Analysis of clinical features of rosacea and rediscussion of a Chinese diagnostic criterion for rosacea
Wang Ben, Zhao Zhixiang, Jian Dan, Shi Wei, Liu Fangfen, Liu Hui, Yu Bin, Xia Jianxin, Yang Jie, Wu Lin, Ju Qiang, Li Ji, Xie Hongfu
Abstract
ObjectiveTo propose a Chinese diagnostic criterion for rosacea on the basis of clinical feature analysis of rosacea, and to assess its sensitivity and specificity.
MethodsA total of 3 350 Chinese patients with newly diagnosed rosacea were collected from Department of Dermatology, Xiangya Hospital, Central South University between December 2017 and July 2018, their phenotypes and clinical features were retrospectively analyzed, and a Chinese modified diagnostic criterion for rosacea was put forward. A national multi-center clinical observational trial, which included 2 269 patients with rosacea and 2 408 patients with other facial skin diseases from 28 centers, was conducted to verify this diagnostic criterion. Then, the sensitivity and specificity of the modified diagnostic criterion were evaluated by comparing with the 2017 standard classification of rosacea developed by the National Rosacea Society Expert Committee (NRSEC) .
ResultsFixed centrofacial erythema occurred in 3 350 (100%) patients with rosacea. Flushing occurred before or simultaneously with fixed erythema in 1 850 (99.4%) of the 1 861 patients with erythema on the cheeks; among the 1 489 patients with erythema on the nose or perioral area, only 52 (3.5%) had flushing; all the 342 patients presenting with phymatous changes had fixed erythema before phymatous changes. Based on the above clinical findings, it was proposed that patients with periodically aggravated fixed erythema on the cheeks accompanied with flushing could be diagnosed with rosacea; patients with fixed erythema on the nose and perioral area accompanied with at least one of selective phenotypes (flushing, telangiectasia, papules and pustules, phymatous changes, or ocular manifestations) could be diagnosed with rosacea. The national multi-center clinical observational trial revealed that the sensitivity of the Chinese modified diagnostic criterion for rosacea was 99.6%, which was close to the sensitivity (100%) of the NRSEC standard, and its specificity was 91.9%, higher than the specificity (73.3%) of the NRSEC standard.
ConclusionThe Chinese modified diagnostic criterion for rosacea has good sensitivity and specificity, and can facilitate the early diagnosis of phymatous rosacea.
Key words:
Rosacea; Diagnosis; Erythema; Flushing; Fixed centrofacial erythema
Contributor Information
Wang Ben
Department of Dermatology, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Disorders, Changsha 410008, China
Zhao Zhixiang
Department of Dermatology, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Disorders, Changsha 410008, China
Jian Dan
Department of Dermatology, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Disorders, Changsha 410008, China
Shi Wei
Department of Dermatology, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Disorders, Changsha 410008, China
Liu Fangfen
Department of Dermatology, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Disorders, Changsha 410008, China
Liu Hui
Department of Dermatology, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
Yu Bin
Department of Dermatology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian, China
Xia Jianxin
Department of Dermatology, The Second Hospital of Jilin University, Changchun 130041, China
Yang Jie
Department of Dermatology, North China University of Science and Technology Affiliated Hospital, Tangshan 063000, Hebei, China
Wu Lin
Department of Dermatology, Peking University Shenzhen Hospital, Shenzhen 518036, China
Ju Qiang
Department of Dermatology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 201112, China
Li Ji
Department of Dermatology, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Disorders, Changsha 410008, China
Xie Hongfu
Department of Dermatology, Xiangya Hospital, Central South University, National Clinical Research Center for Geriatric Disorders, Changsha 410008, China
