Dermatologists and other providers who care for rosacea patients need to classify these patients by phenotype, recognizing that every patient does not fall exclusively into only one of the prior subtyping approaches, according to updated recommendations for rosacea diagnosis, classification and management from the global ROSacea COnsensus (ROSCO) 2019 panel. The recommendations were published as an open access article in August in the British Journal of Dermatology.
Rosacea phenotypes include transient erythema, persistent erythema, telangiectasia, inflammatory papules/pustules, phymas and ocular abnormalities.
“Applying a phenotype-based diagnostic approach is inclusive of the real-life presentation of this disorder. This permits more accurate documentation of the manifestations of this disease and recording responses to therapy,” says ROSCO Panel member Richard L. Gallo, M.D., Ph.D., distinguished professor and endowed chair of dermatology at the University of California, San Diego. “This is a major change in classification of patients with rosacea. It will accelerate development of improved therapies for the disease as a whole.”
This update to the 2017 ROSCO consensus recommendations includes disease burden and treatment goals; defining both cutaneous and ocular features to aid in recognition and diagnosis; and updating the treatment algorithm originally presented in 2017 based on recent evidence, according to ROSCO Panel co-chair Jerry Tan, M.D., FRCP, adjunct professor, Western University, Windsor, Ontario, Canada.
“We also developed clinical tools, including seven patient case studies representing common phenotypes exemplifying
practical use of the treatment algorithm along with a phenotype image library with feature descriptions and multiple skin photo types,” Dr. Tan says. “[We included] a rosacea tracking tool for clinical use to provide ongoing record of a rosacea patients features over time. This should help monitor changes in features, patient impact and response to treatment.”
Galderma funded the ROSCO project and paid panel members for their participation. Dr. Gallo, according to the paper, has served as a consultant for Sente, as well as for MatriSys, of which he is also cofounder and has equity interest. Dr. Tan has been an advisor and/or speaker for Cipher, Galderma, Pola and Valeant; a consultant to Boots and Galderma; and a clinical investigator for Allergan, Cipher, Dermira, Galderma and Valeant.
1. Schaller M, Almeida LMC, Bewley A, et al. Recommendations for rosacea diagnosis, classification and management: Update from the global ROSacea COnsensus (ROSCO) 2019 panel. Br J Dermatol. 2019;