Rosacea treatment update: recommendations from the global ROSacea COnsensus (ROSCO) panel

M. Schaller, L. M C Almeida, A. Bewley, B. Cribier, N. C. Dlova, G. Kautz, M. Mannis, H. H. Oon, M. Rajagopalan, M. Steinhoff, D. Thiboutot, P. Troielli, G. Webster, Y. Wu, E. van Zuuren, J. Tan

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Background: Rosacea is currently treated according to subtypes. As this does not adequately address the spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus panel was established to address this issue. Objectives: To incorporate current best treatment evidence with clinical experience from an international expert panel and establish consensus to improve outcomes for patients with rosacea. Methods: Seventeen dermatologists and three ophthalmologists reached consensus on critical aspects of rosacea treatment and management using a modified Delphi approach. The panel voted on statements using the responses ‘strongly disagree’, ‘disagree’, ‘agree’ or ‘strongly agree’. Consensus was defined as ≥ 75% ‘agree’ or ‘strongly agree’. All voting was electronic and blinded. Results: The panel agreed on phenotype-based treatments for signs and symptoms presenting in individuals with rosacea. First-line treatments were identified for individual major features of transient and persistent erythema, inflammatory papules/pustules, telangiectasia and phyma, underpinned by general skincare measures. Multiple features in an individual patient can be simultaneously treated with multiple agents. If treatment is inadequate given appropriate duration, another first-line option or the addition of another first-line agent should be considered. Maintenance treatment depends on treatment modality and patient preferences. Ophthalmological referral for all but the mildest ocular features should be considered. Lid hygiene and artificial tears in addition to medications are used to treat ocular rosacea. Conclusions: Rosacea diagnosis and treatment should be based on clinical presentation. Consensus was achieved to support this approach for rosacea treatment strategies.

Original languageEnglish (US)
Pages (from-to)465-471
Number of pages7
JournalBritish Journal of Dermatology
Volume176
Issue number2
DOIs
StatePublished - Feb 1 2017

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Rosacea
Therapeutics
Phenotype
Telangiectasis
Patient Preference
Politics
Erythema
Hygiene
Signs and Symptoms
Referral and Consultation

All Science Journal Classification (ASJC) codes

  • Dermatology

Cite this

Schaller, M., Almeida, L. M. C., Bewley, A., Cribier, B., Dlova, N. C., Kautz, G., ... Tan, J. (2017). Rosacea treatment update: recommendations from the global ROSacea COnsensus (ROSCO) panel. British Journal of Dermatology, 176(2), 465-471. https://doi.org/10.1111/bjd.15173
Schaller, M. ; Almeida, L. M C ; Bewley, A. ; Cribier, B. ; Dlova, N. C. ; Kautz, G. ; Mannis, M. ; Oon, H. H. ; Rajagopalan, M. ; Steinhoff, M. ; Thiboutot, D. ; Troielli, P. ; Webster, G. ; Wu, Y. ; van Zuuren, E. ; Tan, J. / Rosacea treatment update : recommendations from the global ROSacea COnsensus (ROSCO) panel. In: British Journal of Dermatology. 2017 ; Vol. 176, No. 2. pp. 465-471.
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abstract = "Background: Rosacea is currently treated according to subtypes. As this does not adequately address the spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus panel was established to address this issue. Objectives: To incorporate current best treatment evidence with clinical experience from an international expert panel and establish consensus to improve outcomes for patients with rosacea. Methods: Seventeen dermatologists and three ophthalmologists reached consensus on critical aspects of rosacea treatment and management using a modified Delphi approach. The panel voted on statements using the responses ‘strongly disagree’, ‘disagree’, ‘agree’ or ‘strongly agree’. Consensus was defined as ≥ 75{\%} ‘agree’ or ‘strongly agree’. All voting was electronic and blinded. Results: The panel agreed on phenotype-based treatments for signs and symptoms presenting in individuals with rosacea. First-line treatments were identified for individual major features of transient and persistent erythema, inflammatory papules/pustules, telangiectasia and phyma, underpinned by general skincare measures. Multiple features in an individual patient can be simultaneously treated with multiple agents. If treatment is inadequate given appropriate duration, another first-line option or the addition of another first-line agent should be considered. Maintenance treatment depends on treatment modality and patient preferences. Ophthalmological referral for all but the mildest ocular features should be considered. Lid hygiene and artificial tears in addition to medications are used to treat ocular rosacea. Conclusions: Rosacea diagnosis and treatment should be based on clinical presentation. Consensus was achieved to support this approach for rosacea treatment strategies.",
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Schaller, M, Almeida, LMC, Bewley, A, Cribier, B, Dlova, NC, Kautz, G, Mannis, M, Oon, HH, Rajagopalan, M, Steinhoff, M, Thiboutot, D, Troielli, P, Webster, G, Wu, Y, van Zuuren, E & Tan, J 2017, 'Rosacea treatment update: recommendations from the global ROSacea COnsensus (ROSCO) panel', British Journal of Dermatology, vol. 176, no. 2, pp. 465-471. https://doi.org/10.1111/bjd.15173

