Systemic Steroids, Clarithromycin and Metronidazole in the Trea tment of Rosacea during Pregnancy

Rosacea is a common skin disease with a predilection for the face. Patients suffer from symptoms like flushing, redness of the face, telangiectasia, pustules, or papules. A more acute form is rosacea fulminans that occurs preferentially in women. Hormonal fluctuations as during a pregnancy can aggravate existent rosacea. The case of a female patient is presented, who was in the 26th week of her pregnancy. She discontinued her usual rosacea medication when she became pregnant. The patient developed rosacea fulminans, which was treated with systemic corticosteroids as recommended. She responded well to clarithromycin 250 mg for three times a week in combination with topical treatment using metronidazole 0.75% creme, continuing this regimen until a stable result was obtained. Based on the observations in this case study the therapy of rosacea fulminans with clarithromycin can help to reduce the symptoms, especially since treatment with systemic isotretinoin and doxycycline is contraindicated during pregnancy.