Systemic therapy of ocular and cutaneous rosacea in children

Abstract

Background

In paediatric rosacea, ocular symptoms are often predominant. Literature about systemic therapy of paediatric ocular rosacea is sparse, though.

Objective

Analysis of children with ocular rosacea treated systemically, particularly addressing remission and recurrence rates.

Methods

Retrospective study reviewing the medical records of children with ocular rosacea treated with systemic antibiotic therapy. Nine out of 19 patients were chosen for detailed analysis.

To our knowledge, this is the first study in paediatric ocular rosacea requiring systemic therapy with a larger patient group and a longer follow-up (mean follow-up = 30.2 months).

Results

Seventeen patients (89.5%) suffered from blepharitis, 15 patients (78.9%) from conjunctivitis, twelve patients (63.2%) from chalazia/styes and nine female patients (47.4%) from corneal involvement.

We used erythromycin (n = 9) or roxithromycin (n = 1) in patients younger than eight years and doxycycline (n = 8) or minocycline (n = 1) in patients older than eight years.

Seven out of nine patients treated with erythromycin, one out of eight patients treated with doxycycline and the patient treated with minocycline achieved a complete remission of ocular and cutaneous symptoms. Two out of nine patients treated with erythromycin, seven out of eight patients treated with doxycycline and the patient treated with roxithromycin achieved a partial remission.

Relapses occurred in the patient treated with minocycline (cutaneous), two out of eight patients treated with doxycycline (ocular and cutaneous) and one out of nine patients treated with erythromycin (cutaneous).

Conclusion

To achieve a complete remission of cutaneous and ocular rosacea, a long-term anti-inflammatory treatment of at least six months is necessary. The remission and relapse rates after successful treatment seem to be lower than in adults as all nine patients treated with erythromycin achieved a complete remission and did not show any relapse.

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