven't a clue which subtype they have (or for that matter, which variant). And many rosaceans have reported being misdiagnosed for rosacea when they had other skin conditions. This only shows that getting an accurate diagnosis from a physician is important since you may be worsening your skin condition with the wrong treatment.

Some of the diseases partially listed for a differential diagnosis by emedicine.com are discussed here. For a longer possible list of other diseases that may be misdiagnosed for rosacea click here. If you know of another disease not mentioned here or on the longer list please email me.

For a discussion of the four subtypes of rosacea click here. There are even other subtypes or variants proposed and you may want to read this article I have written on the subject.

It is important to be diagnosed by a physican who can differentiate rosacea from other diseases that are similar. There are no standard validated tools for assessing the severity of rosacea or its signs or symptoms (see news article). There is no specific test for rosacea so a diagnosis by physician is the only way to really know if you have rosacea.

"There are no histological, serological or other diagnostic tests for rosacea. A diagnosis of rosacea must come from your physician after a thorough examination of your signs and symptoms and a medical history." - NRS, Answer to Question 5, source

"Survey reveals rosacea patients often have other skin conditions." Spring 2002 Rosacea Review. National Rosacea Society. http://rosacea.org/rr/2002/spring/article_3.html

F.W. Danby, M.D, suggests, "a referral to a dermatologist for consideration of at least seven differential diagnoses... (postadolescent acne, contact dermatitis, drug reaction, seborrheic dermatitis, perioral dermatitis, polymorphous light eruption, and facial psoriasis). In the absence of the papules and pustules, where only flushing and telangiectasia exist, actinic erythema and/or actinic telangiectasia would be better referring diagnoses..." source

An accurate diagnosis by a physician is important. The diseases discussed here are the following:

Keratosis pilaris rubra faceii (KP rubra faceii - KPRF)
Keratosis Pilaris Faceii
Discoid Lupus
Lupus Erythematosus, Acute
Lymphedema
Morbihan's disease
Perioral Dermatitis
Pityrosporum Folliculitis
Rheumetoid Arthritis
Sjrogen's Rynaunds disease
Sarcoidosis
Seborrheic Dermatitis
Erythrophobia

Another thought.

Read below for information on sources about this information:

Source of this material can be found at the following url if you scroll down to DIFFERENTIALS >

http://emedicine.com/derm/topic377.htm

If you click on the following link for Seborrheic Dermatitis which has been commonly misdiagnosed as rosacea and scroll down to the DIFFERENTIALS there is even a longer list of diseases to rule out before a diagnosis can be certain for Seborrheic Dermatitis which helps to see the confusion for a diagnosis for rosacea.

http://emedicine.com/derm/topic396.htm

One post on a misdiagnosis with Seborrhea Dermatitis >

http://groups.yahoo.com/group/rosacea-support/message/51625

Another report, Francois went to four different dermatologists >

http://health.groups.yahoo.com/group/rosacea-support/message/68132

One report on misdiagnosing rosacea for Discoid Lupus >

http://health.groups.yahoo.com/group/rosacea-support/message/58405

Since there is no specific test for rosacea you must be certain that your dermatologist rules out all the other diseases before you can know for certain you have rosacea, since there is no specific test for rosacea.

It has been reported that the disease Pityrosporum Folliculitis has been misdiagnosed for rosacea. You may want to check this link out:

http://www.aocd.org/skin/dermatologic_diseases/pityrosporum_folli.html

This was reported at this message: click here for a report

two other messages >

http://groups.yahoo.com/group/rosacea-diet-users-support-group/message/918

http://groups.yahoo.com/group/rosacea-diet-users-support-group/message/921

Dr. Nase post on Pityrosporum folliculitis and testing for yeast

Rheumetoid Arthritis
Sjrogen's Rynaunds disease
see this url >

http://groups.yahoo.com/group/rosacea-knowledge/message/1427

Keratosis Pilaris Faceii - here are a few links >

Keratosis pilaris

http://www.angelfire.com/journal2/sadhelp/kp.htm

http://groups.yahoo.com/group/rosacea-support/message/48956

http://www.aocd.org/skin/dermatologic_diseases/keratosis_pilaris.html

http://www.nlm.nih.gov/medlineplus/ency/imagepages/2693.htm

Rosacean who reports it happened to him

This information may seem overwhelming but so is rosacea! You may need a second opinion from another dermatologist to sort through all this. It is possible that you may have rosacea and at the same time any of the diseases mentioned in this section. Basically what a dermatologist does is rule out diseases by giving you different treatments to see how you respond to the protocol. That takes repeated visits and possibly different treatments. Getting a good dermatologist the first visit is what we all dream about.

Seborrheic Dermatitis and Rosacea

"A number of leading Canadian dermatologists have observed that their rosacea patients often complain of other skin conditions, most notably seborrheic dermatitis, other forms of eczema and psoriasis. A recent Canadian study has confirmed these clinical obeservations and suggests than many rosacea patients (74%) do in fact have other dermatological conditions*....While the association between rosacea, a highly sensitive skin condtion, and seborrheic dermatitis is still not fully understood, both condtions can be effectively treated and controlled. Your family physician or dermatologist is best suited to provide you with a proper diagnosis, treatment plan and counseling...Seborrheic dermatitis affects 3-5% of the general population..." source > Rosacea - Itching Relief from Seborrheic Dermatitis, Rosacea Awareness Program -
http://rosaceainfo.com/enSeborrheic%20Dermatitis%20(E).pdf

* Rosacea: A Review of Family History and Ancestral Community of Origin - W.P. Gulliver et al. Journal of Cutaneous Medicine and Surgery, CDA 76th Annual Conference, Volume 5, 37, (2001).

This subject is apparently a controversy since the International Rosacea Foundation has claimed that "35% of rosaceans have seborrheic dermatitiis" and there are no clinical studies to substantiate this claim. source >

http://internationalrosaceafoundation.org/dermatitis_factor.html

However, there are reports in yahoo groups that physicians have difficulty distinguishing between SD and rosacea. Read this report >

http://health.groups.yahoo.com/group/rosacea-support/message/54095

Another report

Check this one out!

By the way, if you wish to join a support yahoo group for SD >

http://groups.yahoo.com/group/seborrheic-dermatitis-support/

Overlap of sarcoidosis and rosacea.
Simonart T, Lowy M, Rasquin F, Laporte M, De Dobbeleer G, Simonis A, Heenen M.
Department of Dermatology, Erasme University Hospital, Brussels, Belgium.

Haber's syndrome. Report of a new family.
Kikuchi I, Saita B, Inoue S.

Unraveling the mystery of rosacea
Keys to getting the red out
Ken Landow, MD
VOL 112 / NO 6 / DECEMBER 2002 / POSTGRADUATE MEDICINE