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An observational cross-sectional survey of rosacea: Clinical associations and progression between subtypes.

Br J Dermatol. 2013 Apr 21;

Authors: Tan J, Blume-Peytavi U, Ortonne JP, Wilhelm K, Marticou L, Baltas E, Rivier M, Petit L, Martel P

Abstract
BACKGROUND: Few studies have evaluated for differences between rosacea subtypes in epidemiological associations and clinical features. The natural history of rosacea is unknown and progression between subtypes has been implied but not formally evaluated. OBJECTIVE: This study assessed associations between the four rosacea subtypes (erythematotelangiectatic [ETR], papulopustular [PPR], phymatous [PHY], and ocular [OC]), including quantitative and qualitative details on primary and secondary features of rosacea. A secondary objective was to evaluate for the potential of progression between subtypes. METHODS: This cross-sectional study recruited rosacea subjects from Northern Germany and comprised clinical evaluation by a dermatologist and a survey of demographics and onset of rosacea-associated signs and symptoms. RESULTS: 135 rosacea subjects were enrolled. PHY was more frequently associated with PPR than ETR (p < 0.000). Compared to ETR, PPR was significantly associated with facial burning/stinging (p = 0.001), phymas (p < 0.001) and edema (p <0.001); and during flushing episodes, was more frequently associated with burning (p = 0.018), skin tension (p = 0.005), and itching (p = 0.027). ETR was more frequently associated with dry facial skin (p < 0.001). Flushing was reported by 66% and most frequent site involved was cheeks (100%). Papulopustules were evanescent in 42% and most frequent site involved was cheeks (80%) and nose (67%). Of those fulfilling criteria for at least 2 subtypes, 66% developed ETR before PPR; 92% developed ETR before PHY; 83% developed PPR before PHY; and the majority developed cutaneous rosacea -associated features before ocular sign/symptoms. CONCLUSION: Significant differences exist between ETR and PPR in rosacea-associated features and in subtype associations. A small proportion of rosacea subjects may progress between subtypes. This article is protected by copyright. All rights reserved.

PMID: 23600367 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/pubmed/23600367?dopt=Abstract = URL to article