Esther J van Zuuren

• MD
• Leids Universitair Medisch Centrum at Leiden University Medical Centre

Importance Inconsistent reporting of outcomes in clinical trials of rosacea is impeding and likely preventing accurate data pooling and meta-analyses. There is a need for standardization of outcomes assessed during intervention trials of rosacea. Objective To develop a rosacea core outcome set (COS) based on key domains that are globally relevant...

Background When research evidence is limited, inconsistent, or absent, healthcare decisions and policies need to be based on consensus amongst interested stakeholders. In these processes, the knowledge, experience, and expertise of health professionals, researchers, policymakers, and the public are systematically collected and synthesised to reach...

Het merendeel van de antibiotica-allergieregistraties in patiëntendossiers is onjuist of onvolledig. Dit leidt tot onnodig afwijken van het antibioticum van eerste keuze, met negatieve gevolgen voor de patiënt en de maatschappij. Het doel van dit project was om de kwaliteit van antibiotica-allergieregistraties in het ziekenhuis te verbeteren met ee...

The Global Guidelines in Dermatology Mapping Project (GUIDEMAP) assesses the methodological quality of clinical practice guidelines (CPGs) for high‐burden skin diseases. This review focuses on contact dermatitis. We searched MEDLINE, Embase, PubMed, Web of Science, Cochrane Library, Emcare, Epistemonikos, PsycINFO and Academic Search Premier for CP...

Rosacea is a chronic inflammatory disease affecting the cheeks, chin, nose, forehead and frequently the eyes. Recent advances have emphasised the roles of the innate and adaptive immune systems and neurovascular dysregulation underlying the spectrum of clinical features of rosacea. This chapter covers the phenotype‐based diagnosis and classificatio...

Background In biomedical research, it is often desirable to seek consensus among individuals who have differing perspectives and experience. This is important when evidence is emerging, inconsistent, limited, or absent. Even when research evidence is abundant, clinical recommendations, policy decisions, and priority-setting may still require agreem...

Background While many studies have reported on occupational allergic contact dermatitis amongst dental personnel, studies on the relevance of patch testing in dental patients are scarce. Objectives To determine the frequency and clinical relevance of contact allergy in patients with intra‐ and perioral complaints. Methods A total of 360 patients...

Background. Morbihan’s disease (MD), also known as solid persistent facial edema, solid facial lymphedema or rosacea lymphedema, is a rare condition. Objective. Despite existing case reports and literature reviews, clinical guidance for diagnosis and management is lacking. This review aims to provide comprehensive information on the etiology, diff...

Background: In biomedical research, it is often desirable to seek consensus among individuals who have differing perspectives and experience. This is important when evidence is emerging, inconsistent, limited or absent. Even when research evidence is abundant, clinical recommendations, policy decisions and priority-setting may still require agreeme...

The International League of Dermatological Societies (ILDS) initiated the Global Atopic Dermatitis Atlas (GADA) in 2022 to address the worldwide differences in prevalence and disease burden of atopic dermatitis (AD), as well as a lack of data in many middle and low income settings. To establish a baseline, the inaugural Global Report on Atopic Derm...

Geneesmiddelenallergieën kunnen potentieel gevaarlijk zijn en worden daarom zorgvuldig geregistreerd in patiëntendossiers. Lang niet alle geneesmiddelreacties zijn echter een allergie. Een reactie wordt alleen een allergie genoemd als er een onderliggend immunologisch mechanisme is aangetoond. Een onterechte allergieregistratie kan resulteren in ee...

Objective To identify evidence on the reporting quality of consensus methodology and to select potential checklist items for the ACcurate COnsensus Reporting Document (ACCORD) project to develop a consensus reporting guideline. Design Systematic review. Data sources Embase, MEDLINE, Web of Science, PubMed, Cochrane Library, Emcare, Academic Searc...

Background Structured, systematic methods to formulate consensus recommendations, such as the Delphi process or nominal group technique, among others, provide the opportunity to harness the knowledge of experts to support clinical decision making in areas of uncertainty. They are widely used in biomedical research, in particular where disease chara...

