Symptom-Based Approach for Treating Rosacea

Patients with rosacea can have a variety of symptoms, including erythema, flushing, papules, and pustules. Rather than using a one-size-fits-all approach, James Q Del Rosso, DO, advised dermatologists to treat each patient's specific symptoms during his Dermatology Week 2023 session “Managing Rosacea Based on Manifestations.”

"We've come to realize that patients don't fall perfectly into those subtypes," Dr Del Rosso stated, adding, "Treating rosacea based on subtypes creates a mechanical way of viewing the condition, rather than focusing on the particular patient's clinical manifestations."

Dr Del Rosso is an adjunct professor of dermatology at Touro University Nevada in Henderson, NV. The learning objectives of his presentation included describing the common clinical manifestations of cutaneous rosacea, understanding the underlying pathophysiology of rosacea-prone skin with correlations to clinical manifestations, correlating applications of individual treatments for rosacea with specific clinical manifestations, and explaining the rationale behind combination therapy for rosacea. Also included in the session were practical management of rosacea, a recap of new topical therapies for papulopustular rosacea, understanding persistent facial erythema, and physical modalities of persistent manifestations of rosacea.

Dr Del Rosso discussed why only some people get rosacea and its complex pathophysiology with variable clinical presentations. “Facial erythema of rosacea has multiple underlying causes,” he said, continuing, “The primary diagnostic clinical manifestation of rosacea is [centrally located] persistent facial erythema, which may be intensified intermittently by episodes of vasodilation.” He noted, “Papules and pustules may or may not be present and are intermittent lesions.”

“Therapies for rosacea may be correlated with individual visible findings,” he concluded, adding, “Treatments are often sequential to address different manifestations of rosacea.”

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Reference
Del Rosso J. Managing rosacea based on manifestations. Presented at: Dermatology Week; May 3–6; Virtual.