Is it Acne or Is it Rosacea? An Important Distinction

Acne and rosacea are 2 of the most common diagnoses in a dermatology office. Although they have features in common, diagnostic distinction rarely is a clinical challenge. However, despite the relative ease of diagnosis, some clinicians believe that achieving a definitive diagnosis is unnecessary, as they tend to treat both conditions in a similar fashion. Part of the problem seems to be the continued use of the term acne rosacea . In conversations with clinicians, I have concluded that the term is used in several ways: as rosacea that appears similar to acne, presumably papulopustular rosacea; as a synonym for adult acne; or as rosacea that is not a distinct entity but rather a variant of acne. Others utilize the term to define patients who have both conditions simultaneously. It seems to be a widely held belief that acne and rosacea are common comorbidities; however, there are no data in the literature to support this impression. Regardless of the initial intentions for this term, it currently obfuscates the differential diagnosis of papulopustular eruptions on the face. So is making the differential an important distinction, and do we or should we care?