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Background Clinical practice guidelines (CPGs) are essential in delivering optimum health care, such as for atopic dermatitis (AD), a highly prevalent skin disease. Although many CPGs are available for AD, their quality has not been critically appraised. Objective To identify CPGs on AD worldwide and assess with validated instruments if those CPGs...

A healthy man in his 40s was referred to the allergy outpatient clinic with a suspected vinegar allergy. He had a 4-year history of facial flushing and excessive sweating after smelling or consuming vinegar, vinegar-containing products, and spicy food. Sweating and hyperemia occurred within minutes on his entire face and scalp and lasted for 20 to...

Background Rosacea, a chronic facial and ocular inflammatory disease, is readily visible with consequential adverse psychosocial impacts. Progress in epidemiology, pathophysiology, treatments, psychosocial and quality of life impact has led to improved outcomes. Additionally, there has been a transition to updated clinical criteria for diagnosis an...

Introduction Clinical practice guidelines (CPGs), statements that include recommendations intended to optimise patient care, play a critical role in standardising and improving treatment outcomes based on best evidence. It is currently unclear how many CPGs are available globally to assist clinicians in the management of patients with skin disease....

Rosacea is a chronic inflammatory dermatosis mainly affecting the cheeks, nose, chin, and forehead. Rosacea is characterized by recurrent episodes of flushing or transient erythema, persistent erythema, phymatous changes, papules, pustules, and telangiectasia. The eyes may also be involved. Due to rosacea affecting the face, it has a profound negat...

Background After dermatitis, acne is the second skin disease most contributing to the burden of skin diseases worldwide. Recently, seven core outcome domains have been identified that together form an Acne Core Outcome Set (ACORN project). One of these was satisfaction with acne treatment. Objective Our aim was to identify studies that described t...

Linked Article: van Zuuren et al. Br J Dermatol 2020; 182 :1504–1506.

The authors of this research letter developed a treatment guideline for patients with rosacea in The Netherlands, based on a recently published review of all evidence on treating rosacea. The Dutch Society of Dermatology and Venereology funded the project and provided two staff members who supported the working group (WG). The WG consisted further...

这封研究信函的作者根据最近发表的关于治疗红斑痤疮的所有证据的综述,制定了荷兰红斑痤疮患者的治疗指南。荷兰皮肤病和性病学协会资助了该项目,并提供了两名支持该工作组 (WG) 的工作人员。该 WG 由四名皮肤科医生、一名全科医生、一名眼科医生、一名整形外科医生、两名皮肤治疗师和一名患者组成。该项目流程使用了最严格的方法标准。 该指南涵盖了 10 个健康问题,考虑到了有效性和安全性,评估了一系列自我护理措施和治疗选择。针对这些健康问题的建议是通过将证据与患者的价值和偏好、费用和可获得性相结合而提出的。建议为强建议(“建议”)或弱建议(“考虑”),并针对各种治疗方法提供了支持或反对意见。作者在一种算法中列出了相关的治疗方法(图 1)。没有提到局部使用羟甲唑啉治疗持续性红肿(在荷兰无法获得该药物),也...

酒渣鼻是一种主要影响面部皮肤和眼睛的皮肤病。它有许多不同的可见体征和症状,或“特征”。 医生目前正在从一种亚型方法(指定疾病特征分组)转换为一种表型方法,该方法将每个患者看为一个具有其自身特定特征的个体。 2019 ROSCO 小组(专家组)旨在提出建议和制定方法来帮助医生使用表型方法治疗酒渣鼻患者。 专家组由来自世界各地的 19 名皮肤科专家和 2 名眼科专家组成。他们通过流程来投票表达他们对酒渣鼻诊断和管理方面表述的同意程度。有 75% 同意的表述被记录为建议。 专家组建议医生应该在约诊期间与患者讨论疾病负担,并提出问题以帮助他们说明情况。主要治疗目标应该是洁净的皮肤,因为它可以改善患者生活的许多方面。 提供了酒渣鼻如何影响皮肤和眼睛的新描述,以帮助识别这种疾病。最近的研究已被用于更新治...

