Updates on the pathophysiology and management of acne rosacea.
There are many options for the treatment of acne rosacea, including topical and systemic therapies, laser and light-based therapies, and surgical procedures. A classification system for rosacea identifies 4 subtypes (ie, erythematotelangiectatic, papulopustular, phymatous, and ocular), which may help guide therapeutic decision making. Until recently, the pathophysiology of acne rosacea has been poorly understood and limited to descriptions of factors that exacerbate or improve this disorder. Recent molecular studies suggest that an altered innate immune response is involved in the pathogenesis of the vascular and inflammatory disease seen in patients with rosacea. These findings may help explain the benefits of current treatments and suggest new therapeutic strategies helpful for alleviating this disease. The goals of therapy include reduction of papules, pustules, erythema, physical discomfort, and an improvement in quality of life. Standard topical treatment agents include metronidazole, azelaic acid, and sodium sulfacetamide-sulfur. Second-line therapies include benzoyl peroxide, clindamycin, calcineurin inhibitors, and permethrin. There are also various systemic therapy options.
Elsaie
Mohamed L
ML
Department of Dermatology and Cutaneous Surgery, University of Miami, Miami, FL 33136, USA. egydoc77@yahoo.com
Choudhary
Sonal
S
D000284:Administration, Oral; D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D003879:Dermatologic Agents / Q000627:therapeutic use*; D003998:Dicarboxylic Acids / Q000627:therapeutic use; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage; D008795:Metronidazole / Q000627:therapeutic use; D010789:Phototherapy; D012393:Rosacea / Q000145:classification / Q000175:diagnosis / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D013409:Sulfacetamide / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D003998:Dicarboxylic Acids; D008795:Metronidazole; D013409:Sulfacetamide; D015474:Isotretinoin; C010038:azelaic acid