Special ReportStandard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea☆,☆☆
Section snippets
Primary features
Rosacea typically affects the convexities of the central face. The presence of one or more of the following signs with a central face distribution is indicative of rosacea. These signs are commonly transient, and each may occur independently. Many patients may present with more than one of these diagnostic features.
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Flushing (transient erythema). A history of frequent blushing or flushing is common.
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Nontransient erythema. Persistent redness of the facial skin is the most common sign of rosacea.
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Subtypes
The primary and secondary rosacea features described above often occur together. The most common patterns or groupings of signs are provisionally designated as specific subtypes of rosacea and are described here (Table II).
Empty Cell Characteristics Subtype Erythematotelangiectatic Flushing and persistent central facial erythema with or without telangiectasia. Papulopustular Persistent central facial erythema with transient, central facial papules or
Variants
Variants of rosacea, which do not represent morphologic patterns or combinations as seen in rosacea subtypes, may occur. To date, the committee has recognized one such variant.
Exclusions
The committee noted that certain disorders may have been prematurely identified as associated with rosacea or as a variant of rosacea, and for clarity should be recognized at this time as separate entities. There is insufficient basis at present to include the following conditions as types of rosacea.
Future
This investigational instrument is intended to set the stage for a better understanding of rosacea and its subtypes among researchers and practitioners by fostering communication and facilitating the development of a research-based classification system. As a provisional standard classification system, it is likely to require modification in the future as the pathogenesis and subtypes of rosacea become clearer, and as its relevance and applicability are tested by investigators and clinicians.
Acknowledgements
The Committee thanks the following individuals who reviewed and contributed to this document: Dr Joel Bamford, Department of Dermatology, St. Mary's/Duluth Clinic; Dr Mats Berg, Department of Dermatology, Mälar Hospital, Eskilstuna, Sweden; Dr Albert Kligman, Department of Dermatology, University of Pennsylvania; Dr Mark Mannis, Department of Ophthalmology, University of California-Davis; Dr Ronald Marks, Department of Dermatology, University of Wales Medical Center, Cardiff, Wales; Drs Gerd
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The opinions set forth in this report are those of the committee members and do not represent the Food and Drug Administration in any way.
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