Rosacea is a skin disease that mainly affects facial skin and eyes. It has a number of different visible signs and symptoms, or ‘features’. Doctors are currently switching from a subtype approach, which specifies groups of disease features, to a phenotype approach that treats each patient as an individual with their own particular set of features....

Background A transition from a subtyping to a phenotyping approach in rosacea is underway, allowing individual patient management according to presenting fea- tures instead of categorization by predefined subtypes. The ROSacea COnsensus (ROSCO) 2017 recommendations further support this transition and align with guidance from other working groups. Ob...

The classification of rosacea has evolved from a subtyping into a phenotype approach1‐3 and an updated systematic review on interventions in rosacea using this approach was recently published.4 Therefore, we developed a new evidence‐based guideline for all physicians and skin therapists involved in the management of patients suffering from rosacea....

Alle rechten voorbehouden De tekst uit deze publicatie mag worden verveelvoudigd, opgeslagen in een geautomatiseerd gegevensbestand, of openbaar gemaakt in enige vorm of op enige wijze, hetzij elektronisch, mechanisch door fotokopieën of enige andere manier, echter uitsluitend na voorafgaande toestemming van de copyrighthouder. Toestemming voor geb...

Abstract Importance Hypertension is very common, but guideline recommendations for hypertension have been controversial, are of increasing interest, and have profound implications. Objective To systematically assess the consistency of recommendations regarding hypertension management across clinical practice guidelines (CPGs). Design, Setting, an...

Importance: Hypertension is very common, but guideline recommendations for hypertension have been controversial, are of increasing interest, and have profound implications. Objective: To systematically assess the consistency of recommendations regarding hypertension management across clinical practice guidelines (CPGs). Design, Setting, and P...

红斑痤疮是一种常见的慢性皮肤疾病,可导致面部发红、红肿、红丘疹和脓疱。全球大约 1‐20% 的人口受此病困扰。红斑痤疮还可能引起眼睛/眼睑发炎(眼部红斑痤疮)和皮肤增厚,尤其是鼻子(鼻赘)。虽然红斑痤疮的病因尚不清楚,但这种令人苦恼的疾病已有治疗方法。来自荷兰、英国和加拿大的这篇综述旨在找出对红斑痤疮有效的治疗方法。作者收集了 152 项研究的数据。为了减少红肿,溴莫尼定和羟甲唑啉在使用后的 3 ‐ 12 小时内开始发挥作用。对于通过局部(应用于皮肤)治疗来减少丘疹和脓疱,壬二酸、伊维菌素和甲硝唑是有效和安全的。伊维菌素的疗效略高于甲硝唑。二甲胺四环素泡沫也显示出能够大量减少丘疹和脓疱。口服(用口服用)抗生素、四环素、强力霉素 40 毫克或米诺环素 45 毫克可减少丘疹和脓疱的数量。多西环素...

Rosacea is a common, chronic skin condition causing flushing, redness, red pimples and pus‐filled spots (pustules) on the face. It affects about 1‐20% of people worldwide. Rosacea can also cause inflammation of the eyes/eyelids (ocular rosacea) and thickening of the skin, especially the nose (rhinophyma). Although the cause of rosacea is unclear, t...

Objectives To systematically assess the consistency of recommendations regarding hypertension management across clinical practice guidelines (CPGs) and electronic point-of-care (POC) resources Method We identified hypertension management recommendations from eight CPGs and two POC resources in April 2018. We described discrete and unambiguous spec...

BACKGROUND: Irreversible pulpitis, which is characterised by acute and intense pain, is one of the most frequent reasons that patients attend for emergency dental care. Apart from removal of the tooth, the customary way of relieving the pain of irreversible pulpitis is by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning th...

Background: Irreversible pulpitis, which is characterised by acute and intense pain, is one of the most frequent reasons that patients attend for emergency dental care. Apart from removal of the tooth, the customary way of relieving the pain of irreversible pulpitis is by drilling into the tooth, removing the inflamed pulp (nerve) and cleaning the...

Antibiotics as a treatment for irreversible pulpitis?

