Systemic Therapy for Rosacea

H. E. Baldwin, MD


Skin Therapy Letter. 2007;12(2) 

In This Article

Classification of Rosacea

Rosacea is a condition characterized by a constellation of symptoms including central facial erythema and telangiectasias, papules and pustules, granulomatous nodules, phyma formation, and ocular changes. The disorder is capricious with flares and remissions occurring without rationale. For the task of discussing therapy, rosacea is best viewed as a collection of several conditions with a common name. Although many patients have polymorphic disease, most have one predominating feature.

The most commonly used classification system is based on predominant lesion morphology and was developed by a committee of the National Rosacea Society and published in 2002.[3] Patients are classified as having one of four types of rosacea: erythematotelangiectatic, papulopustular, phymatous, or ocular with a variant form referred to as granulomatous. Individual patients may straddle one or more subtypes, but this system allows us to determine therapy based on similar lesion types. Therapeutic options for the various lesion types are easily categorized and there are few medications or modalities that are significantly effective in more than one category.


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