Jump to content
  • Sign Up
  • phenotypes.png
    (1) Flushing
    (2) Persistent Erythema
    (3) Telangiectasia
    (4) Papulopustular
    (Papules/pustules Lesion Counts)
    (5) Phymatous
    (6) Ocular Manifestations

    The RRDi endorsed the phenotype classification of rosacea in November 2016.  Galderma acknowledged the phenotype classification about a year later. In November 2017 the NRS has now moved forward with classifying rosacea into phenotypes with its own published paper. [1] Read about phenotype updates of medical authorities and rosacea organizations that have recognized this superior classification of rosacea

    For over fourteen years, rosacea was classified as subtypes, which has been controversial from the beginning. A new direction has emerged in the diagnosis and classification of rosacea which is superior to the subtype classification because the phenotype uses a "a symptom-oriented therapy approach."  

    "Because rosacea can encompass a multitude of possible combinations of signs and symptoms, the following updated classification system is based on phenotypes—observable characteristics that can result from genetic and/or environmental influences—to provide the necessary means of assessing and treating rosacea in a manner that is consistent with each individual patient's experience. The phenotypes and diagnostic criteria are largely in agreement with those recommended by the global rosacea consensus panel in 2016, and at least 1 diagnostic or 2 major phenotypes are required for the diagnosis of rosacea.' [1]

    For more information read the article by the ROSCO panel: 

    ROSCO Panel Recommends New Approach on Rosacea Diagnosis by Phenotype

    Phenotype Questions

    Phenotype Classification - How does it work? Answer.

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

    What distinguishes the phenotype classification from the subtype classification? Answer.

    Applying the Phenotype Approach for Rosacea to Practice and Research

    In the British Journal of Dermatology, May 25, 2018, it states, “Rosacea diagnosis and classification have evolved since the 2002 National Rosacea Society (NRS) expert panel subtype approach. Several working groups are now aligned to a more patient-centric phenotype approach, based on an individual's presenting signs and symptoms. However, subtyping is still commonplace across the field and an integrated approach is required to ensure widespread progression to the phenotype approach." The article concludes:

    These practical recommendations are intended to indicate the next steps in the progression from subtyping to a phenotyping approach in rosacea, with the goals of improving our understanding of the disease, facilitating treatment developments, and ultimately improving care for patients with rosacea.” [2]

    Subtype Classification Inferior to Phenotype Classification
    "Almost a decade and a half has elapsed since the initial proposition of criteria for rosacea diagnosis and grouping into common presentations or subtypes. Reappraisal of these items suggests shortcomings in case-finding and diagnostic accuracy that require revision to facilitate rather than undermine future investigation. Subtyping of rosacea, a post-hoc means of grouping more common presentations, can be and has been subverted inappropriately to imply strict categories without adequate consideration of the varying phenotypic presentation of individuals and the potential for temporal variation. Scales for rosacea severity are also confounded by similar multidimensional aspects represented in subtyping. In clinical investigation, this can interfere with study of the course of singular features of rosacea and their measurement." [3]

    End Notes
    [1] Standard classification and pathophysiology of rosacea: The 2017 update by the National Rosacea Society Expert Committee

    [2] Applying the phenotype approach for rosacea to practice and research.
    Br J Dermatol. 2018 May 25;
    Tan J, Berg M, Gallo RL, Del Rosso JQ