Background Rosacea is a common chronic facial dermatosis. Classification of rosacea has evolved from subtyping to phenotyping. Objectives Updating our systematic review on interventions for rosacea. Methods We searched: CENTRAL in The Cochrane Library, MEDLINE, EMBASE, LILACS, Science Citation Index, and ongoing trials registers (March 2018) for...

Background It remains uncertain which diet is best for people with type 2 diabetes (T2D). Objective We compared the effects of dietary carbohydrate restriction with fat restriction on markers of metabolic syndrome and quality of life in people with T2D. Design This systematic review of randomized controlled trials (RCTs) and controlled clinica...

Linked Article: Tzaneva et al. Br J Dermatol 2018; 178:682–688.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed‐type drug hypersensitivity reaction with potential life‐threatening complications. To our knowledge, DRESS has never been described in pregnancy. Here, we report on a pregnant woman presenting with erythematous plaques on the abdomen, developing cardiac tamponade due to eosi...

Female pattern hair loss (FPHL), also known as androgenic alopecia, is the most common type of hair loss in women and can have a serious impact on quality of life. In a Cochrane review on interventions for FPHL 47 randomised controlled trials (RCTs) were included with a total of 5290 women (search up to July 2015). Only 5 studies were at low risk o...

Most people have a few brown spots on their skin known as melanocytic naevi or moles. Moles are harmless but can occasionally transform into a potentially lethal tumour called malignant melanoma. Congenital melanocytic nevi (CMN) are ones that are present at birth or develop in the first few weeks of life. Congenital nevi, in particular those that...

A 36-year-old woman presents with facial redness, numerous papules and pustules on the face, and a history of repeated episodes of minimal flushing, all of which become more marked during the summer months. She is troubled by her appearance and is starting to avoid social events. Treatment with 0.75% metronidazole gel applied twice daily reduced th...

Recent studies on congenital melanocytic nevi (CMN) indicate a lower risk for melanoma than assumed for many years. As a result, the treatment paradigm in CMN shifted from complete removal to cosmetically acceptable, less invasive treatment options such as laser treatment. Our objective was to systematically review the efficacy and safety of laser...

Linked Articles: Garcia-Doval et al. Br J Dermatol 2017; 177: 888–889.

Now open ACCESS Background: Up-to-date, trustworthy guidelines are a widely relied-upon means of promoting excellent patient care. Objectives: To determine the quality of recently published acne treatment guidelines by utilizing the Appraisal of Guidelines for Research and Evaluation (AGREE) II Reporting Checklist, the US Institute of Medicine's...

Introduction: Moisturizers play a prominent role in the management of atopic dermatitis by improving the impaired skin barrier function and enhancing skin hydration. Their efficacy was evaluated in a recently published Cochrane Review 'Emollients and moisturizers for eczema'. Objective: In the present review, we summarize the performance and saf...

or moisturisers are widely recommended, but are these effective and safe? We searched for randomised controlled trials (RCTs) in the Cochrane Skin Group Specialised Register, CENTRAL in The Cochrane Library, Medline, Embase, LILACS, GREAT database and five trial registers to December 2015. We included 77 RCTs with 6603 participants. Seven studies (...

Background: Eczema is a chronic skin disease characterised by dry skin, intense itching, inflammatory skin lesions, and a considerable impact on quality of life. Moisturisation is an integral part of treatment, but it is unclear if moisturisers are effective. Objectives: To assess the effects of moisturisers for eczema. Search methods: We sear...

Background The management of acne in adult females is problematic, with many having a history of treatment failure and some having a predisposition to androgen excess. Alternatives to oral antibiotics and combine d oral contraceptives (COCs) are required. Objective Our aim was to conduct a hybrid systematic review of the evidence for benefits and p...

Clinical Question Which interventions are effective and safe for treating female pattern hair loss (FPHL)? Bottom Line There was low- to moderate-quality evidence that topical minoxidil (2% and 5%) was associated with improvements in FPHL. There was low-quality evidence that finasteride was no more effective than placebo. There were inconsistent r...

