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Thread: When a red face isn't rosacea is everyones doctor checking?

  1. #1
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    Default When a red face isn't rosacea is everyones doctor checking?

    It seems to be pretty well accepted in the medical literature that a diagnosis of rosacea can only be made once a multitude of other conditions are first ruled out. My doctor did but i wondering if everyones doctor or derm are ruling these things out to? Especially for people for who redness and flushing are the key symptoms (rather than P&P).

    I remember back when i first started getting flushing that the only thing that came up on the internet for flushing was rosacea, but have since found out there are many many things which can look like rosacea, so thought i'd put it out there.

    When evaluating patients with rosacea, it is important to exclude the diagnoses of polycythemia vera, photosensitive eruption, lupus erythematosus, mixed connective tissue disease, carcinoid syndrome, systemic mastocytosis, or side effects from long-termfacial application of topical steroids. Since rosacea is typically limited to the face, extra facial erythema is generally an exclusionary sign. Rosacea flushing is associated with burning or stinging but not sweating, lightheadedness, or palpitations.
    http://rosacea.ii.net/news/2006/08/r...t-rosacea.html

    Most of these are unlikely or rare but there are also some pretty common conditons that can cause flushing or make it worse, such as allergies, food intolerances, thyroid issues, oestrogen imbalance (for women), lactose intolerance, fructose intolerance and coeliac disease.

    Of course all of the above generally cause other symptoms aside from flushing or redness, most commonly GI issues, but some of these can be symptom less, like Coeliac disease, which is why only about 1 in 1000 people are diagnosised with it despite approx 1 in 100 having it. And the fact that lot's of rosacea say they improve when cutting out wheat or dairy products makes me wonder if some of us also have other things going on, aside from rosacea.

    Anyway most of these are simple blood tests, so is everyone getting checked out for these things?
    ______________
    29, Flushing.
    Tried: Propranolol, Clonidine, Dorxy, Finacea, IPL, Betablockers, NSAIDs.
    Now: Avanza, V-beam, H1, H2, Rosex, Singulair, Friendly food diet.

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    Moderator Melissa W's Avatar
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    Hi Kate,

    My derm diagnosed rosacea without any workup to rule out other diseases. It wasn't until I got chilblains that the drs ordered the whole series of connective tissue blood tests to R/O all the other stuff. And that was months after I was formally diagnosed with rosacea.

    Best wishes,
    Melissa

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    I was diagnosed with rosacea by my primary dr. who sent me for more blood tests to test for lupus, and other auto-immune type diseases. I have had more done with my derm, and also a more complete workup done by a rheumotologist. My ANA was on the high side of normal, which is why all the blood work. I've been told I have a mild case of Raynauds, very common in rosaceans from what I see.

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    Oh and i forgot erythromelgia as a very rare cause of facial flushing.

    So i guess it's not so common to get tested straight away, maybe my doctor did because my facial flushing came so suddenly and rapidly got worse and worse? And then i developed flushing in other areas, like my knees, hands, feet and chest which is when he started testing me for the rarer and more obscure things. So many tests and still no answers for me which means there is at least one other thing missing form this list, so if anyone knows what it is that would be great!

    And Brady Barrow has just posted a link to a detailed list of other skin conditons that can look like rosacea too:

    http://forum.rosaceagroup.org/viewtopic.php?t=7862

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    When I went to the dermatologist with a thought "I believe I have rosacea" then she officially diagnosed me just by me having red cheeks and at least 3 common rosacea triggers.

    Although I really believe it is rosacea that I have, there's a chance I have (also) something else..

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    Wow i'm really shocked that some of the more standard things, that involve really simple blood tests, weren't ruled out for you guys.

    Hopefully not many people have responded here because they have all been checked for all of these things...

    Unfortuently having triggers doesn't automatically mean rosacea. Carsnoid and mastocytosis both get triggered by many of the same things as rosacea, ie stress, heat, cheese, alcohol to name a few, with the result being flushing, wheezing, and GI issues. Most of the rosacea food triggers are on the list because they are high in serotonin, histamine or msg, so if you have food intolerances to these chemicals than eating them can cause flushing (and other things like headaches) even without rosacea.

