Jul 11, 2019
Failure to recognize rosacea in the skin of color population
presents an important gap in dermatology practice. Beginning at
10:06, Dr. Vincent DeLeo talks with Dr. Susan Taylor about how
dermatologists can improve diagnosis and treatment of rosacea in
this patient population. “I think that rosacea is underrecognized
because it’s often confused for other disorders that occur commonly
in skin of color populations,” Dr. Taylor explains. She highlights
various clinical clues distinguishing rosacea from mimickers such
as connective tissue diseases, seborrheic dermatitis, cutaneous
sarcoidosis, and acne vulgaris.
We also bring you the latest in dermatology news and
increased risk of psychiatric problems tied to isotretinoin
Arash Mostaghimi, MD, of Brigham and Women's Hospital in Boston
discusses the study's findings and their
warning letters fall on Trump’s watch
Things you will learn in this episode:
- Overall, rosacea does not occur as commonly in skin of color
patients as in white patients in the United States, but all types
of rosacea can be observed in skin of color.
- The erythematotelangiectatic and papulopustular subtypes are
most common in skin of color populations, with granulomatous
rosacea occurring more frequently in black patients.
- Rosacea is underrecognized and underdiagnosed in skin of color
patients because physicians often don’t appreciate that rosacea can
and does occur in these populations. It also can be difficult to
identify the erythema that is characteristic of rosacea in skin of
- Skin of color patients with rosacea often don’t present to
dermatology for treatment because they have no awareness of the
- Connective tissue diseases such as systemic lupus erythematosus
and dermatomyositis can mimic rosacea in patients with skin of
- Seborrheic dermatitis and rosacea have similar clinical
features and can occur concurrently in the same patient.
- Biopsy is needed to accurately distinguish between
granulomatous rosacea and cutaneous sarcoidosis, as it can be a
challenge to make the diagnosis clinically.
- Comedones, nodules, cysts, and postinflammatory
hyperpigmentation are suggestive of acne vulgaris, as these
findings are not observed in rosacea.
- Most of the same medications used in white patients with
rosacea can be used for skin of color patients.
- The most important factor to keep in mind when treating rosacea
in skin of color patients is that irritation from topical agents
can lead to postinflammatory hyperpigmentation. “I don’t think you
can go wrong being cautious and approaching therapy slowly in this
patient population,” notes Dr. Taylor.
- Daily sunscreen use is important in all skin of color patients,
particularly those with rosacea who may have facial skin that is
more subject to burning or stinging or those who are photosensitive
because of treatment with topical agents.
- Ultimately, dermatologists should rely on information garnered
from patients when rosacea is suspected in skin of color. “I think
the key here is you must think about rosacea when you see a skin of
color patient who comes to you and complains of burning, tingling,
stinging of the facial skin; sensitivity to products; redness of
the skin; papules; and pustules. There are times when as clinicians
you may not be able to appreciate the erythema, but rest assured
that your patient can tell you if his or her facial skin is
Hosts: Elizabeth Mechcatie; Terry Rudd; Vincent
A. DeLeo, MD (Keck School of Medicine of the University of
Southern California, Los Angeles)
C. Taylor, MD (Perelman School of Medicine, University of
Show notes by Alicia Sonners, Melissa Sears, and Elizabeth
You can find more of our podcasts at
Email the show: firstname.lastname@example.org
Interact with us on Twitter: @MDedgeDerm