Rosacea

The pathogenesis of rosacea—a chronic inflammatory disorder that is characterized by facial papules, pustules, and persistent erythema—is multifactorial. Many factors are believed to activate neurovascular and immune responses, leading to inflammation that results in “flares.” One of these components is believed to be infestation with the microorganisms Demodex folliculorum and Demodex brevis, which are skin mites.
The pathogenesis of rosacea is multifactorial: one component is believed to be infestation with microorganisms, the skin mites Demodex folliculorum and Demodex brevis. A compound, ivermectin 1% cream, which is currently under review by the US Food and Drug Administration (FDA), is the first agent to target an underlying cause of rosacea, infestation with the Demodex skin mites. If approved by the FDA, this new compound will be the first medication to address a key component of papulopustular rosacea.
Linda F. Stein Gold, MD, Director of Dermatology Research at Henry Ford Health System, Detroit, MI, has many years of clinical and research experience in the treatment of patients with skin disorders. She spoke with American Health & Drug Benefits about the current status of the treatment of patients with rosacea, suggesting that new treatments currently in late development are expected to improve outcomes.
A novel compound currently in development, ivermectin 1% cream, targets the underlying cause of papulopustular rosacea (a prevalent type of rosacea), which is associated with an infestation of Demodex folliculorum, a skin mite that harbors the bacteria linked to rosacea.
Several studies presented at the 2014 American Academy of Dermatology (AAD) annual meeting sought to characterize the emotional burden of rosacea, as well as what treatments are being prescribed, and how much they are costing the healthcare system.
Rosacea affects an estimated 16 million US adults, but its underlying cause remains unclear. Studies presented at the 2014 American Academy of Dermatology (AAD) annual meeting offered some insights about the mechanism of inflammation, suggesting that doxycycline 40 mg modified release (MR) may improve the symptoms of papulopustular rosacea by modulating factors that augment inflammation. Other investigators reported treatment success for rosacea with novel agents.
Rosacea, a chronic and potentially life-disrupting skin condition, affects an estimated 16 million people in the United States.1,2 Although rosacea generally affects the facial area, it can also occur on the neck, ears, scalp, or chest.2 The manifestations of rosacea include facial erythema; visible blood vessels; swollen, red acne-like bumps; dry eyes; and swollen, reddened eyelids.2,3
Jennifer H. Allen, MD, of Allen Dermatology, Macon, GA, has 30 years of clinical experience. In a conversation with American Health & Drug Benefits (AHDB), Dr Allen shared her observations about and management approaches to rosacea.
On August 26, 2013, the US Food and Drug Administration (FDA) approved topical brimonidine gel 0.33% (Mirvaso, Galderma Laboratories) for the treatment of erythema in rosacea in adults aged 18 years and older. This is the first drug approved by the FDA for the treatment of this condition, and it answers an unmet need in addressing the facial erythema that is a hallmark of this skin disorder.
Rosacea is a common skin condition that leads to persistent erythema, transient flushing, and/or acne-like eruptions across the face. Although effective treatments exist for the pimples and pustules associated with rosacea (ie, papulopustular rosacea), the effective relief of erythema in rosacea (ie, erythematotelangiectatic rosacea) is an unmet medical need.
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