    Plus any conditons that involve inflammation in the skin, like seb derm (or most other things on Brady Barrows list), will get redder with anything that increases blood flow in the skin, so with heat, alcohol, or even with the same foods to avoid for rosacea. And then this inflammation can trigger flushing.

    It all gets so complicated but i guess this range of things is why it's not always so straight forward to get a diagnosis of rosacea, or anything else on this list!

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    Thought it would be worth posting here another article on flushing that's really good, it doesn't cover the full range of things that can possibly cause flushing but does go into a lot more detail about what flushing is and how to diagnosis some of the conditons that cause flushing:

    http://www.clevelandclinicmeded.com/...g/flushing.htm

    It also covers some of the dugs that can cause flushing, which is another long list, but it also possible to get flushing from drugs not on the list, such as SSRI and tricyclic antidepressants.

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    Froggirl,
    I cannot get into the link you posted on the 24th. Any ideas, would like to read this.

    Thank you for your post, for I have been fustrated by this also. GP and derms have taken one look at me, no more than a foot away, and have diagnosed me with rosacea and quicklyl walked out the door. Yet I have questioned this, it may very well be, yet I do believe there are other things going on, for like you, I started flushing very suddenly and very badly and the progression has been a bit severe I now get very bad swelling in my nose, feet and hands, and my nose is constantly running - symptoms I have never had before. Sometimes I wake up in the middle of the night and it hurts to make a fist, due to the swelling in my fingers.

    I had to adamantly request blood tests to screen out lupus and autoimmune conditions. I know for me hormones are part of it. For about 9 months ago my menstration stopped, suddenly, even though i'm only 42.

    And I think since people react so differently to so many things, we all have different things going on in our bodies that is causing these similar sypmtoms clumped as "rosacea".

    Grace

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    This is what I'm dealing with right now. When my first derm diagnosed me with Rosacea 4 years ago, it was at first sight with no testing. My grandmother had Lupus pretty severe, and though I was tested for that 2 1/2 years ago (which came back negative), something else could be very much at work. The derm I saw a couple of weeks ago questions if I do have Rosacea since he was concerned about how sharply my redness cuts off. There are very defined borders on my neck. Also, my level of photosensitivity to fluoro lights concerned him, (he watched me turn 20 shades of red right in front of his eyes). Another thing that's been happening over the past few months is red, blotchy rashes under my eyes. They have a bit of a sting and scaliness to them. IN FACT, just yesterday I laughed so hard about something that I cried. The result of the tears were nasty rashes appearing immediately under each eye, which is still somewhat there today. If this is auto immune, or allergy related, I've been eating asprin like candy and taking antihistamines daily. I'm noticing some relief in color and other issues because of it.

    I see a new 'special' derm on June 15. Hopefully, this will be a start to determine what it is I actually have.

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    Whoops the link i posted to Brady Barrows post wasn't correct, so i've changed it now and it should go through. It's a very long list that he has though, so no easy answers there either. It's frustrating trying to figure it all out isn't it?

    Grace have you had your hormone levels checked? That was one of the first things my doctor did. I have the nose thing too at times, my doctor said it was vasomotor rhinitis, which is where the blood vessels in the nose are overly sensative and dilate too easily. So it's all part of the same thing. The more i read the more i think my asthma is a similar thing too, with the dilation of the blood vessels causing my airways to narrow. My hands and knees are really painful too, night is the worst time, i've noticed though if i elevate my hands above my head they go back to normal but once i put them back down it's like all the blood rushes back and the reddness and swelling returns worse than it was before, so Grace i'm curious if you notice the same thing? I don't know if it means anything but it looks dramatic!

    I have a post about my weird symptoms here: (rather than going into too much detail here).

    http://forum.rosaceagroup.org/viewtopic.php?t=5335

    The short version is that even though i've now been tested for everything listed above (some things 4 times now!) my doctor, nor the three dermatologists, neurologist or endocronologist have any ideas left. It seems that erythromelgia or a rare type of automatic nervous system dysfunction called flushing syndrome are options but these are so uncommon nobody i've seen really feels confident of diagnosising these, so i guess i just have to wait and see how much worse things get.

    Burnt1970 let us know how you go with the specialist, antihistamines help me a lot too. I found having both H1's and H2's helped a lot more than H1's alone so if your not already might be something to try. The allergy reaction to tears sounds really unsusual, hope you get some answers soon.

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