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Rosazea 2009

Neue Erkenntnisse zur Pathophysiologie, klinische Manifestationsformen und Therapiestrategien

Rosacea 2009

New advances in pathophysiology, clinical staging and therapeutic strategies

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Zusammenfassung

Die Rosazea ist eine der häufigsten Dermatosen des Erwachsenenalters. In den letzten Jahren haben Arbeiten zu neuen Erkenntnissen in der Pathophysiologie der Rosazea geführt. Diese zeigen, dass Mechanismen der natürlichen oder angeborenen Immunität wesentlich an den vaskulären und entzündlichen Veränderungen der Rosazea beteiligt sind. Zur differenzialdiagnostischen Einteilung der klinischen Subtypen und einer stadien- und phasengerechten Therapie ist ein gutes Verständnis des Therapeuten über die Erkrankung und ihre Besonderheiten notwendig. Topisch zugelassen sind Metronidazol und Azelainsäure, als „off label use“ haben sich Permethrin, Calcineurininhibitoren und Schwefelrezepturen bewährt. Systemisch werden Antibiotika (z. B. Tetracycline, Makrolidantibiotika) und neuerdings Doxycyclin in submikrobiellen Dosen sowie Isotretinoin in schweren Fällen mit Erfolg verabreicht. Symptome wie Rhinophym und Teleangiektasien werden meist mittels Laser bzw. Dermabrasio behandelt. Diese Arbeit soll einen Überblick über die vielschichtige Erkrankung Rosazea und deren aktuelle Therapieoptionen geben.

Abstract

Rosacea is one of the most common dermatoses of adults. In recent years many studies have contributed to a better understanding of the pathophysiology of rosacea. They suggest that an altered innate immune response is involved in the vascular and inflammatory manifestations seen in rosacea. A good understanding of the disease and its special features is necessary for the differential diagnosis of the many clinical subtypes and for a stage- and phase-specific treatment approach. Topical treatments that are widely accepted are metronidazole and azelaic acid; agents under investigation that show promise include permethrin, calcineurin inhibitors and sulfur compounds. For systemic therapy antibiotics (tetracyclines, macrolides) and recently doxycycline in anti-inflammatory rather than anti-microbial dosages are used, as well as isotretinoin in severe cases. Findings such as rhinophyma and telangiectases can be treated using different laser systems or dermabrasion. This article gives an overview regarding rosacea, a challenging condition with multiple therapeutic options.

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Interessenkonflikt

Der korrespondierende Autor P. Lehmann weist auf folgende Beziehungen hin: Vorträge und Advisory Board von GALDERMA, Vorträge für Intendis und Novartis.

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  1. Zentrum für Dermatologie, Allergologie und Dermatochirurgie – Kompetenzzentrum Hautkrebs, HELIOS-Klinikum Wuppertal, Heusner Str. 40, 42283, Wuppertal, Deutschland

    A. Sobottka &  P. Lehmann

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  2. P. Lehmann
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Correspondence to A. Sobottka or P. Lehmann.

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Sobottka, A., Lehmann, P. Rosazea 2009. Hautarzt 60, 999–1009 (2009). https://doi.org/10.1007/s00105-009-1825-y

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