4.5 Article

Rosacea: New Concepts in Classification and Treatment

Journal

AMERICAN JOURNAL OF CLINICAL DERMATOLOGY
Volume 22, Issue 4, Pages 457-465

Publisher

ADIS INT LTD
DOI: 10.1007/s40257-021-00595-7

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Rosacea is a chronic inflammatory skin condition that primarily affects the face and can greatly impact the quality of life and self-esteem of individuals. In addition to general skincare, there are various treatment options available, both topical and systemic, to address the different features of the condition. Ongoing research is focusing on understanding the underlying mechanisms and developing new therapeutic interventions.
Rosacea is a chronic inflammatory dermatosis mainly affecting the cheeks, nose, chin, and forehead. Rosacea is characterized by recurrent episodes of flushing or transient erythema, persistent erythema, phymatous changes, papules, pustules, and telangiectasia. The eyes may also be involved. Due to rosacea affecting the face, it has a profound negative impact on quality of life, self-esteem, and well-being. In addition to general skin care, there are several approved treatment options available for addressing these features, both topical and systemic. For some features, intense pulse light, laser, and surgery are of value. Recent advances in fundamental scientific research have underscored the roles of the innate and adaptive immune systems as well as neurovascular dysregulation underlying the spectrum of clinical features of rosacea. Endogenous and exogenous stimuli may initiate and aggravate several pathways in patients with rosacea. This review covers the new phenotype-based diagnosis and classification system reflecting pathophysiology, and new and emerging treatment options and approaches. We address new topical and systemic formulations, as well as recent evidence on treatment combinations. In addition, ongoing studies investigating novel therapeutic interventions will be summarized.

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