Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is the initial treatment for mild to moderate acne rosacea?

1. Oral tetracycline

2. Topical metronidazole

3. Fluorouracil cream

4. Topical clindamycin

The correct answer is: Topical metronidazole

Topical metronidazole is considered the first-line treatment for mild to moderate acne rosacea due to its effectiveness in reducing inflammation and controlling the symptoms associated with the condition. Metronidazole, an anti-inflammatory and antimicrobial agent, helps alleviate the erythema and papules that typify rosacea by decreasing the presence of certain bacteria on the skin and also has anti-inflammatory properties that directly contribute to symptom relief. This treatment option is well-tolerated by most patients and provides a direct approach to managing the inflammatory features of rosacea. It is available in various formulations, including creams, gels, and lotions, allowing for patient preference and skin type considerations. Other treatment choices serve different roles or are less preferred for initial management. While oral tetracycline can be effective in more severe cases, it is not the first-line choice for mild to moderate presentations. Fluorouracil cream is primarily used for actinic keratosis and superficial basal cell carcinoma and does not address the specific needs of acne rosacea. Topical clindamycin has antibacterial properties and may be beneficial in some acne treatment contexts but is not specifically recommended as a primary treatment for rosacea, as it does not provide the same anti-inflammatory benefits as metronid