Recommendations for rosacea diagnosis, classification and management: update from the global ROS acea CO nsensus 2019 panel

作者：Martin Schaller, Luiz Maurício Costa Almeida, Anthony Bewley, B. Cribier, J.Q. Del Rosso, Ncoza C. Dlova, Richard L. Gallo, Richard D. Granstein, G. Kautz, Mark J. Mannis, Giuseppe Micali, Hazel H. Oon, Murlidhar Rajagopalan, Martin Steinhoff, Emil Tanghetti, Diane Thiboutot, Patricia Troielli, Guy Webster, Manfred Zierhut, Esther J van Zuuren, Jerry Tan · 发表于：British Journal of Dermatology · 年份：2019 · DOI：10.1111/bjd.18420 · 被引用次数：238 · 研究领域：Acne and Rosacea Treatments and Effects、Dermatologic Treatments and Research、Vitamin C and Antioxidants Research

BACKGROUND: A transition from a subtyping to a phenotyping approach in rosacea is underway, allowing individual patient management according to presenting features instead of categorization by predefined subtypes. The ROSacea COnsensus (ROSCO) 2017 recommendations further support this transition and align with guidance from other working groups. OBJECTIVES: To update and extend previous global ROSCO recommendations in line with the latest research and continue supporting uptake of the phenotype approach in rosacea through clinical tool development. METHODS: Nineteen dermatologists and two ophthalmologists used a modified Delphi approach to reach consensus on statements pertaining to critical aspects of rosacea diagnosis, classification and management. Voting was electronic and blinded. RESULTS: Delphi statements on which the panel achieved consensus of ≥ 75% voting 'Agree' or 'Strongly agree' are presented. The panel recommends discussing disease burden with patients during consultations, using four questions to assist conversations. The primary treatment objective should be achievement of complete clearance, owing to previously established clinical benefits for patients. Cutaneous and ocular features are defined. Treatments have been reassessed in line with recent evidence and the prior treatment algorithm updated. Combination therapy is recommended to benefit patients with multiple features. Ongoing monitoring and dialogue should take place between physician and patients, c...