LAUSR

A 37-year-old female had first visited a local clinic with erythematous scaly patches and pustules of her face and mild itching for several months. She had complained of persistent erythema and burning of the glabella, chin, and both cheeks (Figure 1A). She was otherwise healthy without any underlying disorder such as thyroid dysfunction or menopause. Also, there were no changes in her cosmetics or surrounding environment prior to the onset of the symptoms. Under the diagnosis of rosacea, she had been treated with oral antihistamine, topical metronidazole, and several cycles of 595 nm-pulsed-dye laser therapy over 3 months. However, the symptoms had not improved despite the treatments and eventually worsened. She visited our clinic presenting with severe flushing, dryness, and burning sensation. On physical examination, the patient showed marked telangiectasia and irritation and thinning of the facial skin. We started to treat the patient with an oral combination of propranolol (40 mg daily), minocycline (50 mg daily), and tranexamic acid (250 mg daily) for 1 month. Just 1 week after the start of treatment, we observed noticeable improvement of her erythema and subjective symptoms (Figure 1D). She was satisfied