Guías clínicas para el tratamiento de la rosácea

Rosacea is a chronic inflammatory disease that affects the skin and the eyes. It is characterized by papules, pustules, persisting flushing and development of phymas. There are many different options of treatment but it is unclear which one is the most effective. Objective: To recollect and to analyze all the available trials in dermatological literature about the treatment of rosacea and to give clinical recommendations based on evidence. Methods: A search of multiple databases about different treatments options of papulo-pustular, erythemato-telangiectatic and phimatous rosacea was carried out. The search strategy was made in Medline, Ovid, Lilacs and Embase through Pubmed, from January 1980 to June 2011. After the recollection of the available literature, it was analyzed and rated using Jadad for the randomized controlled trials, CASPE for case and control trials, cohorts and descriptive trials. Finally we give clinical recommendations based on found evidence. Results: One hundred and seventy eight trials were found about different options of rosacea treatment. In papulo-pustular rosacea the most effective treatments are metronidazole, azelaic acid, sulfacetamide and doxycycline. In erythemato-telangiectatic rosacea the most used therapeutic options are physical modalities, and in phymatous rosacea the first line treatment is CO2 laser. Conclusions: This article presents an updated review of therapeutic modalities for rosacea and gives therapeutic recommendations based on the best evidence level.