Rosacea: An Update in Diagnosis, Classification and Management

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.