Rosacea treatment update : recommendations from the global ROSacea COnsensus (ROSCO) panel. / Schaller, M.; Almeida, L. M C; Bewley, A.; Cribier, B.; Dlova, N. C.; Kautz, G.; Mannis, M.; Oon, H. H.; Rajagopalan, M.; Steinhoff, M.; Thiboutot, D.; Troielli, P.; Webster, G.; Wu, Y.; van Zuuren, E.; Tan, J.

In: British Journal of Dermatology, Vol. 176, No. 2, 01.02.2017, p. 465-471.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Rosacea treatment update

T2 - recommendations from the global ROSacea COnsensus (ROSCO) panel

AU - Schaller, M.

AU - Almeida, L. M C

AU - Bewley, A.

AU - Cribier, B.

AU - Dlova, N. C.

AU - Kautz, G.

AU - Mannis, M.

AU - Oon, H. H.

AU - Rajagopalan, M.

AU - Steinhoff, M.

AU - Thiboutot, D.

AU - Troielli, P.

AU - Webster, G.

AU - Wu, Y.

AU - van Zuuren, E.

AU - Tan, J.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background: Rosacea is currently treated according to subtypes. As this does not adequately address the spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus panel was established to address this issue. Objectives: To incorporate current best treatment evidence with clinical experience from an international expert panel and establish consensus to improve outcomes for patients with rosacea. Methods: Seventeen dermatologists and three ophthalmologists reached consensus on critical aspects of rosacea treatment and management using a modified Delphi approach. The panel voted on statements using the responses ‘strongly disagree’, ‘disagree’, ‘agree’ or ‘strongly agree’. Consensus was defined as ≥ 75% ‘agree’ or ‘strongly agree’. All voting was electronic and blinded. Results: The panel agreed on phenotype-based treatments for signs and symptoms presenting in individuals with rosacea. First-line treatments were identified for individual major features of transient and persistent erythema, inflammatory papules/pustules, telangiectasia and phyma, underpinned by general skincare measures. Multiple features in an individual patient can be simultaneously treated with multiple agents. If treatment is inadequate given appropriate duration, another first-line option or the addition of another first-line agent should be considered. Maintenance treatment depends on treatment modality and patient preferences. Ophthalmological referral for all but the mildest ocular features should be considered. Lid hygiene and artificial tears in addition to medications are used to treat ocular rosacea. Conclusions: Rosacea diagnosis and treatment should be based on clinical presentation. Consensus was achieved to support this approach for rosacea treatment strategies.

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Schaller M, Almeida LMC, Bewley A, Cribier B, Dlova NC, Kautz G et al. Rosacea treatment update: recommendations from the global ROSacea COnsensus (ROSCO) panel. British Journal of Dermatology. 2017 Feb 1;176(2):465-471. https://doi.org/10.1111/bjd.15173