Tanghetti Emil A, Jackson J Mark, Belasco Kevin Tate, Friedrichs Amanda, Hougier Firas, Johnson Sandra Marchese, Kerdel Francisco A, Palceski Dimitry, Hong H Chih-Ho, Hinek Anna, Cadena Maria Jose Rueda
J Drugs Dermatol. 2015 Jan;14(1):33-40.
Rosacea is a chronic inflammatory disease with a complex pathophysiology that manifests with central facial redness with or without papulopustular lesions. Often, patients with rosacea present with a constellation of signs and symptoms; for best results, the treatment plan should take into account all symptoms manifesting in the individual patient. The first available pharmacologic treatment to address the redness associated with rosacea is topical brimonidine. In the United States, brimonidine topical gel 0.33% is indicated for persistent facial erythema of rosacea; approval was based on clinically significant efficacy and good safety data from large-scale clinical trials. Use of brimonidine in routine clinical practice has yielded new insights that elaborate on the findings from clinical trials. For example, real-world use has shown that a percentage of patients (in our experience, approximately 10 to 20%) treated with brimonidine experience a worsening of erythema that has been called "rebound." Our routine use of this agent for >1 year has yielded strategies to set patient expectations, optimize treatment initiation, and minimize potential problems; this article details those strategies. Because we believe that the term "rebound" has been used to describe several physiologically distinct events, we have also proposed more specific terminology for such events.
酒渣鼻是一种慢性炎症性疾病，其病理生理过程复杂，表现为面部中央发红，可伴有或不伴有丘疹脓疱性损害。通常，酒渣鼻患者会出现一系列体征和症状；为了获得最佳治疗效果，治疗方案应考虑个体患者出现的所有症状。用于治疗与酒渣鼻相关的面部发红的首个可用药物治疗是外用溴莫尼定。在美国，0.33%的溴莫尼定外用凝胶被批准用于治疗酒渣鼻引起的持续性面部红斑；其批准基于大规模临床试验中具有临床意义的疗效和良好的安全性数据。在常规临床实践中使用溴莫尼定产生了新的见解，进一步阐述了临床试验的结果。例如，实际应用表明，一部分接受溴莫尼定治疗的患者（根据我们的经验，约10%至20%）会出现红斑加重的情况，这被称为“反跳”。我们对该药物进行了超过1年的常规使用，得出了一些设定患者预期、优化治疗起始以及将潜在问题降至最低的策略；本文详细介绍了这些策略。由于我们认为“反跳”一词被用于描述几种生理上不同的事件，我们还为此类事件提出了更具体的术语。
