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Don't overlook all options for ocular rosacea.


Managing ocular rosacea often includes a combination of oral and topical treatments, and some patients find relief with natural strategies such as warm compresses and eyelid massage, Julie C. Harper, MD, said at the Skin Disease Education Foundation's annual Las Vegas Dermatology Seminar.

Ocular rosacea can present in several forms, including sties on the eyelids, blepharitis with chalazia and telangiectasia, and "meibomian inspissation visible as pale streaks perpendicular to the lid margin," according to a review article she cited (Clin Dermatol. 2016 Mar-Apr;34[2]: 146-50).

In a randomized trial of 38 adult patients with ocular rosacea treated with topical cyclosporine (twice a day for 3 months) or oral doxycycline (100 mg twice a day for 1 month, then 100 mg once a day for 2 months), post-treatment symptom scores showed similarly significant improvements for both (Int J Ophthalmol. 2015 Jun 18;8[3]:544-9). However, "cyclosporine was found to be more effective in symptomatic relief and treatment of eyelid signs," said Dr. Harper, a dermatologist in private practice in Birmingham, Ala.

At baseline, all cyclosporine-treated patients had burning, stinging, and light sensitivity, which dropped to 21%, 47%, and 10.5% of the patients, respectively, after 3 months of treatment. Those treated with doxycycline also showed improvement in these symptoms after 3 months, but not to the same degree.

In an interview, Dr. Harper provided the following pearl: 'Always ask about eye involvement in rosacea patients; they won't volunteer information because they think it is unrelated. Teach patients about lid care (lid massage and artificial tears). This is analogous to good skin care in cutaneous rosacea." She disclosed serving as a speaker/ adviser for Allergan, Bayer, and Gal derma, and receiving research support from Bayer. SDEF and this news organization are owned by the same parent company.

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Title Annotation:ROSACEA
Author:Splete, Heidi
Publication:Dermatology News
Date:Dec 1, 2017
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