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?rosacea and HRTFrom: Patti Tessler (tessler@frontiernet.net)Sun May 23 18:07:41 1999
64 yo female with bilateral malar rash consisting of 1 sq cm raised, warm area, one cheek with telangectasias, and similar rash on left ala. Client states rash was previously diagnosed as rosacea, but treatments by her dermatologist were unsuccessful. Rash arose concurrently with use of traditional estrogen patch plus Provera x 14 d, prescribed for hot flashes. Rash was unchanged during Provera-free periods. Rash also occurred with Prempro. Rash disappeared when client replaced prescription HRT with an herbal menopause remedy; however, hot flashes returned. A change to Menest 0.625 plus Provera 2.5 qd has resolved the hot flashes, but not the rash. I'm going to try replacing the Provera with Prometrium, but am not hopeful. I've thought about a second dermatological opinion, Clonidine, Prometrium alone, and an SLE workup. Client wishes to defer lab testing or second opinions until her 65th birthday in August. Thanks for any insights or suggestions.
-- Patti Tessler, BSN, MSN, Family Nurse Practitioner (certified) Orange County, NY mailto:tessler@frontiernet.net
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