Martin Schaller, from the Universitatsklinikum Tubingen in Germany, and colleagues incorporated current best treatment evidence with clinical experience from an international expert panel to establish consensus on critical aspects of rosacea treatment and management. A modified Delphi approach was used with voting on statements.
The panel agreed on phenotype-based treatments for presenting signs and symptoms of rosacea. For the individual major features, including transient and persistent erythema, inflammatory papules/pustules, telangiectasia, and phyma, they identified first-line treatments, in addition to general skin care measures. In an individual patient, multiple features can be treated simultaneously with multiple agents. Another first-line option or addition of another first-line agent should be considered if treatment is inadequate given appropriate duration. Treatment modality and patient preferences may play a role in maintenance treatment selection. For all but the mildest ocular features, ophthalmological referrals should be considered. In addition to medications, lid hygiene and artificial tears can be used to treat ocular rosacea.
"Rosacea diagnosis and treatment should be based on clinical presentation," the authors write. "Consensus is shown for treatment strategies to support this approach."
Several authors disclosed financial ties to pharmaceutical companies, including Galderma, which funded the study.
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