    [3]  Shortcomings in rosacea diagnosis and classification

  • Posts

    • Related ArticlesFrequency of different types of facial melanoses referring to the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital in 2019, and assessment of their effect on health-related quality of life. BMC Dermatol. 2020 Aug 03;20(1):4 Authors: Amatya B, Jha AK, Shrestha S Abstract BACKGROUND: Abnormalities of facial pigmentation, or facial melanoses, are a common presenting complaint in Nepal and are the result of a diverse range of conditions. OBJECTIVES: The objective of this study was to determine the frequency, underlying cause and impact on quality of life of facial pigmentary disorders among patients visiting the Department of Dermatology and Venereology, Nepal Medical College and Teaching Hospital (NMCTH) over the course of one year. METHODS: This was a cross-sectional study conducted at the Department of Dermatology and Venereology, NMCTH. We recruited patients with facial melanoses above 16 years of age who presented to the outpatient department. Clinical and demographic data were collected and all the enrolled participants completed the validated Nepali version of the Dermatology Life Quality Index (DLQI). RESULTS: Between January 5, 2019 to January 4, 2020, a total of 485 patients were recruited in the study. The most common diagnoses were melasma (166 patients) and post acne hyperpigmentation (71 patients). Quality of life impairment was highest in patients having melasma with steroid induced rosacea-like dermatitis (DLQI = 13.54 ± 1.30), while it was lowest in participants with ephelides (2.45 ± 1.23). CONCLUSION: Facial melanoses are a common presenting complaint and lead to substantial impacts on quality of life. Accurate diagnosis and management can prevent or treat many facial melanoses, including those that lead to substantial loss of quality of life, such as melasma with steroid induced rosacea-like dermatitis. Health care systems in low and middle-income countries should dedicate resources to the identification, prevention and treatment of these conditions to improve quality of life. PMID: 32746823 [PubMed - in process] {url} = URL to article
    • "We compiled a comprehensive list of candidate medicinal herbs for skincare by analyzing terms employed in the Donguibogam and identified the characteristics of 52 such herbs using SRKs. Each herb exhibited a different skincare function. Our findings will guide the development of new skincare products via experimental and clinical studies....Further in-depth experimental studies are needed, though our work reduces the time required for future experimentation and product development. Our results enhance the understanding of the previously unknown characteristics of medicinal herbs used for skincare and facilitate the discovering additional novel herbs." [1] The Dongui Bogam (동의보감) is a Korean book compiled by the royal physician, Heo Jun (1539 – 1615) and was first published in 1613 during the Joseon Dynasty of Korea. The title literally means “a priceless book about medicines of an Eastern Country”. [2] Wouldn't it be novel of a grassroots rosacea non profit organization to sponsor clinical studies on this? What if 10K members of the RRDi each donated one dollar and sponsored these kind of studies into medicinal herbs for skincare?  Why not donate a dollar now to start the process? End Notes [1] Integr Med Res. 2020 Dec; 9(4): 100436. Identification of candidate medicinal herbs for skincare via data mining of the classic Donguibogam text on Korean medicine Gayoung Cho, Hyo-Min Park, Won-Mo Jung, Woong-Seok Cha, Donghun Lee, Younbyoung Chae [2] Dongui Bogam, Wikipedia image courtesy of Wikimedia Commons
    • The RRDi is sponsoring free rosacea blogs so you can have your own private or public blog. That way you can direct your friends to your own blog and discuss what you are doing to control your rosacea. If you want it private here are the steps:  PRIVATE BLOG The default blog is public so all you do is change it to private and only invite your friends to view your blog.  (1) To setup your blog you first need to be a member of the RRDi by registering with just your email address.  (2) Go to Blogs and look for the CREATE A BLOG green button: (3) Look for the ONLY MEMBERS I CHOOSE CAN READ THIS BLOG radio button: Then click continue to setup your blog. If you need assistance, use the Invision Community help center or use the RRDi support center (only available for members of the RRDi). 
    • Related ArticlesThe Decrease of Demodex Density After Nd:YAG Laser Application for Facial Telengiactasias: A Case Report. Dermatol Ther. 2020 Jul 30;: Authors: Yalici-Armagan B, Elcin G PMID: 32734702 [PubMed - as supplied by publisher] {url} = URL to article
    • Related ArticlesAcute inflammatory Demodex-induced pustulosis in an immunocompetent patient related to topical steroid use. Pediatr Dermatol. 2020 Jul 29;: Authors: Guzman AK, Gittler JK, Amin B, Srikantha R, Balagula Y Abstract Demodex spp. mites are a common colonizer of sebaceous adult skin. Though usually clinically insignificant, demodicosis may be associated with a wide spectrum of skin diseases in immunocompetent hosts, such as erythematotelangiectatic and papulopustular rosacea, Demodex folliculorum, and blepharitis. We present a case of a healthy 9-year-old boy with an exuberant, inflammatory, Demodex-associated pustular eruption of the face, induced by the use of a high-potency topical steroid and successfully treated with oral ivermectin. PMID: 32729151 [PubMed - as supplied by publisher] {url} = URL to article
×
×
  • Create New...