Puntos para una lectura rápida
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Es necesario tener en cuenta que los pacientes con rosácea son más susceptibles a algunas enfermedades como diabetes mellitus, celiaquía, esclerosis múltiple o artritis reumatoide. Se recomienda tener esto en cuenta durante la entrevista clínica, especialmente en mujeres de mediana edad, y realizar despistaje adecuado en los pacientes seleccionados.
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La fisiopatología de la rosácea engloba factores exógenos, genéticos, vasculares e inmunitarios.
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La nueva clasificación establecida en 2017 propone el enfoque diagnóstico por fenotipos en lugar de por subtipos cerrados como se realizaba de forma tradicional.
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El tratamiento de la rosácea debe enfocarse en función del fenotipo concreto de cada paciente y los mecanismos fisiopatogénicos subyacentes, sin olvidar la prevención de los factores desencadenantes, especialmente la fotoprotección.
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La isotretinoína oral a dosis bajas es efectiva en el manejo de todos los fenotipos de rosácea, excepto la ocular, en la que es más efectiva la antibioterapia oral. Deben mantenerse los controles analíticos y de prevención del embarazo indicados durante la toma de isotretinoína oral.
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Las fuentes de luz (láser o luz pulsada) representan un aspecto fundamental en el tratamiento de todos los fenotipos en rosácea.
Palabras clave
Rosácea
Tratamiento tópico
Tratamiento oral
Fuentes de luz
Situaciones especiales
Identifíquese
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