Improving Treatment of Erythematotelangiectatic Rosacea with Laser and/or Topical Therapy Through Enhanced Discrimination of its Clinical Features.
Rosacea is a chronic inflammatory disease that can present with a variety of cutaneous symptoms. Erythematotelangiectatic rosacea is a subtype characterized by flushing (transient erythema), persistent central facial erythema (background erythema), and telangiectasias. The severity of individual symptoms differs in each patient, which can complicate the selection of an appropriate treatment strategy. Evaluation of these specific symptoms has been greatly improved by the routine use of diagnostic tools such as (video) dermatoscopy. Following a thorough clinical assessment, treatment decisions should be made based on the proportion of these individual symptoms in individual patients. Brimonidine 0.33% gel is recommended in the symptomatic treatment of facial erythema, and there is evidence for the efficacy of laser/light-based therapies in the treatment of erythema and telangiectasias. In patients presenting with both marked background erythema and telangiectasias, initial treatment with brimonidine 0.33% gel to target the erythema followed by laser/light-based therapy for the telangiectasias has been shown to be an effective combination in clinical practice. This article aims to facilitate treatment decision-making in clinical practice through: 1) better differentiation of the main symptoms of erythematotelangiectatic rosacea and 2) practical advice for the selection of appropriate treatments, based on clinical case examples.
Dermatology Clinic, University of Catania, Italy;
Giuseppe
G
Micali
Dermatology Clinic, University of Catania, Italy;
Peter Arne
PA
Gerber
Department of Dermatology, Medical Faculty, University of Düsseldorf, Germany;
Francesco
F
Lacarrubba
Galderma International, Paris, France.
Gregor
G
Schäfer
Br J Dermatol. 2013 Sep;169(3):555-62
23600367
Mol Pharmacol. 2009 Oct;76(4):710-22
19570945
Dermatol Surg. 2007 Apr;33(4):441-8
17430378
J Eur Acad Dermatol Venereol. 2013 Nov;27(11):1336-43
23451732
Cutis. 2009 Jul;84(1):43-7
19743724
J Invest Dermatol. 2014 Nov;134(11):2728-36
24844861
J Drugs Dermatol. 2015 Jan;14(1):33-40
25607906
J Cosmet Dermatol. 2013 Sep;12(3):187-94
23992160
Cutis. 2014 Jul;94(1):21-5
25101340
JAMA Dermatol. 2015 Aug;151(8):825-36
25798811
J Investig Dermatol Symp Proc. 2011 Dec;15(1):53-62
22076328
J Eur Acad Dermatol Venereol. 2014 May;28(5):609-14
23489377
J Manag Care Spec Pharm. 2014 Jun;20(6):623-9
24856600
J Investig Dermatol Symp Proc. 2011 Dec;15(1):40-7
22076326
Lasers Surg Med. 2008 Apr;40(4):233-9
18412227
Int J Dermatol. 2014 May;53(5):e325-7
23879349
Int J Dermatol. 2003 Jun;42(6):430-3
12786867
J Investig Dermatol Symp Proc. 2011 Dec;15(1):24-32
22076324
J Eur Acad Dermatol Venereol. 2015 Mar;29(3):474-81
25074756
Clin Cosmet Investig Dermatol. 2015 Apr 07;8:159-77
25897253
J Drugs Dermatol. 2013 Jun 1;12(6):650-6
23839181
J Dermatol Sci. 2009 Aug;55(2):77-81
19481425
Ann Dermatol Venereol. 2011 Nov;138 Suppl 3:S179-83
22183096
J Investig Dermatol Symp Proc. 2011 Dec;15(1):2-11
22076321
Contact Dermatitis. 2008 Mar;58(3):147-55
18279152
J Clin Aesthet Dermatol. 2012 Mar;5(3):16-25
22468176
J Am Acad Dermatol. 2013 Dec;69(6 Suppl 1):S44-56
24229637
Int J Dermatol. 1998 Apr;37(4):263-6
9585896
J Cutan Pathol. 2007 Oct;34(10):748-53
17880579
J Drugs Dermatol. 2014 Jan;13(1):56-61
24385120
Dermatol Surg. 2003 Jan;29(1):56-8
12534513
J Am Acad Dermatol. 2011 Jun;64(6):1135-46
21292346
J Am Acad Dermatol. 2002 Apr;46(4):584-7
11907512
Cochrane Database Syst Rev. 2015 Apr 28;(4):CD003262
25919144
J Dermatol Sci. 2014 Jul;75(1):49-54
24802713
J Am Acad Dermatol. 2013 Sep;69(3):438-43
23688651
Br J Dermatol. 2008 Sep;159(3):628-32
18565174
Skin Res Technol. 2007 Nov;13(4):472-84
17908201
J Eur Acad Dermatol Venereol. 2011 Feb;25(2):188-200
20586834
Lasers Med Sci. 2002;17(1):26-33
11845365
J Am Acad Dermatol. 2015 May;72(5):749-58; quiz 759-60
25890455
J Investig Dermatol Symp Proc. 2011 Dec;15(1):16-23
22076323
J Am Acad Dermatol. 2006 Jan;54(1):100-4
16384763
Lasers Med Sci. 2010 Jan;25(1):151-4
19636662
Br J Dermatol. 2012 Mar;166(3):633-41
22050040
Arch Dermatol Res. 2008 Mar;300(3):125-31
18071725
J Drugs Dermatol. 2014 Jun;13(6):699-704
24918560
J Clin Aesthet Dermatol. 2015 Sep;8(9):33-8
26430489
J Am Acad Dermatol. 2007 Nov;57(5):800-5
17658664