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How long did it take your dermatologist to diagnose rosacea?

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  • Found this quote from the late Dr. Kligman:

    "Busy doctors who cannot take a detailed history will frequently miss the diagnosis, complicated further by the fact that rosacea is a great mimic of other unrelated disorders that present with a 'red face'."

    A Personal Critique on the State of Knowledge of Rosacea Albert M. Kligman , M.D., Ph.D.
    Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A.
    Brady Barrows
    Blog - Join the RRDi

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    • I saw a dermatologist a couple of months back, on the recommendation of my ophthalmologist for a second opinion on possible rosacea after all the usual treatments for dry eye had failed.

      I have a long history of skin irritation/swelling/dryness, originally misdiagnosed as allergies by GP, but which later appeared to be related to thyroid disease and did resolve to some extent following thyroid replacement. However, dryness issues and additional symptoms of muscle/joint aching suddenly worsened; consultation with a rheumatologist resulted in dx of UCTD, and treatment with hydroxychloroquine.

      In the last few months, facial skin burning, swelling and flushing in addition to severe dry eye suddenly worsened considerably. When i saw the derm, I mentioned my history of thyroid/UCTD but she didn't really acknowledge them, and said she'd never heard of UCTD. She said my skin was extremely dry, doubted that there could be any possible connection with oral burning/numbness I was also suffering; she said the swelling was probably something called rosaceous lymphoedema, and prescribed lymecycline.

      I took the lymecycline for a month with no improvement of eye or skin symptoms, at which point it dawned on me that the swelling and burning had a definite connection with UV exposure, and stopped the lymecycline as there was a risk it was making this photosensitivty worse.

      I don't feel the derm. I saw really took on board my existing health problems, or any possible overlap of symptoms with those of rosacea, and possibly prescribed something that might have made the problem worse. Would she have suggested either thyroid or inflammatory marker tests to rule out other causes if I hadn't already been diagnosed with these problems? I rather doubt it. I still don't know what is going on with my skin, or which department to pursue for further opinions or treatment.

      I know this is 'anecdotal' but in the absence of any conclusive tests for rosacea as distinct from other co-existing conditions which may cause similar symptoms, even clinicians opinions may be anecdotal.
      y-gwair
      Senior Member
      Last edited by y-gwair; 18 June 2011, 10:36 PM.

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      • Another one - 30 seconds

        Here is another one:

        CHILLYK says, "My sister has had problems with her skin since last summer (co-inciding with her being diagnosed also with an underactive thyroid). She went to her GP thinking she had acne, he told her she has Rosacea and sent her away with Metrogel (metronizole gel). She has papules and pustules and redness.

        In the last 2 weeks my cheeks have become redder and redder, my skin is burning and tingling. I went to see my GP last on Wednesday and showed him, told him about my sister. He looked at my face for 30 seconds, asked what my sister used and gave me a prescription for the same!" July 17, 2011 03:46 PM
        Brady Barrows
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        • Western says, "She glanced at my face, asked a few questions and then asked me to wait while she got the attending doctor. When he came in, he took even less time than the original woman. He barely looked at my face and that was it." source
          Brady Barrows
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          • Less than a minute

            Found another one today:

            Debbie says, "I had to go to a few doctors myself (with the last one only seeing patients for less than 1 minute for a diagnosis)."

            i keep finding these brief diagnosis of rosacea without taking a patient history or taking any tests. If you know of any like the one above that is less than five minutes, please add your report to this thread.

            Mahalo.
            Brady Barrows
            Blog - Join the RRDi

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            • About 5 seconds. When the dermatologist came in the room, she took one look at me and said "you have rosacea". That was it. She prescribed me some antibotics and it was over in less than 5 minutes.

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              • Originally posted by JPak View Post
                About 5 seconds. When the dermatologist came in the room, she took one look at me and said "you have rosacea". That was it. She prescribed me some antibotics and it was over in less than 5 minutes.
                We're much more thoughtful about it here at the Forum.

