James Q Del Rosso1,2,3,4,5,6, Emil Tanghetti1,2,3,4,5,6, Guy Webster1,2,3,4,5,6, Linda Stein Gold1,2,3,4,5,6, Diane Thiboutot1,2,3,4,5,6, Richard L Gallo1,2,3,4,5,6. 1. Dr. Del Rosso is Adjunct Clinical Professor of Dermatology at Touro University, Nevada in Henderson, Nevada; and Research Director at JDR Dermatology Research, Clinical Dermatology, Thomas Dermatology in Las Vegas, Nevada. 2. Dr. Tanghetti is with the Center for Dermatology and Laser Surgery in Sacramento, California. 3. Dr. Webster is with Jefferson Medical College in Hockessin, Delaware. 4. Dr. Stein Gold is the Director of Dermatology, Clinical Research, and Division Head of Dermatology at Henry Ford Health System in Detroit and West Bloomfield, Michigan. 5. Dr. Thiboutot is Professor of Dermatology at Penn State University College of Medicine in Hershey, Pennsylvania. 6. Dr. Gallo is Chief, Division of Dermatology, and Professor of Medicine and Pediatrics at the University of California, San Diego in San Diego, California.
Abstract
Importance: Previous consensus articles on rosacea from the American Acne and Rosacea Society (AARS) have focused on pathophysiology, clinical assessment based on phenotypic expressions of rosacea, management guidelines, discussions of individual medical therapies, and reviews of physical modalities. Pathophysiologic mechanisms believed to be operative in rosacea have been covered extensively in the literature. Objective: This article updates the previously published consensus recommendations from the AARS on the management of rosacea, including systematic literature and evidence-based reviews of available therapeutic agents and physical modalities. Observations: This article includes discussions of available published data on topical ivermectin, topical oxymetazoline, combination therapy approaches, and physical devices for the management of rosacea. Consistent with what many publications on rosacea currently emphasize, clinicians are encouraged to define the clinical manifestations present in the patient and to select therapies that correlate with the optimal treatment of those manifestations. There are less data available on how to optimally integrate therapies; however, it appears that rationally selected medical therapies can be utilized concurrently. Conclusion: Due to the multifactorial pathogenesis of rosacea, its clinical presentation is heterogeneous. Rosacea is a chronic and recurrent inflammatory disorder, and clinical manifestations often vary in nature and severity over time, which might necessitate an adjustment in treatment. As new data become available, rosacea management approaches should be updated.
Importance: Previous consensus articles on rosacea from the American Acne and Rosacea Society (AARS) have focused on pathophysiology, clinical assessment based on phenotypic expressions of rosacea, management guidelines, discussions of individual medical therapies, and reviews of physical modalities. Pathophysiologic mechanisms believed to be operative in rosacea have been covered extensively in the literature. Objective: This article updates the previously published consensus recommendations from the AARS on the management of rosacea, including systematic literature and evidence-based reviews of available therapeutic agents and physical modalities. Observations: This article includes discussions of available published data on topical ivermectin, topical oxymetazoline, combination therapy approaches, and physical devices for the management of rosacea. Consistent with what many publications on rosacea currently emphasize, clinicians are encouraged to define the clinical manifestations present in the patient and to select therapies that correlate with the optimal treatment of those manifestations. There are less data available on how to optimally integrate therapies; however, it appears that rationally selected medical therapies can be utilized concurrently. Conclusion: Due to the multifactorial pathogenesis of rosacea, its clinical presentation is heterogeneous. Rosacea is a chronic and recurrent inflammatory disorder, and clinical manifestations often vary in nature and severity over time, which might necessitate an adjustment in treatment. As new data become available, rosacea management approaches should be updated.
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