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Last reviewed: 9 Mar 2025
Last updated: 21 Mar 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • flushing
  • erythema
  • papules and pustules
  • telangiectases
  • ocular manifestations
  • plaque formation
  • facial distribution
  • phymatous changes

Other diagnostic factors

  • acne vulgaris
  • burning or stinging
  • dry appearance
  • oedema
  • peripheral location

Risk factors

  • Fitzpatrick skin type I or II
  • hot baths/showers
  • temperature extremes
  • sunlight
  • emotional stress
  • hot drinks
  • family history
  • female sex
  • spicy foods
  • alcohol
  • medicines

Diagnostic investigations

Investigations to consider

  • skin biopsy
  • antinuclear antibody titre

Treatment algorithm

ONGOING

Contributors

Authors

Abel D. Jarell, MD
Abel D. Jarell

Dermatologist and Dermatopathologist

Northeast Dermatology Associates

Principal Investigator

ActivMed Research

Portsmouth

NH

Disclosures

ADJ declares that he has no competing interests.

Acknowledgements

Dr Abel D. Jarell would like to gratefully acknowledge Dr Alexa Boer Kimball, a previous contributor to this topic.

Disclosures

ABK has received honoraria for consulting from Intendis and has been an investigator for Intendis and Bayer.

Peer reviewers

Jashin J. Wu, MD

Chief Dermatology Resident

University of California

Irvine

CA

Disclosures

JJW declares that he has no competing interests.

Paradi Mirmirani, MD

Physician

Department of Dermatology

Kaiser Permanente Vallejo Medical Center

Vallejo

CA

Disclosures

PM declares that she has no competing interests.

Brian L. Swick, MD

Assistant Clinical Professor of Dermatology and Pathology

University of Iowa

Iowa City

IA

Disclosures

BLS declares that he has no competing interests.

Thierry Simonart, MD, PhD

Physician

Department of Dermatology

Erasme University Hospital

Brussels

Belgium

Disclosures

TS declares that he has no competing interests.

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