臨床および実験皮膚科学研究ジャーナル
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概要

Granulomatous Rosacea: A Systematic Review of Clinical Presentations and Treatments

Anna Aronovich*, Yossi Taieb, Rina Segal, Emmilia Hodak

Rosacea is a common inflammatory disease affecting the face with flushing, papules, pustules and telangiectasias. Granulomatous Rosacea (GR) is infrequent recognized variant of rosacea. Clinically it is a chronic disorder that primarily affects periorificial regions of the face and forehead. The purpose of our work was to systematically review available data about clinical presentation and treatments on granulomatous rosacea. Hence, a systematic review of studies evaluating GR was performed. The search yielded 1363 publications, with 18 eligible for review. Together with our case report, 19 studies were included overall. GR affected 39 males (41%) and 55 females (58%) women, mean age was 47 for males and 48 years for females. Youngest patient of GR was 9 years of age with upper range of 80 years. Cheeks were most common involved (64%), afterwards nose (34%), chin (18%), forehead (9%) and eyelid’s (5%). There is no well-defined treatment protocol when it comes to management of GR. For oral treatments first line of treatment were oral antibiotics such as tetracycline or doxycycline (13 out of 18 studies;72%), second and third lines were isotretinoin (3 out of 18 studies;16%), systemic corticosteroids (3 out of 18 studies; 16%), dapsone (3 out of 18 studies;16%), metronidazole (2 out of 18 studies, 10%), PDT, IPL and Chromophore Gel-Assisted Phototherapy (CGAP) each mentioned once (1 out of 18 studies;5%).

As for topical treatments metronidazole cream (7 out of 18 studies; 39%) was the most prevalent, afterwards tretinoin 0.025% cream, combination of 20% Jessner (Rejuvenize^®) and 0.3%, pimecrolimus, topical azelaic acid, benzoyl peroxide, brimonidine and ivermectin were used. The treatment of GR largely depended on the phenotypic presentation that varied in each patient.