Dermatology Clinic, University of Catania, Catania, Italy.
Expert Opin Pharmacother. 2022 Nov;23(16):1845-1854. doi: 10.1080/14656566.2022.2142907. Epub 2022 Nov 5.
Rosacea is a chronic and relapsing facial dermatosis that encompasses a wide spectrum of clinical phenotypes (transient/persistent erythema, telangiectasias, papules/pustules, edema, phymatous changes, and ocular symptoms) often with uncomfortable symptoms such as flushing, pain, burning, edema, and dryness. Current pharmacological treatment includes topical agents, spanning from several conventional (azelaic acid, metronidazole, sodium sulfacetamide) to new ones (brimonidine, oxymetazoline, ivermectine, minocycline), and systemic agents (doxycycline 40 mg modified-release), all Food and Drug Administration approved.
The aim of our article is to review the state of art of pharmacological treatment, either as monotherapy or in combination therapy, tailored to the most common rosacea phenotypes (persistent erythema, inflammatory papules/pustules). Other topical or systemic drugs and several adjuvant phytotherapeutic agents are considered.
Combined therapies to target different phenotypes, when present in the same patient, represent one of the major achievements in the management of vascular and inflammatory papules and pustules of rosacea. Future investigations should be addressed to early inflammatory phyma or ocular rosacea, which have actually been neglected. Finally, there is still an ongoing need for therapeutic interventions able to relieve symptoms and social burden, all factors that greatly contribute to improve rosacea quality of life.
酒渣鼻是一种慢性、复发性面部皮肤病，涵盖了广泛的临床表型（短暂/持续红斑、毛细血管扩张、丘疹/脓疱、水肿、增生性改变和眼部症状），常伴有不适症状，如潮红、疼痛、灼热、水肿和干燥。目前的药物治疗包括局部治疗药物，从几种传统药物（壬二酸、甲硝唑、磺胺醋酰钠）到新型药物（溴莫尼定、羟甲唑啉、伊维菌素、米诺环素），以及全身治疗药物（多西环素 40mg 控释剂），均获得了食品和药物管理局的批准。
本文旨在综述酒渣鼻的药物治疗现状，无论是单药治疗还是联合治疗，均针对最常见的酒渣鼻表型（持续性红斑、炎症性丘疹/脓疱）。还考虑了其他局部或全身药物和几种辅助植物疗法。
针对不同表型的联合治疗，当同一患者存在多种表型时，是治疗酒渣鼻血管性和炎症性丘疹和脓疱的主要进展之一。未来的研究应针对早期炎症性增生或眼部酒渣鼻，这些方面实际上被忽视了。最后，仍需要进行治疗干预以缓解症状和社会负担，所有这些因素都极大地有助于改善酒渣鼻的生活质量。
