Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the appropriate treatment for severe or resistant acne rosacea?

1. Topical metronidazole

2. Oral tetracycline

3. Fluorouracil cream

4. Intralesional corticosteroids

The correct answer is: Oral tetracycline

Severe or resistant acne rosacea is often treated with systemic medication, and oral tetracycline is a key choice in this context. Tetracyclines, including doxycycline and minocycline, possess anti-inflammatory properties that can help reduce the inflammatory changes associated with rosacea. This makes them particularly effective for managing the more severe manifestations of the condition, especially when topical treatments have failed or are inadequate. Topical metronidazole is primarily used in mild to moderate cases of rosacea and may not provide sufficient relief for more severe presentations. Fluorouracil cream, commonly used for actinic keratosis, does not target the underlying inflammatory process of rosacea directly. Intralesional corticosteroids can help reduce inflammation in specific lesions, but they are not a first-line treatment for widespread or severe cases. The systemic approach with oral tetracycline is therefore the most appropriate course of action for those experiencing severe or resistant acne rosacea.