Pustular Rosacea in an 8-Year-Old Patient: A Rare Presentation of Pediatric Rosacea

Pustular rosacea is a rare chronic inflammatory disease whose prevalence increases with age. We report a case of an 8-year-old patient who presented with a 3-year history of recurrent papulopustular facial eruptions associated with severe burning sensation, primarily affecting the cheeks, nose, and chin, exacerbated by hot weather and swimming. His condition was misdiagnosed as psoriasis, eczema, food allergy, or acne with limited benefit from treatment other than temporary relief from glucocorticoids. Skin biopsy showed hyperkeratosis and vascular ectasia with neutrophilic microabscesses consistent with papulopustular rosacea. He was successfully managed with lifestyle modifications and medications including azelaic acid, metronidazole, and ambroxol hydrochloride resulting in significant improvement. Diagnosing rosacea can be challenging due to its overlap with other conditions. Early diagnosis and treatment are crucial to prevent complications like scarring, persistent erythema, and psychological distress while ensuring a better quality of life and sustained remission.