Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROSacea COnsensus (ROSCO) panel
Updating the diagnosis, classification and assessment of rosacea: recommendations from the global ROSacea COnsensus (ROSCO) panel
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DOI：
10.1111/bjd.15122
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发表时间：
2017-02-01
影响因子：
10.3
通讯作者：
Schaller, M.
中科院分区：
文献类型：
--
作者：
Tan, J.;Almeida, L. M. C.;Schaller, M.
背景酒渣鼻目前是由共识定义的主要和次要特征诊断和亚型管理。然而，个体特征（表型）可以跨越多个亚型，这对临床实践和研究有影响。采用一个表型为主导的方法，可以促进以病人为中心的management.Objectives通过获得国际共识，建立一个表型为主导的酒渣鼻的诊断和分类计划与全球representation.Methods十七皮肤科医生和三个眼科医生使用了修改后的德尔菲方法达成共识，有关酒渣鼻的诊断，分类和严重程度评价的关键方面的声明，以推进临床实践。所有的投票是电子和blinding.Results共识过渡到一个表型为基础的方法酒渣鼻的诊断和分类。以下两个特征被独立地认为是酒渣鼻的诊断特征：（i）与周期性强化相关的持续性中央面部红斑;和（ii）肿瘤状变化。潮红、毛细血管扩张、炎性病变和眼部表现不被认为是单独诊断。专家组就表型严重程度指标的维度达成一致，并确定了评估红斑痤疮患者负担的重要性。结论专家组推荐了一种基于疾病表型的红斑痤疮诊断和分类方法。
Background Rosacea is currently diagnosed by consensus-defined primary and secondary features and managed by subtype. However, individual features (phenotypes) can span multiple subtypes, which has implications for clinical practice and research. Adopting a phenotype-led approach may facilitate patient-centred management.Objectives To advance clinical practice by obtaining international consensus to establish a phenotype-led rosacea diagnosis and classification scheme with global representation.Methods Seventeen dermatologists and three ophthalmologists used a modified Delphi approach to reach consensus on statements pertaining to critical aspects of rosacea diagnosis, classification and severity evaluation. All voting was electronic and blinded.Results Consensus was achieved for transitioning to a phenotype-based approach to rosacea diagnosis and classification. The following two features were independently considered diagnostic for rosacea: (i) persistent, centrofacial erythema associated with periodic intensification; and (ii) phymatous changes. Flushing, telangiectasia, inflammatory lesions and ocular manifestations were not considered to be individually diagnostic. The panel reached agreement on dimensions for phenotype severity measures and established the importance of assessing the patient burden of rosacea.Conclusions The panel recommended an approach for diagnosis and classification of rosacea based on disease phenotype.