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Journal of the American Academy of Dermatology
Volume 80, n° 6
page 1722 (juin 2019)
Doi : 10.1016/j.jaad.2018.08.049
accepted : 28 August 2018

Global epidemiology and clinical spectrum of rosacea, highlighting skin of color: Review and clinical practice experience

Andrew F. Alexis, MD, MPH a, , Valerie D. Callender, MD b, Hilary E. Baldwin, MD c, Seemal R. Desai, MD d, e, Marta I. Rendon, MD f, Susan C. Taylor, MD g
a Skin of Color Center, Mount Sinai St. Luke's and Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York 
b Callender Dermatology and Cosmetic Center, Glenn Dale, Maryland 
c Acne Treatment and Research Center, Morristown, New Jersey 
d Innovative Dermatology, PA, Plano, Texas 
e Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas 
f Rendon Center, Boca Raton, Florida 
g Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 

Correspondence to: Andrew F. Alexis, MD, MPH, Department of Dermatology, Mount Sinai St. Luke's and Mount Sinai West, 1090 Amsterdam Ave, Ste 11B, New York, NY 10025.Department of DermatologyMount Sinai St. Luke's and Mount Sinai West1090 Amsterdam Ave, Ste 11BNew YorkNY10025

Rosacea has been reported less frequently among individuals with skin of color than in those with white skin, but rosacea is not a rare disease in this population. In fact, rosacea might be underreported and underdiagnosed in populations with skin of color because of the difficulty of discerning erythema and telangiectasia in dark skin. The susceptibility of persons with highly pigmented skin to dermatologic conditions like rosacea, whose triggers include sun exposure, is probably underestimated. Many people with skin of color who have rosacea might experience delayed diagnosis, leading to inappropriate or inadequate treatment; greater morbidity; and uncontrolled, progressive disease with disfiguring manifestations, including phymatous rosacea. In this article, we review the epidemiology of rosacea in skin of color and highlight variations in the clinical presentation of rosacea across the diverse spectrum of patient populations affected. We present strategies to aid in the timely diagnosis and effective treatment of rosacea in patients with skin of color, with an aim of promoting increased awareness of rosacea in these patients and reducing disparities in the management of their disease.

The full text of this article is available in PDF format.

Key words : diagnosis, disease management, erythema, ethnicity, flushing, race, rhinophyma, telangiectasia

 Funding sources: Supported by Allergan plc, Dublin, Ireland. Neither honoraria nor other form of payments were made for authorship.
 Conflicts of interest: Dr Alexis has served as an advisory board member for and received research grants to his institution from Allergan, BioPharmx, and Galderma. Dr Callender has served as an advisory board member for and received honorarium from Allergan and has served as an investigator for and received grants from Allergan and Galderma. Dr Baldwin has been a speaker for Allergan, Bayer, and Galderma; served as an advisory board member for Allergan and Galderma; and an investigator for Galderma. Dr Desai has served as a consultant and investigator for Allergan. Dr Rendon has served as an advisory board member for and performed research studies for Allergan and Galderma. Dr Taylor has served as an advisory board member for Allergan, Galderma, and Beiersdorf; an investigator for Croma-Pharma and Aclaris; and a speaker for Galderma and Unilever.
 Reprints not available from the authors.

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