CLINICAL QUESTION Which interventions are effective and safe for treating female pattern hair loss (FPHL)? BOTTOM LINE There was low- to moderate-quality evidence that topical minoxidil (2%and 5%) was associated with improvements in FPHL. There was low-quality evidence that finasteride was no more effective than placebo. There were inconsistent res...

Review question(s) Does a low carbohydrate diet improve relevant markers of metabolic control more than a low fat diet in people with type 2 diabetes? Does a low carbohydrate diet improve quality of life more than a low fat diet in people with type 2 diabetes?

Linked Article: Petrelli et al. Br J Dermatol 2016; 175:1166–1174.

Exon skipping is a new technique, applied in Duchenne muscular dystrophy. Antisense oligonucleotides have been injected subcutaneously in order to generate a internally truncated, but partly functional dystrophin protein. Injection site reactions are very common adverse events after subcutaneous injections with oligonucleotides. Here we describe a...

Over the last few years there has been a rapid development of available targeted inhibitors of oncogenic proteins and kinases for the treatment of different types of cancer. Cutaneous adverse events are among the most frequently observed adverse effects and can lead to dose reduction or even require discontinuation of therapy. So far dozens of thes...

A 46-year-old woman with a 5 year history of skin lesions that were diagnosed as psoriasis vulgaris was treated with adalimumab and ustekinumab. Within 6 months of treatment the disease progressed with development of tumors. Histology of skin tumors and revision of previous biopsies that were taken from plaques both showed a mycosis fungoides. The...

Background Rosacea is currently treated according to subtypes. As this does not adequately address the patient spectrum of clinical presentation (phenotypes), it has implications for patient management. The ROSacea COnsensus (ROSCO) panel was established to address this issue. Objectives To incorporate current best treatment evidence with clinic...

The aims and scope of the British Journal of Dermatology clearly underline that ‘The BJD strives to publish the highest-quality dermatological research’, with an understanding that submissions need to adhere to internationally accepted standards and quality criteria. Compliance with these criteria will expedite the transition of a submission throug...

Background: Rosacea is currently diagnosed by consensus-defined primary and secondary features and managed by subtype. However, individual features (phenotypes) can span multiple subtypes, which has implications for clinical practice and research. Adopting a phenotype-led approach may facilitate patient-centred management. Objectives: To advance...

Linked Article: Gerbens et al. Br J Dermatol 2016; 175:678–686.

Staphylococcus aureus might amplify symptoms in chronic inflammatory skin diseases. This study evaluates skin and mucosal colonization with S. aureus in patients with psoriasis, acne and rosacea. A systematic literature search was conducted. Both odds ratios (OR) for colonization in patients versus controls and the prevalence of colonization in pat...

Rosacea is a chronic disease with a profound impact on quality of life. Although there are a range of treatments for its many manifestations, some cases are difficult to treat. Sbidian et al. show in this double-blind, randomized, placebo-controlled trial that low-dose isotretinoin can be effective in treating difficult-to-treat and frequently rela...

Background: Female pattern hair loss (FPHL), or androgenic alopecia, is the most common type of hair loss affecting women. It is characterised by progressive shortening of the duration of the growth phase of the hair with successive hair cycles, and progressive follicular miniaturisation with conversion of terminal to vellus hair follicles (termin...

What this adds: • Shared decision making combines individual patient interests and values, and clinical best evidence under the guiding principle of patient autonomy. • Patient decision aids support shared decision making and facilitate decisions that have multiple options with varying outcomes for which patients may attribute different values. • P...

Abstract Guideline development is challenging, expensive and labor-intensive. A high-quality guideline with 90 recommendations for breast cancer treatment was developed within 6 months with limited re- sources in Costa Rica. We describe the experience and propose a process others can use and adapt. The ADAPTE method (using existing guidelines to mi...

Background: Staphylococcus (S.) aureus is increasingly implicated as a possible causal factor in the pathogenesis of atopic dermatitis (AD). However, reported prevalences of skin- and nasal colonisation in the literature vary widely. Objective: This study evaluates the prevalence and odds of skin and nasal colonisation with S. aureus in patients...