Abstract Background: Rosacea is a chronic inflammatory disease of the skin, relatively more frequent in women over 30 with a low phototype and proven genetic predisposition. Although its etiology is unknown and possibly multifactorial, the immunological abnormality, associated with neurovascular dysregulation and triggering factors, are important elements in its pathophysiology, which lead to the main changes of inflammation, vasodilation, and angiogenesis that are responsible for the clinical manifestations. Despite the lack of cure, numerous therapeutic options are available for the different clinical presentations of the disease, with satisfactory responses. Objective: To reach a consensus, with recommendations from experts, on the therapeutic management of rosacea suitable to the Brazilian setting. Methods: The study was conducted by five specialized dermatologists from university centers, representatives of the different Brazilian regions, with experience in rosacea, who were appointed by the Brazilian Society of Dermatology. Based on the adapted DELPHI methodology, the experts contributed through an updated bibliographic review of the scientific evidence, combined with personal experiences. Results: The group of experts reached a consensus on the relevant aspects in the therapeutic management of rosacea, providing information on epidemiology, pathophysiology, triggering factors, clinical condition, classification, quality of life, and comorbidities. Consensus was defined as approval by at least 90% of the panel. Conclusion: Despite the impossibility of cure, there are several therapeutic alternatives specific to each patient that provide excellent results, with chances of total improvement and long periods of remission, promoting a positive impact on quality of life. This consensus provides detailed guidance for clinical practice and therapeutic decisions in rosacea.

FUNDAMENTOS: A sepse é causa comum de morbimortalidade em pacientes internados. A sua prevalência está aumentando significativamente em diversas partes do mundo. Pacientes internados em enfermarias de dermatologia apresentam extensas áreas de perda da barreira cutânea, além de uso frequente de corticosteróides sistêmicos, condições favoráveis ao desenvolvimento de sepse. OBJETIVOS: Avaliar a prevalência de sepse em pacientes internados em uma enfermaria de dermatologia e compará-la com a prevalência na enfermaria de clínica médica. MÉTODOS: Trata-se de estudo observacional transversal comparativo de análise de prontuários realizado na Santa Casa de Belo Horizonte. Foram coletados os dados de todos os pacientes internados em quatro leitos da clínica médica e da dematologia no período de julho de 2008 e julho de 2009. Foram analisados em busca da ocorrência de sepse, diagnósticos dermatológicas, comorbidades, tipos de patógenos mais associados e perfil de antibióticos mais utilizados. RESULTADOS: Foram analisados 185 prontuários e a prevalência de sepse entre os pacientes internados na enfermaria de dermatologia foi de 7,6% e na enfermaria de clínica médica 2,2% (p=0,10). Pacientes portadores de comorbidades, diabetes mellitus e neoplasias não demostraram maior ocorrência de sepse. O principal agente encontrado foi Staphylococcus aureus e os antibióticos mais utilizados foram ciprofloxacino e oxacilina. Houve significativa associação de sepse com o uso de corticosteróides sistêmicos (p<0,001). CONCLUSÃO: Torna-se claro que devem ser realizados estudos epidemiológicos mais amplos e acurados no Brasil sobre a sepse, para que os esforços na prevenção e no tratamento dessa grave doença possam ser direcionados de forma mais racional.

BACKGROUND: Sepsis is a common cause of morbidity and mortality among hospitalized patients. The prevalence of this condition has increased significantly in different parts of the world. Patients admitted to dermatology wards often have severe loss of skin barrier and use systemic corticosteroids, which favor the development of sepsis. OBJECTIVES: To evaluate the prevalence of sepsis among patients admitted to a dermatology ward compared to that among patients admitted to an internal medicine ward. METHODS: It is a cross-sectional, observational, comparative study that was conducted at Hospital Santa Casa de Belo Horizonte. Data were collected from all patients admitted to four hospital beds at the dermatology and internal medicine wards between July 2008 and July 2009. Medical records were analyzed for the occurrence of sepsis, dermatologic diagnoses, comorbidities, types of pathogens and most commonly used antibiotics. RESULTS: We analyzed 185 medical records. The prevalence of sepsis was 7.6% among patients admitted to the dermatology ward and 2.2% (p = 0.10) among those admitted to the internal medicine ward. Patients with comorbidities, diabetes mellitus and cancer did not show a higher incidence of sepsis. The main agent found was Staphylococcus aureus, and the most commonly used antibiotics were ciprofloxacin and oxacillin. There was a significant association between sepsis and the use of systemic corticosteroids (p <0.001). CONCLUSION: It becomes clear that epidemiological studies on sepsis should be performed more extensively and accurately in Brazil so that efforts to prevent and treat this serious disease can be made more effectively.