M Schaller1, L M C Almeida2, A Bewley3,4, B Cribier5, N C Dlova6, G Kautz7, M Mannis8, H H Oon9, M Rajagopalan10, M Steinhoff11, D Thiboutot12, P Troielli13, G Webster14, Y Wu15, E van Zuuren16, J Tan17. 1. Department of Dermatology, Universitatsklinikum Tubingen, Tubingen, Baden-Württemberg, Germany. 2. Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil. 3. Whipps Cross University Hospital, London, U.K. 4. Royal London Hospital, London, U.K. 5. Department of Dermatology, Hopitaux Universitaires de Strasbourg, Strasbourg, Alsace, France. 6. Department of Dermatology, University of KwaZulu-Natal College of Health Sciences, Durban, South Africa. 7. Haut- und Laserklinik, Konz, Germany. 8. Department of Ophthalmology and Vision Science, University of California Davis, Davis, CA, U.S.A. 9. National Skin Centre, Singapore. 10. Apollo Hospitals Enterprise, Chennai, Tamil Nadu, India. 11. Department of Dermatology and UCD Charles Institute for Translational Dermatology, University College Dublin, Dublin, Ireland. 12. Department of Dermatology, Pennsylvania State University College of Medicine, Hershey, PA, U.S.A. 13. Faculty of Dermatology, Universidad de Buenos Aires, School of Medicine, Buenos Aires, Argentina. 14. Department of Dermatology and Cutaneous Biology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, U.S.A. 15. Department of Dermatology, Peking University First Hospital, Beijing, China. 16. Department of Dermatology, Leiden University Medical Centre, Leiden, the Netherlands. 17. Department of Medicine, University of Western Ontario, Windsor, ON, Canada.
Abstract
BACKGROUND: Rosacea is currently treated according to subtypes. As this does not adequately address the spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus panel was established to address this issue. OBJECTIVES: To incorporate current best treatment evidence with clinical experience from an international expert panel and establish consensus to improve outcomes for patients with rosacea. METHODS: Seventeen dermatologists and three ophthalmologists reached consensus on critical aspects of rosacea treatment and management using a modified Delphi approach. The panel voted on statements using the responses 'strongly disagree', 'disagree', 'agree' or 'strongly agree'. Consensus was defined as ≥ 75% 'agree' or 'strongly agree'. All voting was electronic and blinded. RESULTS: The panel agreed on phenotype-based treatments for signs and symptoms presenting in individuals with rosacea. First-line treatments were identified for individual major features of transient and persistent erythema, inflammatory papules/pustules, telangiectasia and phyma, underpinned by general skincare measures. Multiple features in an individual patient can be simultaneously treated with multiple agents. If treatment is inadequate given appropriate duration, another first-line option or the addition of another first-line agent should be considered. Maintenance treatment depends on treatment modality and patient preferences. Ophthalmological referral for all but the mildest ocular features should be considered. Lid hygiene and artificial tears in addition to medications are used to treat ocular rosacea. CONCLUSIONS: Rosacea diagnosis and treatment should be based on clinical presentation. Consensus was achieved to support this approach for rosacea treatment strategies.
BACKGROUND:Rosacea is currently treated according to subtypes. As this does not adequately address the spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus panel was established to address this issue. OBJECTIVES: To incorporate current best treatment evidence with clinical experience from an international expert panel and establish consensus to improve outcomes for patients with rosacea. METHODS: Seventeen dermatologists and three ophthalmologists reached consensus on critical aspects of rosacea treatment and management using a modified Delphi approach. The panel voted on statements using the responses 'strongly disagree', 'disagree', 'agree' or 'strongly agree'. Consensus was defined as ≥ 75% 'agree' or 'strongly agree'. All voting was electronic and blinded. RESULTS: The panel agreed on phenotype-based treatments for signs and symptoms presenting in individuals with rosacea. First-line treatments were identified for individual major features of transient and persistent erythema, inflammatory papules/pustules, telangiectasia and phyma, underpinned by general skincare measures. Multiple features in an individual patient can be simultaneously treated with multiple agents. If treatment is inadequate given appropriate duration, another first-line option or the addition of another first-line agent should be considered. Maintenance treatment depends on treatment modality and patient preferences. Ophthalmological referral for all but the mildest ocular features should be considered. Lid hygiene and artificial tears in addition to medications are used to treat ocular rosacea. CONCLUSIONS:Rosacea diagnosis and treatment should be based on clinical presentation. Consensus was achieved to support this approach for rosacea treatment strategies.
Authors: James Q Del Rosso; Emil Tanghetti; Guy Webster; Linda Stein Gold; Diane Thiboutot; Richard L Gallo Journal: J Clin Aesthet Dermatol Date: 2020-06-01
Authors: Martin Schaller; Thomas Dirschka; Sol-Britt Lonne-Rahm; Giuseppe Micali; Linda F Stein Gold; Jerry Tan; James Del Rosso Journal: Acta Derm Venereol Date: 2021-10-31 Impact factor: 3.875
Authors: Esther J van Zuuren; Bernd W M Arents; Mireille M D van der Linden; Sofieke Vermeulen; Zbys Fedorowicz; Jerry Tan Journal: Am J Clin Dermatol Date: 2021-03-23 Impact factor: 7.403
Authors: M Schaller; L M C Almeida; A Bewley; B Cribier; J Del Rosso; N C Dlova; R L Gallo; R D Granstein; G Kautz; M J Mannis; G Micali; H H Oon; M Rajagopalan; M Steinhoff; E Tanghetti; D Thiboutot; P Troielli; G Webster; M Zierhut; E J van Zuuren; J Tan Journal: Br J Dermatol Date: 2019-10-16 Impact factor: 9.302
Authors: E J van Zuuren; Z Fedorowicz; J Tan; M M D van der Linden; B W M Arents; B Carter; L Charland Journal: Br J Dermatol Date: 2019-03-10 Impact factor: 9.302