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Rosacea Phenotype Distinction Between Subtypes

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The ROSCO panel has changed the direction of classifying rosacea from subtypes to phenotypes

What is the difference between a phenotype based treatment vs a subtype based treatment?

Genetics

We have to begin with Genotype which "is the part (DNA sequence) of the genetic makeup of a cell, and therefore of an organism or individual, which determines a specific characteristic (phenotype) of that cell/organism/individual. Genotype is one of three factors that determine phenotype, the other two being inherited epigenetic factors, and non-inherited environmental factors." Wikipedia

Genotype-phenotype distinction

"The genotype–phenotype distinction is drawn in genetics. "Genotype" is an organism's full hereditary information. "Phenotype" is an organism's actual observed properties, such as morphology, development, or behavior." Wikipedia

A phenotype (from Greek phainein, meaning "to show", and typos, meaning "type") is the composite of an organism's observable characteristics or traits, such as its morphology, development, biochemical or physiological properties, phenology, behavior, and products of behavior (such as a bird's nest). Wikipedia

Phenotype and Subtype in Medicine

Phenotype

A phenotype in medicine is "the observable properties of an organism that are produced by the interaction of the genotype and the environment." Merriam Webster Medical Dictionary

Subtype 

A subtype in medicine is "a type that is subordinate to or included in another type <the blood group subtypes> <subtypes of a disease>." Merriam Webster Medical Dictionary

Endotype

"An endotype is a subtype of a condition, which is defined by a distinct functional or pathobiological mechanism. This is distinct from a phenotype, which is any observable characteristic or trait of a disease, such as morphology, development, biochemical or physiological properties, or behavior, without any implication of a mechanism. It is envisaged that patients with a specific endotype present themselves within phenotypic clusters of diseases." Wikipedia

Disease entity

"The main concept in nosology is the disease entity. Normally there are two ways to define a disease entity: Manifestational criteria and Causal criteria.

Manifestational criteria. They are a set of criteria based in signs, symptoms and laboratory findings that define a disease. They define the disease by its symptoms and medical findings.
Causal criteria are a causal chain of events that define the disease describing how it develops. They describe the disease by its etiology." Wikipedia

Why is the phenotype classification superior to the subtype classification?  Answer

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