Date:
Patient:
Reason for Visit:
Follow-up for rosacea
Assessment of disease activity and response to treatment
Evaluation for flares or complications
Management plan discussion
History:
Presenting Illness:
Date of initial rosacea diagnosis
Subtype of rosacea (erythematotelangiectatic, papulopustular, or other)
Current symptoms (facial redness, flushing, papules, pustules, burning sensation)
Frequency and severity of flares
Triggers identified (e.g., sun exposure, spicy food, alcohol)
Past Medical History (PMH):
Underlying medical conditions (e.g., ocular rosacea, rhinophyma)
Prior medications or treatments for rosacea
Social History:
Habits that may worsen rosacea (sun exposure, spicy food, alcohol intake)
Physical Exam:
Skin:
Assess for facial erythema, telangiectasia (visible blood vessels), papules, pustules, and distribution of lesions.
Note the presence of any ocular involvement (e.g., blepharitis, conjunctivitis).
In severe cases, assess for rhinophyma (thickening of nasal skin).
Diagnostic Tests (not routinely needed, may be ordered in specific cases):
Skin biopsy (rarely necessary to differentiate rosacea from other conditions).
Assessment:
Rosacea subtype: Categorize the rosacea based on predominant clinical features.
Disease activity: Evaluate the severity of facial redness, papules, pustules, and impact on daily life.
Triggers: Identify potential factors that worsen rosacea symptoms.
Complications: Assess for ocular rosacea or rhinophyma.
Plan:
Trigger avoidance: Educate the patient about potential triggers and recommend strategies to avoid them (e.g., sun protection, dietary modifications).
Topical medications:
Depending on the subtype, topical medications like metronidazole, azelaic acid, or ivermectin may be prescribed to reduce inflammation and improve symptoms.
Oral medications: In severe cases, oral antibiotics (doxycycline) or other medications like isotretinoin may be considered.
Laser or light therapy (may be considered in some cases): For persistent telangiectasia or papules/pustules.
Patient education: Provide information about rosacea, its chronic nature, and the importance of ongoing management.
Discuss the role of good skincare practices (gentle cleansers, moisturizers, sunscreen) and trigger avoidance.
Address the emotional impact of rosacea and offer support resources if needed.
Follow-up:
Schedule for follow-up appointments based on disease activity:
More frequent visits for patients with frequent flares or requiring medication adjustments.
Less frequent visits for patients with well-controlled rosacea.
Encourage patients to report any worsening symptoms or new complications.
Periodic monitoring for ocular involvement or rhinophyma development.
Disclaimer: This information is for educational purposes only and should not be interpreted as medical advice. Please consult with a qualified healthcare professional for diagnosis and treatment of rosacea