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Annales de Dermatologie et de Vénéréologie
Volume 138, n° S3
pages 192-200 (novembre 2011)
Doi : 10.1016/S0151-9638(11)70089-8
Clinical presentations and classification of rosacea
Formes cliniques et classification de la rosacée
 

T. Jansen
Department of Dermatology, Venereology and Allergology, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany 

Summary

Rosacea is a chronic skin disease affecting up to 10% of the population in some European countries. Rosacea manifests as various combinations of characteristic signs and symptoms in a centrofacial distribution. At present, there is no consensus about the definition or classification of the clinical patterns of rosacea. Initially, four stages were differentiated (pre-rosacea then stages I through III), with several variants (e.g., persistent erythema and edema, rosacea conglobata, and rosacea fulminans). The National Rosacea Society (NRS) in the USA has classified rosacea into four subtypes (erythematotelangiectatic, papulopustular, phymatous, and ocular) and one variant (lupoid or granulomatous rosacea). This classification scheme does not mention progression from one type to another and makes no reference to pathophysiological considerations. It uses major and minor diagnostic criteria based on the physical findings and symptoms. The NRS has also developed criteria for grading disease severity. The classification of rosacea into stages or subtypes, without considering the possibility of progression from one to another, will probably remain controversial until additional knowledge on the pathophysiology of rosacea is obtained.

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

La rosacée est une dermatose chronique qui touche jusqu’à 10% de la population dans certains pays d’Europe. Elle associe des combinaisons de signes et symptômes caractéristiques, à distribution centro-faciale. La définition des formes cliniques de la rosacée et les classifications de la maladie ne sont actuellement pas consensuelles. Elle a été initialement classée en quatre stades (pré-rosacée, puis stades I à III) avec toute une série de variantes cliniques (érythème et oedème persistants, rosacée conglobata, rosacée fulminans, etc.). La National Rosacea Society (États-Unis) a établi quatre soustypes (érythémato-télangiectasique, papulopustuleux, hypertrophique et oculaire) et une variante (rosacée lupoïde ou granulomateuse), sans aborder la progression d’une forme à une autre ni la physiopathologie. Ce système de classification utilise des critères majeurs et mineurs, sur la base des signes cliniques et des symptômes fonctionnels. Le même groupe a proposé des critères pour en grader la sévérité. La classification de la rosacée en stades ou en sous-types, sans préjuger de la possibilité de progression de l’un à l’autre, restera probablement controversée jusqu’à ce qu’on ait une meilleure compréhension de la physiopathologie.

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

Keywords : Rosacea, Classification, Stages, Subtypes, Clinical patterns

Mots clés : Rosacée, Classification, Stades, Sous-types, Formes cliniques




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