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The Cutting Edge: Challenges in Medical and Surgical Therapies |

Carvedilol for the Treatment of Refractory Facial Flushing and Persistent Erythema of Rosacea

Chia-Chi Hsu, MD; J. Yu-Yun Lee, MD
Arch Dermatol. 2011;147(11):1258-1260. doi:10.1001/archdermatol.2011.204.
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Rosacea is a common facial disorder characterized by centrofacial erythema, flushing, telangiectasia, edema, papules, pustules, ocular lesions, and rhinophyma in various combinations.14 The skin lesions most commonly affect the convex areas of the nose, cheeks, chin, and forehead. Rosacea is classified as erythematotelangiectatic (ETR), papulopustular, and phymatous subtypes, and as ocular and granulomatous variants.24 The ETR subtype is typified by frequent episodes of facial flushing, telangiectasias, and persistent centrofacial erythema and may be accompanied by facial edema, burning, or stinging. Severe flushing can cause significant physical discomfort and emotional stress to the patients, and currently no satisfactory treatments are available.

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Figure 1. Severe erythematotelangiectatic rosacea before carvedilol treatment.

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Figure 2. Dramatic clinical improvement after adding carvedilol, 6.25 mg twice daily for 1 week and 3 times daily for the next week.

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Figure 3. Minimal facial erythema while maintaining therapy with carvedilol, 6.25 mg 1 to 3 times a day for 16 months.

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