Abstract
Rosacea represents a common and chronic inflammatory skin disorder. Clinical features
include transient and permanent erythema, inflammatory papules and pustules, phymatous
changes, and ocular signs and symptoms. Rosacea is generally classified into four
subtypes and one variant. Subtype 1, erythematotelangiectatic rosacea, includes clinical
features of flushing and persistent central facial erythema with or without telangiectasia.
Subtype 2, papulopustular rosacea, is characterized by persistent central facial erythema
with transient papules or pustules or both on the central face. Subtype 3, phymatous
rosacea, includes thickening of the skin with irregular surface nodularities and enlargement.
Subtype 4, ocular rosacea, includes inflammation of different parts of the eye and
eyelid. A variant, granulomatous rosacea, is noninflammatory and is characterized
by hard, brown, yellow, or red cutaneous papules or nodules of uniform size. Patients
may present with more than one subtype, and each individual characteristic may fluctuate.
There is debate whether rosacea progresses from one subtype over time or subtypes
represent discreet entities. Defining clinical presentation and improved understanding
of pathophysiology has resulted in identification of novel treatment approaches. This
contribution outlines a rationale for treatment, highlights an evidence-based approach
with approved treatments, and considers novel developments and off-license therapy
available.
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Article info
Footnotes
☆Disclosures: Dr. Layton, has served as a consultant for Steifel-GSK Inc, MEDA Inc, Galderma; Gillette, and L’Oreal.
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Crown Copyright © 2016 Published by Elsevier Inc. All rights reserved.
