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Wound Healing — SCE Dermatology MCQ

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HardWound HealingWound HealingSCE Dermatology

A patient with severe papulopustular and phymatous rosacea has failed adequate topical ivermectin and oral doxycycline. Ocular disease has been assessed and pregnancy is not possible. Which specialist option is supported by BAD guidance?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Use intermittent isotretinoin around 0.25 mg/kg daily under specialist monitoring

Explanation lettering: C = shown as A · A = shown as B · E = shown as C · B = shown as E

D is correct. BAD guidance supports intermittent low-dose isotretinoin, around 0.25 mg/kg, for persistent severe rosacea under specialist supervision. This is distinct from conventional acne dosing and still requires retinoid safety processes, monitoring and discussion of relapse. Systemic corticosteroids and potent facial topical steroids can aggravate rosacea, while continuing an ineffective antimicrobial regimen only adds adverse effects and resistance pressure. Phymatous change may additionally require procedural or surgical treatment; ocular symptoms need parallel ophthalmic assessment where indicated.

Reference: BAD guideline for rosacea: https://doi.org/10.1111/bjd.20485