Dermatologic and ophthalmologic collaboration in the management of skin manifestations of ocular rosacea

Abstract

This case is presented to (1) improve the efficacy of the identification and differential diagnosis and to avoid mistreatment of the skin manifestations of ocular rosacea exhibiting a clinical appearance of those of other disorders and (2) explore opportunities for building dermatologic and ophthalmologic collaboration in the management of patients with ocular symptoms of rosacea. A 33-year-old female patient was diagnosed with acne vulgaris and seborrhea oleosa by a dermatologist. She received a secondary diagnosis of adrenal hyperandrogenism, iron deficiency anemia and selenium and iodine deficiency. The patient underwent facial skin peeling and was prescribed dermatological treatment. Thereafter, she presented to an ophthalmologist and complained of gritty eyes and blurred vision which she had never before experienced. Ocular manifestations included macerated skin of the eyelid angles, palpebral edema, crusts at the eyelid margin and eyelid telangiectasia. The patient was diagnosed with ocular rosacea, dry eye and keratoconjunctivitis sicca, and obtained the prescribed ophthalmological treatment which resulted in an improvement in her ocular symptoms. Therefore, ocular rosacea should be treated through the cooperative efforts of dermatologists and ophthalmologists based on the constellation of clinical findings and symptoms in a particular case.