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Rosacea: An Update in Diagnosis, Classification and Management.

Cindy Na-Young Kang1, Monica Shah1, Jerry Tan2,3

  • 1Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

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Summary

The updated rosacea diagnosis and management focuses on clinical presentation. This phenotype approach guides treatment for flushing, papules, pustules, and ocular symptoms, improving patient outcomes.

Keywords:
alpha-adrenergic agonistanti-parasiticantibioticdiagnosisdicarboxylic aciderythemalaser therapymanagementphenotype approachphymaretinoidsrosaceatelangiectasia

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Area of Science:

  • Dermatology
  • Clinical Medicine

Background:

  • Rosacea diagnosis and classification have evolved.
  • Previous classifications lacked a phenotype-based approach.

Purpose of the Study:

  • To outline the modified diagnostic criteria for rosacea.
  • To provide evidence-based management recommendations based on presenting features.

Main Methods:

  • Diagnosis is based on excluding differentials and identifying key features like persistent erythema or phymatous changes.
  • A combination of specific features can also establish diagnosis.
  • Treatment strategies are tailored to individual symptoms and severity.

Main Results:

  • Key diagnostic criteria include persistent centrofacial erythema or phymatous changes, or combinations of flushing, papules/pustules, telangiectases, and ocular symptoms.
  • Evidence-based treatments target specific manifestations: topical agents for erythema, various topicals/orals for papules/pustules, lasers for telangiectases, and specific therapies for ocular rosacea.
  • Combination and maintenance therapies are outlined, including topical agents for long-term management.

Conclusions:

  • The current phenotype-based approach provides a foundation for rosacea diagnosis, classification, and treatment.
  • Tailoring management to clinical presentation is crucial for effective rosacea care.