Treatment of pediatric ocular rosacea: A systematic review

Ann Dermatol Venereol. 2023 Sep;150(3):199-201. doi: 10.1016/j.annder.2023.05.004. Epub 2023 Aug 16.

Abstract

Background: Ocular rosacea is an underdiagnosed form of rosacea that may occur without typical cutaneous signs of rosacea. Manifestations include blepharitis, lid margin telangiectasias, and scleritis. A systematic comparison of treatment options for ocular rosacea in children is lacking.

Methods: A systematic review was conducted according to the PRISMA guidelines on treatment for pediatric ocular rosacea.

Results: Eleven articles were included, representing 135 patients with a mean age of 5 years, of whom 69% (n = 75/108) were female. 55% (n = 55/99) exhibited ocular symptoms prior to cutaneous symptoms. Most patients (83%, n = 34/41) experienced a delay in diagnosis (mean 27 months, range 2-120 months). Doxycycline was the most frequently reported treatment (25%, n = 33/135). A complete response was achieved in 33% of patients treated with doxycycline (n = 10/30), while 53% (n = 16/30) achieved a partial response. Erythromycin was used in 20% of cases (n = 26/135), with a complete response in 58% (n = 15/26) and partial response in 42% (n = 11/26). Metronidazole was used in 14% of patients (n = 19/135), with a complete response being reported in 79% (n = 15/19) and partial response in 21% (n = 4/19).

Conclusion: Systemic antibiotics, led by doxycycline, were the most commonly reported treatment modalities for pediatric ocular rosacea. Increased awareness of ocular rosacea in this population is crucial for earlier diagnosis.

Keywords: Doxycycline; Ocular; Pediatric; Rosacea; Treatment.

Publication types

  • Systematic Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Child, Preschool
  • Doxycycline / therapeutic use
  • Female
  • Humans
  • Male
  • Metronidazole / therapeutic use
  • Rosacea* / diagnosis
  • Rosacea* / drug therapy
  • Skin Diseases* / drug therapy

Substances

  • Doxycycline
  • Anti-Bacterial Agents
  • Metronidazole