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Recommendations for rosacea diagnosis, classification and management: update from the global ROSacea COnsensus 2019

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This study updates global rosacea management recommendations using a phenotype approach, emphasizing individualized patient care and introducing new clinical tools for better outcomes. It supports the shift from subtypes to phenotypes for rosacea treatment.

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Area of Science:

  • Dermatology
  • Ophthalmology
  • Clinical Practice Guidelines

Background:

  • A shift towards a phenotype approach for rosacea management is ongoing, moving away from traditional subtype categorization.
  • Previous ROSacea COnsensus (ROSCO) recommendations support this phenotyping transition, aligning with broader expert guidance.

Purpose of the Study:

  • To update and expand prior global ROSCO recommendations based on recent research.
  • To support the adoption of the phenotype approach in rosacea through the development of practical clinical tools.

Main Methods:

  • A modified Delphi approach was employed, involving 19 dermatologists and 2 ophthalmologists.
  • Consensus was reached on statements regarding rosacea diagnosis, classification, and management through electronic, blinded voting.

Main Results:

  • Consensus (≥75% agreement) was achieved on key statements for rosacea management.
  • Recommendations include discussing disease burden, aiming for complete clearance, defining cutaneous and ocular features, and updating treatment algorithms.
  • Combination therapy is advised for patients with multiple features, alongside continuous physician-patient dialogue and monitoring. A prototype clinical tool, 'Rosacea Tracker,' was developed.

Conclusions:

  • These updated recommendations serve as a foundation for local guideline development and clinical practice.
  • The study provides essential clinical tools to facilitate the phenotype approach, aiming to enhance patient management in rosacea.
  • The findings underscore the importance of individualized, phenotype-driven care for rosacea patients.