Use of Permethrin in the Treatment of Rosacea Fulminans During Pregnancy: One Case Report

INTRODUCTION: Rosacea fulminans (RF) is a rare dermatological condition which occurs exclusively in women and it is characterized by a sudden onset of painful papules, pustules, cysts and nodules on the face. CASE REPORT: A 28-year-old woman was referred to our clinic due to a painful facial eruption within the 13th week of her second pregnancy. After physical examination, the diagnosis of RF during pregnancy was established. Several treatments were used: mupirocin ointment, topical zinc oxide, topical erythromycin, oral erythromycin, metronidazole gel, oral metronidazole, oral amoxiciline and oral prednisone. Finally, the patient was started on 5% permethrin cream with complete clearing of the lesions. DISCUSSION: Nowadays a wide range of treatments for rosacea are available: topical metronidazole, oral metronidazole, topical ivermectin, oral tetracyclines, oral isotretinoin, systemic steroids, photodynamic therapy or pulsed dye laser. However, in pregnant patients the treatment alternatives are limited. CONCLUSION: We consider that 5% permethrin cream could be an effective, cheap and safe treatment not only in regular patients with rosacea but also in pregnant women, representing an important alternative in the context of pregnancy when therapeutic options are limited. To our knowledge this is the first case of rosacea treated with 5% permethrin cream in monotherapy during pregnancy. This article is protected by copyright. All rights reserved.