                JPak, did you fill your Rx?
                "It's all illusion anyway."

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                • Originally posted by Ghost View Post
                  We're much more thoughtful about it here at the Forum.

                  JPak, did you fill your Rx?
                  This was a couple of years ago, I did take the antibotics (monocyline) but I never renewed the prescription because as I began to do more research I realized that this problem could have been started by me taking too many antibotics in the past. I am now taking care of my gut and I am seeing some good results so far.

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                  • Originally posted by JPak View Post
                    This was a couple of years ago, I did take the antibotics (monocyline) but I never renewed the prescription because as I began to do more research I realized that this problem could have been started by me taking too many antibotics in the past. I am now taking care of my gut and I am seeing some good results so far.
                    That's good to hear (gut care working). So many of use were SO innocent going to derms and taking shiz that didn't work or even served to make things worse. I just cannot believe that they don't know the answer, which is out there. It might not be as simple as popping a pill (but that's no answer, anyway), but it works and it's nothing but healthful. Once you know, you're on your way!
                    "It's all illusion anyway."

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                    • Originally posted by Ghost View Post
                      That's good to hear (gut care working). So many of use were SO innocent going to derms and taking shiz that didn't work or even served to make things worse. I just cannot believe that they don't know the answer, which is out there. It might not be as simple as popping a pill (but that's no answer, anyway), but it works and it's nothing but healthful. Once you know, you're on your way!
                      What makes me scared is that nobody knows how these drugs work. Simply put, all they say is that these antibiotics have anti inflammatory properties which helps but that doesn't really explain how it effects the body or what parts of the body it effects etc. I believe my rosacea was caused by taking way too many antibiotics and accutane way back in high school which messed me up.

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                      • Ghost and Jpak,

                        I really do appreciate your posts but I am trying to keep this thread to how long did your dermatologist take to diagnose your rosacea. This thread is anecdotal evidence that many physicians take about five minutes without taking a pertinent history, ordering any tests to rule out rosacea mimics, taking a good physical exam, or spend much time with the patient. This may explain one factor why some rosaceans are misdiagnosed which is another thread I have created. Dr. Kligman said in one article this may be because doctors are too busy to take a thorough exam.
                        Brady Barrows
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                        • I found the Kligman quote:

                          "Busy doctors who cannot take a detailed history will frequently miss the diagnosis, complicated further by the fact that rosacea is a great mimic of other unrelated disorders that present with a 'red face'."

                          A Personal Critique on the State of Knowledge of Rosacea Albert M. Kligman , M.D., Ph.D.
                          Department of Dermatology, University of Pennsylvania, Philadelphia, PA, U.S.A.
                          Brady Barrows
                          Blog - Join the RRDi

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                          • The problem with docs and 5-minute dx isn't just related to rosacea, you know. It's how many docs do business.

                            Some docs still do their work with awareness, however. Bless them.
                            "It's all illusion anyway."

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                            • i have come to accept that ALL doctors are evil. All of them. They cannot be trusted.

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                              • Originally posted by tests View Post
                                i have come to accept that ALL doctors are evil. All of them. They cannot be trusted.
                                That is quite extreme. There are some good doctors. As with all groups, there are some bad apples, but it doesn't mean that all apples are bad.

                                The cool thing is that anyone can choose their doctor, just like you can choose a lawyer. You don't have to stay with the one you find. That is why word of mouth is the best advertisement. Usually you can go by a well respected friend's recommendation on a doctor. I said usually. But the point of this thread is not to degrade doctors. It is simply to understand and establish from anecdotal reports that many doctors diagnose rosacea in less than five minutes without taking a proper history, physical exam, tests, etc., to rule out rosacea mimics. A careful diagnosis should take thirty minutes to forty five or longer.
                                Brady Barrows
                                Senior Member
                                Last edited by Brady Barrows; 31 October 2011, 12:51 AM.
                                Brady Barrows
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