Clinical analysis of 1 090 cases of rosacea and exploration of new diagnostic criteria for rosacea

Objective To propose a new diagnostic criterion for rosacea based on the analysis of clinical features of rosacea in a large sample. Methods A total of 1 090 Chinese outpatients with rosacea were enrolled from Department of Dermatology of Xiangya Hospital, and their demographic data, clinical manifestations and subjective symptoms were collected. According to results of descriptive analysis, clinical features of rosacea were summarized, and a new diagnostic criterion for rosacea was set up. Then, the sensitivity and specificity of the new diagnostic criterion were verified among 1 200 outpatients clinically characterized by facial erythema. Results Of 1 090 patients with rosacea, 131 (12.0%) were male and 959 (88.0%) were female, and the average age was 33.5 ± 11.1 years (range, 10-66) . Among the 1 090 patients, 715 (65.6%) had initial lesions on the cheek, of whom, 712 (99.6%) had intermittent flushing as the initial symptom, and 689 (96%) had sensitive skin symptoms such as dryness, burning and itching sensations; 208 (19.1%) had initial lesions on the perioral region, of whom, 204 (98.1%) had persistent erythema as the initial symptom; 167 (15.3%) had initial lesions on the nose, of whom, 163 (97.6%) had persistent erythema as the initial symptom; in addition, 311 (28.5%) had lesions on the ocular region, and only 24 (2.2%) had lesions outside the face on the neck and retroauricular region. Based on these clinical features, a new diagnostic criterion for rosacea was proposed, including 1 major condition (intermittent flushing or persistent erythema on the cheek, perioral region or nose) and 5 minor conditions (1. sensitive skin symptoms such as burning, tingling, drying or itching sensations; 2. telangiectasia; 3. papules or pustules; 4. hypertrophy; 5. ocular symptoms) . If with the major condition and at least one minor condition were met, patients could be diagnosed with rosacea. After verification among 1 200 patients with facial dermatitis clinically characterized by facial erythema, the new criterion was proved to have a sensitivity of 99.3% and a specificity of 95.8%. Conclusion A new diagnostic criterion for rosacea with high sensitivity and specificity is proposed, which is worthy of clinical application. Key words: Rosacea; Clinical features; Diagnostic criteria